ABSTRACT
Background India encountered two waves of Covid 19 pandemic with variability in its characteristics and severity. Concerns were raised over the safety of treatment and higher morbidity was predicted for oncological surgery. The present study was conducted to evaluate and compare the rate of morbidity and mortality in patients undergoing curative surgery for cancer before and during the Covid 19 pandemic.Method The prospectively obtained clinical data of 1576 patients treated between April 2019 to May 2021 was reviewed, of these 959 patients were operated before Covid 19 and 617 during the pandemic. The data on complications, deaths, confirmed or suspected Covid 19 cases and Covid 19 infection among health workers (HCW) was extracted.Results A 35% fall in number of surgeries was seen during the Covid period, significant fall was seen in genital and esophageal cancer. There was no difference in postoperative complication; however, the postoperative mortality was significantly higher. A total of 71 patients had Covid 19, of which 62 were preoperative and 9 postoperative, while 30/38 health care workers contracted Covid 19, of which 7 had the infection twice and 3 were infected after two doses of vaccination, there was no mortality in health care workers.Conclusion The present study demonstrate higher mortality rates after surgery in cancer patients, with no significant change in morbidity rates. A substantial proportion of HCWs were also infected though there was no mortality among this group, suggesting high mortality despite following the guidelines and protocols.
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.