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1.
Kidney International Reports ; 8(3 Supplement):S449-S450, 2023.
Article in English | EMBASE | ID: covidwho-2278733

ABSTRACT

Introduction: It is yet not known whether COVID-19 vaccines confer a persistent humoral response in patients with chronic kidney disease. The aim of this study was to evaluate the persistence of the humoral response of antibodies in dialysis patients immunized with the COVID-19 vaccine. Method(s): A multicentre, observational and analytical study was carried out in a prospective cohort of haemodialysis patients >=18 years from six hospitals from the Autonomous City of Buenos Aires who received both components of the COVID-19 vaccine. The date of inclusion to the study was the date of the first dose. IgG antibodies against SARS-Cov-2 were measured using the "COVIDAR IgG" test, which detects antibodies specifically against two coronavirus viral antigens in blood and serum: the spike protein (S) and the binding domain to the receptor (RBD), using the ELISA technique. The COVIDAR IgG test detects qualitatively and semi-quantitatively. In the semi-quantitative determination, the values are measured in absorbance levels (AL) with a maximum of 3.3, and a lower limit of detection of 0.3. The measurements were made immediately before the administration of the first dose, 21 days after it, 21 days after the second dose, and +/- five days of the 1st booster and the 2nd booster. Quantitative data were expressed as median and interquartile range (IQR) according to their distribution. Qualitative data were expressed as absolute and relative frequencies. The analysis was performed with the software R version 4.0.3. None of the funding sources provided financial support for data collection, statistical analysis. Result(s): 102 patients were included, (49.0% female). Median age 51.6 years (IQR 39.8-62.0);41.0% were over 55 years old, 20.5% diabetic. 11 patients on peritoneal dialysis (10.7%). 15.7% (n 16) had COVID-19 prior to vaccination, with a median time from diagnosis to administration of the first dose of 7 months (IQR 6-8). The median time for the administration of the second dose was 2.8 months (IQR 2.7-2.9) and from the second dose to the 1st booster was 4.1 months (IQR 4-4.2). Patients received a 2nd booster at a median of 5.1 months (IQR 4.9-5.1) from the 1st booster. Of the 102 patients, 27 (26.5%) had positive IgG against SARS-Cov-2 at baseline. 98% of patients had positive IgG antibodies against SARS-CoV-2 21 days after the second dose (Figure 1) Among the 16 patients (15.7%) who had COVID-19 before the first component, 14 were IgG positive at baseline and only 2 were IgG non-positive 21 days after the second dose. In patients with COVID-19, antibodies at day 21 after the first component reached almost the highest levels compared to those patients who did not have COVID-19, and the rise between the last measures was lower than patients without COVID-19. In those patients, levels of antibodies dropped 21 days after the second dose and raised after the third one (figure 2). [Formula presented] [Formula presented] Conclusion(s): This study shows that vaccination against COVID-19 in dialysis patients confers immunity, which was 96% after the third dose. The decline in antibody levels in patients without COVID after the second dose highlights the importance of a booster to achieve a persistent immune response. No conflict of interestCopyright © 2023

2.
Cities and Health ; 2022.
Article in English | Scopus | ID: covidwho-2187935

ABSTRACT

The COVID-19 pandemic has exacerbated health and socioeconomic disparities and limited access to both social services and health care. According to national public vaccination strategies, the Ministry of Health of the city of Buenos Aires has led the Butterfly Effect Project. The main objective was to implement a population-specific strategy aimed to surmount these challenges by promoting vaccination to unhoused and at-risk people in the city of Buenos Aires (Argentina). This case study presents the main findings of a survey within the Butterfly Effect Project that explored the obstacles and opportunities faced by unhoused and at-risk people in the city of Buenos Aires in terms of access to the health care system during the pandemic. The study also analyzed perceptions of both COVID-19 and the vaccination campaign. This qualitative exploratory study was conducted through semi-structured interviews carried out with unhoused and at-risk people between June and July 2021. Through this project, the city of Buenos Aires vaccinated more than 10,000 people in vulnerable social and housing situations, including unhoused people and people at risk of becoming unhoused. Peer companions, Paradores (public shelters), and homes for unhoused people were considered ‘essential' during the pandemic. © 2022 Informa UK Limited, trading as Taylor & Francis Group.

