bluuebunny/crossref_metadata_2025_split huggingface dataset:
1351. Predictors of Loss of Infectivity Among Healthcare Workers with Primary and Recurrent SARS-CoV-2 infection: An Observational Cohort Study
Authors: Dzieciolowska Stefka , Longtin Yves , Charest Hugues , Roy Tonya , Fafard Judith , Levade Ines , Longtin Jean , Parkes Leighanne , Villeneuve Jasmin , Savard Patrice , Corbeil Jacques , De Serres Gaston 
Published: November 2023

Abstract

Background
Factors associated with loss of infectivity in healthcare workers (HCWs) with COVID-19 are poorly understood. Understanding predictive factors could help optimize return-to-work criteria and minimize absenteeism.

Methods
Prospective observational cohort study of HCWs with COVID-19 conducted between Feb 20 2022 and March 6 2023 in 20 institutions in Montreal, Canada, with clinical/laboratory follow-up on Day 5, 7 and 10 of infection. Infectivity was determined by viral culture (Vero E6 cells) on nasopharyngeal swabs. Predictors of loss of infectivity were investigated by univariate and multivariate logistic regression.

Results
Overall, 121 participants (79.3% female, mean age 40 years) were recruited. Most (n=107, 88.4%) had received ≥3 vaccines and 20 (16.5%) had a history of prior COVID-19. The proportion of HCWs with a positive viral culture decreased from 71.9% on day 5 of infection to 18.2% on day 10. The proportion of HCWs with a positive RT-PCR decreased from 93.3% (112/120) on day 5 (median Ct value, 23.4 [IQR, 20.6-27.9]) to 61.2% (74/120) on day 10 (median Ct value, 32.5 [IQR, 28.5 to undetectable]). Rapid antigen detection test (RADT) positivity decreased from 81.5% on day 5 to 34.2% on day 10.
Participants with recurrent COVID-19 had lower likelihood of infectivity at each visit (OR on day 5, 0.14; 95% CI 0.05-0.40; p&lt; 0.001; OR on day 7, 0.04; 95% CI, 0.01-0.33; p=0.003) and none were infective on day 10 (p=0.02). At each visit, recurrent cases had higher median RT-PCR Ct values than primary infections (p&lt; 0.03) and were more likely to have a negative RADT result (p&lt; 0.01).
By multivariate analysis, ongoing infectivity was associated with a RT-PCR Ct value &lt; 23 (adjusted OR [aOR] on day 5, 22.75; p&lt; 0.001; aOR on Day 7, 182.30; p&lt; 0.001; and aOR on Day 10; 24.71; p=0.02). A history of previous COVID-19 was associated with a lower probability of infectivity on Day 5 (aOR, 0.005; p=0.003). By contrast, symptom improvement (including fever) and RADT result were not independent predictors of loss of infectivity.

Conclusion
A lower RT-PCR Ct value is associated with ongoing infectivity, whereas COVID-19 reinfection is a predictor of loss of infectivity. These findings could help optimize return-to-work algorithms.

Disclosures
All Authors: No reported disclosures
1353. Safety of AZD7442 (Tixagevimab/Cilgavimab) for Post-exposure Prophylaxis of COVID-19: Final Analysis of the STORM CHASER Phase 3 Study
Authors: Levin Myron J , Ustianowski Andrew , Thissen Jesse , Seegobin Seth , Beavon Rohini , Dey Kanika , Kelly Elizabeth J , Near Karen A , Streicher Katie , Kiazand Alexandre , Esser Mark T 
Published: November 2023

Abstract

Background
In the STORM CHASER phase 3 post-exposure prophylaxis study, 300-mg intramuscular (IM) AZD7442 (tixagevimab/cilgavimab) reduced symptomatic COVID-19 by 33.3% vs placebo at primary analysis (P=0.212; median follow-up: 183 days) and was well tolerated. We report final safety data from STORM CHASER.

Methods
In STORM CHASER (NCT04625972), adults without prior SARS-CoV-2 infection or COVID-19 vaccination were enrolled within 8 days of exposure to a SARS-CoV-2–infected individual and randomized 2:1 to receive a single intramuscular dose of 300-mg AZD7442 (N=749) or placebo (N=372). Results are reported from the November 12, 2022 final data cut-off. The primary safety endpoint was assessment of adverse events (AEs), serious adverse events (SAEs), medically attended AEs (MAAEs), and AEs of special interest (AESIs). AESIs included injection site and hypersensitivity reactions. Efficacy data have previously been reported.

