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1.
Vaccine ; 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2096120

ABSTRACT

INTRODUCTION: The safety profiles of COVID-19 vaccines are incompletely evaluated in Japan. OBJECTIVES: To examine the risk of serious adverse effects after COVID-19 mRNA vaccination (BNT162b2 and mRNA-1273) in cohort studies and self-controlled case series (SCCS). METHODS: Using an administrative claims database linked with the COVID-19 vaccination registry in a city in Japan between September 2020 and September 2021, we identified health insurance enrolees aged ≥ 18 years. We evaluated the risk of acute myocardial infarction, appendicitis, Bell's palsy, convulsions/seizures, disseminated intravascular coagulation, immune thrombocytopenia, pulmonary embolism, haemorrhagic or ischemic stroke, venous thromboembolism, and all-cause mortality, 21 days following any COVID-19 mRNA vaccination, compared with non-vaccination periods. For the cohort studies, we estimated incidence rate ratios (IRRs) by Poisson regression and rate differences (IRDs) by weighted least-squares regression, adjusting for sex, age, and Charlson comorbidity index. We applied a modified SCCS design to appropriately treat outcome-dependent exposures. For the modified SCCS, we estimated within-subject IRRs by weighted conditional Poisson regression. Subgroup analyses stratified by sex and age were also conducted. RESULTS: We identified 184,491 enrolees [male: 87,218; mean (standard deviation) age: 64.2 (19.5) years] with 136,667 first and 127,322 s dose vaccinations. The risks of any outcomes did not increase in any analyses, except for the fact that the modified SCCS indicated an increased risk of pulmonary embolism after the first dose in women (within-subject IRR [95%CI]: 3.97 [1.18-13.32]). CONCLUSION: The findings suggested that the COVID-19 mRNA vaccine was generally safe, whilst a signal of pulmonary embolism following the first dose of the COVID-19 mRNA vaccine was observed.

2.
Lancet Reg Health West Pac ; : 100630, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2095737

ABSTRACT

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.

4.
Epilepsia ; 2022 Oct 13.
Article in English | MEDLINE | ID: covidwho-2063698

ABSTRACT

OBJECTIVE: The risk of seizure following BNT162b2 and CoronaVac vaccinations has been sparsely investigated. This study aimed to evaluate this association. METHOD: Patients who had their first seizure-related hospitalization between February 23, 2021 and January 31, 2022, were identified in Hong Kong. All seizure episodes happening on the day of vaccination (day 0) were excluded, since clinicians validated that most of the cases on day 0 were syncopal episodes. Within-individual comparison using a modified self-controlled case series analysis was applied to estimate the incidence rate ratio (IRR) with 95% confidence intervals (CIs) of seizure using conditional Poisson regression. RESULTS: We identified 1656 individuals who had their first seizure-related hospitalization (BNT162b2: 426; CoronaVac: 263; unvaccinated: 967) within the observation period. The incidence of seizure was 1.04 (95% CI .80-1.33) and 1.11 (95% CI .80-1.50) per 100 000 doses of BNT162b2 and CoronaVac administered, respectively. Sixteen and 17 individuals, respectively, received a second dose after having a first seizure within 28 days after the first dose of BNT162b2 and CoronaVac vaccinations. None had recurrent seizures after the second dose. There was no increased risk during day 1-6 after the first (BNT162b2: IRR = 1.39, 95% CI = .75-2.58; CoronaVac: IRR = 1.19, 95% CI = .50-2.83) and second doses (BNT162b2: IRR = 1.36, 95% CI = .72-2.57; CoronaVac: IRR = .71, 95% CI = .22-2.30) of vaccinations. During 7-13, 14-20, and 21-27 days post-vaccination, no association was observed for either vaccine. SIGNIFICANCE: The findings demonstrated no increased risk of seizure following BNT162b2 and CoronaVac vaccinations. Future studies will be warranted to evaluate the risk of seizure following COVID-19 vaccinations in different populations, with subsequent doses to ensure the generalizability.

