{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T21:08:51Z","timestamp":1767992931621,"version":"3.49.0"},"reference-count":60,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T00:00:00Z","timestamp":1662681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>From March 2021, various countries including Iraq issued prompted recommendations for increased COVID\u201019 vaccine protection in individuals especially those at risk of catching the virus (i.e., lifestyle, health sector workers, and chronic diseases). It is critically important to understand the impact of COVID\u201019 vaccinations with the most commonly used vaccines (Pfizer and AstraZeneca) among populations either on the severity of the disease or the transmissibility of SARS\u2010CoV\u20102 variants of concern (VOCs)\u00a0and in sequential waves. This study was conducted to establish the clinical severity of COVID\u201019 caused by Delta and Omicron SARS\u2010CoV\u20102 variants among patients who either attended or were admitted to hospitals and to compare the effectiveness of Pfizer and AstraZeneca COVID\u201019 vaccines (single or double doses) at least to prevent hospitalizations if not eradicating the pandemic. A case\u2013control study was done of 570 hospitalized patients; including 328 COVID\u201019 confirmed patients (166 males, 160 females) who received homologous vaccinations and 242 unvaccinated patients (128 males, 114 females) during the studied waves.\u00a0The\u00a0study showed that unvaccinated COVID\u201019 patients in both waves had expressed significantly a higher number and longer periods of symptoms than vaccinated ones. Additionally, there was no significant effect of vaccine types, Pfizer and AstraZeneca or vaccine shot numbers on the PCR\u2010Ct in the last (Omicron) wave of the pandemic. However, in the previous (Delta) wave of the pandemic, fully vaccinated (double doses) COVID\u201019 patients had higher PCR\u2010Ct values. Whether among vaccinated or unvaccinated patients, lower CRP levels recorded during the Omicron wave than that of the Delta wave, and regardless of the vaccine type or shot numbers, there were no significant differences between the two waves. Lower WBCs\u00a0were observed in patients (vaccinated and unvaccinated) infected with the Delta variant in comparison to those infected with the Omicron variant and without any remarkable effect of the vaccine type or shot numbers. This is the first molecular and investigational study of the Delta variant and circulated Omicron in Iraq, regarding the severity of these two waves of SARS\u2010CoV\u20102 pandemic and the efficacy of homologous vaccination, indicating the\u00a0insufficiency of two doses and the demand for booster dose(s) as the most effective way of keeping on the safe\u2010side against SARS\u2010CoV\u20102.<\/jats:p>","DOI":"10.1002\/jmv.28098","type":"journal-article","created":{"date-parts":[[2022,8,27]],"date-time":"2022-08-27T10:03:05Z","timestamp":1661594585000},"page":"5867-5876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Disease severity and efficacy of homologous vaccination among patients infected with SARS\u2010CoV\u20102 Delta or Omicron VOCs, compared to unvaccinated using main biomarkers"],"prefix":"10.1002","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3421-4627","authenticated-orcid":false,"given":"Ayad M.","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Chemistry University of Garmian  Kalar Kurdistan Region Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9984-0015","authenticated-orcid":false,"given":"Ahmed M.","family":"Tofiq","sequence":"additional","affiliation":[{"name":"Department of Biology, College of Education Head of International Academic Relations (IRO) University of Garmian  Kalar Kurdistan Region Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6697-0822","authenticated-orcid":false,"given":"Hassan M.","family":"Rostam","sequence":"additional","affiliation":[{"name":"Immunology &amp; Immuno\u2010Bioengineering Group, Infections, Immunity and Microbes Division, School of Life Sciences, Faculty of Medicine &amp; Health Sciences University of Nottingham  Nottingham UK"},{"name":"Department of Medicine, College of Medicine University of Garmian  Kalar Kurdistan Region Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kameran M.","family":"Ali","sequence":"additional","affiliation":[{"name":"Medical Lab Technology Department, Kalar Technical College Sulaimani Polytechnic University  Kalar Kurdistan Region Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2800-6642","authenticated-orcid":false,"given":"Hassan M.","family":"Tawfeeq","sequence":"additional","affiliation":[{"name":"Medical Lab Technology Department, Kalar Technical College Sulaimani Polytechnic University  Kalar Kurdistan Region Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_9_3_1","unstructured":"World Health Organization. Rolling updates on coronavirus disease. Events as they happen. 