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1.
Current Neurology ; 21(2):102-102–106, 2021.
Article in Polish | ProQuest Central | ID: covidwho-2025788

ABSTRACT

Herpes zoster (shingles) is an acute infectious viral disease that may develop in individuals who have previously had chickenpox. Unlike chickenpox, shingles is more likely to occur in adults, with the risk increasing with age. The paper presents treatment outcomes in a 63-year-old patient with severe thoracic pain persisting for 5 weeks. The treatment included 15 sessions of magnetic stimulation using a low induction variable magnetic field, performed once a day, which allowed to significantly reduce pain, as assessed using the Laitinen Pain Scale. The inclusion of magnetic stimulation as an element of comprehensive therapy also improved the patient’s quality of life, as assessed with EuroQol (a score of 25 before the therapy vs. 65 after the therapy).

2.
Int J Infect Dis ; 119: 214-216, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1889481

ABSTRACT

Most of the adverse effects reported in patients who have received COVID-19 vaccines have been mild. However, possible serious adverse effects are being monitored cautiously. There have also been a number of case reports of reactivation of varicella zoster infection within 28 days after immunization with mRNA COVID-19 vaccines. A few cases have also been reported after viral vector and inactivated COVID-19 vaccination. The incidence of meningitis following varicella zoster virus infection is rare. In the current study, we report two cases of male patients who received two different types of COVID-19 vaccine (inactivated and viral vector) and developed varicella zoster meningitis within 10 days after vaccination.


Subject(s)
COVID-19 , Chickenpox , Drug-Related Side Effects and Adverse Reactions , Herpes Zoster , Meningitis , COVID-19 Vaccines/adverse effects , Chickenpox/prevention & control , Chickenpox Vaccine/adverse effects , Drug-Related Side Effects and Adverse Reactions/etiology , Herpes Zoster/diagnosis , Herpes Zoster/epidemiology , Herpes Zoster/etiology , Herpesvirus 3, Human , Humans , Male , Meningitis/etiology , Vaccination/adverse effects
3.
Vaccines (Basel) ; 10(5)2022 May 20.
Article in English | MEDLINE | ID: covidwho-1875822

ABSTRACT

Hematopoietic stem cell transplant (HSCT) recipients have a high risk of developing primary varicella-zoster virus (VZV) infection and reactivation. VZV vaccination may prevent infection and reactivation. In the current study, recipients of allogeneic HSCT (34 females, 45 males) were vaccinated with adjuvanted, recombinant zoster vaccine Shingrix™, which contains the VZV glycoprotein E. Cellular immunity against various VZV antigens was analyzed by interferon-gamma ELISpot. Peripheral blood mononuclear cells (PBMC) of recipients with versus without prior shingles (n = 36 and n = 43, respectively) showed approximately twofold higher VZV-specific responses prior to and post vaccination. After the first and second vaccination, ELISpot responses towards the glycoprotein E were significantly higher in males versus females (median of spots increment 18 versus 1 and 17 versus 4, respectively, p ≤ 0.02 each). Multivariate analysis showed that shingles and sex both impacts significantly on VZV immunity. Whereas vaccination-induced changes could hardly be detected after stimulation with a whole VZV antigen, there was a significant increase in responses towards glycoprotein E after vaccination (p < 0.005). These data indicate that vaccination with Shingrix™ augmented cellular, VZV-specific immunity in HSCT recipients. Shingles and male sex could both be identified as factors leading to increased immunity.

