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1.
Brain Hemorrhages ; 2022 Nov 08.
Article in English | MEDLINE | ID: covidwho-2105019

ABSTRACT

It is news of 28 October 2022 that the Pharmacovigilance Risk Assessment Committee of the European Medicines Agency has recommended to add heavy menstrual bleeding among the side effects of unknown frequency inside the package insert of nucleoside-modified messenger ribonucleic acid vaccines to prevent coronavirus disease 2019 (COVID-19). The decision has been made in the light of the numerous reports of unexpected menstrual changes or abnormal uterine bleeding following COVID-19 vaccination. Here we advance a possible involvement of the particular adenohypophyseal microcirculation in these strange and still unexplained events.

3.
Brain Hemorrhages ; 2022.
Article in English | ScienceDirect | ID: covidwho-1796769

ABSTRACT

Pituitary apoplexy (PA) may complicate the course of coronavirus disease 2019 (COVID-19), posing a potential threat to life. Among vaccines designed to prevent COVID-19, there are those adenoviral vector-based, such as Vaxzevria® (formerly COVID-19 Vaccine AstraZeneca). The product insert states that it can cause very rare coagulation disorders, in particular thrombosis with thrombocytopenia syndrome in some cases accompanied by bleeding, cerebrovascular venous or sinus thrombosis, and thrombocytopenia, including immune thrombocytopenia, also associated with bleeding. Here, we report the onset of PA after Vaxzevria® in a 28-year-old healthy Caucasian female, who experienced long-lasting tension-type headache, hyperprolactinemia and menstrual changes, without thrombocytopenia or thrombosis.

4.
Trop Med Infect Dis ; 7(4)2022 Apr 16.
Article in English | MEDLINE | ID: covidwho-1792426

ABSTRACT

Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium. To counter it, specific vaccines have been launched in record time under emergency use authorization or conditional marketing authorization and have been subjected to additional monitoring. The European Medicines Agency recommend reporting any suspected adverse reactions during this additional monitoring phase. For the first time in the available medical literature, we report a left cubital tunnel syndrome in a 28-year-old right-handed healthy male after seven days from the first dose of Spikevax® (formerly Moderna COVID-19 Vaccine). Histochemistry for Alcian Blue performed on the tissue harvested from the cubital site reveals myxoid degeneration of the small nerve collaterals, a clear sign of nerve injury. It still remains unclear why the syndrome occurs in a localized and not generalized form to all osteofibrous tunnels. Today, modified messenger ribonucleic acid vaccines as Spikevax® represent an avantgarde technological platform with a lot of potential, but one which needs careful monitoring in order to identify in advance those patients who may experience adverse events after their administration.

5.
Pathogens ; 11(4)2022 Apr 03.
Article in English | MEDLINE | ID: covidwho-1776311

ABSTRACT

Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium; to counteract it, specific vaccines have been launched in record time under emergency use authorization or conditional marketing authorization by virtue of a favorable risk/benefit balance. Among the various technological platforms, there is that exploiting a nucleoside-modified messenger RNA (modRNA), such as Comirnaty®, and that which is adenoviral vector-based. In the ongoing pharmacovigilance, the product information of the latter has been updated about the risk of thrombotic thrombocytopenia, venous thromboembolism without thrombocytopenia and immune thrombocytopenia without thrombosis. However, from an in-depth literature review, the same adverse events can rarely occur with modRNA vaccines too. In support of this, we here report a three-case series of thrombotic deaths in patients over 50 with comorbidities temporally after Comirnaty®, investigated by means of post-mortem histopathology and immunohistochemistry. In two out of three cases, the cause of death is traced back to pulmonary microthromboses rich in activated platelets, quite similar morphologically to those described in patients who died from severe COVID-19. Even if remote in the face of millions of administered doses, clinicians should be aware of the possible thrombotic risk also after Comirnaty®, in order to avoid a misdiagnosis with potentially lethal consequences. Since COVID-19 vaccines are inoculated in subjects to be protected, maximum attention must be paid to their safety, and prophylactic measures to increase it are always welcome. In light of the evidence, the product information of modRNA COVID-19 vaccines should be updated about the thrombotic risk, as happened for adenoviral vector-based vaccines.