5.
Middle East Journal of Family Medicine ; 20(9):126-131, 2022.
Article in English | Academic Search Complete | ID: covidwho-2025206

ABSTRACT

Introduction: Documented articles have determined that viral illness during early pregnancy and several antiviral drugs are associated with an increased risk for neurodevelopmental congenital anomalies of the newborn. These include NTDs, the most common and severe malformations of spinal cord (spina bi- fida) or brain (anencephaly, encephalocele, hydrocephalus), which develop within 6 weeks of pregnancy with an incidence of one in 1000 neonates worldwide and they cause lifelong neurological complications. The aim of this study is to describe the clinical characteristics of simultaneous cases of COVID 19 in pregnant women with neural tube defects in their newborns. Patient and methods: This is descriptive study case series including cases of Neural Tube Defects when their mothers were affected with COVID-19 infection that was reported in Zahko Maternity hospital. Those in the labour unit were enrolled in this study and the cases was collected during the period 1st January 2020 and 1st January 2022. The information collected through direct interview with the mothers through questionnaire includes the information about the socio-demographic, obstetrical history and history of COVID 19 infection, severity presence of fever and type of medication received. Results: Regarding the general and obstetrical history of the patients, the current study revealed that the affected age group of mothers was as follows;28 (41.2%) of them (26-30 years), and 15 (22.1) of them (> 35). Anemia and fever in the 1st trimester were found in 54 (79.4%) of them. Alcohol intake was reported in 2 (2.9%) of them, consanguinity in 19 (27.9%) of them, female newborns constituted 38 (55.9%), gestational diabetes mellitus in 1 (1.5%), diabetes mellitus in 6 (8.8%), and hypertension in 5 (7.4%). The drugs received during pregnancy, were as follows;antibiotics;all patients 100%;antihypertensive drugs received by 14 (20.6%), antipyretics 29 (42.6%), antacids 21 (30.9%), and antifungals 16 (23.5%). Conclusions: the COVID19 infection may be blamed as a cause of NTDs, and further research about the pathophysiology is needed. [ FROM AUTHOR] Copyright of Middle East Journal of Family Medicine is the property of Medi+WORLD International Pty. Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

6.
Int. j. high dilution res ; 21: 46-66, June 20, 2022.
Article in English | WHO COVID, LILACS (Americas) | ID: covidwho-2026832

ABSTRACT

Psychological fragility caused to human life has been the largest aftermath of the pandemic posing a raised public health concern globally. This psychological impact is identified as Post-Traumatic Stress Disorder (PTSD) which was the most commonly diagnosed psychological disorder during this pandemic. These cases, if left untreated and unidentified may take a devastating transformation into psychotic disorders and cause gross damage to the individual and the community by disrupting human relations. Keeping in view the beneficial role of Homoeopathy in dealing with psychological disorders based on its philosophy and previous studies, a clinical case series of 10 PTSD cases successfully treated with Homoeopathy during this pandemic are presented here. 10 cases of PTSD consulted during the first wave of pandemic diagnosed based on the clinical picture analogous to PTSD cluster symptomatology from Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and objectively through Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) were treated with Homoeopathic intervention. Homeopathic medicine was prescribed based on the totality of each case through repertorization and in consultation with the sourcebooks of Homoeopathic Materia Medica (HMM). The cases were followed monthly for clinical improvement and every three months using the CAPS-5 score. The outcome was assessed after six months clinically and objectively through the CAPS-5 score. At the end of one year, further to assess the casual attribution of clinical outcome to homoeopathic intervention, validated MONARCH (Modified Naranjo Criteria for Homoeopathy) tool was utilized. The 10 diagnosed PTSD cases showed marked improvement assessed after one year of Homoeopathic treatment. Significant improvement was found in the clinical picture affirmed through CAPS-5 score and MONARCH tool. Homoeopathic medicines showed a significantly beneficial role in the management of PTSD during the pandemic in the presented 10 cases. Further validation through well-designed clinical trials is warranted.


