Safety of BNT162b2 or CoronaVac COVID-19 vaccines in patients with heart failure: A self-controlled case series study

Background: COVID-19 vaccines are important for patients with heart failure (HF) to prevent severe outcomes but the safety concerns could lead to vaccine hesitancy. This study aimed to investigate the safety of two COVID-19 vaccines, BNT162b2 and CoronaVac, in patients with HF. Methods: We conducted a self-controlled case series analysis using the data from the Hong Kong Hospital Authority and the Department of Health. The primary outcome was hospitalization for HF and the secondary outcomes were major adverse cardiovascular events (MACE) and all hospitalization. We identified patients with a history of HF before February 23, 2021 and developed the outcome event between February 23, 2021 and March 31, 2022 in Hong Kong. Incidence rate ratios (IRR) were estimated using conditional Poisson regression to evaluate the risks following the first three doses of BNT162b2 or CoronaVac. Findings: We identified 32,490 patients with HF, of which 3035 were vaccinated and had a hospitalization for HF during the observation period (BNT162b2 = 755;CoronaVac = 2280). There were no increased risks during the 0–13 days (IRR 0.64 [95% confidence interval 0.33–1.26];0.94 [0.50–1.78];0.82 [0.17–3.98]) and 14–27 days (0.73 [0.35–1.52];0.95 [0.49–1.84];0.60 [0.06–5.76]) after the first, second and third doses of BNT162b2. No increased risks were observed for CoronaVac during the 0–13 days (IRR 0.60 [0.41–0.88];0.71 [0.45–1.12];1.64 [0.40–6.77]) and 14–27 days (0.91 [0.63–1.32];0.79 [0.46–1.35];1.71 [0.44–6.62]) after the first, second and third doses. We also found no increased risk of MACE or all hospitalization after vaccination. Interpretation: Our results showed no increased risk of hospitalization for HF, MACE or all hospitalization after receiving BNT162b2 or CoronaVac vaccines in patients with HF. Funding: The project was funded by a Research Grant from the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region (Ref. No. COVID19F01). F.T.T.L. (Francisco T.T. Lai) and I.C.K.W. (Ian C.K. Wong)'s posts were partly funded by the D24H;hence this work was partly supported by AIR@InnoHK administered by Innovation and Technology Commission. © 2022 The Authors

Restoring hope and optimism through staycation programs: an application of psychological capital theory

This study marks an early attempt to evaluate staycation incentive programs initiated by local authorities. It aims to gauge the effectiveness of staycation programs in cultivating learning opportunities and restorative benefits with an emphasis on temporal positive psychological outcomes amid this continuing pandemic. Relying on a survey-based research design, we conducted a survey with 409 local tourists in Macau, where a recent staycation initiative has attained prominent success. We then undertook the structural equation modeling test using AMOS. Results show how short local excursions could still fortify one's psychological capital with respect to ephemeral improvement in hope, confidence, optimism, and resilience in the face of extenuating circumstances. By synthesizing a path leading from COVID-related distress to fortification of a more prepared mental state for the new normal through the staycation's experiential benefits, this study thus puts forth a mechanism that explains why tourists/residents engage in staycation programs, as well as illuminating the psychological values associated with such activities. By answering these questions, this research improvises a three-stage process that identifies pre-trip, during-trip, and post-trip mental encounters that improve participants' psychological capabilities, even if only temporarily. The present inquiry sheds light on a new form of sustainability: mental (or psychological) sustainability. © 2021 Informa UK Limited, trading as Taylor & Francis Group.

Remote assessment of ADHD in children and adolescents: recommendations from the European ADHD Guidelines Group following the clinical experience during the COVID-19 pandemic.

