ABSTRACT
Background: The COVID-19 vaccines were developed unprecedentedly and have proven safe and efficacious in reducing transmissibility and severe infection. The impact of mRNA-based COVID-19 vaccines on atrial arrhythmias (AA) incidence is unknown. Objective(s): To analyze the incidence of AA after COVID-19 vaccination in patients with a cardiac implantable electronic device (CIED). Method(s): BIOTRONIK Home Monitoring data and Medicare claims data from CERTITUDE patients implanted with a CIED between 2010-20 were utilized to identify recipients of one or more doses of the COVID-19 vaccine in 2021. Those who had influenza vaccination in 2020 were also identified in the same cohort as a control. From remote monitoring data, the number of atrial high rate events (AHR) and % burden of AA in the three months post-vaccination was compared to the preceding three months using Wilcoxon signed rank test. Kruskal-Wallis test was used for group difference comparisons. New AF diagnosis was determined from ICD-10 diagnosis codes in Medicare claims. Result(s): First and 2nd doses of COVID vaccine (50% Pfizer, 47% Moderna, and 3% J&J) were administered to 7757 and 6579 individuals with a CIED (age 76.2 (+/-9.0) y, 49% males), respectively. In the same cohort, 4723 (61%) individuals received the influenza vaccine. A statistically significant increase in the number of AHR episodes and % burden of AA was noted in the three months post-vaccination compared to the preceding three months after the 1st and 2nd doses of the COVID-19 vaccine (Figure). No such association was noted following influenza vaccination. In subgroup analysis, AHR episodes increased significantly in age groups >70 and men. Post-vaccination increase in AHR episodes was more significant in those without a pre-vaccination history of AHR episodes (mean increase of AHR 6.9+/-88.4, p<0.001) and was non-significant in those with a preceding history of AHR (p=0.8). Among the 764 patients with no AF diagnosis in claims preceding the first COVID-19 vaccine, 87 (11.4%) developed a new AF diagnosis or AHR event in the first three months post-vaccination. Conclusion(s): We report a small but significant increase in the number of CIED-detected atrial arrhythmias following vaccination for COVID-19 but not influenza, specifically in men and age >70 years. Acknowledging the immense public health benefit of COVID-19 vaccines, our results should prompt increased awareness of evaluating for AF in this high-risk group following vaccination. [Formula presented]Copyright © 2023
ABSTRACT
Introduction: In an effort to alleviate the outbreak of COVID-19, many countries have imposed drastic Lockdown, movement control or shelter in place orders on their residents. Aim(s): The attitudes and factors of people hold towards visiting health care services play an integral role in determining a society's readiness to accept behavioral change measures from health authorities. Material(s) and Method(s): A cross-sectional online survey of 220 Indian residents was conducted between 3rd April 2020 and 15th may 2020.1 Result: Findings showed that 79.09% is not visited to health facilities for COVID-19 and 20.91% sought medical help. Out of that majority 39.39% want to visit government hospital, 34.85% are visited private hospital, 15.15% are community health center, 6.06% are primary health center, and 3.03% are in rural Hospital and 1.52% private clinic. Contributing factor distribution shows that 98.18% are aware about COVID-19 disease condition majority 22.71% from Health Professionals. 74.09%, person acknowledges availability of health facility and 80% persons acknowledge advice and guidance from Government, friends, relatives made them to seek medical help for COVID-19. Hindrance factors shows 66.82% peoples hesitate to contact health facility for COVID-19 among them 41.26% due to Fear of isolation or quarantine and other factors like How to tell, Whom to tell, Fear of relationships with family and neighbors and. 49.55% people not visiting health care facilities due to fear of covid-19 positive diagnosis. 46.39% peoples are having fear of Quarantine foe so many days so not approaching to health care facilities. Conclusion(s): There are some other factors not to seek medical help are Responsibility of family, Fear of isolation by society, Somebody may discuss about them & Others health issues will open, Fear of breaking of relationship, Social stigma, Specialty doctors are available only in big cities, Lack of society support.Copyright © 2020 Ubiquity Press. All rights reserved.