Results
Across both the AZD7442 and placebo groups, 928 (82.1%) participants completed the study. Median follow-up was 455 days (∼15 months) in both groups. AEs occurred in 46.5% and 51.9% of participants administered AZD7442 and placebo, respectively (Table). Most AEs were mild to moderate in severity; 30 (4.0%) and 26 (7.0%) of participants in the AZD7442 and placebo groups, respectively, reported an AE of grade 3 (severe) or higher. SAEs occurred in 2.7% and 4.3% of AZD7442 and placebo participants, MAAEs in 12.7% and 14.0%, AESIs in 0.5% and 1.1%, and deaths in 0.4% and 0.5%, respectively.

Conclusion
These findings support the long-term safety of AZD7442.

Disclosures
Myron J. Levin, MD, Dynavax: Advisor/Consultant|GSK: Advisor/Consultant|GSK: Grant/Research Support|GSK: Data safety monitoring/Advisory board|Johnson & Johnson: Grant/Research Support|Merck & Co.: Advisor/Consultant|Moderna: Grant/Research Support|Novavax: Grant/Research Support|Pfizer: Advisor/Consultant|Seqirus: Advisor/Consultant Andrew Ustianowski, MD, PhD, Gilead: Honoraria|Gilead: Advisory Board|GSK: Honoraria|Janssen: Honoraria|Merck: Honoraria|Merck: Advisory Board|Sanofi: Honoraria|ViiV Healthcare/GSK: Advisory Board Jesse Thissen, MSc, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Seth Seegobin, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Rohini Beavon, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Kanika Dey, MSc, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Elizabeth J. Kelly, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Karen A. Near, MD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Katie Streicher, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Alexandre Kiazand, MD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds Mark T. Esser, PhD, AstraZeneca: Employee|AstraZeneca: Stocks/Bonds
1359. Understanding Data Completeness from Sites Participating in the N3C Limited Data Set
Authors: Koren Yuval , Aggarwal Shivani , Poscover Daniel , Barr Charles 
Published: November 2023

Abstract

Background
Numerous data sources such as registries utilize data collected across multiple sites, typically across a geographic region. Understanding the degree to which individual sites contribute core data components such as diagnoses, treatments, procedures, and measurements, is an essential step when conducting analyses using a multi-site database. The National COVID Cohort Collaborative (N3C) is the largest repository of deidentified clinical data from 18.9 million patients tested for or diagnosed with COVID-19 in the United States, and has been cited in over 150 publications, preprints, and presentations. Data is systematically collected across electronic health records from multiple sites and harmonized into the OMOP Common Data Model (CDM). Here, we aim to describe data completeness from participating sites using the N3C Level 3 Limited Data Set.

Methods
Key OMOP CDM data tables (measurement, drug_exposure, condition_occurrence, and procedure_occurrence) from two N3C data releases six months apart (August 2022 and February 2023) were assessed. A site was considered to contribute to a key data table if a threshold of at least 1,000 records and lag of no more than 5 months within 6 months prior to the data release date through the data release was observed for that site. Records with dates after the data release date or with missing dates were not included. The proportion of sites with data in at least one key table and data in all key tables in the August 2022 and February 2023 data releases was determined.

Results
Of the 77 sites identified in the N3C Limited Data Set in August 2022, 76.6%-83.1% had data in at least one key table and 75.3% (N=58) had data in all four key tables. A drop of 6.8% in the number of sites with data in all 4 key tables was observed in the February 2023 data release. The condition_occurrence table was most impacted by site attrition (12.5%) between these data releases, while the drug_exposure was the least impacted (3.2%).

Conclusion
We observed a minor heterogeneity and a high proportion of sites contributing key data tables through the two N3C data releases under investigation. Assessing such sites characteristics during the study design phase may be an essential step when designing high-quality real-world studies that utilize multi-site data.

Disclosures
Yuval Koren, MSc, AstraZeneca: Grant/Research Support Daniel Poscover, MBA, AstraZeneca: Grant/Research Support Charles Barr, MD, MPH, AstraZeneca: Grant/Research Support
1360. Remdesivir in COVID 19 patients with kidney disease: A study on the renal function and outcomes
Authors: Barez Marie Yvette , Lagura C R Y S T A L F A Y E G , Ivy Leano-Togonon Jennifer 
Published: November 2023

Abstract

Background
The COVID-19 pandemic has high mortality rates in patients with kidney disease. Remdesivir, an antiviral nucleotide prodrug, showed to shorten time to recovery in adults hospitalized with COVID 19. However, individuals with kidney disease were not included in clinical trials, thus when emergency use authorization was granted, it was recommended to avoid use in patients with eGFR &lt; 30mL/min “unless benefit outweighs the risk”. In this study, we aim to determine the effect of Remdesivir on renal function and outcomes among COVID19 patients with kidney disease.