Subject(s)
Humans , Stress Disorders, Post-Traumatic , Homeopathic Therapeutics , COVID-19/psychology , Retrospective Studies
7.
Disabil Rehabil Assist Technol ; : 1-13, 2022 Sep 12.
Article in English | MEDLINE | ID: covidwho-2017474

ABSTRACT

PURPOSE: The purpose of this case series was to explore the influence of powered wheelchair standing device (PWSD) use on participants': (1) activities and participation; (2) quality of life; and (3) lower extremity passive range of motion (LE PROM). CASE DESCRIPTION: Eight participants enrolled in the case series (five adults and three children). Outcome measures included: the Canadian Occupational Performance Measure (COPM), the EQ-5D-5L or the EQ-5D-Y, the Patient-Assessment of Constipation Quality of Life Questionnaire (PAC-QOL), LE PROM measurements and PWSD use data automatically collected by each PWSD. Participants were provided with a front wheel-drive PWSD designed for both outdoor and indoor use for up to 12-months of use. OUTCOMES: Four participants completed the 12-month case series. Three participants achieved clinically significant improvements in performance on the COPM. Three of the four participants reporting issues with constipation achieved clinically significant improvements in their total PAC-QOL scores. Almost all participants demonstrated changes in some LE PROM. CONCLUSIONS: Applying the Human Activity Assistive Technology model may help to explain differences in both PWSD use and outcomes amongst the individual participants in this case series. The participants who were most successful in using the PWSD were in environments with sufficient space to use the PWSD to perform everyday activities and had higher frequencies of PWSD use. The outcomes of this case series may assist both researchers and clinicians when implementing future PWSD studies recommending PWSDs to their clients/patients. Implications for rehabilitationA wide variety of factors may influence powered wheelchair standing device (PWSD) use.PWSD use may lead to improvements in activities, participation, quality of life and lower extremity passive range of motion.The participants who were most successful in using the PWSD were in environments that permitted use of the PWSD during the performance of everyday activities.COVID-19 restrictions prohibited in-person sessions with a therapist, which could have assisted participants in better integrating the PWSD in their daily lives.

8.
Front Pediatr ; 10: 935236, 2022.
Article in English | MEDLINE | ID: covidwho-2009891

ABSTRACT

On 11 March 2020, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) was declared as a pandemic by the World Health Organization (WHO). As the COVID-19 pandemic has ravaged worldwide, children have not been unaffected. Information gleaned from adult experience with the disease has aided in disease detection and treatment strategies in children. Numerous cases have been described in adult literature about hematologic manifestations of COVID-19. This case series aims to report several hematologic presentations in patients with COVID-19 and multisystem inflammatory syndrome in children (MIS-C, an immune-mediated reaction leading to severe COVID-19 illness) with and without a primary hematologic disorder.

9.
European Journal of Obstetrics & Gynecology and Reproductive Biology ; 2022.
Article in English | ScienceDirect | ID: covidwho-2007676

ABSTRACT

Objectives To document how many pregnant women with COVID-19 reported in the literature had participated in randomised trials, what treatments they received outside such trials and compare the latter with evidence-based treatment recommendations. Study Design: Two clinical trial registries were searched to identify COVID-19 trials open to pregnant women. Studies were then extracted from a regularly updated list of scientific case reports and case series of confirmed or suspected maternal COVID‐19 in pregnancy to identify the number of women enrolled into a trial and the pharmaceutical treatments they received outside such trials. Results 156 studies (case reports, case series and registries) reporting 43,185 pregnant women with COVID-19, after de-duplication. Of these 2,671 (6.2%) were potentially eligible for a randomised trial but only seven women (0.26%) were reported to have enrolled. For 2,839 women the papers included information on treatment received, 1515/2829 (54%) women had received ≥ 1 treatment and in total a COVID-19 pharmaceutical treatment was administered 1,296 times outside of a trial. In 566 (44%) cases the treatments administered to the pregnant women were not recommended by the National Institutes of Health (NIH) at the time of administration. Of 179 case reports of women with COVID 19 in pregnancy, 109/179 women received ≥ 1 COVID-19 pharmaceutical treatment and in total COVID-19 experimental pharmaceutical treatments were administered 274 times. Conclusion During the early phase of the COVID-19 pandemic, pregnant women excluded from randomised trials did not avoid unproven or ineffective treatments.

