THE RATE OF ADVERSE EVENTS AFTER COVID-19 VACCINATION IS SIMILAR IN PATIENTS WITH CELIAC DISEASE AND NON-CELIAC POPULATION: RESULTS OF A LARGE INTERNATIONAL CROSS-SECTIONAL STUDY

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

Vascular Access Devices (Vad) and Covid+19 Patiens Not Admitted in the Icu

The study of COVID-19 patient's management with vascular access has been very low but a consensus has been reached to improve care in this type of patient. The importance of care, the proper choice of the vascular access device (DAV), the reduction of adverse effects and the minimization of contagion risks by health personnel are a new axis of study. AIM Highlight the work of the Vascular Access Unit from Arnau de Vilanova Hospital with Covid 19 patients who didn't require admission to the Intensive care Unit. Methodology: Observational, descriptive and retrospective study by auditing the digitized medical records of 52 patients with medical discharged from the Arnau de Vilanova hospital from March 2019 to December 2021. Result(s): The 90% of DAVs were removal at the end of the therapy. In the 100% of the cases the first change dressing was 7 days later the insertion due to the use of cyanoacrylate use at the exit site. The average use was 16 days. 5 devices were remove for malfunction, 12 for exitus and 35 were removed for end of treatment. The average number of days from the time the patient is admitted until the day insertion is requested is 5 days. Conclusion(s): The existence of a UAV has meant an increase in patient safety and has allowed to be carried out the therapy for COVID 19 patients who were not included in the ICU The UAV has been able to insert the DAVs at bedside, improving the safety profile of the personnel. The use of new materials such as cyanoacrylate has reduced the workload and the risk of occupational exposure, while also reducing costs.

Vascular Accesses Used in the Administration of Antineoplasic Therapy in an Oncological Day Hospital

Introduction: Antineoplasic chemotherapy in intravenous infusion is one of the most common therapeutic modalities in cancer patients. The vast majority of antineoplasic drugs have an Osmolarity >900 mOsm/l, so its administration must be done through central venous routes. However, the channelling of central routes is limited to patients with difficulty in peripheral venous approach or long-term treatments. Objective(s): Describe the vascular accesses used at the University Hospital of La Ribera for the administration of antineoplastic drugs, assess the adequacy of the same and determine if the type of vascular access used varied during the COVID-19 pandemic. Methodology: A quantitative, observational and analytical cross-sectional study of the vascular accesses used in the administration of antineoplasic therapy in cancer day hospital was carried out. Data collection was carried out through direct observation and consultation of the medical history. The pre-pandemic period was executed from 20 to 21/1/2020(n=125), the pandemic sample from 8 to 12/2/21(n=121). Result(s): Although 70% of the drugs administered had the capacity for tissue aggression, the peripheral venous route was established in 69.9% of cases, the forearm being the most frequent anatomical location (n=102) and the peripheral venous catheter the most commonly used device (n=172). The expected duration of treatment was medium-term in 74.8% of patients. The use of central venous routes during the pandemic increased by 30.7%,(p=0.017), being the subcutaneous venous reservoir the one with the highest representation(RVSC 75.5 %, IPCC 24.5 %). Conclusion(s): Short peripheral venous catheter was the most used device in the administration of chemotherapy in oncology HDD of the UHLR, even administering drugs with high tissue aggression and establishing a medium duration of treatment, being this an area of improvement in the care of cancer patients. During the pandemic, the use of central routes increased in the administration of antineoplasic treatment on an outpatient basis.

Vascular Access and Covid-19 Pandemic in a Quality Program for Intravenous Therapy in Spain (Incativ)

Introduction: INCATIV is a research program carried out by nurses on 34 hospitals of the Region of Valencia (Spain). This program measures vascular access quality on patients of these hospitals via cross-sections. The objective of the study is to evaluate the influence of COVID-19 pandemic in the registers of the vascular accesses' quality program. Method(s): Quantitative observational, analytical, and retrospective study of two cross-sections. First cross-section was developed before pandemic (C10: 02-2020) and second cross-section during pandemic (C11: 05-2020). Data was obtained from INCATIV's platform. Result(s): Among 34 participant hospitals in INCATIV Program, there was a 100% of participation at C10, collecting 7647 registers of all hospital units included at the program. 4820 vascular accesses were evaluated. Only a 1.22% of them presented signs of phlebitis. 92% of the vascular accesses had the right dressing. At C11, there was a 50% of participation. 3234 registers were collected. Phlebitis rate remains at 1.15%. The use of correct dressing reached at 92% too. Discussion and conclusion: Data indicate a strong decrease in the number of participating hospitals as on the number of registers of this quality program focused on intravenous therapy, confirming the existence of changes in the trend of the registers, in the absence or presence of pandemic moments. On the other hand, it is observed that there are no statistically significant differences related to the quality of the vascular accesses, showing that two main indicators measured, included at INCATIV bundle, such as type of dressing and signs of phlebitis, remain constant despite being measured at two different pandemic moments. Further studies are necessary about how vascular accesses nursing care has changed only in COVID-19 patients.