ABSTRACT
Objective: To evaluate ifthe COVID-19vaccine produces changes in the menstrual pattern, type ofchange anddysmenorrhea. Methods: Observational and cross-sectional study. 6616 digital surveys were carried out on women who received a vaccine against COVID-19. Asurvey was applied via networks and in gynecological consultations. Percentages and 95 %confidence intervals were calculated from 2x2 tables, menstrual changes were analyzed in the sample and in subgroups according to type of vaccine, number of doses, age, and residence. Results: 86.5 % (3535/4087) reported menstrual changes, the most frequent being: menstrual delay (40.4 %) and heavier menstrual bleeding (37.7 %). Dysmenorrhea presented in 39 % accompanying menstrual changes, but 2.1 % as the only symptom. A statistically significant difference was observed: 1) more menstrual changes with mechanism of action chimpanzee viral vector when compared to inactivated virus, 2) human viral vector and inactivated virus more menstrual changes 18-34 years compared to 35-50 years and less changes when compared to chimpanzee viral vector in 35-50 years 3) mRNA was the least associated with menstrual absence when compared to human viral vector 53 % and chimpanzee 50 % more frequent. Conclusion: Menstrual changes are very common after vaccination against COVID-19, this being related to the type of vaccine administered. Some mechanisms of action seem to be related to a greater or lesser risk of specific menstrual changes. © 2023 Sociedad de Obstetricia y Ginecologia de Venezuela. All rights reserved.
ABSTRACT
Background: Individuals with underlying cardiovascular disease (CVD) have an increased vulnerability to COVID-19 and poorer outcomes. Little is known about the impact social distancing guidelines have had on the health behaviors of this population. Objective: The purpose of this study was to examine levels of social isolation, anxiety, depression, loneliness, stress, cognitive function, alcohol use, substance use and health appointment engagement pre-pandemic and after social distancing guidelines were initiated among individuals with CVD. Methods: A secondary analysis was completed of a cross-sectional study that utilized a web-based survey. The parent sample included 184 participants recruited using social media. Forty-nine participants (27%) reported a history of CVD that included hypertension, heart failure, myocardial infarction and/or peripheral artery disease. Descriptive statistics and Wilcoxon signed-rank tests with Bonferroni correction were used to compare levels of social isolation, anxiety, depression, loneliness, stress, cognitive function, alcohol use, substance use, and delay/canceled healthcare appointments before and during social distancing recommendations. Results: The majority of participants with CVD were female (92%), white (94%), college graduates (92 %), working full-time (45%), and living with two or more people (71%). There were significant differences (p<0.001) between pre- and during COVID-19 restrictions for levels of social isolation, anxiety, cognitive function, and loneliness, while depression (p=0.006), perceived stress (p=0.108), alcohol use (p=0.056), and substance use (p=0.141) were not significantly different. About half of the participants (45%) delayed or canceled healthcare appointments because they were afraid to be exposed to COVID-19. One-third (37%) of participants had a healthcare provider delay an appointment, 27% of participants' healthcare providers canceled, and 67% of respondents had a healthcare provider change to telehealth appointments. Conclusions: The COVID-19 pandemic has concerning repercussions on the mental health of individuals with CVD. A heightened awareness by healthcare providers regarding the psychosocial needs of patients with CVD during the COVID-19 pandemic is warranted. The sample in this study is homogenous, limiting generalization, however, telehealth appointments with the above sample emerged as a viable mechanism for providers to interact with individuals with CVD. Psychosocial and biophysical outcomes from telehealth engagements are areas for further investigation.