2020.https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/events-as-they-happen. Accessed July 31 2020."},{"key":"e_1_2_9_4_1","unstructured":"World Health Organization.Coronavirus disease (COVID\u201019) pandemic.2019.https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019. Accessed February 22 2022."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-3750-8"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.24868"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","unstructured":"GarrettN TapleyA AndriesenJ et al.High rate of asymptomatic carriage associated with variant strain Omicron.MedRxiv.2021.doi:10.1101\/2021.12.20.21268130","DOI":"10.1101\/2021.12.20.21268130"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom12050631"},{"key":"e_1_2_9_9_1","first-page":"3295","article-title":"Occurrence of COVID\u201019 symptoms during SARS\u2010CoV\u20102 infection defines waning of humoral immunity","volume":"12","author":"Wu J","year":"2021","journal-title":"Front Immunol"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06357-4"},{"key":"e_1_2_9_11_1","doi-asserted-by":"crossref","unstructured":"ThakurV BholaS ThakurP et al.Waves and variants of SARS\u2010CoV\u20102: understanding the causes and effect of the COVID\u201019 catastrophe.Infection.2022;(2):309\u2010325.","DOI":"10.1007\/s15010-021-01734-2"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","unstructured":"World Health Organization. Tracking SARS\u2010CoV\u20102 variants. Accessed February 20 2022.https:\/\/www.who.int\/en\/activities\/tracking-SARS-CoV-2-variants\/","DOI":"10.1038\/s41592-023-01833-y"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-04188-6"},{"key":"e_1_2_9_14_1","unstructured":"CascellaM RajnikM AleemA DulebohnSC Di NapoliR.Features evaluation and treatment of coronavirus (COVID\u201019). National Library of Medicine. National Center for Biotechnology Information.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554776\/Access March 20 2022."},{"key":"e_1_2_9_15_1","unstructured":"https:\/\/gov.krd\/coronavirus-en\/situation-update\/"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-022-07545-4"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30471-0"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","unstructured":"Davies N. G. Abbott S. Barnard R. C. et al. (2021).Estimated transmissibility and impact of SARS\u2010CoV\u20102 lineage B.1.1.7 in England.Science 372(6538).https:\/\/doi.org\/10.1126\/science.abg3055","DOI":"10.1126\/science.abg3055"},{"key":"e_1_2_9_19_1","unstructured":"Kurdistan Regional Government. Corona Virus (COVID\u201019). Accessed March 17 2022.https:\/\/www.worldometers.info\/coronavirus\/"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00306-8"},{"key":"e_1_2_9_21_1","unstructured":"https:\/\/www.who.int\/westernpacific\/emergencies\/covid-19\/covid-19-vaccines"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/00368504211000906"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42399-020-00363-4"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0261221"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmni.2021.100926"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-021-06698-5"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27002"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/iid3.582"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.plabm.2022.e00294"},{"key":"e_1_2_9_30_1","unstructured":"UCI. COVID\u201019 Protocols. Accessed March 25 2022.https:\/\/www.uci.org\/covid-19-pandemic-international-eventsprotocols-for-organisation-and\/2Cm1PAdb4wjLf6XswFgbiU"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2021.100208"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-04411-y"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.12.033"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medj.2020.12.004"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.11.010"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01410-w"},{"key":"e_1_2_9_37_1","doi-asserted-by":"crossref","unstructured":"RiemersmaKK GroganBE Kita\u2010YarbroA et al.Vaccinated and unvaccinated individuals have similar viral loads in communities with a high prevalence of the SARS\u2010CoV\u20102 delta variant.MedRxiv.2021.https:\/\/doi.org\/10.1101\/2021.07.31.21261387","DOI":"10.1101\/2021.07.31.21261387"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27563"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab421"},{"key":"e_1_2_9_40_1","doi-asserted-by":"crossref","unstructured":"SheikhA KerrS WoolhouseM McMenaminJ RobertsonC. Severity of Omicron variant of concern and vaccine effectiveness against symptomatic disease: national cohort with nested test negative design study in Scotland2021.https:\/\/doi.org\/10.1016\/S1473-3099(22)00141-4","DOI":"10.1016\/S1473-3099(22)00141-4"},{"key":"e_1_2_9_41_1","unstructured":"Prevention ECfD Control. Risk of SARS\u2010CoV\u20102transmission from newly\u2010infected individuals with documented previous infection or vaccination. In: ECDC Stockholm Sweden;2021."