ABSTRACT
Introduction and Objectives: Cases suggestive of immune-mediated acute hepatitis following SARS-CoV-2 vaccination have been reported. The risk of liver injury after Covid-19 vaccination is unknown. This study aimed to estimate the cumulative incidence of liver injury within 90 days after the Covid-19 vaccine, defined as the occurrence of AST and/or ALT increases at least two times the limit of normal or ALP increases at least x 2. To compare with an active comparator group (influenza vaccine). Material(s) and Method(s): Retrospective cohort study. We analyze a consecutive sample of adult patients vaccinated with Covid-19 vaccines (Sputnik, AstraZeneca/Oxford, Covishield, or Sinopharm) between January 1 and May 30, 2021, and a historical control group vaccinated with influenza between March 1 and July 30, 2019. Qualifying labs were collected as part of routine clinical care or the development of symptoms. Result(s): From a total of 29,918 subjects who received the Covid-19 vaccine in 2021 and 24,753 who received the Influenza vaccine in 2019, 130 and 148 patients, respectively, were excluded because of previously altered liver function tests or known hepatic disease. Both groups were comparable in age (73 years old (IQR 65-80), p=0.125) and gender (67% were females). In the Influenza group were more dysmetabolic and immunosuppressed patients. A total of 269 and 273 patients, respectively, presented altered liver function tests within 90 days post-vaccination. The cumulative incidence of liver injury was 4.6 per 1,000 (95% CI 3.9-5.5) for Covid-19 and 5.1 per 1,000 (95%CI 4.3-6.1) for Influenza (p=0.453). Although, two patients from the COVID group had a more severe injury, with hyperbilirubinemia, development of autoantibodies and requirement of steroids for disease control. Conclusion(s): The occurrence of events was similar in subjects vaccinated with Covid-19 compared to the control group. Acute hepatitis characteristics arising after the COVID-19 vaccine needs to be further clarified.Copyright © 2023
ABSTRACT
Background : Since the beginning of the SARS-CoV 2 pandemic, there have been many reports of increased incidence of VTE (venous thromboembolism) and arterial events as a complication, which were the basis for the hypothesis that patients should receive higher doses of thromboprophylaxis (TP) or full anticoagulation. Aims : To determine the incidence of thrombotic events (TE) in patients hospitalized for moderate or severe SARS-CoV2 disease (Covid-19). Methods : Retrospective single center cohort study with adult patients with a positive rt-PCR for SARS-CoV2 , included as from the date of hospital admission due to Covid-19 and followed for 90 days or until death. Results : A total of 1621 patients were included. The mean age was 68.7 years (SD 21.1) and 57% (913) were female, of which 6.5% (59) were pregnant. Overall mortality was 21.6% (348). The overall incidence of symptomatic thrombotics events within 90 days was 1.72% (28/1621, 95%CI 1.19-2.49%), whereas the incidence of pulmonary embolism (PE) was 0.98% (15, 95%CI 0.60-0.16%), deep venous thrombosis (DVT) 0.74% (11, 95%CI 0.42-0.12%), ischemic stroke 0.24% (4, 95%CI 0.09-0.65%) and ischemic arterial events 0.06% (1, 95%CI 0.008-0.43%). No acute coronary syndrome events were recorded. Median hospital stay length percentage under adequate TP was 78%. The median time since positive rt-PCR for the thrombotic event to develop was 22 days (IQR 25th-75th 19-43 days). Median hospital stay length percentage under adequate thromboprophylaxis was 78% (IQR 25th-75th 50-89%). Conclusions : Unlike previous reports, the incidence of thrombotic events was low among our patients with moderate or severe Covid-19.
ABSTRACT
Backgrounds. In addition to being a public physical health emergency, Coronavirus disease 2019 (COVID-19) has been identified as a psychological health emergency of global concern. The emergency measures implemented by the Italian Government from March to June 2020 included drastic limitations to living conditions that may have impacted on women with children in particular. Nevertheless, few studies focused on them investigating psychopathological consequences of lockdown and protective factors for mental health. Aims. First aim was to examine differences on generalized anxiety symptoms between working women with children and without children;second, we investigated whether psychological resilience contributed to low emotional impact of the COVID-19 lockdown. Method. An online survey was administered to 516 working mothers and 514 working women without children. Participants responded to Generalized Anxiety Disorder Scale (GAD7) and ConnorDavidson Resilience Scale (CD-RISC 25). Results. Significant differences emerged between the two groups, with higher symptoms and percentages of generalized anxiety disorders (GADs) in the group of mothers relative to women without children. Regression analysis showed that CD-RISC 25 score, more than having/not having children, had a predictive effect on GAD7 score, concurring to reduce anxiety symptoms. Conclusions. Our findings suggest that dealing with lockdown was a particularly stressful experience for working mothers who had to balance personal life, work, and raising children without other resources. Resilience may be a protection against emotional problems and supportive interventions should be implemented in the present and in the future to promote mental health in this population.