Safety and Immunogenicity of Coronavac and Chadox1 Vaccines against Sars-Cov-2 in Patients with Rheumatoid Arthritis: Brazilian Multicentric Study

Objectives: To evaluate the safety and immunogenicity of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with Rheumatoid Arthritis (RA). Method(s): These data are from the 'SAFER (Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases)' study, a Brazilian multicentric longitudinal phase IV study to evaluate COVID-19 vaccine in immunomediated rheumatic diseases (IMRDs). Adverse events (AEs) in patients with RA were assessed after two doses of ChAdOx1 or CoronaVac. Stratification of postvaccination AEs was performed using a diary, filled out daily. The titers of neutralizing antibodies against the receptor-biding domain of SARS-CoV-2 (anti-RBD) were measured by chemilumine scence test after each dose of immunizers. Proportions between groups were compared using the Chi-square and Fisher's exact tests for categorical variables. Clinical Disease Activity Index (CDAI) before and after vaccination was assessed using the McNemar test. Result(s): A total of 188 patients with RA were included in the study, most of them were female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed. The more common AEs after the first dose were pain at injection site (46,7%), headache (39,4%), arthralgia (39,4%) and myalgia (30,5%), and ChAdOx1 had a higher frequency of pain at the injection site (66% vs 32 %, p alpha 0.001) arthralgia (62% vs 22%, p alpha 0.001) and myalgia (45% vs 20%, p alpha 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection site (37%), arthralgia (31%), myalgia (23%) and headache (21%). Arthralgia (41,42 % vs 25 %, p = 0.02) and pain at injection site (51,43% vs 27%, p = 0.001) were more common with ChAdOx1. No patients had a flare after vaccination. The titers of anti-RBDafter two doses of ChAdOx1 were higher compared to two doses of CoronaVac (6,03 BAU/mL vs 4,67 BAU/mL, p alpha 0,001). Conclusion(s): The frequency of local adverse effects, particularly pain at injection site, was high. AEs were more frequent with ChAdOx1, especially after the first dose. The use of the immunizers dis not change the degree of inflammatory activity of the disease. In patients with RA, ChAdOx1 was more immunogenic than CoronaVac. .

Clinical Effectiveness and Adverse Events of Adjunctive Remdesivir Administration Vs Standard of Care in Adults with Severe and Critical Covid-19

Intro: The unavailability of specific treatment for COVID-19 prompted the empirical use of remdesivir, a viral RNA polymerase inhibitor. Since evidences present conflicting results, this study aims to determine the clinical effectiveness and adverse events of adjunctive remdesivir administration vs standard of care (non-remdesivir) in COVID-19 adult patients in a tertiary hospital in Baguio City, Philippines. Method(s): We performed a single-center, retrospective study of severe to critical COVID-19 patients admitted from September 2020 to September 2021. Stratified random sampling was employed and data collection was through chart review. Analysis was done with R Statistical Software version 4, utilizing paired T-test and McNemar test, with p-value of <0.05 considered as significant. Finding(s): A total of 318 patients were reviewed and classified into the remdesivir (n=159) and standard of care (non-remdesivir) (n=159) groups. Baseline characteristics were comparable except for co-morbidities (p<0.05). There were no noted significant differences between both groups in terms of morality (p=0.885) and reduction in chest radiograph infiltrates (p=0.182). However, the average number of days to clinical improvement (7 days vs 12 days) and recovery (16 days vs 21 days) were statistically lesser in the remdesivir group (p=0.00). Also, those who experienced diarrhea (p=0.33) and transaminitis (p=0.003) were significantly higher in those given remdesivir. Conclusion(s): There was no significant difference in terms of mortality in those given remdesivir vs standard of care alone. Nevertheless, remdesivir administration is associated with significantly faster time to clinical improvement and recovery. The drug is thought to facilitate faster lung viral load clearance and improved pulmonary function through inhibition of RNA polymerase. Though not potentially life-threatening, the drug may cause diarrhea and elevation in transaminases.Copyright © 2023

The Changes in the Travel Characteristics Due to Corona Virus Pandemic: A Case Study in Al-Qadisiyah Governorate, Iraq

