INCIDENCE, FEATURES AND OUTCOME OF DISEASE RELAPSE AFTER COVID-19 VACCINATION IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES

BackgroundThe approved COVID-19 vaccines showed clear safety and efficacy in reduction of severe SARS-CoV-2 disease. Patients with idiopathic inflammatory myopathies (IIM) were not well represented in these vaccine trials and there are limited data in the literature about development of confirmed disease flare after COVID-19 vaccination.ObjectivesTo evaluate frequency, features and outcome of disease relapses in patients with IIM following SARS–CoV-2 vaccination.MethodsA cohort of 176 IIM patients (mean age:57.6 years, 117 females, 59 males, 106 PM, 70 DM) were interviewed after the 3rd wave of COVID-19 pandemic and prospectively followed. Relapses were determined using the IMACS disease state criteria, outcome of the flares with myositis response criteria, calculating the total improvement score (TIS).ResultsA total of 146 (82.9%) patients received vaccination and 17/146 (11.6%) patients had relapse within 3 months and 13/146 (8.9%) patients within one month. The relapse rate of unvaccinated patients (1/30;3.3%) was not significantly different (p>0.1). No fatal flare has been observed. Three months after the post-vaccination relapses, 70.6% of the patients (12/17) achieved improvement of disease activity (average TIS score:30±15.81;7 minor, 5 moderate and 0 major improvement). Six months after flares improvement was detected in 14/16 (87.5%) of relapsed patients (average TIS score: 43±20.17;3 minimal, 7 moderate and 4 major). Forward stepwise logistic regression analysis revealed that the active state of myositis at time of injection (p<0.0001;OR: 31.2 CI: 9.0 – 108) and the application of BNT162b2 vaccination (p=0.026;OR: 4.06 CI: 1.1 – 14.7) were significantly associated with the occurrence of relapse.ConclusionMinority of the vaccinated IIM patients had confirmed disease flare after COVID-19 vaccination and majority of the relapses improved after individualized treatment. Active disease state at the time of vaccination probably contributes to the increased risk of post vaccination myositis flare.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

The Impact of the Pandemic on the Crisis Management Practices of Hungarian SMEs

In the aftermath of the coronavirus epidemic, there is hardly an economic operator that has not suffered a very severe economic crisis. In this period, the question of how to manage a crisis effectively and appropriately has become a focus of attention. Although the nature of global economic crises was already a major lesson after 2008, some actors were still not adequately prepared to weather another crisis. Today we are in a particularly difficult situation. Not only the COVID-19 epidemic, but also the Russian-Ukrainian conflict are complicating economic conditions. In this study, we sought to answer the question of how small businesses have tried to respond to the economic challenges they face. Our survey asked businesses in the SME sector about, among other things, how they had dealt with the crisis. This paper presents the results. © 2022 IEEE.

Effects of pulmonary rehabilitation in post-COVID syndrome

Introduction: Significant portion of the patients manifest symptoms, like coughing, dyspnoea, fatigue, exercise intolerance, sleep disorders or neuropsychological symptoms in post-COVID condition. It has influence on patients' quality of life and workability. Pulmonary rehabilitation (PR) has favourable effect on the cardiovascular system, metabolism, respiratory and peripheral muscles, lung mechanics and psychological condition of the patient. Aim(s): Our aim was to assess the effectiveness of a post-COVID PR program in terms of the improvement of patients' functional condition and quality of life. Method(s): 50 patients were involved (female:male=26:24, age 55+/-12 years, BMI: 31+/-8 kg/m2) at the Department of Pulmonology, Semmelweis University, Budapest, Hungary. At the onset of the program we measured lung function, 6-minute walking distance (6MWD), chest wall expansion (CWE), lung function and quality of life (EQ5D and postCovid Functional Scale (PCFS). The post-COVID rehabilitation included controlled breathing techniques, chest wall mobilization, strengthening of respiratory and peripheral muscle, endurance training for cycle and treadmill, dietetic, psychological health assessment and counselling. Result(s): Rehabilitation resulted in improvement in 6MWD (496.16 (80-780) vs. 526.32 (328-744) m;p<0.05), CWE (39.4 (15.2-98.9) vs. 47.4 (20.1-100.5) cm;p<0.05) and quality of life (EQ5D, PCFS). Statistically significant improvement was detected in IVC and FVC. No side effect was observed related to the PR program. Conclusion(s): There is an urgent need of an available PR for patients who suffer from post-COVID pulmonary symptoms to avoid serious medical, social and economic complications and it is safe for the patients.