The COVID-19 pandemic led ADHD services to modify the clinical practice to reduce in-person contact as much as possible to minimise viral spread. This had far-reaching effects on day-to-day clinical practice as remote assessments were widely adopted. Despite the attenuation of the acute threat from COVID, many clinical services are retaining some remote practices. The lack of clear evidence-based guidance about the most appropriate way to conduct remote assessments meant that these changes were typically implemented in a localised, ad hoc, and un-coordinated way. Here, the European ADHD Guidelines Group (EAGG) discusses the strengths and weaknesses of remote assessment methods of children and adolescents with ADHD in a narrative review based on available data and expert opinions to highlight key recommendations for future studies and clinical practice. We conclude that going forward, despite remote working in clinical services functioning adequately during the pandemic, all required components of ADHD assessment should still be completed following national/international guidelines; however, the process may need adaptation. Social restrictions, including changes in education provision, can either mask or exacerbate features associated with ADHD and therefore assessment should carefully chart symptom profile and impairment prior to, as well as during an ongoing pandemic. While remote assessments are valuable in allowing clinical services to continue despite restrictions and may have benefits for routine care in the post-pandemic world, particular attention must be paid to those who may be at high risk but not be able to use/access remote technologies and prioritize these groups for conventional face-to-face assessments.

Gaining resilience through transformative services in cause-related events: an interaction ritual chain perspective

PurposeThis study aims to unlock a ritual chain mechanism that promotes socio-mental (or socio-psychological) resilience. This study draws on interaction ritual chains theory and the concept of transformative service to answer the question of how people could be inspired toward an elevated level of group solidarity, emotional energy, morality and, thus, socio-mental resilience. Design/methodology/approachThis study took a qualitative approach resting upon online reviews and observations from an augmented food festival about hot pot delicacies dedicated to medical workers fighting hard amid the early coronavirus outbreak. FindingsThe results of this study point to four primary ritual outcomes (e.g. emotional energy, group solidarity, symbols of relationships and standards of morality) along with a two-tier micro-macro socio-mental resilience sustainability paradigm. Research limitations/implicationsEmpirical findings from this study could help operators to justify their transformative initiatives as means for customers to replenish their depleted physical and mental resources. Originality/valueThis inquiry presents new nuances to interaction ritual chains. This study also extends the transformative role of hospitality services to accentuate a linkage among individuals, communities and the society.

Safety of Inactivated and mRNA COVID-19 Vaccination among Patients Treated for Hypothyroidism: a Population-based Cohort Study

Background: Thyroiditis and Graves’ disease have been reported after COVID-19 vaccination. Patients with hypothyroidism due to various etiologies may be at risk of thyroid-specific outcomes. We aimed to evaluate the risks of thyroid-specific outcomes and adverse events after COVID-19 vaccination among patients treated for hypothyroidism. Methods: In this population-based cohort from Hong Kong Hospital Authority electronic health records with Department of Health vaccination records linkage, levothyroxine users were categorized into unvaccinated, vaccinated with BNT162b2 (mRNA vaccine) or CoronaVac (inactivated vaccine) between 23 February and 9 September 2021. Propensity score (PS) weighting with inverse probability of treatment weighting (IPTW) was applied to balance the baseline characteristics among the three groups, which included age, sex, history of COVID-19, health care utilization, comorbidities, baseline thyroid-stimulating hormone (TSH) level (within the 6 months before the index date), and recent use of medications including anti-hypertensive, anti-diabetic and lipid-lowering agents. Study outcomes were dosage reduction or escalation in levothyroxine, emergency department visit, unscheduled hospitalization, adverse events of special interest (AESI) according to World Health Organization's Global Advisory Committee on Vaccine Safety, and all-cause mortality. Results: In total, 47,086 levothyroxine users were identified (BNT162b2: n=12,310;CoronaVac: n=11,353;unvaccinated: n=23,423). After PS weighting, all baseline characteristics had standardised differences of less than 0.2, implying a balance of covariates among the three groups. COVID-19 vaccination was not associated with increased risks of levothyroxine dosage reduction (BNT162b2: HR=0.971, 95% CI 0.892–1. 058;CoronaVac: HR=0.968, 95% CI 0.904–1. 037) or escalation (BNT162b2: HR=0.779, 95% CI 0.519–1.169;CoronaVac: HR=0.715, 95% CI 0.481–1. 062). Besides, COVID-19 vaccination was not associated with a higher risk of emergency department visits (BNT162b2: HR=0.944, 95% CI 0.700-1.273;CoronaVac: HR=0.851, 95% CI 0.647-1.120) or unscheduled hospitalization (BNT162b2: HR=0.905, 95% CI 0.539-1.520;CoronaVac: HR=0.735, 95% CI 0.448-1.207). There were two (0. 016%) deaths and six (0. 062%) AESI recorded for BNT162b2 recipients, and one (0. 009%) and three (0. 035%) for CoronaVac recipients, respectively. Sensitivity analyses were performed by stratifying the groups according to age, sex and pre-vaccination thyroid status. The results were largely consistent with the main analysis. Conclusion: BNT162b2 or CoronaVac vaccination is not associated with unstable thyroid status or an increased risk of adverse outcomes among patients treated for hypothyroidism. These reassuring data should encourage them to get vaccinated against COVID-19 for protection from potentially worse COVID-19-related outcomes.Presentation: No date and time listed

