Browsing by Author "Gonzalez, Cecilia"
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- ItemEffectiveness of an inactivated SARS-CoV-2 vaccine in children and adolescents: a large-scale observational study(ELSEVIER, 2023) Jara, Alejandro; Undurraga, Eduardo A.; Flores, Juan Carlos; Zubizarreta, Jose R.; Gonzalez, Cecilia; Pizarro, Alejandra; Ortuno-Borroto, Duniel; Acevedo, Johanna; Leo, Katherinne; Paredes, Fabio; Bralic, Tomas; Vergara, Veronica; Leon, Francisco; Parot, Ignacio; Leighton, Paulina; Suarez, Pamela; Rios, Juan Carlos; Garcia-Escorza, Heriberto; Araos, RafaelBackground Policymakers urgently need evidence to adequately balance the costs and benefits of mass vaccination against COVID-19 across all age groups, including children and adolescents. In this study, we aim to assess the effectiveness of CoronaVac's primary series among children and adolescents in Chile. Methods We used a large prospective national cohort of about two million children and adolescents 6-16 years to estimate the effectiveness of an inactivated SARS-CoV-2 vaccine (CoronaVac) in preventing laboratory-confirmed symptomatic SARS-CoV-2 infection (COVID-19), hospitalisation, and admission to an intensive care unit (ICU) associated with COVID-19. We compared the risk of individuals treated with a complete primary immunization schedule (two doses, 28 days apart) with the risk of unvaccinated individuals during the follow-up period. The study was conducted in Chile from June 27, 2021, to January 12, 2022, when the SARS-CoV-2 Delta variant was predominant but other variants of concern were co-circulating, including Omicron. We used inverse probability-weighted survival regression models to estimate hazard ratios of complete immunization over the unvaccinated status, accounting for time-varying vaccination exposure and adjusting for relevant demographic, socioeconomic, and clinical confounders.Findings The estimated adjusted vaccine effectiveness for the inactivated SARS-CoV-2 vaccine in children aged 6-16 years was 74.5% (95% CI, 73.8-75.2), 91.0% (95% CI, 87.8-93.4), 93.8% (95% CI, 87.8-93.4) for the prevention of COVID-19, hospitalisation, and ICU admission, respectively. For the subgroup of children 6-11 years, the vaccine effectiveness was 75.8% (95% CI, 74.7-76.8) for the prevention of COVID-19 and 77.9% (95% CI, 61.5-87.3) for the prevention of hospitalisation.Interpretation Our results suggest that a complete primary immunization schedule with the inactivated SARS-CoV-2 vaccine provides effective protection against severe COVID-19 disease for children 6-16 years.Copyright & COPY; 2023 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
- ItemEffectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile(MASSACHUSETTS MEDICAL SOC, 2021) Jara, Alejandro; Undurraga, Eduardo A.; Gonzalez, Cecilia; Paredes, Fabio; Fontecilla, Tomas; Jara, Gonzalo; Pizarro, Alejandra; Acevedo, Johanna; Leo, Katherine; Leon, Francisco; Sans, Carlos; Leighton, Paulina; Suarez, Pamela; Garcia Escorza, Heriberto; Araos, RafaelInactivated SARS-CoV-2 Vaccine in Chile In a national prospective cohort study involving 10.2 million participants in Chile, the effectiveness of an inactivated SARS-CoV-2 vaccine, which had been developed in China and administered in two doses 28 days apart, was estimated. Effectiveness among fully immunized persons was estimated at 65.9% for Covid-19 and at 87.5% for hospitalization, 90.3% for ICU admission, and 86.3% for death.