},{"key":"e_1_2_9_42_1","doi-asserted-by":"crossref","unstructured":"PeacockTP BrownJC ZhouJ et al.The SARS\u2010CoV\u20102 variant Omicron shows rapid replication in human primary nasal epithelial cultures and efficiently uses the endosomal route of entry.BioRxiv.2022.https:\/\/doi.org\/10.1101\/2021.12.31.474653","DOI":"10.1101\/2021.12.31.474653"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-04386-2"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-04385-3"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-04388-0"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.04.026"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2020.104657"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/6615787"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2020.09.002"},{"key":"e_1_2_9_50_1","doi-asserted-by":"crossref","unstructured":"PulliamJR vanSchalkwykC GovenderN et al.Increased risk of SARS\u2010CoV\u20102 reinfection associated with emergence of the Omicron variant in South Africa.MedRxiv.2021.doi:10.1126\/science.abn4947","DOI":"10.1101\/2021.11.11.21266068"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2020.06.008"},{"key":"e_1_2_9_52_1","doi-asserted-by":"crossref","unstructured":"KuodiP GorelikY ZayyadH et al.Association between vaccination status and reported incidence of post\u2010acute COVID\u201019 symptoms in Israel: a cross\u2010sectional study of patients infected between March 2020 and November 2021.medRxiv.2022.https:\/\/doi.org\/10.1101\/2022.01.05.22268800","DOI":"10.1101\/2022.01.05.22268800"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-021-01548-7"},{"key":"e_1_2_9_54_1","doi-asserted-by":"crossref","unstructured":"LyngseFP MortensenLH DenwoodMJ et al.SARS\u2010CoV\u20102 Omicron VOC transmission in Danish Households.medRxiv.2021.https:\/\/doi.org\/10.1101\/2021.12.27.21268278","DOI":"10.1101\/2021.12.27.21268278"},{"key":"e_1_2_9_55_1","doi-asserted-by":"crossref","unstructured":"KhanK KarimF CeleS et al.Omicron infection enhances neutralizing immunity against the Delta variant.medRxiv.2021.doi:10.1101\/2021.12.27.21268439","DOI":"10.1101\/2021.12.27.21268439"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.27778"},{"key":"e_1_2_9_57_1","doi-asserted-by":"crossref","unstructured":"BernalJL AndrewsN GowerC et al.Effectiveness of Covid\u201019 vaccines against the B. 1.617. 2 (Delta) variant.N Engl J Med.2021; (385):585\u2010594.","DOI":"10.1056\/NEJMoa2108891"},{"key":"e_1_2_9_58_1","doi-asserted-by":"crossref","unstructured":"Doria\u2010RoseNA ShenX SchmidtSD et al.Booster of mRNA\u20101273 strengthens SARS\u2010CoV\u20102 Omicron neutralization.medRxiv.2021.doi:10.1101\/2021.12.15.21267805","DOI":"10.1101\/2021.12.15.21267805"},{"key":"e_1_2_9_59_1","doi-asserted-by":"crossref","unstructured":"WilhelmA WideraM GrikscheitK et al.Reduced neutralization of SARS\u2010CoV\u20102 omicron variant by vaccine sera and monoclonal antibodies.MedRxiv.2021.https:\/\/doi.org\/10.1101\/2021.12.07.21267432","DOI":"10.1101\/2021.12.07.21267432"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2349890"},{"key":"e_1_2_9_61_1","volume-title":"Covid\u201019: Early studies give hope omicron is milder than other variants","author":"Christie B","year":"2021"}],"updated-by":[{"DOI":"10.1002\/jmv.28824","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000}}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.28098","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmv.28098","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.28098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T12:28:51Z","timestamp":1692620931000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.28098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,9]]},"references-count":60,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1002\/jmv.28098"],"URL":"https:\/\/doi.org\/10.1002\/jmv.28098","archive":["Portico"],"relation":{"correction":[{"id-type":"doi","id":"10.1002\/jmv.28824","asserted-by":"object"}]},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,9]]},"assertion":[{"value":"2022-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}