10.
Qatar Med J ; 2022(3): 39, 2022.
Article in English | MEDLINE | ID: covidwho-1994385

ABSTRACT

BACKGROUND: COVID-19 infection has been spreading across the globe since the end of 2019, and it continues to cause chronic multi-system sequelae, of which thyroid dysfunction appears to be the major one. We have discussed here 10 cases of thyroid dysfunction after COVID-19 infection. METHODS: Case series report. From October 2020 to July 2021, a series of 10 cases of thyroid dysfunction after COVID-19 infection were recorded and managed in a single outpatient endocrine center in Doha, Qatar. CASES PRESENTATION: We have reported 5 cases of Graves's hyperthyroidism, 2 of chronic primary hypothyroidism (including one with Grave's disease [GD]) who was treated through radioactive iodine (RAI) therapy, one case of subacute thyroiditis, one case with "Sick euthyroid disease," and one case of central hypothyroidism. Presently, patients with GD are being treated with carbimazole and those with hypothyroidism are being treated with levothyroxine. The remaining patients had recovered with euthyroid. CONCLUSION: This is the largest case series reported from a single center to date. The findings of this series indicate a bimodal distribution of thyroid dysfunction in patients with COVID-19 infection. A review of the literature and discussion of potential pathophysiological mechanisms has been presented. We have emphasized the importance of screening for thyroid dysfunction in "post-COVID-19" cases, considering that the prevalence may be underestimated.

11.
JMIR Form Res ; 6(7): e37382, 2022 Jul 20.
Article in English | MEDLINE | ID: covidwho-1974521

ABSTRACT

BACKGROUND: Novel interventions should be developed for people who have undergone psychological trauma. In a previous case study, we found that the number of intrusive memories of trauma could be reduced with a novel intervention. The intervention included a brief memory reminder, a visuospatial task and mental rotation, and targeted trauma memory hotspots one at a time in separate sessions. OBJECTIVE: This case series (N=3) extended the first case study with 3 new cases to determine whether a similar pattern of beneficial results is observed. We explored whether the brief intervention would result in reduced numbers of intrusive memories and whether it would impact symptoms of posttraumatic stress, depression and anxiety, and general functioning. Acceptability of the intervention was also explored. METHODS: A total of 3 women completed the study: 2 with posttraumatic stress disorder and other comorbidities and 1 with subthreshold posttraumatic stress disorder. The primary outcome was the change in the number of intrusive memories from the baseline phase to the intervention phase and at the 1-month follow-up, with an assessment of the intrusion frequency at 3 months. Participants monitored the number of intrusive memories in a daily diary for 1 week at baseline, for maximum of 6 weeks during the intervention phase and for 1 week at the 1-month and 3-month follow-ups. The intervention was delivered in person or digitally, with guidance from a clinical psychologist. A repeated AB design was used (A was a preintervention baseline phase and B intervention phase). Intrusions were targeted individually, creating repetitions of an AB design. RESULTS: The total number of intrusive memories was reduced from the baseline to the intervention phase for all participants. The total number for participant 3 (P3) reduced from 38.8 per week during the baseline phase to 18.0 per week in the intervention phase. It was 13 at the 3-month follow-up. The total number for P4 reduced from 10.8 per week at baseline to 4.7 per week in the intervention phase. It was 0 at the 3-month follow-up. The total number for P5 was reduced from 33.7 at baseline to 20.7 per week in the intervention phase. It was 8 at the 3-month follow-up. All participants reported reduction in posttraumatic stress symptoms in the postintervention phase. Depression and anxiety symptoms reduced in 2 of the 3 participants in the postintervention phase. Acceptability was favorable. CONCLUSIONS: We observed good compliance with the intervention and intrusive memory diary in all 3 cases. The number of intrusive memories was reduced for all participants during the intervention phase and at the 1-month follow-up, with some improvement in other symptoms and functioning. Further research should explore the remote delivery of the intervention and whether nonspecialists can deliver the intervention effectively.