6.
J Thromb Thrombolysis ; 52(4): 1043-1046, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1525570

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a complex disease with many clinicopathological aspects, including abnormal immunothrombosis, and the full comprehension of its pathogenetic mechanisms is urgently required. METHODS/RESULTS: By means of a multidisciplinary approach, we here report a catastrophic COVID-19 in a 44-year-old Philippine male patient, discovered lupus anticoagulant (LAC)-positive shortly before death, occurred 8 days after hospitalization in a clinical scenario refractory to standard high acuity care recalling Asherson's syndrome (catastrophic antiphospholipid syndrome). CONCLUSION: A parallelism between this severe form of COVID-19 and Asherson's syndrome can be so drawn. Both the diseases in fact exhibit hypercytokinemia, thrombotic microangiopathy, disseminated intravascular coagulation and multiple organ failure, they show a relationship with viral infections, and they are burdened by a high mortality rate. A genetic predisposition to develop these two overlapping conditions may be supposed.


Subject(s)
Antiphospholipid Syndrome , COVID-19 , Lupus Coagulation Inhibitor/blood , Adult , Fatal Outcome , Humans , Male
7.
Eur J Health Law ; : 1-8, 2021 Oct 18.
Article in English | MEDLINE | ID: covidwho-1495773

ABSTRACT

Coronavirus Disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium, and extraordinary measures concerning with health, law and policy are required around the world. One of these is without doubts the "green pass", officially known in the European Union (EU) as EU Digital COVID Certificate (EUDCC). Initially conceived as a tool for overcoming the lockdown restrictions, it has unexpectedly turned into a means of discrimination between pass holders and non-holders, thus increasing social tension at the expense of solidarity and brotherhood. Here, we analyze in depth the dark sides of the "green pass" in the light of the European and international legislation and of the ongoing pandemic scenario.

8.
J Vasc Surg ; 74(5): 1771-1772, 2021 11.
Article in English | MEDLINE | ID: covidwho-1472085

Subject(s)
COVID-19 , Humans , SARS-CoV-2
9.
13.
Med Hypotheses ; 153: 110638, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1284380

ABSTRACT

COVID-19 is a complex disease with many clinicopathological issues, including respiratory, gastrointestinal, neurological, renal, cutaneous, and coagulative ones; in addition, reactive arthritis has been reported by different authors. Here, we hypothesize that a peripheral microangiopathy involving nerve supply, a viral demyelination, or an immune-mediated irritating antigenic stimulus on synovial sheaths after SARS-CoV-2 infection may all induce a carpal, cubital or tarsal tunnel syndrome of variable entity in genetically predisposed subjects associated with myxoid nerve degeneration.


Subject(s)
COVID-19 , Carpal Tunnel Syndrome , Cubital Tunnel Syndrome , Tarsal Tunnel Syndrome , Humans , SARS-CoV-2
14.
J Med Virol ; 93(7): 4054-4057, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1148833

ABSTRACT

On March 11, 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19) a pandemic; from that date, the vaccine race has begun, and many technology platforms to develop a specific and effective COVID-19 vaccine have been launched in several clinical trials (protein subunit, RNA-based, DNA-based, replicating viral vector, nonreplicating viral vector, inactivated virus, live attenuated virus, and virus-like particle). Among the next-generation strategies, nucleoside-modified messenger RNA vaccines appear the most attractive, not only to counteract emerging pathogens but also for the possible applications in regenerative medicine and cancer therapy. However, exactly as all innovative drugs, they deserve careful pharmacovigilance in the short and long term.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Vaccines, Synthetic , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/immunology , Humans , Hypersensitivity/etiology , Liposomes/adverse effects , Nanoparticles/adverse effects , Nucleosides , Pandemics/prevention & control , Pharmacovigilance , Polyethylene Glycols/adverse effects , RNA, Messenger/chemistry , Vaccines, Synthetic/administration & dosage , Vaccines, Synthetic/adverse effects , Vaccines, Synthetic/immunology
15.
Prostaglandins Other Lipid Mediat ; 154: 106540, 2021 06.
Article in English | MEDLINE | ID: covidwho-1096205

