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1.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335266

ABSTRACT

ABSTRACT Background The administration of a third (booster) dose of COVID-19 vaccines in Peru initially employed the BNT162b2 (Pfizer) mRNA vaccine. The national vaccination program started with healthcare workers (HCW) who received BBIBP-CorV (Sinopharm) vaccine as primary regimen and elderly people previously immunized with BNT162b2. This study evaluated the reactogenicity and immunogenicity of the “booster” dose in these two groups in Lima, Peru. Methods We conducted a prospective cohort study, recruiting participants from November to December of 2021 in Lima, Peru. We evaluated immunogenicity and reactogenicity in HCW and elderly patients previously vaccinated with either two doses of BBIBP-CorV (heterologous regimen) or BTN162b2 (homologous regimen). Immunogenicity was measured by anti-SARS-CoV-2 IgG antibody levels immediately before boosting dose and 14 days later. IgG geometric means (GM) and medians were obtained, and modeled using ANCOVA and quantile regressions. Results The GM of IgG levels increased significantly after boosting: from 28.5±5.0 AU/mL up to 486.6±1.2 AU/mL (p<0.001) which corresponds to a 17-fold increase. The heterologous vaccine regimen produced higher GM of post-booster anti-SARS-CoV-2 IgG levels, eliciting a 13% fold increase in the geometric mean ratio (95%CI: 1.02-1.27) and a median difference of 92.3 AU/ml (95%CI: 24.9-159.7). Both were safe and well tolerated. Previous COVID-19 infection was also associated with higher pre and post-booster IgG GM levels. Conclusion Although both boosting regimens were highly immunogenic, two doses of BBIBP-CorV boosted with BTN162b2 produced a stronger IgG antibody response than the homologous BNT162b2 regimen in the Peruvian population. Additionally, both regimens were mildly reactogenic and well-tolerated.

2.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-322632

ABSTRACT

Background: Large cases reported that older age and comorbidity are predictors for poor prognosis in COVID-19 patients. Nevertheless, context-specific evidence relevant in low-and middle-income countries is still pending. Methods Retrospective cohort study using electronic health records of confirmed cases admitted in hospitalization areas from the Peruvian Social Health Insurance. The main variable was the presence of comorbidities and the outcomes were in-hospital mortality or intensive care unit admission, and in/out hospital mortality. We used Kaplan-Meier survival curves with the Log-Rank test to compare time-to-event outcomes between comorbidities groups. Crude and adjusted Cox regression models were used to estimate hazard ratios (HR). Statistical analyses were conducted with a significance level of 5%. Results In patients with ICU admission or in-hospital death, 45.99% had one comorbidity and 50.26% had two or more comorbidities. Using in/out hospital deaths up to 60 days as the outcome, the overall survival of patients with two comorbidities is lower than patients with one comorbidity, and both are lowest than a patient without comorbidities (Log-rank test p = 0.001). After adjusting for sex, age, severity, and hospital care network patients with one comorbidity (HR: 1.16;IC 95 %: 1.04–1.31) and with two or more comorbidities (HR: 1.13;IC 95%: 1.01–1.26) are at higher risk to die compared with those without comorbidities. Conclusion The presence of comorbidities in hospitalized patients with COVID-19 are risk factors for ICU admission and mortality. Proper identification of these factors can help to identify patients at higher risk in hospital admission and provide specialized care to prevent deaths.

3.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321563

ABSTRACT

Background: In February 2021, Peru initiated its vaccination campaign for COVID-19 prevention using the inactivated virus vaccine BBIBP-CorV, prioritizing healthcare workers. Our study aims to evaluate the effectiveness of this vaccine to prevent SARS-CoV-2 infections, all-cause death and death due to COVID-19 in this population, during a period of high transmission in which the lambda variant predominated.Methods: We conducted a retrospective cohort study, from February 9 to June 30, 2021. We integrated several databases, including the national registry of Health care workers (HW) , the national registry of deaths and the national registries of SARS-CoV-2 diagnostic tests to calculate the effectiveness of the vaccine in preventing the three outcomes among partially immunized and fully immunized HW. The extension of the Cox proportional hazards regression was used to model the mortality results, and the Poisson regression was used to model SARS-CoV-2 infection, allowing in each case time-varying immunization status of the subjects.Findings: 606,772 HW were eligible for the study, 396,440 (66%) were female and the mean age was 44 (IQR: 33·0, 51·0). In fully immunized HCW, the effectiveness of the vaccine was 83·6 (95% CI: 80·2 to 86·4) for prevention of all-cause mortality, 88·7 (95% CI: 85·1 to 91·4) for COVID-19 mortality, and 40·3 (95% CI 38·9 to 41·6) for prevention of SARS-CoV-2 infection.Interpretation: The inactivated virus BBIBP-CorV vaccine was highly effective for prevention of all-cause death and COVID-19 related deaths in HCW with complete immunization. These results were consistent within different subgroups and sensitivity analyses.Funding: Peruvian National Institute of Health.Declaration of Interest: None to declare. Ethical Approval: This study was approved by the Research Ethics Committee of the Peruvian National Institute of Health (INS Peru), (ID: 10812-2021).