12.
Syst Rev ; 11(1): 155, 2022 07 30.
Article in English | MEDLINE | ID: covidwho-1968762

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, some studies describing different aspects of the infection included very similar participants, rising suspicion about double reporting. We aimed to evaluate the Gantt chart as a tool to highlight possible double reporting. The chart is routinely used in business applications to depict tasks of a project, by plotting horizontal bars against time, showing their time span and overlaps. METHODS: All case reports and case series of pregnant women with COVID-19, published by July 15, 2020, were included. Initial and final dates of participants' enrollment, country, city, hospital, and number of pregnancies were plotted in the Gantt chart. Bars stand for enrollment dates of each study, according to hospital and city, thus allowing comparisons. RESULTS: We included 116 articles in the present analysis. The Gantt chart highlighted papers in which some participants were likely the same, thus allowing easier identification of double reporting of cases. Combining all information and pregnancy characteristics and outcomes helped to recognize duplications when the authors did not acknowledged the previous publication. CONCLUSIONS: Unintended double reporting may occur, especially in exceptional times. The Gantt chart may help researchers to visually identify potential duplications, thus avoiding biased estimates in systematic reviews or meta-analysis.


Subject(s)
COVID-19 , Female , Hospitals , Humans , Pandemics , Pregnancy , Systematic Reviews as Topic
13.
Front Med (Lausanne) ; 9: 879996, 2022.
Article in English | MEDLINE | ID: covidwho-1952388

ABSTRACT

Introduction: Gastrointestinal symptoms are common among COVID-19 patients. Although gastrointestinal involvements are mostly benign, they rarely indicate a severe pathology like intestinal ischemia. The present case series describes 21 patients with bowel ischemia, necrosis, or perforation. Methods: The present case series was conducted from April 2020 to February 2022 in the surgical wards of two Iranian hospitals. We retrospectively included adult patients with concomitant COVID-19 and intestinal ischemia. Primary outcomes were defined as the length of stay and survival. Results: Twenty-four patients with a median age of 61.5 years were included in the study. Sixteen (67%) patients were male, and 13 (54%) were without any comorbidities. Macrovascular mesenteric ischemia was not identified in 21 patients (87.5%). Gastrointestinal manifestations appeared on the median of seven days (range 2-21) after the diagnosis of COVID-19, with the most common symptom being abdominal pain. All the patients had a significantly elevated C-Reactive Protein prior to surgery, ranging from 68 to 362. D-dimer was measured in eight patients and was significantly elevated, ranging from 1,878 to over 5,000 ng/mL. One patient was managed conservatively due to a good clinical condition. Except for one patient with angioinvasive mucormycosis and one other with leukocytoclastic vasculitis, pathologic evaluation revealed general features of intestinal necrosis, including ulcer, hemorrhage, necrosis, neutrophilic infiltration (in seven patients), neutrophilic abscess (in four patients), and edema. Bowel necrosis accompanied mortality of 15 (62.5%) patients and a median of 6.5 days of hospital stay. Conclusion: Intestinal ischemia in COVID-19 patients is associated with a high mortality rate. Further research is needed to elucidate the dynamics of intestinal ischemia in the setting of COVID-19.

14.
Front Cardiovasc Med ; 9: 844626, 2022.
Article in English | MEDLINE | ID: covidwho-1952274

ABSTRACT

Acute myocarditis is a rare but serious complication associated with mRNA-based coronavirus disease 2019 (COVID-19) vaccination. In this article, four COVID-19 mRNA vaccination induced myocarditis cases managed at our tertiary Medical Center have been discussed. Three patients had typical myocarditis. One patient suffered from atrioventricular block and heart failure, which required more intensive treatment, but eventually improved. Additionally, a review of cardiac magnetic resonance imaging (MRI) features related to the diagnosis of myocarditis showed that COVID-19 mRNA vaccine-associated myocarditis tend to have more late-gadolinium enhancement (LGE) accumulation in the inferior lateral wall direction. According to a report by the U.S. Centers for Disease Control and Prevention (CDC), the diagnosis of COVID-19 mRNA vaccine-associated myocarditis is based on clinical symptoms, altered myocardial enzymes, cardiac MRI finding, or histopathology. Cardiac MRI is relatively less invasive than myocardial biopsy and plays an important role in the diagnosis of myocarditis. This review may aid in the diagnosis of COVID-19 mRNA vaccine-associated myocarditis.

