ABSTRACT
While several studies have been conducted on HLA and Covid-19 infection, few investigated the role of HLA polymorphism on vaccination response. We previously analyzed the HLA allele and haplotype frequencies in a hundred weak responders (antibody levels <5th percentile) after mRNA anti-Covid vaccine and found some suggestions about specific alleles and one haplotype. We moved on typing individuals enrolled in the same cohort study ("RENAISSANCE") with antibody titers above the 95th percentile at six months after vaccination, in order to search for any alleles predictive of strong humoral response. Individuals with clinical history of COVID-19 or positive anti-nucleocapsid antibodies were excluded. Allelic frequencies were compared with those of weak responders and of the general population, taken from the national bone marrow donor registry, IBMDR. N = 123 evaluable individuals presented with >95th percentile antibody titers at six months after BNT162b2 vaccine. One-third of them had >2080 BAU/mL, lowest value was 1261 BAU/mL. Comparison of allelic frequencies with weak responders showed a significant different proportion of individuals carrying A*03:01, A*24:02 and DRB1*16:01 (21.5% vs. 3.6%, 7.7% vs. 14.9% and 3.2% vs. 8.1% respectively). Moreover, when looking at alleles of the ancestral haplotype A3-B35-C4-DR1, we observed frequencies of 4.47%, 0.84% and 0% in the present cohort, IBMDR and weak responders, respectively. After adjusting for age, gender and BMI, the presence of A*03:01 confirmed to be statistically significant (p<0.0001) and was predictive of high antibody titers at six months with an odds ratio of 12.5 with respect to weak antibody levels. Age was the only other significant variable, with an odds ratio of 0.96. Clinical collection data is underway to correlate Covid-19 infection rates in both cohorts, in an attempt to find a definite correlation between HLA and vaccine protection.
ABSTRACT
Background: Tocilizumab is the repurposed drug used in the severely ill COVID-19 patients. A lot of traction has gain over the drug but more studies are awaited to ensure the efficacy of the drug with proper backing from empirical data. Tocilizumab, a drug which is used in treatment of rheumatoid arthritis suddenly came into limelight when it got listed as drugs used for the treatment of COVID-19 patients. As earlier discussed, many existing drugs which were already in use for treating other ailments were being tested if they are suitable to treat COVID-19 disease. Tocilizumab have the anti-inflammatory properties which were in particular were useful in COVID-19 which creates an inflammation all across the organs. Summary: COVID-19 is the novel disease outbreak later progressed into deadly pandemic has presented the huge challenge to contain it clinically as no drug was available prior the outbreak of the disease. Vast amount of drugs can be used to at least suppress the viral spread which was found to be true. Although it was not hundred percent foolproof but it was an emergency situation and various drugs were used according to local ground conditions and patients response to the drug along with age and severity of the illness. Tocilizumab was one such drug which was repurposed for the treatment of COVID-19 patients. Many drugs such as Hydroxycholoroquine (HCQ), Tocilizumab were repurposed from their existing use. Tocilizumab is currently used in the treatment of rheumatoid arthritis. Various studies have shown the efficacy of the drug among the severely ill COVID-19 patients which ranges up to 66 percent. In certain cases worsening of the existing medical condition has been observed. Conclusion: Vaccine nationalism must be set aside and low and middle income countries where most of the population of the world resides, should be vaccinated as even one case can culminate into another disaster as was seen during highly contagious COVID-19. More empirical data is needed from across the globe to ensure the assessment of the efficacy of the drug. Also certain cases of shortage of the said drug for non-COVID-19 purpose also looked into seriously has it can create a parallel disaster.
ABSTRACT
OBJECTIVE: This study aimed to improve the post-marketing surveillance on mRNA anti-SARS- CoV-2 vaccines, characterizing the adverse events (AEs) after the first dose of mRNA BNT162b vaccine. The associations between the AEs and individuals' characteristics were explored. PATIENTS AND METHODS: All adult healthcare workers at Niguarda Hospital ( Milan, Italy) who were referred for the first dose of vaccine were offered to participate in a cross-sectional survey during the second-dose administration, between 18 January and 7 February 2021. All participants completed a questionnaire about age, gender, weight, height, medical history, concurrent therapies, employment status, previous diagnosis/testing for SARS- CoV-2 infection, and a list of 24 AEs (solicited AEs). The development of at least one solicited AEs was the main outcome. AEs were stratified by the presence of injection-site symptoms, systemic symptoms or both, and the differences between strata were assessed as a secondary outcome. Biometric data and reports of a previous diagnosis of SARS-CoV-2 infection were also explored, as predictors of the main outcome. RESULTS: 7,014 healthcare workers were included. An incidence of 3 per 10.000 persons for serious AEs following the first administration of the mRNA BNT162b vaccine was found. An association between the development of non-serious AEs with young age, female gender, low body mass index, and previous history of SARS-CoV-2 was described. CONCLUSIONS: This real-life study supported data on the safety profile of the BNT162b2 mRNA vaccine. Our findings on the associations between the development of non-serious AEs with some individual characteristics may help physicians and patients make educated and informed medical decisions towards anti-COVID-19 vaccination.
