ABSTRACT
INTRODUCTION: The COVID-19 pandemic has meant a drastic change in many aspects of daily life and its impact has been even more evident for the elderly. OBJECTIVE: The aim of this study is to quantify the impact of confinement during the COVID-19 pandemic on the healthcare activity of the elderly over the age of 64 in an Oral Health Unit (USBD) of the Health Area of Gran Canaria. MATERIAL AND METHODS: This is a retrospective observational study with data from January 2017 to December 2020. Using an interrupted time series design, we compare the level of visits before and after the decree of the first state of alarm in March 2020. RESULTS: During the period of confinement, an average of 7 patients per day aged 64 years and older stopped visiting the USBD, -6.9573 [-10.40;-3.517]. This represents a drop of close to 85% per week, and 100% in institutionalised patients. 83% of the visits scheduled before confinement did not take place. CONCLUSIONS: The interruption of care activity during confinement has been almost total, which could lead to a higher risk of morbidity and mortality in the long term. The backlog of non received dental treatment represents a threat to patients' oral health and is likely to affect the USBD's capacity for care in the near future.
ABSTRACT
BACKGROUND: As COVID-19 became a pandemic, the urgent need to find an effective treatment vaccine has been a major objective. Vaccines contain adjuvants which are not exempt from adverse effects and can trigger the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). There is very little information about autoimmune endocrine disease and the ASIA after the use of mRNA-based SARS-CoV2 vaccination. CASE SERIES: We report three cases and also review the literature showing that the thyroid gland can be involved in the ASIA induced by the mRNA-based SARS-CoV2 vaccination. We present the first case to date of silent thyroiditis described in the context of SARS-CoV2 vaccination with Pfizer/BioNTech. Also, we discuss the first subacute thyroiditis in the context of SARS-CoV2 vaccination with the Moderna's vaccine. Finally, we provide another case to be added to existing evidence on Graves' disease occurring post-vaccination with the Pfizer/BioNTech vaccine. DISCUSSION: Adjuvants play an important role in vaccines. Their ability to increase the immunogenicity of the active ingredient is necessary to achieve the desired immune response. Both the Moderna and the Pfizer/BioNTech vaccines use mRNA coding for the SARS-CoV2 S protein enhanced by adjuvants. In addition, the cross-reactivity between SARS-CoV2 and thyroid antigens has been reported. This would explain, at least, some of the autoimmune/inflammatory reactions produced during and after SARS-CoV2 infection and vaccination. CONCLUSION: The autoimmune/inflammatory syndrome induced by adjuvants involving the thyroid could be an adverse effect of SARS-CoV2 vaccination and could be underdiagnosed.