15.
Vaccine ; 40(32): 4394-4402, 2022 07 30.
Article in English | MEDLINE | ID: covidwho-1946788

ABSTRACT

BACKGROUND: Rapid deployment of COVID-19 vaccines is challenging for safety surveillance, especially on adverse events of special interest (AESIs) that were not identified during the pre-licensure studies. This study evaluated the risk of hospitalisations for predefined diagnoses among the vaccinated population in Malaysia. METHODS: Hospital admissions for selected diagnoses between 1 February 2021 and 30 September 2021 were linked to the national COVID-19 immunisation register. We conducted self-controlled case-series study by identifying individuals who received COVID-19 vaccine and diagnosis of thrombocytopenia, venous thromboembolism, myocardial infarction, myocarditis/pericarditis, arrhythmia, stroke, Bell's Palsy, and convulsion/seizure. The incidence of events was assessed in risk period of 21 days postvaccination relative to the control period. We used conditional Poisson regression to calculate the incidence rate ratio (IRR) and 95% confidence interval (CI) with adjustment for calendar period. RESULTS: There was no increase in the risk for myocarditis/pericarditis, Bell's Palsy, stroke, and myocardial infarction in the 21 days following either dose of BNT162b2, CoronaVac, and ChAdOx1 vaccines. A small increased risk of venous thromboembolism (IRR 1.24; 95% CI 1.02, 1.49), arrhythmia (IRR 1.16, 95% CI 1.07, 1.26), and convulsion/seizure (IRR 1.26; 95% CI 1.07, 1.48) was observed among BNT162b2 recipients. No association between CoronaVac vaccine was found with all events except arrhythmia (IRR 1.15; 95% CI 1.01, 1.30). ChAdOx1 vaccine was associated with an increased risk of thrombocytopenia (IRR 2.67; 95% CI 1.21, 5.89) and venous thromboembolism (IRR 2.22; 95% CI 1.17, 4.21). CONCLUSION: This study shows acceptable safety profiles of COVID-19 vaccines among recipients of BNT162b2, CoronaVac, and ChAdOx1 vaccines. This information can be used together with effectiveness data for risk-benefit analysis of the vaccination program. Further surveillance with more data is required to assess AESIs following COVID-19 vaccination in short- and long-term.


Subject(s)
COVID-19 Vaccines , COVID-19 , BNT162 Vaccine , Bell Palsy/chemically induced , Bell Palsy/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , ChAdOx1 nCoV-19 , Humans , Malaysia/epidemiology , Myocardial Infarction/chemically induced , Myocardial Infarction/epidemiology , Myocarditis/chemically induced , Myocarditis/epidemiology , Pericarditis/chemically induced , Pericarditis/epidemiology , Seizures/chemically induced , Stroke/chemically induced , Stroke/epidemiology , Thrombocytopenia/chemically induced , Thrombocytopenia/epidemiology , Vaccines, Inactivated , Venous Thromboembolism/chemically induced , Venous Thromboembolism/epidemiology
16.
Clin Hemorheol Microcirc ; 2022 Jul 07.
Article in English | MEDLINE | ID: covidwho-1933550

ABSTRACT

In 2021 the delta variant was discovered, heralding the start of the second pandemic wave. This case series aims to analyse and compare the coagulation and hemorheology profiles of COVID-19 patients diagnosed with acute stroke during the pandemic's second wave and ascertain the effect on patient outcomes. This case series reports 4 cases with their respective characteristics. Case 1 reports on COVID-19 patients without comorbidities, Case 2 with comorbidities, Case 3 with strokes in young patients, and Case 4 with strokes in elderly patients. All cases had abnormal coagulation and hemorheology factors with mixed outcomes. Coagulation and hemorheology factors tend to be higher in COVID-19 patients with acute stroke. The value of coagulation and hemorheology factors can be a prognostic outcome in COVID-19 patients with severe disease, especially in patients associated with acute stroke.