ABSTRACT
Background: Antithrombotic treatment, including low molecular weight heparin (LMWH), has been proposed as a potential therapy for Coronavirus disease 2019 (COVID-19), to counteract diffuse intravascular clotting activation. However, it is unclear whether prophylactic or therapeutic doses are similarly effective in reducing mortality. Methods: We performed a systematic review and meta-analysis of clinical studies to evaluate the efficacy of heparin (either, LMWH or fondaparinux) compared to no anticoagulation in reducing overall mortality. A subgroup analysis comparing prophylactic or therapeutic regimen was performed. Secondary endpoints were major bleeding and length of hospital stay (LOS). Results: 12 studies were included, 2 prospective and 10 retrospective with 15,704 patients. Of these, 11,251 (71.6%) were on heparins. Ten studies reported data on all-cause mortality (figure), showing that both prophylactic and full dose reduced mortality (pooled Hazard Ratio [HR] 0.55, 95% confidence interval [CI] 0.48-0.63 and HR 0.49, 95% CI 0.41-0.59, respectively). The prophylactic dose was associated with a lower risk of major bleeding (Odds Ratio [OR] 0.60, 95% CI 0.41-0.87), while a nonsignificant trend towards an increased risk of bleeding for the therapeutic dose was noted (OR 1.55, 95% CI 0.98-2.43). Finally, LOS was evaluated in 3 studies;the mean difference for prophylactic heparin treatment was -2.38 (-3.14, -1.61) days. Discussion: Heparin is effective in reducing mortality in COVID-19 patients, with therapeutic and prophylactic regimens showing a similar reduction in the mortality rate. Prophylactic dose may be considered as the first choice in all patients with COVID-19 requiring hospital admission.
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Disruption at the physical workplace, developed by threats like the coronavirus, triggers revisiting old assumptions and exploring opportunities for new ways of remote working. With the global epidemic spreading, businesses are gearing up with the managers and their respective teams to work from home (WFH). This research has offered a setting for advancing understanding of virtualization of WFH process by exploring the factors that enable or constrain the information and communication technology (ICT) enabled virtualization of processes in employee’s WFH process through empirical support for the process virtualization theory (PVT). Setting pandemic outbreak as a context, outcome of this research is reliant on two independent studies conducted to examine the influencing factors. First study conducted just before the onset of pandemic outbreak, found that parts of the constructs proposed in the PVT had expected outcomes regarding the characteristics of process virtualization. Contrary to this, second study conducted after pandemic outbreak found that major constructs proposed in the PVT behaved otherwise regarding the characteristics of process virtualization. To fill the gaps in empirical knowledge, the enablers and inhibitors so found together may be motivations to anticipate business organizations and their workforces to experiment with this form of work process, predominantly improved flexibility for organizations and employees, improved productivity, quicker responsiveness to the needs and unexpected man-made and natural disasters, lower absenteeism, improved employee retention, greater cost control, along with more general social benefits. © 2020, IFIP International Federation for Information Processing.
ABSTRACT
Autonomous delivery robot (ADR) technology for last-mile freight deliveries is a valuable step towards low-carbon logistics. The ongoing COVID-19 pandemic has put a global spotlight on ADRs for contactless package deliveries, and tremendous market interest has been pushing ADR developers to provide large-scale operation in several US cities. The deployment and penetration of ADR technology in this emerging marketplace calls for collection and analysis of consumer preference data on ADRs. This study addresses the need for research on public acceptance of ADRs and offers a detailed analysis of consumer preferences, trust, attitudes, and willingness to pay (WTP) using a representative sample of 483 consumers in Portland. The results reveal six underlying consumer segments: Direct Shoppers, E-Shopping Lovers, COVID Converts, Omnichannel Consumers, E-Shopping Skeptics, and Indifferent Consumers. By identifying the WTP determinants of these latent classes, this study provides actionable guidance for fostering mass adoption of low-carbon deliveries in the last-mile. © 2020 Elsevier Ltd