Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials

Autores
Korang, Steven Kwasi; von Rohden, Elena; Veroniki, Areti Angeliki; Ong, Giok; Ngalamika, Owen; Siddiqui, Faiza; Juul, Sophie; Nielsen, Emil Eik; Feinberg, Joshua Buron; Petersen, Johanne Juul; Legart, Christian; Kokogho, Afoke; Maagaard, Mathias; Klingenberg, Sarah; Thabane, Lehana; Bardach, Ariel Esteban; Ciapponi, Agustín; Thomsen, Allan Randrup; Jakobsen, Janus C.; Gluud, Christian
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background COVID-19 is rapidly spreading causing extensive burdens across the world. Effective vaccines to prevent COVID-19 are urgently needed. Methods and findings Our objective was to assess the effectiveness and safety of COVID-19 vaccines through analyses of all currently available randomized clinical trials. We searched the databases CENTRAL, MEDLINE, Embase, and other sources from inception to June 17, 2021 for randomized clinical trials assessing vaccines for COVID-19. At least two independent reviewers screened studies, extracted data, and assessed risks of bias. We conducted meta-analyses, network meta-analyses, and Trial Sequential Analyses (TSA). Our primary outcomes included all-cause mortality, vaccine efficacy, and serious adverse events. We assessed the certainty of evidence with GRADE. We identified 46 trials; 35 trials randomizing 219 864 participants could be included in our analyses. Our meta-analyses showed that mRNA vaccines (efficacy, 95% [95% confidence interval (CI), 92% to 97%]; 71 514 participants; 3 trials; moderate certainty); inactivated vaccines (efficacy, 61% [95% CI, 52% to 68%]; 48 029 participants; 3 trials; moderate certainty); protein subunit vaccines (efficacy, 77% [95% CI, -5% to 95%]; 17 737 participants; 2 trials; low certainty); and viral vector vaccines (efficacy 68% [95% CI, 61% to 74%]; 71 401 participants; 5 trials; low certainty) prevented COVID- 19. Viral vector vaccines decreased mortality (risk ratio, 0.25 [95% CI 0.09 to 0.67]; 67 563 participants; 3 trials, low certainty), but comparable data on inactivated, mRNA, and protein subunit vaccines were imprecise. None of the vaccines showed evidence of a difference on serious adverse events, but observational evidence suggested rare serious adverse events. All the vaccines increased the risk of non-serious adverse events. Conclusions The evidence suggests that all the included vaccines are effective in preventing COVID-19. The mRNA vaccines seem most effective in preventing COVID-19, but viral vector vaccines seem most effective in reducing mortality. Further trials and longer follow-up are necessary to provide better insight into the safety profile of these vaccines.
Fil: Korang, Steven Kwasi. Copenhagen University Hospital; Dinamarca
Fil: von Rohden, Elena. Copenhagen University Hospital; Dinamarca
Fil: Veroniki, Areti Angeliki. Imperial College London; Reino Unido. St. Michael’s Hospital; Canadá
Fil: Ong, Giok. John Radcliffe Hospital; Reino Unido
Fil: Ngalamika, Owen. University of Zambia; Zambia
Fil: Siddiqui, Faiza. Copenhagen University Hospital; Dinamarca
Fil: Juul, Sophie. Copenhagen University Hospital; Dinamarca
Fil: Nielsen, Emil Eik. Copenhagen University Hospital; Dinamarca
Fil: Feinberg, Joshua Buron. Copenhagen University Hospital; Dinamarca
Fil: Petersen, Johanne Juul. Copenhagen University Hospital; Dinamarca
Fil: Legart, Christian. Universidad de Copenhagen; Dinamarca. Copenhagen University Hospital; Dinamarca
Fil: Kokogho, Afoke. Henry M. Jackson Foundation Medical Research International; Nigeria
Fil: Maagaard, Mathias. Copenhagen University Hospital; Dinamarca. Zealand University Hospital; Dinamarca
Fil: Klingenberg, Sarah. Copenhagen University Hospital; Dinamarca
Fil: Thabane, Lehana. Mcmaster University; Canadá
Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ciapponi, Agustín. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Thomsen, Allan Randrup. Universidad de Copenhagen; Dinamarca
Fil: Jakobsen, Janus C.. University of Southern Denmark; Dinamarca. Copenhagen University Hospital; Dinamarca
Fil: Gluud, Christian. Copenhagen University Hospital; Dinamarca. University of Southern Denmark; Dinamarca
Materia
COVID-19
Vaccines
Trial Sequential Analysis
Network meta-analysis
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/224283
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/224283
