ABSTRACT
Background: COVID-19 is a disease due to a new form of coronavirus called SARS-CoV2 which causes an acute infection with respiratory symptoms. This new virus is different from those that cause SARS (severe acute respiratory syndrome) or MERS (respiratory syndrome of Middle East). Clinical manifestations can range from asymptomatic infection to life-threatening disease. By November 2021, more than 250 million people have had confirmed covid-19 and more than four million have died worldwide. Literature data show increased mortality from COVID-19 in cancer patients (pts). Moreover, cancer pts often fail to respond adequately to the initial vaccination. The aim of our study was to evaluate, sex differences in safety and tolerability of m-RNA-1237 Moderna COVID- 19 vaccine booster dose (fourth dose) in oncology pts, focusing on the first week after vaccination. Material(s) and Method(s): We have retrospectively analyzed sex differences on safety and tolerability of m-RNA-1237 Moderna COVID-19 vaccine booster dose (fourth dose) in 37 cancer patients (pts). All pts were vaccinated in March 2022 while undergoing active cancer therapy. There were 21 men (56.7%), 16 women (43.2%) Mean age 70 years (range 48-82) We analyzed the following adverse events (AE): fever, joint pain, injection site pain, lymphadenopathies, chills, nausea and vomiting, headache, diarrhea. AE were analyzed and stratified in grades from G1 to G4 according to CTCAE scale. Result(s): Of 37 pts analyzed, 9 (24.3%) developed AE and all within one week of vaccination. All pts with AE were female All AE were G1 and G2.No pts presented G3-G4 AE. The AE found in the 9 pts were fever (100%) and injection site pain (100%) No pts had joint pain, lymphadenopathy, chills, nausea and vomiting, headache and diarrhea. Using the Fischer test we found that the difference in the two sexes between the development of adverse events related to vaccination was statistically significant (p 0.0001) Conclusion(s): Our results demonstrate that m-RNA-1237 Moderna COVID-19 vaccine second booster dose (fourth dose) is usually well tolerated among cancer pts: All AE were G1 and G2. No pts presented G3-G4 AE. In addition, despite the limited number of pts, we found a statistically significant difference between male and female pts in the development of adverse events related to vaccination.
ABSTRACT
INTRODUCTION: The impact of Covid-19 on the survival of patients presenting with acute coronary syndrome (ACS) remains to be defined. METHODS: Consecutive patients presenting with ACS at 18 Centers in Northern-Italy during the Covid-19 outbreak were included. In-hospital all-cause death was the primary outcome. In-hospital cardiovascular death along with mechanical and electrical complications were the secondary ones. A case period (February 20, 2020-May 3, 2020) was compared vs. same-year (January 1-February 19, 2020) and previous-year control periods (February 20-May 3, 2019). ACS patients with Covid-19 were further compared with those without. RESULTS: Among 779 ACS patients admitted during the case period, 67 (8.6%) tested positive for Covid-19. In-hospital all-cause mortality was significantly higher during the case period compared to the control periods (6.4% vs. 3.5% vs. 4.4% respectively;p 0.026), but similar after excluding patients with COVID-19 (4.5% vs. 3.5% vs. 4.4%;p 0.73). Cardiovascular mortality was similar between the study groups. After multivariable adjustment, admission for ACS during the COVID-19 outbreak had no impact on in-hospital mortality. In the case period, patients with concomitant ACS and Covid-19 experienced significantly higher in-hospital mortality (25% vs. 5%, p < 0.001) compared to patients without. Moreover, higher rates of cardiovascular death, cardiogenic shock and sustained ventricular tachycardia were found in Covid-19 patients. CONCLUSION: ACS patients presenting during the Covid-19 pandemic experienced increased all-cause mortality, driven by Covid-19 positive status due to higher rates of cardiogenic shock and sustained ventricular tachycardia. No differences in cardiovascular mortality compared to non-pandemic scenarios were reported.
ABSTRACT
In this paper, we present the results of the noise monitoring in the urban area of Milan, Italy, associated with COVID-19 outbreak. In order to limit the diffusion of the pandemic, Italy adopted growing levels of restrictive measures, which ended with a 41-day lockdown from March 23 to May 3 2020. This action created a new kind of environment including a remarkable reduction of air, water and soil pollutants, together with a partial recovery of the ecosystems otherwise compromised. The presence of a permanent noise monitoring system made of 24 sensors installed in the city of Milan, allowed capturing the changes in the urban sound environment in a pre, during and post-lockdown period (months from February to June 2020). The comparison of the noise levels in terms of both absolute noise levels (Lden) and hourly noise profiles (median over lockdown period) with the same period of 2019, showed a dramatic reduction of the noise levels of approximately 6 dB. Splitting the contribution of all-non-traffic noises or anomalous noise events (ANE) from the recorded noise levels, we observe a greater contribution of the latter during the lockdown period. The use of DYNAMAP noise prediction system over an extended urban area allowed the evaluation of the population exposure to noise, estimating an increase of 14.9% and 16.4% of the exposed population to noises with Lden below 53 dB(A) and Lnight below 45 dB(A) with respect to 2019.