Methods
This retrospective study included the following: &gt;18 years old, RT-PCR confirmed COVID19 infection treated with Remdesivir and who were confirmed to have kidney disease.

Results
There were 106 patients included; the mean age was 62.25±13.96 years old, more than half of the population were males (53%). The majority of the population had acute kidney injury (70.7%) while the rest had chronic kidney disease and 25% underwent renal replacement therapy. Most of them were classified as severe (66%) and critical (25%) COVID infection.
To determine effects on renal function laboratory parameters were determined at baseline and after completion of treatment. There was an overall significant improvement in eGFR (&lt; 0.01), albuminuria (0.013) and in acid-base balance (0.003) and odds ratio showed that none of the demographic, clinical and laboratory profile significantly increased the chance of death in terms of overall clinical outcome.
In terms of overall clinical outcome, this study had a mortality rate of 4.9% as 5 out of 106 patients expired.

Conclusion
Use of Remdesivir in patients with kidney disease was not associated with renal function deterioration. Contrary to concerns there was rather an overall significant improvement in eGFR, degree of albuminuria and acid-base balance after treatment regardless of their disease severity and its use in patients on hemodialysis have not shown any detrimental impact on mortality.

Disclosures
All Authors: No reported disclosures
1364. Association Between Tixagevimab/Cilgavimab Administration and Self-Reported SARS-CoV-2 Infection During the Omicron Surge
Authors: Mathew Daniya S , Saunders-Hao Patricia , Jain Sumeet , Ball Trever , Abel-Bey Amparo , Bowman Keisha , Gandhi Shivanthidevi , Gautam-Goyal Pranisha , Brown Zenobia 
Published: November 2023

Abstract

Background
Immunocompromised patients are at high risk for COVID-19 morbidity and mortality. While findings from the PROVENT study led to emergency use authorization of tixagevimab/cilgavimab (TC) for pre-exposure prophylaxis, less is known of its protection in vaccinated immunocompromised patients against the SARS-CoV-2 Omicron variants and subvariants. The purpose of this study was to evaluate association between TC and self reported SARS-CoV-2 infection during the Omicron variant surge in vaccinated immunocompromised persons.

Methods
This was a retrospective study that surveyed and evaluated electronic health records of patients who received TC between January 2022-November 2022. TC’s protection against SARS-CoV-2 infection was evaluated preliminarily by average monthly infection rates before and after the BA.5 variant was regionally predicted to be &lt; 50% of infections (October 29, 2022). Multivariate logistic regression was used to determine odds of infections during 4 months before and 4 months after subvariants, while controlling for age, race, gender, vaccination status, and immunocompromised conditions.

Results
43% (126/293) of recruited patients completed the study’s survey. All patients were vaccinated with at least primary series for SARS-CoV-2 infection. A majority were female (53.2%), &gt; 65 yrs (61.1%), White (70.4%), and immunocompromised with solid malignancy (61.1%). Average monthly infection rate during the BA.5 variant was 4.4% and after was 12.1%. Patients who received a vaccine booster twice were 68% less likely to be infected prior to Omicron subvariants compared to those who only received their primary vaccination series (OR=0.32; p=0.10). During this period, patients with rheumatoid arthritis were 5.6 times more likely than patients with solid malignancy to be infected (OR=5.64; p=0.07). During Omicron subvariants, patients with Lupus were most likely to be infected compared to patients with solid malignancy, but not statistically significant (OR=1.78; p=0.69).

Conclusion
In the presence of changing vaccine coverage, therapies, and changing variants, the effectiveness of TC in the Omicron era is difficult to assess. These preliminary findings describe a real world snapshot of SARS-CoV-2 infections in high-risk patients who received TC.

Disclosures
All Authors: No reported disclosures
1368. In-hospital and post-discharge mortality among adults with COVID-19 associated hospitalization, COVID-NET, March 2020–April 2021.
Authors: Patel Kadam , Kirley Pam Daily , Kawasaki Breanna , Meek James , Openo Kyle P , Monroe Maya , Henderson Justin , Lynfield Ruth , Sosin Daniel M , Rowe Adam , Bushey Sophrena , Shiltz Eli , Sutton Melissa , Keipp Talbot H , Swain Ashley , Whitaker Michael , Taylor Christopher , Havers Fiona P 
Published: November 2023

Abstract

Background
Since the COVID-19 pandemic began in 2020, &gt; 1 million persons have died in the US due to COVID-19. While various research illustrated in-hospital mortality in detail, post-discharge mortality has not been well described. Data from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) were used to describe in-hospital and post-discharge mortality among adults hospitalized with COVID-19 in the US during the first year of the pandemic.