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repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trialsKorang, Steven Kwasivon Rohden, ElenaVeroniki, Areti AngelikiOng, GiokNgalamika, OwenSiddiqui, FaizaJuul, SophieNielsen, Emil EikFeinberg, Joshua BuronPetersen, Johanne JuulLegart, ChristianKokogho, AfokeMaagaard, MathiasKlingenberg, SarahThabane, LehanaBardach, Ariel EstebanCiapponi, AgustínThomsen, Allan RandrupJakobsen, Janus C.Gluud, ChristianCOVID-19VaccinesTrial Sequential AnalysisNetwork meta-analysishttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background COVID-19 is rapidly spreading causing extensive burdens across the world. Effective vaccines to prevent COVID-19 are urgently needed. Methods and findings Our objective was to assess the effectiveness and safety of COVID-19 vaccines through analyses of all currently available randomized clinical trials. We searched the databases CENTRAL, MEDLINE, Embase, and other sources from inception to June 17, 2021 for randomized clinical trials assessing vaccines for COVID-19. At least two independent reviewers screened studies, extracted data, and assessed risks of bias. We conducted meta-analyses, network meta-analyses, and Trial Sequential Analyses (TSA). Our primary outcomes included all-cause mortality, vaccine efficacy, and serious adverse events. We assessed the certainty of evidence with GRADE. We identified 46 trials; 35 trials randomizing 219 864 participants could be included in our analyses. Our meta-analyses showed that mRNA vaccines (efficacy, 95% [95% confidence interval (CI), 92% to 97%]; 71 514 participants; 3 trials; moderate certainty); inactivated vaccines (efficacy, 61% [95% CI, 52% to 68%]; 48 029 participants; 3 trials; moderate certainty); protein subunit vaccines (efficacy, 77% [95% CI, -5% to 95%]; 17 737 participants; 2 trials; low certainty); and viral vector vaccines (efficacy 68% [95% CI, 61% to 74%]; 71 401 participants; 5 trials; low certainty) prevented COVID- 19. Viral vector vaccines decreased mortality (risk ratio, 0.25 [95% CI 0.09 to 0.67]; 67 563 participants; 3 trials, low certainty), but comparable data on inactivated, mRNA, and protein subunit vaccines were imprecise. None of the vaccines showed evidence of a difference on serious adverse events, but observational evidence suggested rare serious adverse events. All the vaccines increased the risk of non-serious adverse events. Conclusions The evidence suggests that all the included vaccines are effective in preventing COVID-19. The mRNA vaccines seem most effective in preventing COVID-19, but viral vector vaccines seem most effective in reducing mortality. Further trials and longer follow-up are necessary to provide better insight into the safety profile of these vaccines.Fil: Korang, Steven Kwasi. Copenhagen University Hospital; DinamarcaFil: von Rohden, Elena. Copenhagen University Hospital; DinamarcaFil: Veroniki, Areti Angeliki. Imperial College London; Reino Unido. St. Michael’s Hospital; CanadáFil: Ong, Giok. John Radcliffe Hospital; Reino UnidoFil: Ngalamika, Owen. University of Zambia; ZambiaFil: Siddiqui, Faiza. Copenhagen University Hospital; DinamarcaFil: Juul, Sophie. Copenhagen University Hospital; DinamarcaFil: Nielsen, Emil Eik. Copenhagen University Hospital; DinamarcaFil: Feinberg, Joshua Buron. Copenhagen University Hospital; DinamarcaFil: Petersen, Johanne Juul. Copenhagen University Hospital; DinamarcaFil: Legart, Christian. Universidad de Copenhagen; Dinamarca. Copenhagen University Hospital; DinamarcaFil: Kokogho, Afoke. Henry M. Jackson Foundation Medical Research International; NigeriaFil: Maagaard, Mathias. Copenhagen University Hospital; Dinamarca. Zealand University Hospital; DinamarcaFil: Klingenberg, Sarah. Copenhagen University Hospital; DinamarcaFil: Thabane, Lehana. Mcmaster University; CanadáFil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Ciapponi, Agustín. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Thomsen, Allan Randrup. Universidad de Copenhagen; DinamarcaFil: Jakobsen, Janus C.. University of Southern Denmark; Dinamarca. Copenhagen University Hospital; DinamarcaFil: Gluud, Christian. Copenhagen University Hospital; Dinamarca. University of Southern Denmark; DinamarcaPublic Library of Science2022-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/224283Korang, Steven Kwasi; von Rohden, Elena; Veroniki, Areti Angeliki; Ong, Giok; Ngalamika, Owen; et al.; Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials; Public Library of Science; Plos One; 17; e0260733; 1-2022; 1-231932-6203CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1371/journal.pone.0260733info:eu-repo/semantics/altIdentifier/url/https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0260733info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:50:34Zoai:ri.conicet.gov.ar:11336/224283instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:50:35.115CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
title Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
spellingShingle Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
Korang, Steven Kwasi
COVID-19
Vaccines
Trial Sequential Analysis
Network meta-analysis
title_short Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
title_full Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
title_fullStr Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
title_full_unstemmed Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
title_sort Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials
dc.creator.none.fl_str_mv Korang, Steven Kwasi
von Rohden, Elena
Veroniki, Areti Angeliki
Ong, Giok
Ngalamika, Owen
Siddiqui, Faiza
Juul, Sophie
Nielsen, Emil Eik
Feinberg, Joshua Buron
Petersen, Johanne Juul
Legart, Christian
Kokogho, Afoke
Maagaard, Mathias
Klingenberg, Sarah
Thabane, Lehana
Bardach, Ariel Esteban
Ciapponi, Agustín
Thomsen, Allan Randrup
Jakobsen, Janus C.
