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1.
Cancer Research ; 82(4 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1779467

ABSTRACT

Background: Since the beginning of the covid19 pandemic, clinical and demographic data showed that cancer patients are at high risk of developing severe consequences of Sars-Cov2 disease. For this reason, vaccination is strongly recommended, especially for patients on active treatment. Nevertheless, the efficacy of the Sars-Cov2 vaccine in cancer patients is not fully investigated. Our trial aim to explore the seroconversion in a large series of vaccinated cancer patients undergoing active treatment. Here we present a subgroup analysis concerning patients affected by breast cancer. Methods: The "VAX-on" is a single-center study that enrolled 366 cancer patients who underwent oncological treatment within the last six months. The study was approved by the ethics committee and all patients had to sign specific informed consent to be enrolled. Subjects were vaccinated against Sars-Cov2 with mRNA vaccine BNT162b2 (Comirnaty)-Pfizer BioNTech. Blood samples were obtained to quantify the production of specific anti-Spike IgG antibodies at day 21 from the first dose and at 6-8 weeks after the second dose. The antibody laboratory title cut-off of 50 U.A./mL defined the seroconversion. Results are shown as Mean and Standard Deviation for Scontinuous variable, percentage (%) for categorical ones. The Mann-Whitney test or Chi-Square test were used to compare continuous or categorical groups, respectively. Results: A total of 100 patients with breast cancer were enrolled. Clinical and demographic data are summarized in Table 1. The median age was 60.5 years and the majority had an ECOG PS of 0 (75%). Almost all were women (97%), with advanced cancer in 60% of cases. In early or advanced setting 46% patients were treated with chemotherapy while 54% were on target therapy (also including monoclonal antibody and CDK4/6 inhibitors). The mean antibody title after the first dose of mRNA Comirnaty vaccine was 2185.03±9303.26 U.A./mL (M±SD), while after the second dose the mean antibody title rise to 6492.10±10425.95 (M±SD). After the first dose 61% of patients were considered as immunized, meanwhile after the second dose 86% of patients resulted immunized (defined as an antibody title >50 U.A./mL). In the 9 patients in treatment with steroids (prednisone > 10mg/die or equivalent), there was a trend to a decreased antibody development compared to patients without chronic use of steroids (p 0.06 and 0.05 after the first and second dose, respectively). Of interest, patients using G-CSF (12%) had a significant reduction in the production of Sars-Cov2 antibody after vaccination compared to patients who did not use them (p 0.02 and <0.001 after the first and second dose, respectively), with only 75% resulted positively immunized after the second dose (p=0.04). No differences were seen when comparing patients in advanced with non-advanced stage. Conclusions: Our study demonstrated 86% seroconversion in cancer patients after the second dose of mRNA vaccine regardless of disease stage or type of cancer treatment received. Further evaluations are needed to define whether the use of corticosteroids and G-CSF have an impact on seroconversion.

2.
Osteoporosis International ; 32(SUPPL 1):S197-S198, 2022.
Article in English | EMBASE | ID: covidwho-1748506

ABSTRACT

Objective: Ever since the times of ancient physicians and surgeons like Sushruta (600 BC) or Hippocrates (400 BC), it is clear that physical development of individuals with sedentary lifestyle is different from the one of the physically active individuals. Only after the year 2000, with the first discovery of causality of IL-6 and muscular movement, an intensive study of this problematics has begun. Currently, there are about 600 known operations (myokins) that are interrelated with muscle functions. Muscular tissue interrelates with others mechanistically, but it also forms humoral harmony in which the muscular tissue has a dominant and determining role. This phenomenon is relevant for pathophysiology of chronical low-grade inflammation, muscle loss, origin and development of noncommunicable diseases. These cause approx. 75% of deaths in population. Solution of this problem has been considerably affecting cost-effectivity in the health care system today and thus the state economy as well. Therapeutic recommendations together with the whole health care strategy need to be adjusted according to the above mentioned findings, including the patients with osteoporosis and osteopenia. There are, so far, no known suitable medicaments which would be used for solving problematics of muscular loss. This is a reason why more attention needs to be paid to the recommended physical regime (150 min/week, according to WHO) and dietary regime (basic diet + proteins). We have built a complex diagnostic and therapeutic program for our patients. Definition of pathological values follows EWGSOP and WHO. Methods: Patient cohorts: Osteoporosis 60-70 y, 70-80 y, osteopenia 60- 70 y and 70-80 y. Control group for osteopenia 60-80 y. We followed information about the control group during the COVID-19 time period, particularly their physical activity regime. 1) Instructions for patients used to be delivered in a form of lectures for different age groups. Now, during the COVID-19 time period, instructions are provided individually. 2) SarQol (Sarcopenia and Quality of Life) questionnaire (Beaudart 2015). Czech version used with agreement from sarqol.org. Assessment is now done individually only. 3) Measuring hand-grip is standardised according to Southampton protocol with a dynamometer Jamar. Values of 20 kg are found pathological (female values). 4) Determination of BMI, according to WHO, the border figure is 25 or 30 kg/m2 . 5) DXA method determination of selective muscle index as a measure for muscle mass. ALM/Ht2 for age above 60 y, border value for sarcopenia is ≤5.45 kg/m2 . 6) From laboratory examinations we aimed at IL-6 and CRP(hs) - these are not a subject of this report. Results: Conclusion: We have been running a physical activity and dietary program for our patients for more than 2 y. Physical activity is aimed at 150 min/week (WHO) and basic diet aims at the Mediterranean type + protein saturation, considerable stress is given to whey proteins enriched with Leucin. Patients have been instructed. Due to adherence to this regime we are able to report on statistically relevant changes in muscle power and also in complex muscle mass, even during the current pandemic situation. (Table Presented).