ABSTRACT

Coronavirus Disease 2019 (COVID-19) is upsetting the world and innovative therapeutic solutions are needed in an attempt to counter this new pandemic. Great hope lies in vaccines, but drugs to cure the infected patient are just as necessary. In the most severe forms of the disease, a cytokine storm with neuroinflammation occurs, putting the patient's life at serious risk, with sometimes long-lasting sequelae. Palmitoylethanolamide (PEA) is known to possess anti-inflammatory and neuroprotective properties, which make it an ideal candidate to be assumed in the earliest stage of the disease. Here, we provide a mini-review on the topic, pointing out phospholipids consumption in COVID-19, the possible development of an antiphospholipid syndrome secondary to SARS-CoV-2 infection, and reporting our preliminary single-case experience concerning to a 45-year-old COVID-19 female patient recently treated with success by micronized / ultramicronized PEA.


Subject(s)
Amides/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Antiphospholipid Syndrome/drug therapy , COVID-19/drug therapy , Ethanolamines/administration & dosage , Neuroprotective Agents/administration & dosage , Palmitic Acids/administration & dosage , SARS-CoV-2/metabolism , Antiphospholipid Syndrome/etiology , Antiphospholipid Syndrome/metabolism , Antiphospholipid Syndrome/pathology , COVID-19/complications , COVID-19/metabolism , COVID-19/pathology , Female , Humans , Middle Aged
18.
Ann Thorac Surg ; 112(2): 682-683, 2021 08.
Article in English | MEDLINE | ID: covidwho-987094
19.
Vaccine ; 38(48): 7581-7584, 2020 11 10.
Article in English | MEDLINE | ID: covidwho-845859

ABSTRACT

Today, Coronavirus Disease 2019 (COVID-19) is a global public health emergency and vaccination measures to counter its diffusion are deemed necessary. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the etiological agent of the disease, unleashes a T-helper 2 immune response in those patients requiring intensive care. Here, we illustrate the immunological mechanism to train the immune system towards a more effective and less symptomatic T-helper 1 immune response, to be exploited against SARS-CoV-2.


Subject(s)
BCG Vaccine/administration & dosage , Bacterial Vaccines/administration & dosage , Betacoronavirus/immunology , Coronavirus Infections/prevention & control , Immunity, Innate/drug effects , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Propionibacteriaceae/immunology , Betacoronavirus/drug effects , Betacoronavirus/pathogenicity , COVID-19 , COVID-19 Vaccines , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Coronavirus Infections/virology , Corynebacterium , Humans , Immunization Schedule , Immunogenicity, Vaccine , Interleukins/genetics , Interleukins/immunology , Patient Safety , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Pneumonia, Viral/virology , SARS-CoV-2 , Th1 Cells/drug effects , Th1 Cells/immunology , Th1 Cells/virology , Th1-Th2 Balance/drug effects , Th2 Cells/drug effects , Th2 Cells/immunology , Th2 Cells/virology , Vaccination , Viral Vaccines/administration & dosage , Viral Vaccines/biosynthesis
20.
J Med Virol ; 92(11): 2429-2439, 2020 11.
Article in English | MEDLINE | ID: covidwho-838040

ABSTRACT

We report a review of all the experimental and clinical studies performed in the last 60 years on the antiviral activity of inactivated Corynebacterium parvum (Cutibacterium acnes). This bacterium has been originally investigated and used for its oncolytic properties linked to immunomodulating activity, but the interest to successfully prevent and treat bacterial, fungal, and viral infections and lethality, uprising the innate immunity barriers produced many experimental models and very few clinical studies. The dramatic defenseless situation due to impending CoViD-19 pandemic claims to exhume and highlight this aspecific strategy in preventive and therapeutic settings; as a matter of fact, no new or mutated virus can potentially escape to this strong innate immune surveillance strengthened by adequate C. parvum protocols.


Subject(s)
Immunity, Innate , Immunologic Factors/administration & dosage , Immunologic Surveillance , Propionibacterium acnes/immunology , Virus Diseases/immunology , Virus Diseases/therapy , Animals , COVID-19/prevention & control , Clinical Trials as Topic , Humans , Immunologic Factors/therapeutic use , Virus Diseases/prevention & control
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