THE BURDEN of POST-SARS-COV2 VACCINE COMPLICATIONS and NEWLY DIAGNOSED IMMUNEMEDIATED INFLAMMATORY DISEASES

Background: Local and systemic reactions have been observed after all vaccines for SARS-CoV-2 but in the majority of cases, symptoms are mild and self-limiting. However, evidence on more severe clinical scenarios, requiring admission to hospital or referral to outpatient clinics after the administration of SARS-CoV-2 vaccines has accrued. This also includes newly diagnosed diseases, such as cardiovascular and immune-mediated infammatory diseases (IMID). Objectives: We aimed at quantifying the burden of post-vaccine hospital admissions/referrals and of newly diagnosed IMID. Methods: Clinical records of patients referred to our Internal Medicine institution (both inpatients and outpatients) between February and June 2021 were retrospectively assessed. Subjects having received one or more doses of any of the EMA-approved SARS-CoV-2 vaccines within the previous 30 days were included. Subjects with a previous diagnosis of IMID were excluded. Results: Our cohort included 99 patients, 45 females and 54 males, with a mean age of 64 years and a median of 3 comorbities (range 0-7). Eighty-eight patients (89%) required admission to the Internal Medicine ward while 11 were referred to the outpatient clinic. 68 (69%) of patients received the vaccine BNT162b2, 16 (16%) the ChAdOx1 nCoV-19, 9 (9%) the mRNA-1273 and 6 (6%) the Ad26. COV2.S. Twenty-seven (27%) subjects developed symptoms after the frst vaccine dose with a mean latency of 2 days (median=0 indicating symptom onset on the day of the vaccine administration). Twenty-four (24%) subjects developed symptoms after the second dose with a mean latency of 4 days (median 1 day). All the other subjects did not develop symptoms within the week after the vaccine and were admitted for reasons apparently unrelated to vaccine administration. The number of presenting complaints ranged between 1 and 4 with 87% of subjects presenting with 1 or two coexisting complaints. Gastrointestinal manifestations were the most frequent being the presenting complaint in 31 (31%) of patients followed by severe fatigue/appetite loss in 19 (19%) of subjects, fever in 18 (18.2%) and neurological manifestation in 16 (16%) of subjects. A temporal and causal association with the SARS-CoV-2 vaccine was identifed since all other known causes for these manifestations were ruled out. No in-hospital deaths were observed and 19 (19%) patients were diagnosed with a new onset IMID (Table 1). The clinical picture of these subjects was not signifcantly different from that of patients without a confrmed IMID and neither were demographic features. No association with the type of vaccine was observed. Conclusion: Our data show that post-vaccine newly diagnosed IMID may represent a challenge in clinical practice and it seems that no demographic or clinical feature is able to predict their onset. A multidisciplinary cooperation and registry data are needed in order to reliably estimate and defne the impact of SARS-CoV-2 vaccinations on new onset IMID.

Communicating the pandemic between social relations, norms and family life: A qualitative and quantitative analysis of Ansa articles during the lockdown

This paper presents the results of a double computer-assisted analysis of selected Ansa news agency texts during the domestic quarantine period (lockdown: 10 March 2020 - May 18 2020). More specifically, the research focuses on lexicon, concepts and interpretative sequences in the construction of three media metaphors: 1) "war-like and post-apocalyptic" (CBPA);2) "segregationist and normative" (SN), 3) "reactive and participatory" (RP). Some aspects of the new social and family relations in the Covid Age thus emerge - also on the basis of the concept of 'interactional anomie'. © 2021 Franco Angeli Edizioni. All rights reserved.

Comunicare la pandemia tra relazioni sociali, norme e vita familiare: Un'analisi quali-quantitativa degli articoli Ansa durante il lockdown

This paper presents the results of a double computer-assisted analysis of selected Ansa news agency texts during the domestic quarantine period (lockdown: 10 March 2020 - May 18 2020). More specifically, the research focuses on lexicon, concepts and interpretative sequences in the construction of three media metaphors: 1) "war-like and post-apocalyptic" (CBPA);2) "segregationist and normative" (SN), 3) "reactive and participatory" (RP). Some aspects of the new social and family relations in the Covid Age thus emerge - also on the basis of the concept of 'interactional anomie'. © 2021 Franco Angeli Edizioni. All rights reserved.

Childbirth Care among SARS-CoV-2 Positive Women in Italy

The new coronavirus emergency spread to Italy when little was known about the infection's impact on mothers and newborns. This study aims to describe the extent to which clinical practice has protected childbirth physiology and preserved the mother-child bond during the first wave of the pandemic in Italy. A national population-based prospective cohort study was performed enrolling women with confirmed SARS-CoV-2 infection admitted for childbirth to any Italian hospital from 25 February to 31 July 2020. All cases were prospectively notified, and information on peripartum care (mother-newborn separation, skin-to-skin contact, breastfeeding, and rooming-in) and maternal and perinatal outcomes were collected in a structured form and entered in a web-based secure system. The paper describes a cohort of 525 SARS-CoV-2 positive women who gave birth. At hospital admission, 44.8% of the cohort was asymptomatic. At delivery, 51.9% of the mothers had a birth support person in the delivery room;the average caesarean section rate of 33.7% remained stable compared to the national figure. On average, 39.0% of mothers were separated from their newborns at birth, 26.6% practised skin-to-skin, 72.1% roomed in with their babies, and 79.6% of the infants received their mother's milk. The infants separated and not separated from their SARS-CoV-2 positive mothers both had good outcomes. At the beginning of the pandemic, childbirth raised awareness and concern due to limited available evidence and led to "better safe than sorry" care choices. An improvement of the peripartum care indicators was observed over time.

Management of patients with suspected or confirmed COVID-19, in the radiology department.

OBJECTIVES: From December 2019, a novel coronavirus disease named COVID-19 was reported in China. Within 3 months, the World Health Organization defined COVID-19 as a pandemic, with more than 370,000 cases and 16,000 deaths worldwide. In consideration of the crucial role of diagnostic testing during COVID-19, the aim of this technical note was to provide a complete synthesis of approaches implemented for the management of suspected or confirmed COVID-19 patients. KEY FINDINGS: The planning of a robust plan to prevent the transmission of the virus to patients and department staff members should be fundamental in each radiology service. Moreover, the speed of spread and the incidence of the pandemic make it necessary to optimize the use of personal protective devices and dedicated COVID-19 equipment, given the limited availability of supplies. CONCLUSION: In the management of radiographic and CT imaging, staff should take special precautions to limit contamination between patients and other patients or professionals. IMPLICATIONS FOR PRACTICE: An isolated imaging room should be dedicated to suspected or confirmed COVID-19 cases, including radiography and CT scanners. This paper will provide guidance concerning disposable protective gear to be utilized, as well as on the cleaning and sanitation of radiology room and equipment.