ABSTRACT
Background: Vaccination for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has already resulted in a reduction in new infection and mortality cases. Preliminary reports indicate variable and reduced antibody response in multiple sclerosis (MS) patients treated with different disease-modifying therapies (DMTs). Objective and Aim: To determine the effects of different DMT on the humoral response after COVID-19 vaccination in MS patients. Methods: A total of 154 MS patients were vaccinated with one of three available SARS-CoV-2 vaccines (BNT162b2, mRNA-1273, and Ad26.COV2.S). The humoral response was determined by measurement of either unspecific IgG antibodies or anti-spike IgG antibodies. The time between vaccination and serological testing and time from the last infusion date (if applicable) to testing were determined. Humoral response greater than 1.0 was considered as positive and suggestive of acquired immunity. Results: Overall, 89 out of 127 (70.1%) and 15 out of 27 (55.6%) MS patients had a positive anti-S1 test and unspecific IgG test, respectively. Excluded from the analysis were two patients who had only one dose of the mRNA vaccine with negative seroconversion and four patients with a history of SARS-CoV-2 PCRpositive test and positive seroconversion. In the remaining sample, there were no sex and age differences in seroconversion (both p>0.05). Based on DMT groups, seroconversion was seen in 22/26 (84.6%) patients treated with interferon-β, 18/19 (94.7%) on glatiramer acetate, 14/16 (87.5%) on natalizumab, 6/10 (60%) on teriflunomide, 3/8 (37.5%) on sphingosine-1-phosphate (S1P) modulators, 9/9 (100%) on dimethyl fumarate, 0/3 (0%) on cladribine (but all of these patients had prior ocrelizumab from 8 to 9 months prior), 4/28 (14.3%) on anti-CD20 depleters, and 3/5 (60%) on off-label medications. 87.5% (21/24) of non-treated MS patients had positive seroconversion. Seroconverted MS patients treated with anti-CD20 had numerically greater time from the last infusion to the first vaccination (162.3 vs. 80.9 days). Conclusion: MS patients treated with B-cell depleting medications and S1P modulators have significantly lower seroconversion after COVID-19 vaccination when compared to DMT-naive patients and other DMT groups. Future studies should determine the risk of severe clinical outcomes in vaccinated patients with no evidence of seroconversion.
ABSTRACT
The Covid-19 pandemic has put the leadership and practical experience of nurses to the test, and has made care visible as an essential issue for human life and global health. Objective. The purpose of this literature review is to reflect on the contributions and challenges of nurses in times of pandemic. Method. A literature review was carried out, using the Wos and SciencieDirect databases, searching for the keywords "nursing" AND "Covid-19" AND "disaster", then it was supplemented with other documents selected from various sources, mainly reports of international organizations that have been relevant in the nursing and public health work during the pandemic period. Results. 48 documents and articles that met the inclusion criteria were reviewed. Conclusions. The main contribution of nurses to the pandemic is related to the ability to form a large containment force against Covid-19, guided by compassionate care. While some challenges are self-care and planning for the recovery of the post-pandemic health system.
ABSTRACT
Ageism in old age has been related to the social imaginary, responsible for maintaining prejudices and stereotypes towards older people. Prevailing as a common phenomenon in westernized countries like Chile, replicating an image of old age full of deficiencies and bodily deterioration. This article reflects on the phenomenon of ageism that promotes behaviors that exclude older people from life in society and from formal care. For this, it will be contextualized on the imaginaries that predominate in Chilean society about old age, and that transversally affect the family, institutions and professions;secondly, some explanatory theories about ageism will be described to better understand the phenomenon and its generational impact, and finally, about the initial abandonment of the elderly during the Covid-19 pandemic as a result of State ageism. Making this issue visible favors informed social debate and the promotion of new public policies in favor of the inclusion of older people.