4.
Int J Dermatol ; 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1819901

ABSTRACT

BACKGROUND: Although there is literature reporting correlations between varicella zoster virus (VZV) infections and COVID-19, insufficient evidence exists in this regard. This scoping review aims to identify the existing evidence regarding clinical characteristics of primary VZV infection or reactivation in COVID-19. METHODS: Following the PRISMA Extension for Scoping Reviews, MEDLINE and EMBASE were searched for all peer-reviewed articles with relevant keywords including "Zoster," "Herpes," and "COVID-19" from their inception to November 20, 2021. RESULTS: A total of 19 articles with three observational studies and 16 case reports or series were included. Primary VZV infections or reactivation were observed in 25 patients. Forty-eight percent of the patients had disseminated VZV infection. The median time of VZV-related rash after the onset of respiratory symptoms was 7.0 days (interquartile range: 0-18.8). Those with COVID-19 and primary VZV infection or reactivation had low lymphocyte counts with a median of 0.67 × 103 /µl. CONCLUSION: This scoping review identified uncertainty and a lack of strong evidence to see the association between primary VZV infection or reactivation and COVID-19. However, those with COVID-19 may be more likely to have disseminated VZV, which poses an additional challenge from an infection prevention standpoint. Future studies are warranted to determine the association between primary VZV infection or reactivation and long-term consequences related to COVID-19.

5.
Am J Ophthalmol Case Rep ; 26: 101549, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1800222

ABSTRACT

Purpose: Herpes zoster (HZ) has been identified as a potential association with the BNT162b2 COVID-19 vaccination. This study evaluated this possible association in a cohort of patients receiving the vaccination. Methods: Epic electronic health records of adult patients who received at least one COVID-19 vaccination between January 12, 2020 and 9/30/2021 within the NYU Langone Health were reviewed to analyze a new diagnosis of herpes zoster within 3 months before compared to 3 months after vaccination. Results: Of the 596,111 patients who received at least one COVID-19 vaccination, 716 patients were diagnosed with HZ within three months prior to vaccination, compared to 781 patients diagnosed within 3 months afterwards. Using the chi-square test for independence of proportions, there was not a statistically significant difference in frequency of HZ before (proportion: 0.0012, 95% CI: [0.0011, 0.0013]) vs. after vaccination (proportion: 0.0013, 95% CI: [0.0012, 0.0014]); (p = 0.093). Conclusions and importance: This study did not find evidence of an association between COVID-19 vaccination and a new diagnosis of HZ. We encourage health care professionals to strongly recommend COVID-19 vaccinations per Centers for Disease Control (CDC) recommendations and vaccination against HZ according to Food and Drug Administration (FDA) approval for the recombinant zoster vaccine.

6.
Open Forum Infect Dis ; 9(5): ofac118, 2022 May.
Article in English | MEDLINE | ID: covidwho-1784385

ABSTRACT

Background: Case reports have described herpes zoster (HZ) in patients with coronavirus disease 2019 (COVID-19). However, this constitutes low-quality evidence for an association. We therefore performed a retrospective cohort study to assess the risk of developing HZ following a COVID-19 diagnosis. Methods: We compared the HZ incidence in ≥50-year-olds diagnosed with COVID-19 vs those never diagnosed with COVID-19. We used data from the US MarketScan Commercial Claims and Encounters and Medicare Supplemental (3/2020-2/2021) and Optum Clinformatics Data Mart (3-12/2020) databases. Individuals with COVID-19 were exact-matched 1:4 to those without COVID-19 by age, sex, presence of HZ risk factors, and health care cost level. Adjusted incidence rate ratios (aIRRs) were estimated by Poisson regression. Results: A total of 394 677 individuals ≥50 years old with COVID-19 were matched with 1 577 346 individuals without COVID-19. Mean follow-up time after COVID-19 diagnosis and baseline characteristics were balanced between cohorts. Individuals diagnosed with COVID-19 had a 15% higher HZ risk than those without COVID-19 (aIRR, 1.15; 95% CI, 1.07-1.24; P < .001). The increased HZ risk was more pronounced (21%) following COVID-19 hospitalization (aIRR, 1.21; 95% CI, 1.03-1.41; P = .02). Conclusions: We found that COVID-19 diagnosis in ≥50-year-olds was associated with a significantly increased risk of developing HZ, highlighting the relevance of maintaining HZ vaccination.