Methods
COVID-NET is a population-based surveillance system in 14 states that captures laboratory-confirmed COVID-19-associated hospitalizations, defined as any patient residing in the catchment areas with a positive SARS-CoV-2 test during hospitalization or ≤ 14 days prior to admission. Detailed chart reviews were conducted by trained surveillance officers on a representative sample stratified by age group, state, and month. Cases were linked to death certificate data to identify those who died ≤ 60 days after hospital discharge. Data were restricted to adults ages ≥ 18 years admitted from March 2020–April 2021. Proportions of mortality and hospitalization rate (per 100,000) were calculated by month to investigate trends in adults aged ≥ 75 years.

Results
176,044 hospitalized adults met the COVID-NET case definition during the study period; 26,149 underwent full chart review. Overall, 9.7% died in-hospital and 6% died post-discharge; among those ≥ 75 years, these proportions were 18.1% and 16.2%, respectively (Figure 1). Among adults who died post-discharge, 47.5%, 33.1% and 28.3 were discharged to another facility, hospice, and private residence +/- services, respectively. Post-discharge mortality among those ≥ 75 years exceeded in-hospital mortality during October 2020 and December 2020 – February 2021. Hospitalization rates among those ≥ 75 years peaked in December 2020; the following month, January 2021, had the highest proportion of post-discharge mortality (22.6%) in this age group (Figure 2).
Mortality among hospitalized adults ages ≥18 years with laboratory-confirmed COVID-19, COVID-19-Associated Hospitalization Surveillance Network, March 2020–April 2021
Figure 1
Hospitalization Rate and Mortality among laboratory-confirmed COVID-19 among adults ages ≥75 years, COVID-19 Associated Hospitalization Surveillance Network, March 2020–April 2021
Figure 2

Conclusion
Among all deaths in adults with a COVID-19-associated hospitalization, two-thirds occurred in-hospital and one-third occurred ≤ 60 days post-discharge. Increases in post-discharge mortality followed a period of high COVID-19-associated hospitalization rates among ≥ 75 years.

Disclosures
All Authors: No reported disclosures
1374. Foodborne disease outbreak at a delivery pizza and sushi restaurant, Kazakhstan, 2023
Authors: Ablimitova Feruza , Balmagambetov Arystan , Horth Roberta , Nabirova Dilyara 
Published: November 2023

Abstract

Background
On February 3, 2023, the Kazakhstan Ministry of Health was notified of 71 hospitalized cases of acute gastointestinal illness among people who had ordered food from a delivery sushi and pizza restaurant in Talgar (population=50,000). We conducted an investigation from February 4 to 16 to identify risk factors.

Methods
We conducted a retrospective cohort study among people who consumed food from the sushi bar from January 31 to February 1, 2023. To find additional cases, we used a line list of orders made by customers provided by the restaurant. We interviewed customers by telephone and face-to-face. Patient gastric samples and food samples were submitted for microbial testing. We conducted an environmental assessment. We performed Poisson logistic regression using R software.

Results
Of 381 people identified, 364 were interviewed, of which 215 (59%) had become ill. Main symptoms were abdominal pain (98%), diarrhea (94%), nausea (94%), headache (91%), chills (82%), fever (81%), and vomiting (55%). Mean illness duration was 4 days (range=1-8). Mean onset time was 34 hours (range=6-91 hours) and 33% were hospitalized. Risk of illness was significantly higher among people who ate Caesar sushi rolls (1.55, 95% confidence interval [CI]=1.18-2.04), chicken and mushroom pizza (1.74, CI: 1.16-2.5), and "American" pizza (1.59, CI: 1.21-2.09). Among people who became ill, 60% had eaten Caesar sushi rolls and 40% american pizza. Attack rate was highest among those who had chicken pizza (97%). There was no common ingedient identified in the three foods. E.coli at concentration 103 and Enterococcus spp. were detected in Caesar rolls. Of 22 gastric samples tested, B. cereus was detected in 45%, Enterococcus in 50%, E. coli in 23%. Environmental assessment found several food safety violations including improper storage conditions, prepared foods being stored with raw materials, and missing or expired workers' health and food certifications.
Factors associated with acute gastrointestinal illness, Talgar, Kazakhstan, 2023

Conclusion
Because multiple pathogens were detected in food and patient samples and disease was associated with multiple foods, we suspect that food contaminated at different points in the preparation process was likely the source of the outbreak. The restaurant was closed and sanitized. We made recommendations to improve food handling and safety practices.

