ABSTRACT
Objectives: To evaluate the safety and immunogenicity of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with Rheumatoid Arthritis (RA). Method(s): These data are from the 'SAFER (Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases)' study, a Brazilian multicentric longitudinal phase IV study to evaluate COVID-19 vaccine in immunomediated rheumatic diseases (IMRDs). Adverse events (AEs) in patients with RA were assessed after two doses of ChAdOx1 or CoronaVac. Stratification of postvaccination AEs was performed using a diary, filled out daily. The titers of neutralizing antibodies against the receptor-biding domain of SARS-CoV-2 (anti-RBD) were measured by chemilumine scence test after each dose of immunizers. Proportions between groups were compared using the Chi-square and Fisher's exact tests for categorical variables. Clinical Disease Activity Index (CDAI) before and after vaccination was assessed using the McNemar test. Result(s): A total of 188 patients with RA were included in the study, most of them were female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed. The more common AEs after the first dose were pain at injection site (46,7%), headache (39,4%), arthralgia (39,4%) and myalgia (30,5%), and ChAdOx1 had a higher frequency of pain at the injection site (66% vs 32 %, p alpha 0.001) arthralgia (62% vs 22%, p alpha 0.001) and myalgia (45% vs 20%, p alpha 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection site (37%), arthralgia (31%), myalgia (23%) and headache (21%). Arthralgia (41,42 % vs 25 %, p = 0.02) and pain at injection site (51,43% vs 27%, p = 0.001) were more common with ChAdOx1. No patients had a flare after vaccination. The titers of anti-RBDafter two doses of ChAdOx1 were higher compared to two doses of CoronaVac (6,03 BAU/mL vs 4,67 BAU/mL, p alpha 0,001). Conclusion(s): The frequency of local adverse effects, particularly pain at injection site, was high. AEs were more frequent with ChAdOx1, especially after the first dose. The use of the immunizers dis not change the degree of inflammatory activity of the disease. In patients with RA, ChAdOx1 was more immunogenic than CoronaVac. .
ABSTRACT
Background: Systemic sclerosis (SSc) patients are particularly prone to developing loss of muscle strength and worsening of physical performance due to decreased physical activity1. The lifestyle changes imposed by the SARS-CoV-2 outbreak have increased the incidence of sarcopenia in at-risk individuals2. However, the literature is scarce on the impacts of the COVID-19 pandemic on muscle strength and physical performance of SSc patients. Objectives: (1) To assess the impact of the COVID-19 pandemic on muscle strength and physical performance of SSc patients and (2) to verify the associations of muscle strength and physical performance with infammatory markers in a cohort study. Methods: SSc patients who met the ACR/EULAR 2013 classifcation criteria were included. Patients followed between 2019 and 2021. Muscle strength was measured by handgrip strength (kg) and sit and stand (SST, seconds) tests. Physical performance was measured by timed up and go (TUG, seconds) and short physical performance battery (SPPB, points). Infammatory markers were measured by C-reactive protein (CRP). T test for independent samples, Mann-Whitney U test of independent samples and Spearman's correlation coef-fcients were explored. The signifcance level was set at p ≤ 0.05 for all analyses. Results: Forty SSc patients concluded this study. At baseline, the mean age was 59 ± 11. 1 years old and the median disease duration was 13.1 (6.4-19.2) years. Patients had a median of 4.5 clinic visits (3.0-6.0) over the 2 years. The majority of patients were women (37, 92.5%). Te n patients (25%) had diffuse cutaneous disease, 30 patients (75%) non-diffuse cutaneous disease [25 patients (62.5%) had limited cutaneous disease, and 5 (12.5%) had sine scleroderma SSc]. The median of CRP was 2.9 (1.2-5.3). The median of handgrip strength was 20.0 (10.3-25.8) kg to the right hand and 19.0 (12.0-22.8) kg to the left hand. The median of SST was 14.4 (11.9-18.7) seconds. The median of TUG was 8.6 (7.7-9.5) seconds and the median of SPPB was 9.8 (9.0-11.0) points. The CRP was positively associated with SST (r=0.3, p=0.047) and TUG (r=0.3, p=0.029), and negatively with SPPB (r=-0.4, p=0.016). After 2 years of follow-up, the patients showed improvement in the left handgrip strength test (p=0.049) and SST (p=0.001). In physical performance, they showed improvement in the TUG test (p=0.005) and SPPB (p=0.001). The CRP was associated positively with TUG (r=0.4, p=0.033), no other associations were found. Conclusion: Despite the COVID-19 pandemic and the restrictions imposed, in this population of patients with SSc, we did not detect any worsening in muscle strength and physical performance. Some of these parameters of muscle strength and physical performance were associated with the infammatory marker CRP. More investigations are needed to assess the actual impact and possible associations.
ABSTRACT
The pandemic caused by the SARS-CoV-2 coronavirus showed the need to know in patients, what are the risk factors and diseases that could be the most susceptible to developing the most serious forms of COVID-19, which It would lead to admission to the Intensive Care Units for hemodynamic and ventilatory management, which also constitutes a high risk of death. 135 patients admitted to the ICU with positive PCR tests were studied from March to August 2020 and it was found that during this study period the most affected age group was 55 to 65 years (31.8%) followed by group 66 to 74 years (25.1%). The mean was 58 years. In addition, there was a predominance in the male gender with 69,6% over 30.4% in the female gender. In the analysis of the most frequent comorbidities, obesity was found in 26.6%, arterial hypertension with 23.7% and diabetes mellitus in 21.4%.
ABSTRACT
The environmental control of the vector inside and around households, as a fundamental strategy for the prevention of arboviruses such as dengue, zika and chikungunya, demands an uninterrupted involvement of the population. The pandemic context of Covid-19, and consequently the social isolation has reduced professional surveillance in the households, making the performance of the population even more necessary. Studies that seek to understand the involvement of communities in the implementation of preventive actions have been almost exclusively local. This article reports an intervention research based on workshops on preventive practices carried out before social isolation, in 16 municipalities in the five Brazilian regions and involved 379 participants. Our results show the preventive actions recommended by campaigns that are the most commonly understood and performed by the population;situations that hinder execution;preventive practices of citizens' own initiative;and practices based on popular knowledge. It became evident that information to communities cannot be restricted to mass campaigns, and that it is necessary to invest in educational actions adequate to the variety of national contexts, seeking collective and intersectoral constructions of strategies to confront arboviruses. Copyright © 2022, Institute de Medicina Social da UERJ. All rights reserved.