ABSTRACT
Vaccination is a promising strategy to control the ongoing pandemic; however, solid organ recipients tend to develop a weaker immune response to vaccination. Anti-spike SARS-CoV-2 antibodies titers were measured 2-4 weeks post-vaccination completion in 131 KT patients without previous infection. Demographic, clinical, and laboratorial parameters were analyzed to identify which factors contributed to seroconversion. Factors that influenced seroconversion, that occurred in 76 patients (58%), were longer time post-transplant, immunosuppression without an antiproliferative drug and vaccination with mRNA vaccines. Patients who received mRNA vaccines had significantly higher rates of seroconversion compared with adenovirus vector vaccines (67% vs 33%, P < .001) and higher anti-spike IgG titers. These findings reinforce the need to discuss the vaccination strategy in this population, including a third dose with a mRNA vaccine.
Subject(s)
COVID-19 , Kidney Transplantation , Antibodies, Viral , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Humans , Kidney Transplantation/adverse effects , SARS-CoV-2 , Transplant Recipients , Vaccination , Vaccines, Synthetic , mRNA VaccinesABSTRACT
BACKGROUND: The development of vaccines to prevent COVID-19 breakouts came with highly positive results but some unexpected side effects. Rare side effects have been seen with the BNT162b2 SARS-CoV 2 vaccine. CASE PRESENTATION: We present the case of a 45-year-old female patient who developed an acute kidney injury needing urgent hemodialysis one week after the second administration of the BNT162b2 SARS-CoV 2 vaccine. She developed a macular rash on her lower limbs and palms as well. A kidney biopsy was performed 10 days after vaccine inoculation, diagnosing acute interstitial nephritis and acute tubular necrosis with cellular casts. The patient was treated with three corticosteroid pulses followed by daily prednisolone. We witnessed clinical improvement 4 days after the initial corticosteroid treatment with progressive recovery of kidney function and hemodialysis withdrawal. After 2 weeks, the patient had recovered her kidney function. Immunophenotyping was performed, diagnosing a hypersensitivity to the vaccine and the polyethylene glycol excipient. CONCLUSION: Patients may develop acute reactions to vaccines. In this case, symptoms seem to correlate significantly with its inoculation and, although this case had a favourable outcome, these side effects must be made aware for clinicians and patients.
ABSTRACT
The COVID-19 outbreak has ravaged all societal domains, including education. Home confinement, school closures, and distance learning impacted students, teachers, and parents' lives worldwide. In this study, we aimed to examine the impact of COVID-19-related restrictions on Italian and Portuguese students' academic motivation as well as investigate the possible buffering role of extracurricular activities. Following a retrospective pretest-posttest design, 567 parents (n Italy = 173, n Portugal = 394) reported on their children's academic motivation and participation in extracurricular activities (grades 1 to 9). We used a multi-group latent change score model to compare Italian and Portuguese students': (1) pre-COVID mean motivation scores; (2) rate of change in motivation; (3) individual variation in the rate of change in motivation; and (4) dependence of the rate of change on initial motivation scores. Estimates of latent change score models showed a decrease in students' motivation both in Italy and in Portugal, although more pronounced in Italian students. Results also indicated that the decrease in students' participation in extracurricular activities was associated with changes in academic motivation (i.e., students with a lower decrease in participation in extracurricular activities had also a lower decrease in motivation). Furthermore, students' age was significantly associated with changes in motivation (i.e., older students had lower decrease). No significant associations were found for students' gender nor for parents' education. This study provides an important contribution to the study of students' academic motivation during home confinement, school closures, and distance learning as restrictive measures adopted to contain a worldwide health emergency. We contend that teachers need to adopt motivation-enhancing practices as means to prevent the decline in academic motivation during exceptional situations.
ABSTRACT
Not available.