UNPLANNED HOPSITAL ADMISSION AND EMERGENCY ATTENDANCE FOLLOWING TWO-DOSE OF BNT162B2 AMONG PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A POPULATION-BASED COHORT STUDY

Background: Real-world population-based safety data about the COVID-19 mRNA vaccine is lacking in patients with various immunocompromised conditions, including inflammatory bowel disease (IBD). Aim: To determine the incidence rates of unplanned IBD-related hospital admission and all-cause emergency attendance following BNT162B2 vaccination in IBD patients. Methods: Through the Government commissioned, territory-wide active COVID19 safety surveillance, we linked population-level vaccination records and health outcome data, between March 10 (1st day of vaccination program) and September 30, 2021, to assess the association between two-dose of BNT162b2 and unplanned IBD-related hospitalization and all-cause emergency attendance. We used inverse probability treatment weightingbased cohort study design to balance the baseline characteristics between vaccinated and unvaccinated IBD patients. Poisson regression model was fitted to estimate the adjusted incidence rate ratio (IRR) of unplanned IBD hospital admission and 28-day emergency room attendance following the vaccination, using the unvaccinated group as the reference. Results: Among more than 4.1 million citizens with successful vaccine and health record-linkage, we identified 941 IBD patients (age: 46.0 ± 15.0 years, male: 64.2%) who completed twodose of BNT162b2 and 1196 age-sex matched unvaccinated IBD patients as control (age: 49.3 ± 18.3 years, male: 58.9%). After inverse propensity weighting, all baseline demographic and clinical characteristics were well balanced (standard mean difference < 0.1;Table 1). During a median follow-up of 59-60 days (181.2 person-years for BNT162b2 group;253.6 person-years for the unvaccinated group), there was no significant difference in the risk of unplanned IBD-related hospital admission [3.31 versus 5.13 per 100 person-years, IRR: 0.75 (0.38, 1.47)] and 28-day all-cause emergency room attendance [39.1 vs 47.5 per 100 person-years, IRR: 1.08 (0.76-1.53)] between BNT162b2 recipients and unvaccinated individuals. Series of stratified analyses, including patients with Crohn’s disease (N= 378) or ulcerative colitis (N=553), who received immunosuppressants (N=454) or biologics (N= 192), all showed that receiving two-dose of BNT162b2 vaccine was not associated with a higher risk of unplanned IBD-admission and 28-day emergency attendance when compared to their counterparts without vaccination (Figure 1). Conclusion: Results from this populationbased study showed no increase in risk of unplanned IBD-related hospitalization and allcause emergency attendance following two-dose of BNT162b2 Covid-19 vaccination in patients with IBD. This observation potentially reassures the medium-term safety of mRNA vaccine in patients with IBD, although there is still possible self-selection bias in receiving the vaccine. (Table Presented) (Figure Presented)

Inactivated and mRNA COVID-19 Vaccines Affect F-18-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Oncology Patients

