BackgroundSeveral chronic diseases accelerate cognitive decline; however, it is still unknown how different patterns of multimorbidity influence individuals’ trajectories across the cognitive continuum. ObjectivesWe aimed to investigate the impact of multimorbidity and of specific multimorbidity patterns on the transitions across cognitive stages (normal cognition, cognitive impairment, no dementia [CIND], dementia) and death. MethodsWe included 3122 dementia-free individuals from the Swedish National study on Aging and Care in Kungsholmen. Using fuzzy c-means cluster analysis, multimorbid participants were classified into mutually exclusive groups characterized by commonly coexisting chronic diseases. Participants were followed up to 18 years to detect incident CIND, dementia, or death. Transition hazard ratios (HRs), life expectancies, and time spent in different cognitive stages were estimated using multistate Markov models. ResultsAt baseline, five multimorbidity patterns were identified: neuropsychiatric, cardiovascular, sensory impairment/cancer, respiratory/metabolic/musculoskeletal, and unspecific. Compared to the unspecific pattern, the neuropsychiatric and sensory impairment/cancer ones showed reduced hazards of reverting from CIND to normal cognition (HR 0.53, 95% CI 0.33-0.85 and HR 0.60, 95% CI 0.39-0.91). Participants in the cardiovascular pattern exhibited an increased hazard of progression from CIND to dementia (HR 1.70, 95% CI 1.15-2.52) and for all transitions to death. Subjects with the neuropsychiatric and cardiovascular patterns showed reduced life expectancy at age 75, with an anticipation of CIND (up to 1.6 and 2.2 years, respectively) and dementia onset (up to 1.8 and 3.3 years, respectively). ConclusionsMultimorbidity patterns differentially steer individual trajectories across the cognitive continuum of older adults and may be used as a risk stratification tool.

The COVID-19 pandemic posed a global health crisis, with new severe acute res-piratory syndrome coronavirus 2 (SARS-CoV-2) variants weakening vaccine -driven protection. Trained immunity could help tackle COVID-19 disease. Our objective was to analyze whether heat-killed Mycobacterium manresensis (hkMm), an environmental mycobacterium, induces trained immunity and con-fers protection against SARS-CoV-2 infection. To this end, THP-1 cells and primary monocytes were trained with hkMm. The increased secretion of tumor necrosis factor alpha (TNF-a), interleukin (IL)-6, IL-1b, and IL-10, metabolic activ-ity, and changes in epigenetic marks suggested hkMm-induced trained immu-nity in vitro. Healthcare workers at risk of SARS-CoV-2 infection were enrolled into the MANRECOVID19 clinical trial (NCT04452773) and were administered Nyaditum resae (NR, containing hkMm) or placebo. No significant differences in monocyte inflammatory responses or the incidence of SARS-CoV-2 infection were found between the groups, although NR modified the profile of circulating immune cell populations. Our results show that M. manresensis induces trained immunity in vitro but not in vivo when orally administered as NR daily for 14 days.

The original publication of this article [1] contained an incomplete author contribution section. The incorrect and correct information has been listed in this correction article. The original article has been updated. Incorrect IG, MT, MS, JP, NF, LC, FL, AK, NG, ET, PG conceptualised the project. All authors were involved with generation of the protocol. IG, MT, ATM, MS, GP and JP wrote the first draft of the manuscript. All authors listed have been implicated in the development of the ongoing project described in the protocol including patients. All authors were involved in editing and approving the manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. IG, MT, MS, and AK act as guarantors. Correct. IG, MT, MS, JP, NF, GP,LC, FL, AK, NG, ET, PG conceptualised the project. All authors were involved with generation of the protocol. IG, MT, ATM, MS, GP and JP wrote the first draft of the manuscript. All authors listed (IG,MT,AM,MS,JP,NF, LC,RK,IG,MR,DR,JS,JP,PA,ET,IG ,MG,RM,RH,JH,MF,AM,AJ,AS,MJ,MC,AD,SD,PT,CF,AL ,PN,MM,HK,FS,FC,AA,MK,LK,JF,PK,TK,LC,FL,AK,PG) have been implicated in the development of the ongoing project described in the protocol including patients. All authors(IG,MT,AM,MS,JP,NF,LC,RK,IG,MR,DR,JS, JP,PA,ET,IG,MG,RM,RH,JH,MF,AM,AJ,AS,MJ,MC,AD ,SD,PT,CF,AL,PN,MM,HK,FS,FC,AA,MK,LK,JF,PK,TK ,LC,FL,AK,PG) were involved in editing and approving the manuscript. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. IG, MT, MS, and AK act as guarantors. © The Author(s) 2023.

Objective: The aim of this study was to determine the impact of the lockdown measures adopted during the COVID-19 pandemic on routine childhood vaccination coverage rates in Catalonia (Spain) and to estimate its recovery once the progressive return to ‘normalcy’ had begun.Study design: We conducted a public health register-based study. Methods: Routine childhood vaccination coverage rates were analysed in three periods: a first pre-lockdown period (from January 2019 to February 2020), a second lockdown period with full re-strictions (from March 2020 to June 2020), and, finally, a third post-lockdown period with partial re-strictions (from July 2020 to December 2021).Results: During the lockdown period, most of the coverage rates remained stable, concerning the pre-lockdown period; however, when comparing the vaccination coverage rates in the post-lockdown period to the pre-lockdown period, we observed decreases in all types of vaccines and doses analysed, except for coverage with the PCV13 vaccine in 2-year-olds, which experienced an increase. The most relevant reductions were observed in measles-mumps-rubella and diphtheria-tetanus-acellular pertussis vaccination coverage rates.Conclusions: Since the beginning of the COVID-19 pandemic, there has been an overall decline in routine childhood vaccine coverage rates, and the pre-pandemic rates have not yet been recovered. Immediate and long-term support strategies must be maintained and strengthened to restore and sustain routine childhood vaccination.(c) 2023 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.