Disclosures
All Authors: No reported disclosures
1375. Strengthening Global Capacity to Detect Antimicrobial Resistance Threats
Authors: Benoit Tina , Aubert Rachael , Clemente Jacob , Sievert Dawn 
Published: November 2023

Abstract

Background
Antimicrobial resistance (AR) poses a major global threat, with a reported 1.27 million deaths in 2019. This resulted in years of life lost as well as a large burden on the healthcare system. Transmission of resistant pathogens is not limited to one geographic area and can easily be influenced by international travel and trade of food and other products. Addressing the global threat of AR is recognized as a major action item within the U.S. National Action Plan for Combating Antibiotic Resistant Bacteria. In 2021, the Centers for Disease Control and Prevention (CDC) established the Global Antimicrobial Resistance Laboratory and Response Network (Global AR Lab & Response Network). The network provides financial and technical support to partners, with a focus on detecting and monitoring existing threats, identifying risk factors, preventing and controlling spread, and mitigating the emergence of new threats.

Methods
In just over 2 years, CDC has invested more than $40 million through the Global AR Lab & Response Network on projects with more than 20 organizations in nearly 50 countries. Using a multi-pathogen approach, the network focuses on healthcare-associated, sexually transmitted, fungal, enteric, and invasive bacterial and respiratory pathogens.

Results
CDC’s Global AR Lab & Response Network is strengthening capacity to detect and respond to AR threats identified in the CDC 2019 AR Threats Report. Accomplishments include implementing trainings for high quality laboratory methods; monitoring resistance in bacteria and fungi to inform on changes in resistance and improve interventions; training and implementing activities to prevent, detect, and respond to AR in healthcare settings; and enhancing data sharing nationally, regionally, and globally.

Conclusion
Through this innovative approach with plans for expansion, the Network will continue to use a One-Health methodology to focus on enhancing global capacity to quickly detect AR threats and built upon existing laboratory and response efforts. Findings from these projects will also inform intervention strategies to address current and future AR threats.

Disclosures
All Authors: No reported disclosures
1378. Seroprevalence and risk factors for cysticercosis in Mexican-Americans in Starr County, Texas
Authors: Duffey Megan M , O’Connell Elise M , Leining Lauren M , Tang Nina L , Hanis Craig L , Brown Eric L , Gunter Sarah M 
Published: November 2023

Abstract

Background
Neurocysticercosis (NCC) is a parasitic infection caused by the tapeworm Taenia solium, and is a leading cause of epilepsy and chronic headaches in endemic areas including Latin America, Africa, and Asia. The epidemiology of NCC has not been well-studied in the United States to date, but small epidemiological studies suggest evidence of this disease in populations living in poverty and who have immigrated from an endemic region. There is a population living in Starr County, Texas along the Texas-Mexico border in whom the presence of other neglected tropical diseases has been demonstrated due to the intersection of poverty, climate, and high rate of immigration.

Methods
Our study was a serologic survey and risk factor analysis of cysticercosis in a pre-existing cohort of Mexican-Americans in Starr County, Texas. We used a triplex enzyme-linked immunoassay (ELISA) against cysticercosis-specific antigens and self-reported survey data and neighborhood-level variables to conduct a risk-factor analysis of seropositive participants.

Results
We identified an overall seropositivity to T. solium in 7.4% (45/605) of the cohort which likely represents a combination of parasite exposure, T. solium disease outside of the central nervous system, old calcified NCC, and viable or degenerating NCC. Female gender, specific occupation and indoor versus outdoor occupation were found to be significantly associated with cysticercosis seropositivity. Thirty-nine of the 45 seropositive participants were female (p 0.021), 26 were employed in healthcare, caregiving, or social service (p 0.009), and 42 were employed in an indoor occupation (p &lt; 0.001). These occupations could pose a risk for T. solium transmission. A geospatial analysis of cases at the census tract level showed increased percentage of seropositivity centered around urban cities Rio Grande City and Roma, as well as smaller city La Grulla and census-designated place Alto Bonito.

Conclusion
There is a critical need to investigate these cysticercosis-seropositive cases with brain imaging to evaluate for neurocysticercosis, as well as conduct an epidemiological investigation to determine disease transmission in Starr County.

Disclosures
All Authors: No reported disclosures