17.
Orthoplastic Surgery ; 2022.
Article in English | ScienceDirect | ID: covidwho-1926815

ABSTRACT

Introduction;The free superficial circumflex iliac artery perforator (SCIP) flap evolved from the traditional groin flap, conferring numerous advantages. The thin nature of the flap avoids the need for secondary revisions and debulking procedures, particularly pertinent when theatre capacity was limited during the COVID-19 pandemic. We present a series reporting our centre’s first year experiences undertaking SCIP flap reconstruction for traumatic limb injuries following the establishment of our regional major trauma network. Materials and methods;A retrospective analysis of all patients treated for traumatic limb defects in our centre was undertaken between September 2020 to September 2021. Data was collected on patient demographics, injury, flap dimensions and flap survival. Results;Ten patients (M:F 1:1, mean age 45 years) with traumatic limb defects were reconstructed with SCIP flaps performed by the senior authors. All had sustained open fractures. Nine had lower limb defects, most commonly at the medial ankle, one had a volar wrist defect with a devascularised hand. The mean flap dimension was 6.3x14.5cm. All were anastomosed end-to-side to the recipient artery except one end-to-end anastomosis to a posterior tibial artery perforator using super-microsurgery. There was 100% flap survival. Complications consisted of one flap suffering <10% tip necrosis requiring debridement and small skin graft. Conclusion, The SCIP flap provides reliable, thin and pliable tissue without the need for secondary flap revisions and should be considered in the armamentarium of the reconstructive surgeon in extremity trauma reconstruction, particularly in the current environment surrounding the global pandemic.

18.
J Hepatol ; 77(5): 1339-1348, 2022 11.
Article in English | MEDLINE | ID: covidwho-1926640

ABSTRACT

BACKGROUND & AIMS: Case reports of severe acute liver injury (ALI) following COVID-19 vaccination have recently been published. We evaluated the risks of ALI following COVID-19 vaccination (BNT162b2 or CoronaVac). METHODS: We conducted a modified self-controlled case series analysis using the vaccination records in Hong Kong with data linkage to electronic medical records from a territory-wide healthcare database. Incidence rate ratios (IRRs) for ALI outcome in the 56-day period following first and second doses of COVID-19 vaccines in comparison to the non-exposure period were estimated and compared to the ALI risk in patients with SARS-CoV-2 infection. RESULTS: Among 2,343,288 COVID-19 vaccine recipients who were at risk, 4,677 patients developed ALI for the first time between 23rd February 2021 to 30th September 2021. The number of ALI cases within 56 days after the first and second dose of vaccination were 307 and 521 (335 and 334 per 100,000 person-years) for BNT162b2, and 304 and 474 (358 and 403 per 100,000 person-years) for CoronaVac, respectively, compared to 32,997 ALI cases per 100,000 person-years among patients within 56 days of SARS-CoV-2 infection. Compared to the non-exposure period, no increased risk was observed in the 56-day risk period for first (IRR 0.800; 95% CI 0.680-0.942) and second (IRR 0.944; 95% CI 0.816-1.091) dose of BNT162b2, or first (IRR 0.689; 95% CI 0.588-0.807) and second (IRR 0.905; 95% CI 0.781-1.048) dose of CoronaVac. There were no severe or fatal cases of ALI following COVID-19 vaccination. CONCLUSION: There was no evidence of an increased risk of ALI associated with BNT162b2 or CoronaVac vaccination. Based on all current available evidence from previous studies and our study, the benefit of mass vaccination far outweighs the ALI risk from vaccination. LAY SUMMARY: There have been some recent reports that COVID-19 vaccination could be associated with acute liver injury. In our study, we found no evidence that COVID-19 vaccination increased the risk of acute liver injury, which was much more common after SARS-CoV-2 infection than after vaccination. Hence, our study provides further data indicating that the benefits of mass COVID-19 vaccination outweigh the potential risks.