Analysis of Diagnostic and Medical Delay Data Among Lung Cancer Patients in 2019 and 2020

Objectives: This study aims to investigate the diagnosis and medical delay among lung cancer patients, furthermore, the involvement of the SARS-CoV-2 pandemic in diagnostic delay. Method(s): The retrospective study was performed in Pulmonology Department at Fejer County University Teaching Hospital in Hungary, between January 1, 2019 and December 31, 2020. We analysed the data of patients with primary lung cancer and changes in the diagnostic and medical delay time (n=102). Descriptive statistical analyses were applied (mean, standard deviation, absolute and relative frequency). Result(s): The average age is 68 years. 44.1% of patients were admitted to the institution from lung care, 12.7% from the emergency department and 43.1% from other providers. The mean diagnostic delay was 89.8+/-47.9 days in the two years. The time from first appointment to the chest CT was 21.42+/-28.08 days. On average, 21.93+/-25.1 days elapsed from CT to bronchoscopy. On average 35.79+/-29.2 days elapsed between oncoteam consultation and initiation of treatment. For those requiring PET/CT, the total diagnostic time increased from 69.7 days to 119.6 days (p<0.001). The total diagnostic time of patients receiving chemotherapy (22.9 days) was significantly lower compared to both patients receiving surgery (50.9 days) and those receiving radiotherapy (101.3 days) (p<0.001). In 2020, the number of primary lung care appointments decreased significantly, from 58% to 31% of all primary care visits, while the proportion of primary appointments in other care settings increased significantly from 2019 to 2020, from 28% to 58% (p=0.008). No significant difference was observed in the mean of the total diagnostic delay times (p=0.273), it was 83.8+/-47.9 days in 2019 and then 94.7+/- 47.8 days. Conclusion(s): Reducing the therapeutic delay - which constitutes a substantial part of the total diagnostic period, is a realistic goal and should be targeted. Copyright © 2022

Identifying the areas affected by the pandemic based on the opinions of Hungarian SME sector

The coronavirus pandemic that escalated in 2020 brought changes in all areas of life, putting all sectors of the economy, including households and businesses, on a new footing. Changed working conditions and closures have put many businesses in a difficult situation. Many businesses managed to survive the restrictions at considerable cost, but there were also some entities that did not survive the difficult months following the outbreak of the coronavirus epidemic. New ways of working and changed circumstances have rewritten previous management and practical principles and experience. The aim of this paper is to describe the impact of the coronavirus epidemic and the areas most affected by the subsequent crisis, based on the results of a questionnaire survey of 161 enterprises in Hungary. The aim of the study is to identify the areas which are the most vulnerable in the life of SMEs and which should be given the most attention in the next possible future crises. © 2022 IEEE.

Preference system for the choice of savings in a generation-specific approach of the financial culture before and after the coronavirus pandemic

Savings play an important role in the financing of the economy, as they are the source of credit in the classical four-sector model. Although modern financial innovations have opened up a wide space and brought new forms of credit financing, the physical savings of economic agents are still the key determinant of the system. Changes in living standards, inflation and interest rates have a significant impact on the level and motivation of savings. Nevertheless, household savings still play an important role in the financing structure of the macroeconomy. Crises have a significant impact on the ability and willingness of the population to save, as was the case during the downturn caused by the coronavirus epidemic. The aim of this paper is to examine the circumstances of savings formation before and in the aftermath of the epidemic in order to build a picture of the main influencing factors and their importance. © 2022 IEEE.

What has Become Important during the Pandemic? - Reassessing Preferences and Purchasing Habits as an Aftermath of the Coronavirus Epidemic through the Eyes of Different Generations

The pandemic, consumer preferences and the composition of the consumer basket changed. Each generation sees differently the impact of the virus on different areas of our lives, which is largely related to the general set of values that characterizes each generation. The focus of our research is the relationship between the generation-specific value system and the changes in consumer behaviour caused by the virus. In the primary data analysis, we focused on the examination of the consumer habits that were modified by the pandemic, the composition of the consumer basket, the customer habits, which differ for each generation and are related to the individual value system. In the light of the results, we were able to determine how the composition of the consumer basket changed, analysing, generation-specifically, which product and service purchase came to the forefront as a result of the crisis.

AKI in hospitalized patients with COVID-19: A Mexican population

Background: Although severe acute respiratory syndrome coronavirus (SARSCoV- 2) infection is primarily a respiratory disease, other organs are also affected. Several pathological studies confirm that SARS-CoV-2 invades kidney tissue causing endothelial damage, glomerular and vascular changes, extensive acute tubular injury and podocyte viral infection. AKI in COVID-19 appears to be frequent, with an AKI incidence of up to 46%, and a 20% requirement for renal replacement therapy (RRT). Patients with AKI show a trend towards worse outcomes and increased mortality. Information on Latin- American population is scarce. Methods: We created a cohort to describe the incidence, risk factors, and outcomes associated with AKI in hospitalized patients with COVID-19 in Mexico City, excluding patients with a known chronic kidney disease. AKI was defined and classified according to KDIGO guidelines. Results: We included 127 patients. 11 patients (8.66%) met the criteria for severe COVID-19, and were more likely to have AKI (81.82% vs. 54.31%, p=0.078). Of the 72 (56.69%) patients that had AKI, 48% were diagnosed at the time of admission. Patients with AKI were more likely to be men (61.7% vs. 42.42%, p=0.043) and older (55.68 years vs. 48.89 years, 0.018). With regards disease severity, 72% of them had a grade 1 AKI. 7 patients (9.72%) had grade 3 AKI, 4 of which needed renal replacement therapy. Overall length of stay was longer in patients with AKI (12 days vs. 7 days, p=0.003). A nonsignificant trend towards stay in critical care units was observed. 3 out of 127 patients died, all 3 had AKI. Conclusions: Amongst our studied population, AKI was associated with a longer length of stay and with a trend towards a more use of critical care services. The lack of association of AKI with mortality could be due to the low overall in-hospital mortality of COVID-19 patients (2.40%).