7.
SAGE Open Med Case Rep ; 10: 2050313X221077737, 2022.
Article in English | MEDLINE | ID: covidwho-1770092

ABSTRACT

Herpes zoster which is the reactivation of varicella-zoster virus, a pathogenic human alpha-herpes virus, following primary infection or chicken pox, is known to occur especially in advanced age and in the immunocompromised among other predisposing factors. COVID-19 vaccination-induced immunomodulation is a novel scenario, hypothesized to be a result of shifting of T-lymphocyte population towards vaccine-induced naïve CD8+ subset, offsetting the balance of varicella-zoster virus responsive T-helper cells, thereby defecting the cell-mediated immunity which suppresses the latent varicella-zoster virus. The exact mechanism, however, is still elusive. Herein, we discuss a case of reactivation of varicella-zoster virus following BNT162b2 mRNA COVID-19 vaccine in an elderly female on oral medication for long-term diabetes and hypertension with good control who has undergone local radiotherapy for an underlying adenocarcinoma of rectum awaiting surgical resection, highlighting the key features of pathogenesis of the disease in relation to COVID-19 vaccination with a pertinent survey of the literature. This case report highlights the importance of differentiating vaccine-related cutaneous reactions with clinically more significant adverse events, early specific therapy thus preventing poorer acute and chronic outcomes.

8.
J Family Med Prim Care ; 10(11): 4299-4302, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1687208

ABSTRACT

Various dermatological manifestations have been observed in patients with Coronavirus disease (COVID-19) infection ranging from maculopapular rashes, urticaria, chickenpox-type lesions, chilblain-like, distal-limb ischemia, and livedo racemosa. While most of these cutaneous findings are self-resolving, they may aid in the timely diagnosis of this infection. We are reporting three patients presenting with dermatological features resembling (i) varicella zoster, (ii) herpes labialis, and (iii) Steven Johnson Syndrome (SJS) who were subsequently diagnosed with Covid-19 infection. The skin lesions disappeared after successful treatment of Covid-19.

9.
Hum Vaccin Immunother ; 18(1): 2027196, 2022 12 31.
Article in English | MEDLINE | ID: covidwho-1631418

ABSTRACT

Due to COVID-19, vaccinations dropped in 2020 and 2021. We estimated the impact of reduced recombinant zoster vaccine (RZV) use on herpes zoster (HZ) cases, complications, and quality-adjusted life-year (QALY) losses among older adults. Various scenarios were compared with Markov models using data from national sources, clinical trials, and literature. Missed series initiations were calculated based on RZV distributed doses. In 2020, 3.9 million RZV series initiations were missed, resulting in 31,945 HZ cases, 2,714 postherpetic neuralgia cases, and 610 lost QALYs. Scenarios further projected disease burden increases if individuals remain unvaccinated in 2021 or the same number of initiations are missed in 2021. Health professionals should emphasize the importance of vaccination against all preventable diseases during the COVID-19 era.


Subject(s)
COVID-19 , Herpes Zoster Vaccine , Herpes Zoster , Neuralgia, Postherpetic , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Cost-Benefit Analysis , Herpes Zoster/epidemiology , Herpes Zoster/prevention & control , Herpesvirus 3, Human , Humans , Neuralgia, Postherpetic/epidemiology , Neuralgia, Postherpetic/prevention & control , Pandemics , United States/epidemiology , Vaccination , Vaccines, Synthetic
10.
Cureus ; 13(9): e18049, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1459358

ABSTRACT

During the coronavirus 2019 (COVID-19) pandemic, sundry dermatological conditions related to COVID-19 pneumonia have been published. COVID-19 primarily affects the respiratory system, but secondarily it also affects the heart, kidney, brain, skin, spinal cord, etc. Herpes Zoster (HZ) is considerably important morbidity associated with COVID-19 pneumonia. Recrudescence of HZ occurs because of the latent varicella-zoster virus (VZV) predominantly because of the decline in cell-mediated immunity (CMI). Abating CMI is due to the increasing age, but could also occur if the patient is suffering from an immunosuppressive disease or is using immunosuppressive drugs. In our case, the patient had no lymphopenia unlike the other cases, yet still, he developed HZ. HZ is associated with post-herpetic neuralgia (PHN), HZ ophthalmicus (HZO), and cerebral arteritis increasing morbidity and mortality, especially in elderly people and those who are immunocompromised.

