ABSTRACT
Background Patients with celiac disease (CeD) reported increased COVID-19 vaccine hesitancy due to a fear of adverse events (AEs). However, the risk of AEs post-COVID-19 vaccination in patients with CeD is unknown. Purpose To assess whether the rate of common side effects (SEs) and AEs due to COVID vaccines are higher in patients with CeD compared to a non-CeD population. Method We conducted a collaborative international cross-sectional study in 16 countries between April 2022 and July 2022. An online survey was distributed to patients with CeD through patients' local societies, and to non-CeD from the general population in each country through social media posts, word-of-mouth, and through academic institutions. We collected data on participant demographics, medical conditions, CeD diagnosis, GFD adherence, history of COVID-19 vaccinations (type and doses) and self-reported SEs and AEs post-COVID-19 vaccine. SEs included pain/swelling at the site, fatigue, fever, chills, nausea and/or headaches. AEs included thrombosis, myocarditis, anaphylactic reaction, and hospitalization related to the vaccine. Logistic regression models were used to assess predictors such as CeD diagnosis, age, gender, vaccine type and comorbidities on the likelihood of reporting SEs and AEs post-vaccine. Result(s) : A total of 17,795 participants completed the survey, 13,638 with CeD (median age of 45[27]) and 4,157 non-CeD controls (median age of 43[20]). There were no significant differences in sex between CeD and controls. Overall, CeD patients had similar odds of SEs compared with non-CeD individuals (aOR=1.02;95% CI=0.92-1.14). SEs were slightly increased only in the second dose of the vaccine in the CeD population compared to non-CeD individuals (aOR= 1.35;95% CI=1.19-1.53). The most common reported SEs in CeD and controls were pain/swelling at the injection site (29% vs 23 %, p< 0.0001) and fatigue (29% vs 24%, p<0.0001). The odds of SEs were higher with Moderna Spikevax, AstraZeneca/Oxford and Johnson and Johnson vaccines than after the Pfizer vaccine (p< 0.0001). The overall rate of AEs post-vaccine was similar between patients with CeD and non-CeD individuals (aOR= 1.29;95% CI= 0.89-1.87). Overall, female gender, older age, GFD adherence, respiratory conditions, obesity and receiving immunosuppressive medications increased the odds of SEs, while only age and a history of allergies increased the odds of AEs. Conclusion(s) In this large international study, patients with CeD reported similar rates of SEs and AEs post-COVID vaccine compared to non-CeD individuals. This information is highly relevant as it addresses the main concern leading to COVID-19 vaccine hesitancy in CeD patients. Disclosure of Interest None Declared
ABSTRACT
Background and aims: There´s emerging evidence on the association of GBS with SARS-CoV-2 infection. Neurotropism by coronavirus has been documented as well as various neurological manifestations such as encephalitis, stroke, encephalopathy and peripheral nerve disease. Methods: A 67-year-old male, no comorbidities presents three weeks prior to admission with fever, cough, taste and smell disturbances, myalgias, asthenia, clumsy hand movements and progressive lower limbs weakness. 15 days prior to admission: difficulty swallowing, diaphoresis. At admission: breathing difficulty and palpitations. Glasgow 13 E4 V5 M4, bulbar compromise, bradylalia, diminished gag reflex, sternocleidomastoid and trapezius weakness, MRC scale upper and lower limbs: proximal 3/5 distal 2/5, generalized areflexia, distal diffuse hypoesthesia Results: Ferritin 519 LDH 236 D Dimer >10,000 Hgb 19 WBC 11590 L 12% N 80% P 241,000 CK 111 CK MB 17. Chest CT: COVID19 pneumonia, CO-RADS 3. Pulmonary angiography: Posterior right lower lobe segmental PE. Scores: PESI 108, Geneva 10. SARS-CoV-2 PCR negative, SARS-CoV-2 IgG/IgM: Positive. Lumbar puncture not performed due to PE. Met Asbury GBS criteria, HUGHES 4, mEGOS 8 at admission, EGRIS 4. Progression of ascending symmetrical bilateral flaccidity with respiratory failure requiring mechanical ventilation for 10 days, tracheostomy and gastrostomy were performed. Discharged at day 60 with muscle strength recovery, upper limbs 4/5 and lower limbs 3/5, Sensitivity recovery, diminished lower limb reflexes. Therapy: Enoxaparin 60mg every 12h, Immunoglobulin 0.4mg/kg/day/5 doses. Discharge HUGHES 3. [Formula presented] [Formula presented] Conclusions: GBS is caused by an anomalous response of the immune system to an infectious agent. This particular patient presents with a GBS associated with SARS-CoV-2 infection and PE.