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The in-house ELISA SARS-CoV-2 serological assay, developed by the Armauer Hansen Research Institute (AHRI) in Ethiopia, measures anti-SARS-CoV-2 receptor binding domain (RBD) antibodies. This study aimed to compare the performance of our cost-effective in-house ELISA with two established commercially available SARS-CoV-2 antibody detection assays during the pre-Omicron COVID-19 pandemic. In April 2021, serum samples were collected from 1441 students across 60 schools in Oromia, from 15 hotspot districts and towns. Socio-demographic data were gathered using CSentryCSProDataEntry7.2.1. Performance agreements between AHRI’s in-house ELISA and the two commercial assays were analyzed in these serum samples. Statistical analyses, including Cohen’s kappa (κ), overall percentage agreement, positive percent agreement (PPA), and negative percent agreement (NPA), were performed using STATA software. Diagnostic parameters were presented with 95% confidence intervals (CI), calculated using the Clopper-Pearson method. The performance comparison of the in-house ELISA showed substantial agreement with the two commercial assays. The overall concordance rate between in-house ELISA and Elecsys CLIA was 80.8% (95% CI 75.0–86.5), while the agreement between in-house ELISA and the Rapid LFA test (IgG + IgM) was 75.8% (95% CI 70.1–81.5). The kappa coefficients were: in-house ELISA vs. Elecsys CLIA (κ = 0.61, 95% CI 0.55–0.67), in-house ELISA vs. Rapid LFA test (IgG + IgM) (κ = 0.52, 95% CI 0.46–0.58), and Elecsys CLIA vs. Rapid LFA test (IgG + IgM) (κ = 0.73, 95% CI 0.67–0.78). The in-house ELISA demonstrated strong agreement with the Elecsys CLIA, showing a PPA of 81.7% and an NPA of 80.1%. Compared to the Rapid LFA test (IgG + IgM), which had a PPA of 83% and an NPA of 70.4%, the in-house ELISA exhibited better overall agreement with Elecsys CLIA. This study’s findings indicate substantial agreement between the in-house ELISA and Elecsys. However, only modest agreement was observed between the in-house ELISA and the rapid test (IgG + IgM). Together, these results suggest the utility of the in-house ELISA as a cost-effective tool for sero surveillance studies and monitoring the effect of interventions in resource-poor settings.

The evolution of COVID-19 pandemic has been characterized by the rapid emergence of new SARS-CoV-2 variants, each of which poses unique challenges to public health. This study analyzes the dispersion profiles during the Pre-Omicron and Post-Omicron phases in different epidemiological contexts. The Brazilian state of Espirito Santo, despite its low population density, plays a critical role as a commercial hub due to its intense port activity, which may have contributed to COVID-19 cases and mortality rates being higher than the national average. The state recorded 34,000 confirmed cases and 377 deaths per 100,000 inhabitants. Genomic surveillance revealed that the Pre-Omicron phase was dominated by the B.1.1.33 lineage, characterized by localized intraregional circulation. In contrast, the Post-Omicron phase, dominated by the BQ.1.1 lineage, exhibited greater diversity in circulating lineages, increased international interactions, and rapid viral dissemination, highlighting distinct transmission dynamics between such periods. This study highlights the need for adaptive public health strategies that account for both viral behavior and regional socioeconomic factors, while highlighting the strategic importance of Espirito Santo in monitoring SARS-CoV-2 evolution.

Background: Post-exertional malaise (PEM), which is the cardinal feature of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), is also reported in a proportion of patients with post-COVID-19 syndrome (PCS). Our objective was to identify determinants that may be linked to the emergence of PEM in PCS patients. Methods: Patients fulfilling the World Health Organization definition for PCS who attended the post-COVID unit of the Internal Medicine Department of Angers University Hospital, France, between June 2020 and December 2023 were included retrospectively. Their medical records were reviewed to extract information on COVID-19 infection history, characteristics of post-exertional malaise (PEM), fatigue severity, and relevant epidemiological variables. Results: The study included 220 patients, grouped according to whether post-exertional malaise was present (PCS/PEM+) or absent (PCS/PEM–). PEM was observed in 26.4% of patients and was significantly linked to earlier COVID onset in 2020/2021 (OR 5.68 (95% CI: 1.66–19.45), p = 0.006), as well as higher fatigue levels (OR 2.07 (95% CI: 1.22–3.50), p = 0.007). Conclusions: Patients who contracted COVID-19 during the pre-Omicron period reported PEM more frequently than those infected in later waves. This observation could reflect differences in viral characteristics following the emergence of the Omicron variant; however, alternative explanations—such as increasing vaccination coverage, accumulating post-infectious immunity, or other unmeasured factors—cannot be ruled out. Based on the observed link between PEM and symptom severity, PCS patients should be systematically assessed for the presence of PEM.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has impacted global health. Remdesivir was approved based on clinical trials demonstrating improved outcomes in hospitalized patients. The ReEs-COVID19 study provides real-world evidence on its effectiveness and safety across two periods: Pre-Omicron and Omicron. This retrospective, observational cohort study included 1610 patients hospitalized with COVID-19, treated with remdesivir during Pre-Omicron (September 2020–February 2021; n = 606) and Omicron (June 2022–March 2023; n = 1004) periods. Primary endpoint: time to discharge; Hepatic/renal function abnormalities were also investigated. In the Omicron period patients were older and had more comorbidities but remdesivir was initiated earlier (median: 2 days from symptom onset) compared to the Pre-Omicron period (8 days). ICU admissions rates and direct COVID-19-related deaths were significantly lower, but overall 30-day mortality was higher during the Omicron period. Earlier remdesivir administration was associated with faster discharge. Abnormal liver tests and acute kidney injury were rare across both periods. ReEs-COVID19 confirmed remdesivir’s effectiveness and safety in real-world clinical settings during both periods, underscoring its importance in treatment of hospitalized COVID-19 patients, especially when initiated earlier in the disease course. Further research is needed to evaluate its utility in specific subgroups (e.g., immuno-compromised) and in combination with other treatments.

SARS-CoV-2 has acquired many mutations that influence the severity of COVID-19’s course or the risk of developing long COVID. In 2022, the dominant SARS-CoV-2 variant was Omicron. This study aimed to compare the course of COVID-19 in the periods before and during the dominance of the Omicron variant. Risk factors for developing long COVID were also assessed. This study was based on stationary visits of patients after COVID-19 and follow-up assessments after 3 months. Clinical symptoms, comorbidities, and vaccination status were evaluated in 1967 patients. Of the analyzed group, 1308 patients (66.5%) were affected by COVID-19 in the period before the Omicron dominance. The prevalence of long COVID was significantly lower among patients of the Omicron group (47.7% vs. 66.9%, p < 0.001). The risk of long COVID was higher for women (OR: 1.61; 95% CI: 1.31, 1.99]) and asthmatics (OR: 1.46; 95% CI: 1.03, 2.07]). Conclusively, infection during the Omicron-dominant period was linked to a lower risk of developing long COVID. Females are at higher risk of developing long COVID independent of the pandemic period. Individuals affected by COVID-19 in the Omicron-dominant period experience a shorter duration of symptoms and reduced frequency of symptoms, except for coughing, which occurs more often.