ABSTRACT
Background: Mast cell disorders (MCDs) are characterized by the proliferation and accumulation of mast cells in different tissues and their inappropriate release of mediators. Primary MCDs include systemic and cutaneous mastocytosis and monoclonal MC activation syndrome. They manifest with symptoms ranging from rash to anaphylaxis, idiopathic or elicited by heterogeneous factors, including vaccines. Vaccines are useful to prevent severe lung disease and mortality in COVID-19. Early reports of allergic reactions to COVID-19 vaccines emerged;however, their frequency is low. There are limited data on the safety of COVID-19 vaccine for immediate allergic reactions in high-risk patients like those with MCDs. To date, data concerning both the type of premedication and its need in these patients undergoing COVID-19 vaccines are limited. The objective of this study is to evaluate the safety of COVID-19 vaccine in patients with MCDs. Method(s): We included retrospectively patients with primary MCDs, according to WHO criteria, attending the Clinical Immunology and Allergy Unit at AO Mauriziano from June 2000 to December 2021, who underwent COVID-19 vaccination. We reported demographic and clinical data and noted -by phone call -vaccine type, premedication scheme, and contingent reactions. Result(s): We enrolled 44 patients (22 female, 50%), with a median age at diagnosis of 43.4 yrs. 25 patients had ISM, 8 CM, and 11 MMCAS. Median tryptase level was 44.3 ng/ml. 17 patients had history of anaphylaxis, none after vaccination. 37 patients (84.1%) underwent COVID-19 vaccination, 7 refused it. 32 completed the vaccination course, and 5 received two doses only. 25 patients were fully vaccinated with mRNA vaccine. The PEG-allergic one underwent Ad26.COV2.S vaccine, another one had first ChAdOx1, then mRNA-1273. All patients were vaccinated in hospital setting and observed for one hour. Most patients continued the daily antihistamine;9 started it few days before the injection;4 patients underwent vaccination without premedication. None showed anaphylaxis. One patient had immediate flushing;another had a delayed asthma exacerbation. A non-premedicated patient had immediate urticaria at first dose, while he tolerated others with AH The small cohort and the retrospective design limit this study. Nonetheless, the absence of severe hypersensitivity reactions to COVID-19 vaccines in our patients with MCDs, is an important finding. Conclusion(s): Our results confirm that patients with MCDs may be safely vaccinated to COVID-19.
ABSTRACT
Objective. To analyse, through the experience of the women interviewed, the impact that the migratory experience has had on them in the context of pregnancy and childbirth, and the quality of the obstetric care received during labor and childbirth. Materials and Methods. For this study, a qualitative methodology was adopted known as Cohen's phenomenology. The study was conducted in the period between January 2022 - March 2022 recruiting a sample of 11 immigrant women at the Policlinico of Bari and the Societa Cooperativa Sociale OASI 2 San Francesco Onlus. Results. From the analysis of the interviews, five main themes emerged: Migration, Memory, Assistance to immigrant women, The language barrier, Loneliness. The stories uncovered the basic needs that bring every woman together during pregnancy and childbirth and the cultural aspects, bringing out the impact of migratory trauma. The women reported that they had received good obstetric care, defining the image of a midwife as the one who stands beside. However, several difficulties emerged, from the language barrier to loneliness, burdened by the restrictions imposed by the COVID-19 pandemic. Conclusions. It emerged from the interviews that the preparation of the midwife in the transcultural field is essential in order to be able to provide appropriate and personalized assistance. The goal of health workers is to create a mental attitude of openness towards confrontation and knowledge, and suspension from judgment. It is important to approach the life of immigrant women and tear down barriers, embracing the possibility of other narratives of body, health and disease.
ABSTRACT
Background. COVID-19 is caused by SARS-CoV-2 virus and in many cases lead to a pneumonia. However a number of neumuscular manifestations have been associated to SARS-CoV-2 infection. Furthermore, multiorgan symptoms after COVID-19 are being reported by increasing numbers of patients, ranging from cough to fatigue and muscle pain. However, the long-term health consequences of COVID-19 remain largely unclear. Methods: We evaluated 124 patients hospitalized between march and May 2020 for SARS-COV-2 associated pneumonia at 6 and 12 months. We retrospectively collected clinical, laboratory and radiological information available. for each patient, cognitive tests, scales for depression and anxiety and a specific Fatigue Severity Scale (FSS) were performed. Results. Twenty-five patients died during hospitalization. At 12 months follow up 85 patient were evaluated. Eighty-seven (70%) patiens were male and mean age was 67.3 years. During hospitalization 43 (36.5%) of patients complain of myalgia. This patients had higher CK levels than patients who did not (534 U/L vs 93 U/l, p < 0.001). At 12 months 42% of patients complain about myalgia while 34% about fatigue. Mean FSS value were 32.93, and were significatively higher in patiets who complain about fatigue (41.52 vs 27.08 p < 0.001) and Muscle pain (40.84 vs 26.80, p < 0.001) compared to who did not. Conclusions. During hospitalization for COVID-19 myalgia was associated with an higher level of CK, suggesting a possible muscle involvement. At 12 month myalgia and fatigue were present in a more than a third of patient suggesting that this manifestation could be one of the main COVID-19 sequelae.
ABSTRACT
Background: liver injury has been reported at variable rate during COVID-19 outbreak, but the impact of pre-existing liver damage and related etiology has not been detailed so far Methods: we studied the reciprocal impact of COVID-19 and viral or metabolic pre-existing advanced liver diseases in patients consecutively admitted at 3 Italian hospitals during the COVID-19 emergency In this preliminary analysis we analyzed the results of patients enrolled in the observational study from February 28th to April 10th 2020;further analyses will be presented at the meeting Simultaneously, we investigated the prevalence of COVID-19 in patients with all HCV genotypes and any stage of fibrosis or HCV genotype 3 and cirrhosis prospectively enrolled in two real world studies on sofosbuvir/velpatasvir pangenotypic treatment recently published by our collaborative group Results: in the observational study, prevalence of HCVAbs and HBsAg positivity, among 332 COVID-19 infected patients matched recently reported national data Demographic and laboratory results in the table Overall 27 4% and 24 3%, respectively showed increased ALT and AST levels Only 10 patients (3 0%) had HCVAbs, 1 with detectable HCV-RNA, the remaining with spontaneously or treatment-induced HCVRNA clearance The frequency of HCVAbs among subjects with increased ALT at baseline (6.6%) was significantly higher than in patients with normal liver enzymes (1 8%) (p=0 038) Pre-existing cirrhosis was reported in 10, 7 had non viral origin cirrhosis, 70% of non viral origin died Overall mortality was 27 1% Cirrhosis, older age, low white blood cell (WBC) and lymphocyte count were independent predictors of death (OR=6 14, 95%CI 1 11-34 15, p=0 038;OR=1 05, 95%CI 1 03-1 07, p=0 0001, OR=1 10, 95% CI 1 01-1 16;OR=1 06, 95%CI 0 39-0 90, p=0 015) Among HCV patients recently treated with pangenotypic regimen, only 1 (0 07%) with cirrhosis in the pangenotypic study and 2 (1%) in the GT3 cirrhosis study reported COVID-19 ascertained infection, all of them recovered Conclusion: in the observational study, prevalence of HCVAbs is low among patients with COVID-19 Pre-existing cirrhosis is associated with high mortality Whether patients recently cured for HCV infection had a smaller exposure or were less vulnerable to COVID-19 as compared to patients with cirrhosis of metabolic origin deserves further investigation.