Many measures have been imposed by governments around the world to limit the spread of COVID-19. Iraqi authorities adopted a continuous cycles of reinforcement and relaxation in the measures, thus travel behaviors are significantly affected as a result of these measures. This study focuses on the impact of the COVID-19 pandemic on travel pattern in Al-Qadisiyah governorate, Iraq, during three different phases, one phase before pandemic and two phases during the pandemic to study the impact of the variation in imposed measures. Data were collected through a qualitative interviews and online questionnaire surveys that included questions on primary purpose of trip, mode choice of transport, frequency of trips before and during pandemic (including two phases). Descriptive analysis and inferential statistical analysis (especially nonparametric tests) were conducted to analyze the collected data. Results show a significant shifting from work/studying trips to shopping and others trips purposes during the first phase, where distance education and teleworking were imposed. In the second phase, the recommendation for work and study from home were lifted thus the primary trips for work or study purposes have resumed somewhat like their previous pace but with less frequent than its usual in pre-pandemic. A significant reduction in public transport and car-sharing usage was observed during first phase-COVID-19 compared to pre-COVID-19 and second phase-COVID-19. People gave the pandemicrelated factors a higher priority than general factors when selecting a transport mode during the pandemic. However, they put less priority for such factors during second phase of COVID-19 as compared to first phase, due to relaxation in the imposed measures. Changes in travel behavior during a pandemic have an impact on travel demand and favorable transport modes, thus understanding this behavior can help in transportation planning, and decision-making. © 2023 WITPress. All rights reserved.

A Prospective, Longitudinal Evaluation of SARS-CoV-2 COVID-19 Exposure, Use of Protective Equipment and Social Distancing in a Group of Community Physicians.

INTRODUCTION: Healthcare workers experience a significant risk of exposure to and infection from SARS-CoV-2, COVID-19. Nonetheless, little research has focused on physicians' use of personal protective equipment (PPE), their concerns about becoming infected and their social distancing maneuvers. METHODS: All staff physicians at Advocate Lutheran General Hospital were invited to participate. Their COVID-19 IgG antibody level was measured and an online questionnaire was completed. The questionnaire assessed the risk of COVID-19 exposure, PPE usage, concern for contracting COVID-19, the performance of high-risk procedures, work in high-risk settings, and social distancing practices. Testing was performed in September (T0), and December 2020 (T1) at the height of the global pandemic. RESULTS: A total of 481 (26.7%) of 1800 AGLH physicians were enrolled at T0 and 458 (95% of the original group) at T1. A total of 21 (4.3%) and 39 (8.5%) participants had antibodies at T0 and T1. A total of 63 (13.8%) worked in high-risk settings and 111 (24.2%) performed high-risk procedures. Participants working in high-risk settings had increased exposure to COVID-19 infected patients (OR = 4.464 CI = 2.522-8.459, p < 0.001). Participants were highly adherent to the use of PPE and social distancing practices including mask-wearing in public (86%, 82.1%), avoiding crowds (85.1%, 85.6%), six feet distancing (83.8%, 83.4%), and avoiding public transportation (78%, 83.8%). A total of 251 (55.4%) participants expressed moderate to extreme concern about becoming infected with COVID-19. CONCLUSIONS AND RELEVANCE: Among a group of community physicians, consistent PPE use and social distancing practices were common. These practices were associated with a low level of initial acquisition of COVID-19 infections and a relatively low longitudinal risk of infection.

Transportation, the pathogen vector to rule them all: Evidence from the recent coronavirus pandemic.

Introduction: It is common knowledge that mobility refers to a distinct vector for pathogens, but the importance of prevention and the infusion of public health practices within transportation systems is not manifest. Replication studies of this effect are important because transportation remains veiled in modern societies, since its demand is not direct, but derived. Methods: Variables mirroring transportation and logistics' systems intensity (trade data, the logistics performance index, and investment in transportation) are cross-tabulated with epidemiological data from the recent coronavirus pandemic. As the samples of the data pertain to a dependent commonality, the statistical hypothesis test applicable is McNemar's test. In addition, the statistical power of the test(s) is calculated as a marker of methodological validity and reliability. To further strengthen the analytical methodology, a plethora of descriptive statistics have been calculated and multiple correspondence analysis (MCA) has been conducted. Results: This work confirms that the domain of transportation bears a strong association with not only mortality of a disease, but its recovery rates as well. All crosstabs provide statistically significant results and the statistical power calculated is very high, signifying the appropriateness of the methodology and the very low probability of Type II error. The MCA results are significant, as well. Conclusions: The impact, or even the presence of transportation is veiled, as transportation comprises of derived demand dynamics. As such, its activities and even the prerequisites for its efficient operations many times go unnoticed. This work replicates a known effect, that mobility exacerbates the presence of a pathogen. The significance of this research lies on the fact that distinct indicators that reflect transportation and logistics are (though a robust calculatory methodology) statistically associated with epidemiological data.