4.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327717

ABSTRACT

ABSTRACT Objectives To know and explore from convalescent plasma donator’s voices the experience in the blood donation process at a Peruvian social security hospital. Methods Qualitative study with a phenomenological design. The investigation was carried out in 01 hospitals of the social security of Peru. Semi-structured interviews were carried out. Results Eleven donors of convalescent plasma were interviewed. The main motivations for donating were being able to contribute to national research and supporting patients affected by COVID-19. Fears focus on the possible risk of contagion within the hospital. Donors emphasised the attention and support of health personnel alongside the donation procedure. The main expectations and suggestions point towards greater dissemination of donation campaigns with special emphasis on safety. Likewise, an improvement in the time of the donation procedure (from enrolment to the extraction of convalescent plasma), and the implementation of friendly spaces to encourage future blood donation campaigns were highlighted. Conclusions The experience of the convalescent plasma donors was positive. However, improvements must be made in terms of processes and infrastructure to ensure future successful blood donation campaigns.

5.
EuropePMC;
Preprint in English | EuropePMC | ID: ppcovidwho-327118

ABSTRACT

Background: COVID-19 vaccination may reduce anxiety and depression. However, the pandemic significantly impacted the elderly from low-middle-income countries. Therefore, we aimed to estimate the effect of vaccination against COVID-19 on the emotional health of older adults. Methods: We selected a nationally stratified sample of non-hospitalized adults aged 60 to 79 years who intended to receive the COVID-19 vaccine or had already received it during recruitment. We assess the fear, anxiety, and worry about COVID-19, general anxiety, and depression at baseline and after a month. We estimated the adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) for each altered emotional health outcomes in those who had one and two doses, compared with those who were not vaccinated using multilevel logistic regression with mixed effects. Results: We recruited 861 older adults. Loss to follow-up was 20.8%. At baseline, 43.9% had only one dose of the vaccine, and 49.1% had two doses. In the analysis during follow-up, those who had two doses had less fear (ORa: 0.19;CI95%: 0.07 to 0.51) and anxiety to COVID-19 (ORa: 0.45;CI95%: 0.22 to 0.89), compared to non-vaccinated. We observed no effects in those with only one dose. Limitations: Inability to obtain the planned sample size for primary analysis. There is a selection bias during recruitment and a measurement bias because of self-reported vaccination. Conclusions: COVID-19 vaccination with two doses in elders improves the perception of COVID-19 infection consequences. This information could be integrated into the vaccination campaign as its beneficial effect.

7.
BMC Med Educ ; 21(1): 128, 2021 Feb 24.
Article in English | MEDLINE | ID: covidwho-1102336

ABSTRACT

BACKGROUND: As the disease caused by the novel coronavirus has spread globally, there has been significant economic instability in the healthcare systems. This reality was especially accentuated in Ecuador where, the shortage of healthcare workers combined with cultural and macroeconomic factors has led Ecuador to face the most aggressive outbreak in Latin America. In this context, the participation of final-year medical students on the front line is indispensable. Appropriate training on COVID-19 is an urgent requirement that universities and health systems must guarantee. We aimed to describe the knowledge, attitudes, and practices of Ecuadorian final-year medical students that could potentially guide the design of better medical education curricula regarding COVID-19. METHODS: This was a cross-sectional 33-item online survey conducted between April 6 to April 2020 assessing the knowledge, attitudes, and practices toward the diagnosis, treatment, prevention, and prognosis toward COVID-19 in Ecuadorian final-year medical students. It was sent by email, Facebook, and WhatsApp. RESULTS: A total of 309 students responded to the survey. Out of which 88% of students scored high (≥ 70% correct) for knowledge of the disease. The majority of students were pessimistic about possible government actions, which is reflected in the negative attitude towards the control of COVID-19 and volunteering during the outbreak in Ecuador (77%, and 58% of the students, respectively). Moreover, 91% of students said they did not have adequate protective equipment. The latter finding was significantly associated with negative attitudes. CONCLUSIONS: Although a large number of students displayed negative attitudes, the non-depreciable percentage of students who were willing to volunteer and the coexisting high level of knowledge displayed by students, suggests that Ecuador has a capable upcoming workforce that could benefit from an opportunity to strengthen, improve and advance their training in preparation for COVID-19. Not having personal protective equipment was significantly associated to negative attitudes. Providing the necessary tools and creating a national curriculum may be one of the most effective ways to ensure all students are trained, whilst simultaneously focusing on the students' most pressing concerns. With this additional training, negative attitudes will improve and students will be better qualified.


Subject(s)
COVID-19/epidemiology , Health Knowledge, Attitudes, Practice , Pandemics , SARS-CoV-2 , Students, Medical/psychology , Adult , Attitude of Health Personnel , COVID-19/diagnosis , COVID-19/therapy , Cross-Sectional Studies , Ecuador/epidemiology , Female , Health Care Surveys/statistics & numerical data , Humans , Male , Personal Protective Equipment/statistics & numerical data , Prognosis , Students, Medical/statistics & numerical data , Volunteers/statistics & numerical data , Young Adult
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