11.
BMC Infect Dis ; 21(1): 746, 2021 Aug 03.
Article in English | MEDLINE | ID: covidwho-1365324

ABSTRACT

BACKGROUND: Varicella-zoster virus (VZV) is a known cause of aseptic meningitis, with a predisposition for an immunocompromised population. A dermatomal rash usually accompanies aseptic meningitis secondary to VZV. CASE PRESENTATION: We report the case of a 31-year-old male with a history of chickenpox in childhood and recent shingles who presented with severe frontal headaches secondary to VZV meningitis. The patient had also recently received the measles-mumps-rubella (MMR) vaccine. He recovered without any neurological sequala. CONCLUSION: This case report describes an immunocompetent patient with recent MMR vaccination who developed aseptic meningitis secondary to VZV without any dermatomal involvement (Zoster Sine Herpete).


Subject(s)
Chickenpox , Exanthema , Herpes Zoster , Meningitis, Aseptic , Adult , Herpes Zoster/diagnosis , Herpesvirus 3, Human , Humans , Male , Meningitis, Aseptic/diagnosis , Meningitis, Aseptic/etiology , Vaccination
12.
Inflamm Res ; 70(9): 935-937, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1355995

ABSTRACT

We report a case of itchy papulovesicular rash consistent with varicella-zoster virus reactivation after Pfizer-BioNTech vaccine second dose administration. While there have been cases of varicella-zoster virus reactivation due to COVID-19 or COVID-19 vaccine inoculation in older individuals with pre-existing conditions, this case report describes the first case of varicella-zoster virus reactivation on a healthy, young male in the absence of pre-existing conditions. The mechanisms underlying varicella-zoster virus reactivation in patients with COVID-19 are unknown and should be further characterized.


Subject(s)
COVID-19 Vaccines/adverse effects , Chickenpox/etiology , Chickenpox/virology , Herpesvirus 3, Human , Adult , COVID-19 Vaccines/administration & dosage , Chickenpox/pathology , Humans , Male , Skin/pathology , Vaccination/adverse effects
13.
Dermatol Ther (Heidelb) ; 11(4): 1119-1126, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1230303

ABSTRACT

Herpes zoster (HZ) is associated with substantial morbidity. It is caused by reactivation of the latent varicella zoster virus (VZV) following decline in cell-mediated immunity, which is commonly age-related, but also occurs in individuals with immunosuppressive diseases and/or treatment. Since coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has been associated with T cell immune dysfunction and there have been reports of HZ in COVID-19 patients, we have performed a review of available literature on whether COVID-19 could trigger HZ. We identified 27 cases of HZ following COVID-19, which most frequently occurred within 1-2 weeks of COVID-19, and the majority of cases had typical presentation. Atypical presentations of HZ were noted especially in patients with lymphopenia. It has been hypothesized that VZV reactivation occurs as a consequence of T cell dysfunction (including lymphopenia and lymphocyte exhaustion) in COVID-19 patients. Based on current evidence, which is limited to case reports and case series, it is not possible to determine whether COVID-19 increases the risk of HZ. Practitioners should be aware of the possible increased risk of HZ during the pandemic period and consider timely therapeutic and preventive measures against it.

14.
World J Urol ; 40(1): 43-49, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1219705

ABSTRACT

PURPOSE: To review the potential ancillary cardiovascular and other health impacts of compliance with general adult vaccination series in the prostate cancer active surveillance (AS) population. No previous review has been published in regard to this specific topic. METHODS: Literature review of PubMed data up to December 2020 RESULTS: Compliance rates for adult vaccination are in the approximate anemic range of 25-50% with occasional higher rates of specific vaccines in the elderly population including annual influenza and pneumococcal prevention. Herpes zoster (HZ) and numerous other vaccine preventive illnesses are associated with an increased risk of cardiovascular events. Preliminary evidence suggests vaccine compliance could reduce overall morbidity and mortality, and adherence to heart healthy lifestyle changes and parameters could further improve vaccine efficacy and overall wellness. COVID-19 vaccine utilization and research should also continue to reinforce the direct and ancillary benefits of this entire preventive intervention category. CONCLUSIONS: Multiple ancillary lifestyle change recommendations could be included in the AS criteria to potentially reduce morbidity and mortality in this population, and perhaps the most unsung intervention is to improve the inadequate rates of general adult vaccination compliance and other heart healthy behavioral changes that impact their efficacy. Heart health, prostate health, and immune system health are closely interlinked.