- ItemEffectiveness of CoronaVac in children 3-5 years of age during the SARS-CoV-2 Omicron outbreak in Chile(NATURE PORTFOLIO, 2022) Jara, Alejandro; Undurraga, Eduardo A.; Zubizarreta, Jose R.; Gonzalez, Cecilia; Acevedo, Johanna; Pizarro, Alejandra; Vergara, Veronica; Soto-Marchant, Mario; Gilabert, Rosario; Flores, Juan Carlos; Suarez, Pamela; Leighton, Paulina; Eguiguren, Pablo; Carlos Rios, Juan; Fernandez, Jorge; Garcia-Escorza, Heriberto; Araos, RafaelThe outbreak of the B.1.1.529 lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Omicron) has caused an unprecedented number of Coronavirus Disease 2019 (COVID-19) cases, including pediatric hospital admissions. Policymakers urgently need evidence of vaccine effectiveness in children to balance the costs and benefits of vaccination campaigns, but, to date, the evidence is sparse. Leveraging a population-based cohort in Chile of 490,694 children aged 3-5 years, we estimated the effectiveness of administering a two-dose schedule, 28 days apart, of Sinovac's inactivated SARS-CoV-2 vaccine (CoronaVac). We used inverse probability-weighted survival regression models to estimate hazard ratios of symptomatic COVID-19, hospitalization and admission to an intensive care unit (ICU) for children with complete immunization over non-vaccination, accounting for time-varying vaccination exposure and relevant confounders. The study was conducted between 6 December 2021 and 26 February 2022, during the Omicron outbreak in Chile. The estimated vaccine effectiveness was 38.2% (95% confidence interval (CI), 36.5-39.9) against symptomatic COVID-19, 64.6% (95% CI, 49.6-75.2) against hospitalization and 69.0% (95% CI, 18.6-88.2) against ICU admission. The effectiveness against symptomatic COVID-19 was modest; however, protection against severe disease was high. These results support vaccination of children aged 3-5 years to prevent severe illness and associated complications and highlight the importance of maintaining layered protections against SARS-CoV-2 infection.
- ItemExploring the relationship between capillary refill time, skin blood flow and microcirculatory reactivity during early resuscitation of patients with septic shock: a pilot study(2023) Contreras, Roberto; Hernandez, Glenn; Daniel Valenzuela, Emilio; Gonzalez, Cecilia; Ulloa, Rodrigo; Soto, Dagoberto; Castro, Ricardo; Guzman, Camila; Oviedo, Vanessa; Alegria, Leyla; Vidal, Diego; Morales, Sebastian; Adolfo Ospina-Tascon, Gustavo; Bakker, Jan; Kattan, EduardoCapillary refill time (CRT), a costless and widely available tool, has emerged as a promising target to guide septic shock resuscitation. However, it has yet to gain universal acceptance due to its potential inter-observer variability. Standardization of CRT assessment may minimize this problem, but few studies have compared this approach with techniques that directly assess skin blood flow (SBF). Our objective was to determine if an abnormal CRT is associated with impaired SBF and microvascular reactivity in early septic shock patients. Twelve septic shock patients were subjected to multimodal perfusion and hemodynamic monitoring for 24 h. Three time-points (0, 1, and 24 h) were registered for each patient. SBF was measured by laser doppler. We performed a baseline SBF measurement and two microvascular reactivity tests: one with a thermal challenge at 44 & DEG;C and other with a vascular occlusion test. Ten healthy volunteers were evaluated to obtain reference values. The patients (median age 70 years) exhibited a 28-day mortality of 50%. Baseline CRT was 3.3 [2.7-7.3] seconds. In pooled data analysis, abnormal CRT presented a significantly lower SBF when compared to normal CRT [44 (13.3-80.3) vs 193.2 (99.4-285) APU, p = 0.0001]. CRT was strongly associated with SBF (R-2 0.76, p < 0.0001). An abnormal CRT also was associated with impaired thermal challenge and vascular occlusion tests. Abnormal CRT values observed during early septic shock resuscitation are associated with impaired skin blood flow, and abnormal skin microvascular reactivity. Future studies should confirm these results.
- ItemFrailty and reduced gait speed are independently related to mortality of cirrhotic patients in long-term follow-up(2021) Soto, Ruben; Antonio Diaz, Luis; Rivas, Violeta; Fuentes-Lopez, Eduardo; Zalaquett, Macarena; Jose Bruera, Maria; Gonzalez, Cecilia; Mezzano, Gabriel; Benitez, CarlosIntroduction and objectives: Frailty is characterized by a poor restoration of homeostasis after a stressor event. Although it is not usually diagnosed, it has been associated with decreased survival in cirrhotic patients. We aimed to evaluate the impact of frailty and decreased gait speed over survival in cirrhotic patients at long-term follow-up.
- ItemNeutralizing antibodies induced by homologous and heterologous boosters in CoronaVac vaccines in Chile(2023) Acevedo, Johanna; Acevedo, Monica L.; Gaete-Argel, Aracelly; Araos, Rafael; Gonzalez, Cecilia; Espinoza, Daniela; Rivas, Solange; Pizarro, Pablo; Jarpa, Stephan; Soto-Rifo, Ricardo; Jara, Alejandro; Valiente-Echeverria, FernandoObjectives: To determine the impact of a booster dose on the humoral response in individuals inoculated with a complete schedule of any SARS-CoV-2 vaccine, we evaluated the neutralizing antibody (NAb) titres of homologous or heterologous booster doses over a 90-days period in CoronaVac vaccinees from 3 centres in Santiago, Chile.