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In this case-control study, the main risk factors for atrophic gastritis (AG) were comprehensively analyzed in a real-world environment to identify potential risk factors associated with garlic intake and its effects on AG. Design Upper gastrointestinal endoscopy and pathological examination were performed as part of a gastric cancer screening and health check-up program. The detailed characteristics of both the case group and healthy control group were recorded and analyzed. All participants were fasted for at least 4 h and a urea breath test13C-UBT) was performed in all participants at rest. Both univariate and multivariate logistic regression analyses were performed and presented as the odds ratio (OR) and 95% confidential interval (CI), with additional subgroup analysis stratified by infectious state based on the presence, eradication or absence of H. pylori. Setting Gansu Province in China. Participants 10,035 people from Gansu Province in China were included. Among 7,058 participants, 4,712 (66.8%) had AG. Garlic intake was a significant risk factor for AG in participants currently (infected state) or previously (eradicated state) infected with H. pylori (OR = 1.39, 95% CI: 1.06–1.83; OR = 1.16, 95% CI = 1.01–1.32). Garlic intake was not significantly associated with AG in participants without H. pylori’ s infection (OR = 1.14, 95% CI: 0.88–1.46). The association between garlic intake and AG differed by H. pylori infectious state. People in the infected or eradicated states are at a higher risk for AG associated with garlic intake. Diet may regulate the pathogenic role of H. pylori and intestinal flora.

Centers for Disease Control and Prevention guidelines consider SARS-CoV-2 reinfection when sequential COVID-19 episodes occur >90 days apart. However, genomic diversity acquired over recent COVID-19 waves could mean previous infection provides insufficient cross-protection. We used genomic analysis to assess the percentage of early reinfections in a sample of 26 patients with 2 COVID-19 episodes separated by 20-45 days. Among sampled patients, 11 (42%) had reinfections involving different SARS-CoV-2 variants or subvariants. Another 4 cases were probable reinfections; 3 involved different strains from the same lineage or sublineage. Host genomic analysis confirmed the 2 sequential specimens belonged to the same patient. Among all reinfections, 36.4% involved non-Omicron, then Omicron lineages. Early reinfections showed no specific clinical patterns; 45% were among unvaccinated or incompletely vaccinated persons, 27% were among persons <18 years of age, and 64% of patients had no risk factors. Time between sequential positive SARS-CoV-2 PCRs to consider reinfection should be re-evaluated.