Introduction: We aimed to analyse the effect of coronavirus disease 2019 (COVID-19) vaccination on F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging findings in cancer patients. Methods: A total of 165 oncology patients who underwent FDG PET/CT between 1 May 2021 and 30 September 2021 after their first or second COVID-19 vaccination with were included in this retrospective study. The occurrence and pattern of FDG uptake at the injection site (usually deltoid), ipsilateral axillary and other regional lymph nodes, were measured. Results: Overall, the incidence of FDG-avid ipsilateral regional nodal uptake was 26.7% (44/165), with a median maximal standardised uptake value of 3.2 (range, 1.7-13.8). Vaccine-associated hypermetabolic lymphadenopathy (VAHL) was found in 11.4% (5/44) of the subjects beyond 6 weeks after vaccination. VAHL was more common in patients receiving BioNTech-Fosun mRNA vaccine (compared with patients receiving the Sinovac CoronaVac inactivated vaccine), and in women (p < 0.05). Conclusion: VAHL is common and can be observed beyond 6 weeks after vaccination. It was seen more frequently in women and in patients receiving the mRNA-based vaccine. Proper vaccination history documentation, locating the vaccination site contralateral to the primary cancer, and appropriate scheduling of FDG PET/CT are advisable for correct image interpretation.

Just-in-Time CSR for Urgent Needs during the COVID-19 Outbreak: The Case of Casinos

The casino industry may have been stigmatized by its notorious image due to the negative consequences that gambling brings. Yet, they are at the forefront in combating the pandemic, taking a proactive stand to expedite corporate social responsibility (CSR) through a constellation of means in a timely manner. Moreover, the majority of research focuses on the long-term strategic CSR, leaving ad-hoc CSR initiatives that are responsive without previous planning underexplored. Proactive and prompt CSR efforts exerted by casino conglomerates hence offer researchers a case in better understanding this rarely researched area pertaining to just-in-time CSR amid a mega turbulence. Based on data collected from casino websites, social media, and other public media, we have organized their initiatives into themes germane to safeguarding their personnel and guests, giving encouragement to the society, contributing to financial charities as well as daily necessities and protective supplies, promoting safety and better quality of life during the pandemic, and more. These endeavors do make a real difference in saving lives as well as uniting the community to build up resilience to mitigate the aftermath of the crisis. These expedited CSR efforts render a new phenomenon that we refer as just-in-time CSR. © 2022 Informa UK Limited, trading as Taylor & Francis Group.

A pilot home-based cardiac telerehabilitation program

Introduction: Tele-cardiac rehabilitation has demonstrated safety and efficacy in several clinical studies. With the outbreak of COVID-19, the centered-based CR service was totally suspended. To facilitate patients to exercise at home while being monitored. A pilot home-based cardiac tele-rehabilitation program was developed with a structured protocol at Princess Margaret Hospital (PMH) and rolled out from October 2020. Objectives: 1. To minimize the impact of suspension of in-hospital CR service due to outbreak of COVID-19. 2. To evaluate the effects and develop a home-based CR program for remote rehabilitation, based on advanced technological infrastructure and complementary clinical protocols. Methodology: Target patients: Low risk cardiac patients who fulfil the intake criteria, able and willing to use digital monitoring devices including blood pressure machine, smart watch and smart phone. Program design: The program will last for 12 weeks and consists of education, exercise training and relaxation training. Each consenting patient will be given a training kit containing a training log-book, informative educational leaflets and a set of QR codes to access our home-made education, exercise training & relaxation practice videos. Individual phone consultation by multidisciplinary will be scheduled once a week at the first five weeks. Patients can view the video at their own convenience, and then discuss or ask questions during phone follow-up. Individualized exercise will be prescribed according to patients' age, mobility and cardio fitness level. Patients can follow the designated video to do exercise at home. They will be instructed to measure and record their blood pressure, heart rate, and rate perceived exertion (RPE) before and after exercise. Physiotherapist will phone call patient to monitor and coach patients. Evaluation: All patients will undergo a detailed face-to-face assessment at baseline and at 12-week. They are including 6-minute walk test, body mass index (BMI), waist circumference, blood test for lipid profile, etc. In addition, patients will also request to fill in a set of questionnaires to measure the physical activity level, functional performance and psychological fitness. Conclusion: It believes that tele-rehabilitation is a more cost-effective model compared to center-based CR. It enables a new direction for the CR program.