Gluud, Christian
author Korang, Steven Kwasi
author_facet Korang, Steven Kwasi
von Rohden, Elena
Veroniki, Areti Angeliki
Ong, Giok
Ngalamika, Owen
Siddiqui, Faiza
Juul, Sophie
Nielsen, Emil Eik
Feinberg, Joshua Buron
Petersen, Johanne Juul
Legart, Christian
Kokogho, Afoke
Maagaard, Mathias
Klingenberg, Sarah
Thabane, Lehana
Bardach, Ariel Esteban
Ciapponi, Agustín
Thomsen, Allan Randrup
Jakobsen, Janus C.
Gluud, Christian
author_role author
author2 von Rohden, Elena
Veroniki, Areti Angeliki
Ong, Giok
Ngalamika, Owen
Siddiqui, Faiza
Juul, Sophie
Nielsen, Emil Eik
Feinberg, Joshua Buron
Petersen, Johanne Juul
Legart, Christian
Kokogho, Afoke
Maagaard, Mathias
Klingenberg, Sarah
Thabane, Lehana
Bardach, Ariel Esteban
Ciapponi, Agustín
Thomsen, Allan Randrup
Jakobsen, Janus C.
Gluud, Christian
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COVID-19
Vaccines
Trial Sequential Analysis
Network meta-analysis
topic COVID-19
Vaccines
Trial Sequential Analysis
Network meta-analysis
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background COVID-19 is rapidly spreading causing extensive burdens across the world. Effective vaccines to prevent COVID-19 are urgently needed. Methods and findings Our objective was to assess the effectiveness and safety of COVID-19 vaccines through analyses of all currently available randomized clinical trials. We searched the databases CENTRAL, MEDLINE, Embase, and other sources from inception to June 17, 2021 for randomized clinical trials assessing vaccines for COVID-19. At least two independent reviewers screened studies, extracted data, and assessed risks of bias. We conducted meta-analyses, network meta-analyses, and Trial Sequential Analyses (TSA). Our primary outcomes included all-cause mortality, vaccine efficacy, and serious adverse events. We assessed the certainty of evidence with GRADE. We identified 46 trials; 35 trials randomizing 219 864 participants could be included in our analyses. Our meta-analyses showed that mRNA vaccines (efficacy, 95% [95% confidence interval (CI), 92% to 97%]; 71 514 participants; 3 trials; moderate certainty); inactivated vaccines (efficacy, 61% [95% CI, 52% to 68%]; 48 029 participants; 3 trials; moderate certainty); protein subunit vaccines (efficacy, 77% [95% CI, -5% to 95%]; 17 737 participants; 2 trials; low certainty); and viral vector vaccines (efficacy 68% [95% CI, 61% to 74%]; 71 401 participants; 5 trials; low certainty) prevented COVID- 19. Viral vector vaccines decreased mortality (risk ratio, 0.25 [95% CI 0.09 to 0.67]; 67 563 participants; 3 trials, low certainty), but comparable data on inactivated, mRNA, and protein subunit vaccines were imprecise. None of the vaccines showed evidence of a difference on serious adverse events, but observational evidence suggested rare serious adverse events. All the vaccines increased the risk of non-serious adverse events. Conclusions The evidence suggests that all the included vaccines are effective in preventing COVID-19. The mRNA vaccines seem most effective in preventing COVID-19, but viral vector vaccines seem most effective in reducing mortality. Further trials and longer follow-up are necessary to provide better insight into the safety profile of these vaccines.