Subject(s)
Cardiovascular Diseases/prevention & control , Life Style , Medication Adherence , Population Surveillance , Prostatic Neoplasms/psychology , Vaccination , Adult , Aged , COVID-19 Vaccines/administration & dosage , Cardiovascular Diseases/epidemiology , Checklist , Humans , Male , Middle Aged , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology
15.
J Am Acad Dermatol ; 85(1): 46-55, 2021 07.
Article in English | MEDLINE | ID: covidwho-1171221

ABSTRACT

BACKGROUND: Cutaneous reactions after messenger RNA (mRNA)-based COVID-19 vaccines have been reported but are not well characterized. OBJECTIVE: To evaluate the morphology and timing of cutaneous reactions after mRNA COVID-19 vaccines. METHODS: A provider-facing registry-based study collected cases of cutaneous manifestations after COVID-19 vaccination. RESULTS: From December 2020 to February 2021, we recorded 414 cutaneous reactions to mRNA COVID-19 vaccines from Moderna (83%) and Pfizer (17%). Delayed large local reactions were most common, followed by local injection site reactions, urticarial eruptions, and morbilliform eruptions. Forty-three percent of patients with first-dose reactions experienced second-dose recurrence. Additional less common reactions included pernio/chilblains, cosmetic filler reactions, zoster, herpes simplex flares, and pityriasis rosea-like reactions. LIMITATIONS: Registry analysis does not measure incidence. Morphologic misclassification is possible. CONCLUSIONS: We report a spectrum of cutaneous reactions after mRNA COVID-19 vaccines. We observed some dermatologic reactions to Moderna and Pfizer vaccines that mimicked SARS-CoV-2 infection itself, such as pernio/chilblains. Most patients with first-dose reactions did not have a second-dose reaction and serious adverse events did not develop in any of the patients in the registry after the first or second dose. Our data support that cutaneous reactions to COVID-19 vaccination are generally minor and self-limited, and should not discourage vaccination.


Subject(s)
COVID-19 Vaccines/adverse effects , Drug Eruptions/etiology , Adult , Drug Eruptions/epidemiology , Female , Global Health , Humans , Male , Middle Aged , Registries
16.
Vaccines (Basel) ; 9(4)2021 Mar 25.
Article in English | MEDLINE | ID: covidwho-1154566

ABSTRACT

Theoretically, the subunit herpes zoster vaccine ShingrixTM could be used as a varicella vaccine that avoids the risk of developing shingles from vaccination, but bedside mixing strategies and the limited supply of the adjuvant component QS21 have made its application economically impracticable. With lipid nanoparticles (LNPs) that were approved by the FDA as vectors for severe acute respiratory syndrome coronavirus 2 vaccines, we designed a series of vaccines efficiently encapsulated with varicella-zoster virus glycoprotein E (VZV-gE) and nucleic acids including polyinosinic-polycytidylic acid (Poly I:C) and the natural phosphodiester CpG oligodeoxynucleotide (CpG ODN), which was approved by the FDA as an immunostimulator in a hepatitis B vaccine. Preclinical trial in mice showed that these LNP vaccines could induce VZV-gE IgG titers more than 16 times those induced by an alum adjuvant, and immunized serum could block in vitro infection completely at a dilution of 1:80, which indicated potential as a varicella vaccine. The magnitude of the cell-mediated immunity induced was generally more than 10 times that induced by the alum adjuvant, indicating potential as a zoster vaccine. These results showed that immunostimulatory nucleic acids together with LNPs have promise as safe and economical varicella and zoster vaccine candidates.

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