ABSTRACT
Background: There is paucity of real-world data on COVID-19 vaccine effectiveness and safety from cohort designs. The current study aimed to evaluate vaccine performance during second wave in India. It also aimed to determine adverse events of significant concern (AESCs), and to ascertain the effect of vaccination on persistent health issues in individuals post COVID-19. Methods: A cohort study was conducted from July-2021 to December-2021 in a tertiary hospital of north India. The primary outcome was vaccine-effectiveness against COVID-19. Secondary outcomes were AESCs, and persistent health issues in those receiving vaccine. Regression analyses were performed to determine risk factors. Results: In 2760 healthcare workers (HCWs) included, 1033 COVID-19 events were reported. Around 6-17% vaccine effectiveness was observed against COVID-19 occurrence. One dose-recipients were at 1.6-times increased risk of COVID-19. Prior SARS-CoV-2 infection was a strong independent protective factor against COVID-19 (aOR 0.66). Full vaccination reduced moderate-severe COVID-19 by 57%. Those with lung disease were at 2.5-times increased risk of moderate-severe COVID-19. AESCs were observed in 1.3% including one case each of myocarditis and severe hypersensitivity. Individuals with hypothyroidism were at 5-times and those receiving vaccine after recovery from COVID-19 were at 3-times higher risk of persistent health issues. Conclusion: COVID-19 vaccination reduced COVID-19 severity but offered marginal protection against occurrence. Relationship of asthma and hypothyroidism with COVID-19 outcomes necessitates focused research. Independent protection of prior SARS-CoV-2 infection was high and persistent health issues were common in individuals receiving vaccine post COVID-19. Recommendations of vaccinating those recovered from COVID-19 need further studies.
Subject(s)
Lung Diseases , Asthma , Myocarditis , Drug Hypersensitivity , COVID-19 , HypothyroidismABSTRACT
There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycaemia due to diabetes present as a common comorbidity in these COVID-19 patients as well as indiscriminate steroid use has resulted in this surge. Here, we report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted at our center between mid-April and early June 2021. Out of the 13, the only common factor was COVID-19 at some time point before diagnosis of mucormycosis or coexistent with it. The cases showed a male preponderance and four of them showed intracranial extension of disease. Eleven of them had received steroids as part of COVID-19 management protocol and twelve of them had pre-existing or newly diagnosed diabetes. We have summarized other probable risk factors being considered such as immunosuppressed state, antiviral and Ayurvedic (Indian traditional) medications, oxygen therapy, with each of which we could not find a link of mucormycosis. We propose that COVID-19 itself through molecular mechanisms predisposes to mucormycosis, with other factors such as dysglycaemia providing a second hit.