ABSTRACT
Introduction: Vaccines against COVID-19 are effective. However, a percentage of people with a complete vaccination scheme are at risk of contracting and becoming ill from COVID-19. These cases are known as "vaccinated cases of infection". Objective: To identify the clinical characteristics of patients with SARS-CoV-2 infection with a history of vaccination for COVID-19. Methods: Retrospective cohort study in 271 vaccinated and positive patients who attended medical units in Baja California Sur, with or without a complete scheme and registered in SINOLAVE. Clinical characteristics, management, sequelae and mortality were analyzed. Descriptive statistics and association measures were used. Authorized by the ethics and research committees. Results: Age 48.5 ± 12.1 years, 19.5% met the definition of infection in vaccinated, 93% with outpatient management, 3.7% mortality, the most frequent comorbidity: diabetes / hypertension. 92% of the cases vaccinated with Cansino had COVID, followed by Pfizer with 26%. There is a higher risk of hospitalization and mortality in patients with an incomplete scheme. Conclusions: The vaccines are effective, most of the cases were ambulatory. Patients vaccinated with Cansino showed a higher COVID infection, the reinforcement of this vaccine could reduce the disease in patients already vaccinated. Of the patients who died, the majority did not have a complete vaccination schedule.
Introducción: Las vacunas contra la COVID-19 son efectivas. Sin embargo, un porcentaje de personas con esquema completo de vacunación tiene riesgo de contagiarse y enfermar por COVID-19. Estos casos se conocen como "casos de infección en vacunados". Objetivo: Identificar las características clínicas de los pacientes con infección por SARS-COV-2 con antecedente de vacunación para COVID-19.Métodos: Estudio de cohorte retrospectivo con 271 vacunados y positivos que acudieron a las unidades médicas en Baja California Sur, con esquema completo o sin él y registrados en el SINOLAVE. Se analizaron características clínicas, manejo, secuelas y mortalidad. Se utilizó estadística descriptiva y medidas de asociación. El estudio fue autorizado por los comités de ética e investigación. Resultados: Edad: 48.5 ± 12.1 años; 19.5% cumplieron con la definición de infección en vacunados; 93% con manejo ambulatorio; mortalidad del 3.7%; la comorbilidad mas frecuente: diabetes/hipertensión. El 92% de los casos vacunados con Cansino presentaron COVID, seguido por los que recibieron Pfizer, con el 26%. Existe mayor riesgo de hospitalización y mortalidad en pacientes con esquema incompleto. Conclusiones: las vacunas son efectivas, la mayoría de los casos fueron ambulatorios. Los pacientes vacunados con Cansino mostraron mayor infección por SARS-CoV-2; el refuerzo de esta vacuna, podría disminuir la enfermedad en los pacientes ya vacunados. De los pacientes que murieron, la mayoría no tenía esquema completo de vacunación.
Subject(s)
COVID-19 Vaccines , Vaccines , SARS-CoV-2 , COVID-19 , BNT162 Vaccine , ImmunityABSTRACT
La literatura más reciente indica que la enfermedad renal crónica constituye la comorbilidad con mayor riesgo de desarrollar enfermedad grave por SARS-CoV-2, coronavirus 2019 (COVID-19). Muchas sociedades científicas se han posicionado a favor de la vacunación de los pacientes con enfermedad renal crónica como prioritaria, debido a esta alta vulnerabilidad. En España, la quinta actualización de la Estrategia de vacunación frente a COVID-19 del Consejo Interterritorial de Salud, incluyó a los pacientes con ERC dentro del grupo 7 (personas con condiciones de muy alto riesgo). A lo largo del artículo se describen los tipos de vacunas según mecanismo de acción, las vacunas actualmente aprobadas por la Agencia Europea del Medicamento (EMA) y todo lo relacionado con el proceso de vacunación (preparación, administración y seguimiento), además de los aspectos a tener en cuenta en los pacientes con enfermedad renal crónica.Alternate : The most recent evidence indicates that chronic kidney disease is the comorbidity with the highest risk of developing severe disease due to SARS-CoV-2, coronavirus 2019 (COVID-19). Many scientific societies have advocated for vaccination of patients with chronic kidney disease as a priority, due to this high vulnerability. In Spain, the fifth update of the COVID-19 vaccination strategy published by the Interterritorial Health Council included CKD patients in group 7 (people with very high-risk conditions). This manuscript describes the types of vaccines according to mechanism of action, the vaccines currently approved by the European Medicines Agency (EMA) and information related to the vaccination process (preparation, administration and follow-up), as well as aspects to be taken into account in patients with CKD.
ABSTRACT
INTRODUCTION: Coronavirus disease 2019 (COVID-19) has spread rapidly, giving rise to a pandemic, causing significant morbidity and mortality. In this context, many vaccines have emerged to try to deal with this disease. OBJECTIVE: To review the reported cases of neurological manifestations after the application of COVID-19 vaccines, describing clinical, analytical and neuroimaging findings and health outcomes. METHODS: We carried out a review through bibliographic searches in PubMed. RESULTS: We found 86 articles, including 13 809 patients with a wide spectrum of neurological manifestations temporally associated with COVID-19 vaccination. Most occurred in women (63.89%), with a median age of 50 years. The most frequently reported adverse events were Bell's palsy 4936/13 809 (35.7%), headache (4067/13 809), cerebrovascular events 2412/13 809 (17.47%), Guillain-Barré syndrome 868/13 809 (6.28%), central nervous system demyelination 258/13 809 (1.86%) and functional neurological disorder 398/13 809 (2.88%). Most of the published cases occurred in temporal association with the Pfizer vaccine (BNT162b2), followed by the AstraZeneca vaccine (ChAdOX1-S). CONCLUSIONS: It is not possible to establish a causal relationship between these adverse events and COVID-19 vaccines with the currently existing data, nor to calculate the frequency of appearance of these disorders. However, it is necessary for health professionals to be familiar with these events, facilitating their early diagnosis and treatment. Large controlled epidemiological studies are necessary to establish a possible causal relationship between vaccination against COVID-19 and neurological adverse events.