Evolutionary selection for travel agencies under COVID-19 adversity through the lens of life history theory

This study draws on life history theory to rationalize how tourism enterprises make decisions and evolve during the COVID-19 pandemic. Using a case study approach, the current work improvises the house of trade-off paradox as a visual metaphoric framework that integrates three major dyadic trade-off pairs along with four organizational resource configuration aspects. This inquiry further synthesizes the wheel of selection strategy to pinpoint a mechanism in which tourism agencies mutate to adapt to a new normal based on acute environmental shocks. We further provide practical implications for operators with valuable insights germane to post-pandemic recovery.

Delivering warmth and expediting love: just-in-time CSR in the midst of COVID-19 mega disruption

Purpose: This study aims to move beyond the current understanding of corporate social responsibility (CSR) to propose the concept of just-in-time (JIT) CSR as a metaphor that reflects hospitality operators’ endeavors to expedite socially responsible measures to both internal and external organizational stakeholders during times when functional and emotional supports are urgently needed. Design/methodology/approach: This research used a qualitative approach in two studies. Study 1 engaged a media analysis to better grasp the knowledge of the research problem at hand. Study 2 involved interviews from stakeholders to assess their emotions and perceptions of meanings of major contents discerned from the first study. Findings: This research highlights a process in which operators’ CSR practices (e.g. for business practices, for organizational strategy and for stakeholder well-being) during the COVID-19 crisis are imbued with connotative meanings (e.g. place-as-safety, place-as-partnership and place-as-warmth) that ultimately give shape to three core outcomes (e.g. individual rejoinder, brand resonance and societal resilience). Research limitations/implications: While JIT CSR is not an antidote for all devastations caused by COVID-19, it is posited as a needed mechanism that operators could use to ameliorate the situation and to go beyond their own stake to bring a broader array of societal benefits to humanity. Originality/value: This research underscores how hospitality operators expedite crisis responses to the pandemic, and how their societal objectives transform the image of a place from a commercial venue into a place imbued with meaning associated with safety, partnership and warmth. © 2021, Emerald Publishing Limited.

Cardiovascular sequalae in uncomplicated COVID-19 survivors

Background: A high proportion of COVID-19 patients were reported to have cardiac involvements. Data pertaining to cardiac sequalae is of urgent importance to define subsequent cardiac surveillance.

Taking a break is for accomplishing a longer journey: hospitality industry in Macao under the COVID-19 pandemic

Purpose: This paper aims to analyze how a real-time COVID-19 pandemic is impacting Macao’s hospitality industry, and illustrates why lessons from COVID-19 are an opportunity for further development for the city. Design/methodology/approach: This case study highlights local government and hospitality industry responses to a real-time crisis. Academic studies, media news and reports have been collected to illustrate why the Macao’s response to the COVID-19 pandemic could be taken as a city case study example. Previous crisis experience provided guidance to Macao’s success in this pandemic. Findings: Macao has succeeded in managing the adverse effects of COVID-19, illustrating the coexistence of challenges and opportunities from experiencing the epidemic. With no COVID-19 cases in the city, cross-border tourism with China resumed in September. Macao is undeniably over reliant on the gambling industry to provide tax income and employment, creating an unbalanced industrial structure. However, the Chinese and Macao Governments, the hospitality industry and other stakeholders, have presented high levels of engagement, unity and rational courses of action during the pandemic. This paper examines Macao’s two orientations – intra and post-coronavirus – which are shown to be instrumental in the city’s future tourism development. Practical implications: As the paper is Macao-specific, some generalization may not be applicable. The lessons and strategies proposed in the paper may only be theoretically and temporarily workable in this real-time situation. However, as COVID-19 will remain for some time globally, the efficacy of the findings justifies further ongoing analysis and application beyond Macao. Originality/value: The case offers a first-hand analysis on the governance of Macao to negate the impacts of COVID-19, enabling a comprehensive review on the practices and policies that were effective during the virus outbreak. There is reference for researchers and practitioners in the public policy domain, and particularly in the area of crisis management and destination resilience. The result is worthy of future exploration on how the mechanism of centralized government facilitates risk management, and the rebuilding of a tourism economy in a crisis context, comparing this to other national systems. © 2021, Emerald Publishing Limited.