ABSTRACT
Introduction: Solid organ transplant recipients have 2-5 times increased mortality after coronavirus disease 2019 (COVID-19) infection as compared to general population. These patients also have lower protection after vaccination against COVID-19. Therefore, the risk of breakthrough infection and hospitalization are also significantly higher in this patient population. Studies on efficacy of COVID-19 vaccination in post liver transplant (LT) patients are limited. We aimed to investigate the rate of mortality, hospitalization, and breakthrough infection and assess possible risk factors in COVID-19 infection mortality post LT. Methods: A retrospective chart review study. All post liver transplant patients at Carolinas Medical Center (CMC) who were tested positive for respiratory syndrome coronavirus 2 (SARS-CoV- 2) PCR test from Dec. 2020 (when first COVID-19 vaccine was approved in the US for emergency use authorization) until Nov. 2021 were included in this study. Breakthrough infection was defined as COVID-19 infection ≥14 days after full vaccination. Data was analyzed using Prism (GraphPad Software, San Diego, CA) and reported as mean ± SEM. T- test and chi square tests were applied for analyzing the data. Results: Thirty-six patients were identified and 66.1±9.6 months post liver transplantation (LT). Mean age was 61.2±1.6 years-old, male (72.2%) and Caucasian (91.6%). Ten patients (27.7%) expired. Chronic kidney disease (CKD) was present in 70.0% of expired patients as compared to 53.3% of recovered (p=0.0003). Type 2 diabetes (T2DM) was present in 70.0% vs. 25.0% of expired and recovered patients, respectively (p<0.0001). Hypertension (HTN) was present in 90.0% vs. 55.0% of expired and recovered patients, respectively (p<0.0001). No statistically significant difference was observed in weight of expired vs. recovered patients (50% vs. 65% obesity;p=0.4). Only 9 patients were vaccinated. Breakthrough infection rate was 25% and 2/9 (22.2%) died vs. 29.6% of non-vaccinated patients (p=0.4). COVID-19 infection occurred 4.9±0.86 months after vaccination. Hospitalization (44.4% vs. 55.5%) and ICU admission (22.2% vs. 37.0%) was not statistically different among vaccinated and non-vaccinated patients. Conclusion: T2DM and CKD were significantly higher among COVID-19 infected patients who expired, which are similar risk factors in patients who have not had a liver transplant. However, obesity was not significantly correlated with mortality as it was shown before in non-immunocompromised population. Although COVID-19 vaccine is effective in post LT patients, larger studies are warranted to evaluate its efficacy in this population. Our study also highlights that the efficacy of current COVID-19 vaccines decreases in 4-6 months after full vaccination, which warrants evaluating the efficacy of booster dose(s) in post LT patients
ABSTRACT
Background and Objectives: The spread of COVID-19 in the world has had adverse effects on all aspects of people' life and social and economic development of the communities. The current study was conducted to determine the knowledge, attitudes, and practices toward COVID-19 in the general population of Qazvin province.
ABSTRACT
Background and Objectives: The spread of COVID-19 in the world has had adverse effects on all aspects of people´ life and social and economic development of the communities. The current study was conducted to determine the knowledge, attitudes, and practices toward COVID-19 in the general population of Qazvin province. Methods: This cross-sectional study conducted on 1223 people above 15 years in Qazvin province between December and January 2020. We used multistage stratified random sampling to select the participants from urban and rural health centers. The questionnaires were completed by the patients as well as through phone interviews. The questions included demographic information and knowledge, attitude, and practice toward COVID-19. Results: In total, 1223 subjects with a mean (standard deviation) age of 35.6 ± 12.2 years participated in this study. The scores of knowledge, attitudes, and practice were 68%, 72% and 91%, respectively. The lowest score of knowledge was related to awareness of common symptoms of the disease (6%). Forty-two subjects believed they observed the principles of disease prevention. A distance of 2 meters was observed by 50.3%. The scores of knowledge (P=0.007) and practice (P=0.028) increased with age, and the scores of knowledge (P<0.001) and attitude (P=0.001) increased and decreased with an increase in the education level, respectively. Males had significantly lower knowledge (P=0.002) and practice (P<0.001) scores. Moreover, rural residents had higher attitude scores compared to urban residents (P=0.002). Conclusion: The results suggest that the general population of Qazvin province had desirable knowledge, attitude and practice towards COVID-19 at the time of the epidemic. © 2021 The Authors. Published by Tehran University of Medical Sciences.