Subject(s)
COVID-19 Vaccines , COVID-19 , Humans , Anthraquinones , BNT162 Vaccine , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Liver/injuries , Pyrazoles , RNA, Messenger , SARS-CoV-2
19.
Cureus ; 14(6): e25987, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1918095

ABSTRACT

Much of the literature involving COVID-19 and chronic inflammatory dermatological conditions have focused on the safety of immunomodulatory therapy in the setting of this highly infectious virus. While general mortality associated with the infection and vaccine has been studied in depth, the effects of the virus and vaccine on inflammatory skin disease states have not been. It is well known that psoriasis can be triggered by stress, infection, certain medications, and, although not as common, vaccinations. Further, existing literature has briefly commented on psoriasis flares after COVID vaccination, but these have not touched on flares among their patients' current therapy, nor flares after COVID infection. In this case report, we report five cases observed at our institution over the last year of either new-onset psoriasis or flares of previously well-controlled psoriasis shortly after infection with COVID-19 or COVID-19 vaccination, with no other identifiable triggers. These cases can serve to raise awareness of issues related to managing stubborn psoriatic flares and bring to the forefront conversations that are likely to arise with our patients regarding the risks and benefits of COVID vaccination and boosters. While the definitive etiology of the association between COVID and psoriasis remains unclear, it is important that the dermatologic community be aware when evaluating patients with new-onset or worsening psoriasis as we move forward in times of this COVID-19 era.

20.
Cardiovasc Res ; 118(10): 2329-2338, 2022 07 27.
Article in English | MEDLINE | ID: covidwho-1901160

ABSTRACT

AIMS: Concern about the cardiovascular safety of coronavirus disease 2019 (COVID-19) vaccines among individuals with cardiovascular disease (CVD) may lead to vaccine hesitancy. We sought to assess the association between two COVID-19 vaccines, BNT162b2 and CoronaVac, and the risk of major adverse cardiovascular events (MACE) in individuals with established CVD. METHODS AND RESULTS: We identified individuals with a history of CVD before 23 February 2021 and a diagnosis of MACE between 23 February 2021 and 31 January 2022 in Hong Kong. MACE was defined as a composite of myocardial infarction, stroke, revascularization, and cardiovascular death. Electronic health records from the Hong Kong Hospital Authority were linked to vaccination records from the Department of Health. A self-controlled case-series method was used to evaluate the risk of MACE for 0-13 and 14-27 days after two doses of COVID-19 vaccine. We estimated incidence rate ratios (IRRs) to compare the risk of MACE between each risk period and the baseline period. A total of 229 235 individuals with CVD were identified, of which 1764 were vaccinated and had a diagnosis of MACE during the observation period (BNT162b2 = 662; CoronaVac = 1102). For BNT162b2, IRRs were 0.48 [95% confidence interval (CI) 0.23-1.02] for the first dose and 0.87 (95% CI 0.50-1.52) for the second dose during the 0-13 days risk period, 0.40 (95% CI 0.18-0.93) for the first dose and 1.13 (95% CI 0.70-1.84) for the second dose during the 14-27 days risk period. For CoronaVac, the IRRs were 0.43 (95% CI 0.24-0.75) for the first dose and, 0.73 (95% CI 0.46-1.16) for the second dose during the 0-13 days risk period, 0.54 (95% CI 0.33-0.90) for the first dose and 0.83 (95% CI 0.54-1.29) for the second dose during the 14-27 days risk period. Consistent results were found in subgroup analyses for different sexes, age groups and different underlying cardiovascular conditions. CONCLUSION: Our findings showed no evidence of an increased risk of MACE after vaccination with BNT162b2 or CoronaVac in patients with CVD. Future research is required to monitor the risk after the third dose of each vaccine.


Subject(s)
BNT162 Vaccine , COVID-19 Vaccines , COVID-19 , Cardiovascular Diseases , BNT162 Vaccine/adverse effects , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/etiology , Humans , Risk Factors
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