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1.
Clinics ; 78: 100150, 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1421262

RESUMO

Abstract Objective: To evaluate inactivated CoronaVac prime vaccination, antibody decay, booster dose, and safety in ANCA-Associated Vasculitis (AAV) patients. Methods: Fifty-three AAV patients and 106 Controls (CG) received CoronaVac on days: D0 (first dose), D28(second dose), and D210 (booster dose, 32 AAV: 32 CG). The primary outcome was immunogenicity after the second vaccine dose (day 69) assessed by Seroconversion Rates (SC) of anti-SARS-CoV-2 S1/S2 IgG and Neutralizing Antibodies (NAb). Secondary outcomes were safety, immunogenicity (D28/D240), 6-months antibody decay (D210) and the booster dose response (D240). Results: At D69 SC (65.1% vs. 96.8%, p = 0.0001), GMT (21.3 UA/mL vs. 67.7 UA/mL, p < 0.001) and NAb- positivity (53.7% vs. 80.6%, p = 0.001) were moderate but lower in naïve-AAV patients than CG. Patients without SC used more often IS (93.3% vs. 53.3%, p = 0.015), mycophenolate mofetil (20% vs. 0%, p = 0.037) and prednisone (60.0% vs. 28.6%, p = 0.057) than seroconverted. NAb negativity in AAV patients was associated with prednisone treatment (57.9% vs. 18.2%, p = 0.015) and IS (84.2% vs. 55.0%, p = 0.046). Logistic regression analysis models showed that only prednisone was associated with lower seroconversion (OR = 0.2, 0,95% CI 0.05-0.86, p = 0.030) and with lower NAb positivity (OR = 0.2, 0,95% CI 0.05-0.88, p = 0.034). After six months (D69-D210) a decrease in IgG positivity occurred in 32 AAV patients (15.7%, p = 0.074) and 32 CG (18.7%, p = 0.041). For the NAb positivity, the 6-month decrease was not significant (p = 0.114) whereas a major reduction occurred for CG (p < 0.001). A booster dose (D240) resulted in an increment in IgG-positivity (21.9%, p = 0.023) and NAb-positivity (34.4%, p = 0.006) in AAV patients. No moderate/severe adverse events attributable to the vaccine were observed. Conclusion: This study provides novel data on the excellent safety and moderate immunogenicity of CoronaVac in AAV patients. A six-month mild antibody waning was observed with a good response to the booster dose, although levels remained lower than CG (CoronavRheum-NCT04754698).

2.
Fink, Thais T.; Marques, Heloisa H.S.; Gualano, Bruno; Lindoso, Livia; Bain, Vera; Astley, Camilla; Martins, Fernanda; Matheus, Denise; Matsuo, Olivia M.; Suguita, Priscila; Trindade, Vitor; Paula, Camila S.Y.; Farhat, Sylvia C.L.; Palmeira, Patricia; Leal, Gabriela N.; Suzuki, Lisa; Odone Filho, Vicente; Carneiro-Sampaio, Magda; Duarte, Alberto José S.; Antonangelo, Leila; Batisttella, Linamara R.; Polanczyk, Guilherme V.; Pereira, Rosa Maria R.; Carvalho, Carlos Roberto R.; Buchpiguel, Carlos A.; Xavier, Ana Claudia L.; Seelaender, Marilia; Silva, Clovis Artur; Pereira, Maria Fernanda B.; Sallum, Adriana M. E.; Brentani, Alexandra V. M.; Neto, Álvaro José S.; Ihara, Amanda; Santos, Andrea R.; Canton, Ana Pinheiro M.; Watanabe, Andreia; Santos, Angélica C. dos; Pastorino, Antonio C.; Franco, Bernadette D. G. M.; Caruzo, Bruna; Ceneviva, Carina; Martins, Carolina C. M. F.; Prado, Danilo; Abellan, Deipara M.; Benatti, Fabiana B.; Smaria, Fabiana; Gonçalves, Fernanda T.; Penteado, Fernando D.; Castro, Gabriela S. F. de; Gonçalves, Guilherme S.; Roschel, Hamilton; Disi, Ilana R.; Marques, Isabela G.; Castro, Inar A.; Buscatti, Izabel M.; Faiad, Jaline Z.; Fiamoncini, Jarlei; Rodrigues, Joaquim C.; Carneiro, Jorge D. A.; Paz, Jose A.; Ferreira, Juliana C.; Ferreira, Juliana C. O.; Silva, Katia R.; Bastos, Karina L. M.; Kozu, Katia; Cristofani, Lilian M.; Souza, Lucas V. B.; Campos, Lucia M. A.; Silva Filho, Luiz Vicente R. F.; Sapienza, Marcelo T.; Lima, Marcos S.; Garanito, Marlene P.; Santos, Márcia F. A.; Dorna, Mayra B.; Aikawa, Nadia E.; Litvinov, Nadia; Sakita, Neusa K.; Gaiolla, Paula V. V.; Pasqualucci, Paula; Toma, Ricardo K.; Correa-Silva, Simone; Sieczkowska, Sofia M.; Imamura, Marta; Forsait, Silvana; Santos, Vera A.; Zheng, Yingying; HC-FMUSP Pediatric Post-COVID-19 Study Group.
Clinics ; 76: e3511, 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1350613

RESUMO

OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.


Assuntos
Humanos , Masculino , Criança , Adolescente , COVID-19/complicações , Qualidade de Vida , Estudos Prospectivos , Centros de Atenção Terciária , Teste para COVID-19 , SARS-CoV-2 , América Latina
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