Fil: Korang, Steven Kwasi. Copenhagen University Hospital; Dinamarca
Fil: von Rohden, Elena. Copenhagen University Hospital; Dinamarca
Fil: Veroniki, Areti Angeliki. Imperial College London; Reino Unido. St. Michael’s Hospital; Canadá
Fil: Ong, Giok. John Radcliffe Hospital; Reino Unido
Fil: Ngalamika, Owen. University of Zambia; Zambia
Fil: Siddiqui, Faiza. Copenhagen University Hospital; Dinamarca
Fil: Juul, Sophie. Copenhagen University Hospital; Dinamarca
Fil: Nielsen, Emil Eik. Copenhagen University Hospital; Dinamarca
Fil: Feinberg, Joshua Buron. Copenhagen University Hospital; Dinamarca
Fil: Petersen, Johanne Juul. Copenhagen University Hospital; Dinamarca
Fil: Legart, Christian. Universidad de Copenhagen; Dinamarca. Copenhagen University Hospital; Dinamarca
Fil: Kokogho, Afoke. Henry M. Jackson Foundation Medical Research International; Nigeria
Fil: Maagaard, Mathias. Copenhagen University Hospital; Dinamarca. Zealand University Hospital; Dinamarca
Fil: Klingenberg, Sarah. Copenhagen University Hospital; Dinamarca
Fil: Thabane, Lehana. Mcmaster University; Canadá
Fil: Bardach, Ariel Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Ciapponi, Agustín. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Fil: Thomsen, Allan Randrup. Universidad de Copenhagen; Dinamarca
Fil: Jakobsen, Janus C.. University of Southern Denmark; Dinamarca. Copenhagen University Hospital; Dinamarca
Fil: Gluud, Christian. Copenhagen University Hospital; Dinamarca. University of Southern Denmark; Dinamarca
description Background COVID-19 is rapidly spreading causing extensive burdens across the world. Effective vaccines to prevent COVID-19 are urgently needed. Methods and findings Our objective was to assess the effectiveness and safety of COVID-19 vaccines through analyses of all currently available randomized clinical trials. We searched the databases CENTRAL, MEDLINE, Embase, and other sources from inception to June 17, 2021 for randomized clinical trials assessing vaccines for COVID-19. At least two independent reviewers screened studies, extracted data, and assessed risks of bias. We conducted meta-analyses, network meta-analyses, and Trial Sequential Analyses (TSA). Our primary outcomes included all-cause mortality, vaccine efficacy, and serious adverse events. We assessed the certainty of evidence with GRADE. We identified 46 trials; 35 trials randomizing 219 864 participants could be included in our analyses. Our meta-analyses showed that mRNA vaccines (efficacy, 95% [95% confidence interval (CI), 92% to 97%]; 71 514 participants; 3 trials; moderate certainty); inactivated vaccines (efficacy, 61% [95% CI, 52% to 68%]; 48 029 participants; 3 trials; moderate certainty); protein subunit vaccines (efficacy, 77% [95% CI, -5% to 95%]; 17 737 participants; 2 trials; low certainty); and viral vector vaccines (efficacy 68% [95% CI, 61% to 74%]; 71 401 participants; 5 trials; low certainty) prevented COVID- 19. Viral vector vaccines decreased mortality (risk ratio, 0.25 [95% CI 0.09 to 0.67]; 67 563 participants; 3 trials, low certainty), but comparable data on inactivated, mRNA, and protein subunit vaccines were imprecise. None of the vaccines showed evidence of a difference on serious adverse events, but observational evidence suggested rare serious adverse events. All the vaccines increased the risk of non-serious adverse events. Conclusions The evidence suggests that all the included vaccines are effective in preventing COVID-19. The mRNA vaccines seem most effective in preventing COVID-19, but viral vector vaccines seem most effective in reducing mortality. Further trials and longer follow-up are necessary to provide better insight into the safety profile of these vaccines.
publishDate 2022
dc.date.none.fl_str_mv 2022-01
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/224283
Korang, Steven Kwasi; von Rohden, Elena; Veroniki, Areti Angeliki; Ong, Giok; Ngalamika, Owen; et al.; Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials; Public Library of Science; Plos One; 17; e0260733; 1-2022; 1-23
1932-6203
CONICET Digital
CONICET
url http://hdl.handle.net/11336/224283
identifier_str_mv Korang, Steven Kwasi; von Rohden, Elena; Veroniki, Areti Angeliki; Ong, Giok; Ngalamika, Owen; et al.; Vaccines to prevent COVID-19: A living systematic review with Trial Sequential Analysis and network meta-analysis of randomized clinical trials; Public Library of Science; Plos One; 17; e0260733; 1-2022; 1-23
1932-6203
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
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info:eu-repo/semantics/altIdentifier/url/https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0260733
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
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publisher.none.fl_str_mv Public Library of Science
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reponame_str CONICET Digital (CONICET)
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instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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