3.
Medicina (B Aires) ; 82(1):13-20, 2022.
Article in English | PubMed | ID: covidwho-1624323

ABSTRACT

Recently it has been demonstrated the clinical effectiveness of tocilizumab (TCZ) associated with systemic steroids for the treatment of severe SARS-CoV-2 pneumonia with rapid progression. The objective of this work was to describe the epidemiological, clinical, laboratory and evolution characteristics of the patients who received this treatment. Between March and June 2021, TCZ was administered in a cohort study of adults with severe SARS-CoV-2 pneumonia, in a private hospital in the City of Buenos Aires;30 patients were included, 63% men, middle age 55 years. Obesity (33%), arterial hypertension (26%) and diabetes (25%) were the most frequent comorbidities. We found associated infections during hospitalization in half of the cohort, within them, pneumonia associated with mechanical ventilation was the most frequent and methicillin-sensitive Staphylococcus aureus, the most prevalent germ. Patients with secondary infections had a higher requirement for invasive mechanical ventilation (IMV) (100% vs. 19% p < 0.001) and more days of hospitalization (median 23 vs. 15 p = 0.009). Of the entire cohort, seven who died during hospitalization had the highest requirement for IMV (100% vs. 43% p = 0.010) and secondary infections (100% vs. 35%, p = 0.006). In this relatively young cohort of patients with severe or critical SARS-CoV-2 pneumonia, obesity does not appear to be a predisposing factor for superinfection or death. The presence of secondary infections, organ failure and shock are presented as probable factors of worse evolution, as well as the requirement of IMV.

4.
Medicina ; 81(3):408-414, 2021.
Article in English | GIM | ID: covidwho-1619327

ABSTRACT

This study describes the incidence of early events supposedly attributable to vaccination or immunization (ESAVI) that occurred in healthcare workers who had been inoculated with the first component of the Sputnik V vaccine. Safety at 72 h post-immunization was analyzed based on a self-reported form. Between January 5 and January 20, 2021, in Buenos Aires, Argentina, a total of 707 healthcare workers (median age 35 yrs, female 67%) were vaccinated. The response rate was 96.6% (n: 683) and 487 (71.3%) participants reported at least one ESAVI. The incidence rate was 6.3 per 1000 person/hours. The total number of ESAVIs was 1434. A total of 469 local reactions were reported, 57% of the participants reported pain at the injection site, and 11% had redness and swelling. A total of 968 systemic reactions were informed, including new or worsened muscle pain, referred by 58% of the participants, fever referred by 40%, and diarrhea referred by 5%. Five percent (n: 34) had serious adverse events and one participant had to be hospitalized. The ESAVI rate was higher in females than males (66.4% versus 51.4%;HR 1.38;95% CI 1.13-5.38) and in workers younger than 55 yrs old (63.0% versus 28.0%;HR 2.66;95% CI 1.32-5.38). This study demonstrates high rates of early local and systemic reactions. However, serious events were rare. Studies on long-term safety, stratified by sex and age, are needed.

5.
Medicina ; 81(2):135-142, 2021.
Article in English | GIM | ID: covidwho-1472861

ABSTRACT

Most countries in Latin America have already reported thousands of confirmed cases and vulnerable populations are the most affected by the coronavirus disease 2019 (COVID-19) pandemic. Preventive measures such as hygiene, social distancing, and isolation, essential to stop the spread of coronavirus, are difficult to accomplish for vulnerable populations due to their living conditions. Seroepidemiological surveys are assets to measure the transmission for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Until July 1st, the incidence rate of SARS-CoV-2 infection in Barrio Padre Mugica, one of the largest slums in Buenos Aires City, was 5.9%. This study aimed to establish the prevalence of SARS-CoV-2 antibodies immunoglobulin G (IgG) immediately after the outbreak, and to identify neighbourhood, household and individual factors associated with seroconversion. The prevalence based on IgG was 53.4% (95% CI 52.8% to 54.1%). For each polymerase chain reaction (RT-qPCR) confirmed case, nine people tested IgG positive, indicating a high rate of undetected (probably asymptomatic) infections. Hence, the high rate of undiagnosed people suggests that clinical criteria and epidemiological nexus should be considered. The high seroprevalence observed in the context of an intense epidemic in a vulnerable area might serve as a reference to other countries. This study contributes to future decision making by understanding population immunity against SARS-CoV2 and its relation to living conditions and foccus that comprehensive biosocial, household-level interventions are needed.

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