3.
Critical Care Medicine ; 50(1 SUPPL):52, 2022.
Article in English | EMBASE | ID: covidwho-1692089

ABSTRACT

INTRODUCTION: Most adults receiving mRNA vaccines for SARS-CoV-2 (SCV2) exhibit IgG antibodies (Ab) targeting the S1 spike protein within a week of dose 2. However, correlates of protection are still not fully understood. The aim of this study was to better quantify the % of neutralizing Ab (nAb) that develop after dose 2 and also identify factors affecting the timing and degree of nAb production. METHODS: Using a fluorescence immunoassay to quantify the % of SCV2-Ab capable of blocking S1 at its receptor binding domain (for attaching to ACE-2 receptors), residents/ staff (n=70;ages 23-100 yrs) of an assisted living facility had blood samples measured on day 7 and 21 following dose 2 of the Pfizer-BioNTech mRNA vaccine. Based on existing research, %nAb < 30% is delineated as inadequate protection (“nAb negative”). RESULTS: Except for a 58 yo man taking daily prednisone (asthma) and a 55 yo man on levothyroxine, 100% of those < 70 yrs (n=33) were nAb+ (>30% nAb) on day 7 after dose 2. However, if >70 yo (n=37), the % of nAb+ findings diminished with age. Only half of those 71-80 yo, 33% of those 81-90 yo and 11% of those >90 yo were nAb+. Nonetheless, 2 weeks later, the %+ among those tested had increased to 83%, 71%, and 50% for those respective age groups. When examining the average of nAb% measurements within each of the various age group stratifications 1 week after dose 2, the averages ranged 96-100% for the 3 age groups < 50 years (ie, 23-30, 31-40 and 41-50), while the age group averages were borderline or inadequate for those >70 yo. However, 21 days after dose 2, the average %nAb measurement had become 91% for those 61 to 70 years of age, 75% for those 71-80, and 55% for those 81-90. For persons > 90 yo (n=8), the average %nAb was 35% but half of those persons (n=4) had no detectable nAb, either at day 7 or day 21. No persons had any significant declines in %nAb between Day 7 and 21 and the majority sustained or improved their %nAb. CONCLUSIONS: Escalating age and immunomodulating medications/conditions do impact the timing and degree of nAb developing after mRNA vaccination. Most persons < 90 yo are observed to be “positive” for protective levels of nAb by 3 weeks after dose 2. On-going investigations are addressing the duration and sustained degree of nAb+ findings as well as external validation of the tool used in this research.

4.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617068

ABSTRACT

Background: The COVID-19 pandemic disrupted the lives of children and adolescents by invading their families, peer groups and school, worsening their prospects and causing anxiety about the future. Due to the threat of COVDI-19, restrictions were imposed worldwide, forcing changes in daily life, social interactions, education and work. There is no doubt that these strict restrictions have contributed immensely to reducing the risk of SARS-CoV-2 virus spread, but at the same time had significantly affected the health of young people in all its dimensions. The main aim of this study is to present changes in health and health behaviours between 2018 and 2021. Method: Data from the Youth and COVID-19 survey conducted in the first quarter of 2021 by the Institute of Mother and Child in Warsaw among adolescents aged 11-17 years (n=1571) as well as data from the Health Behaviour in School-aged Children (HBSC) according to the 2018 survey conducted in the same age groups (n=7701) were analysed. So were analysed indicators of physical development, mental health, subjective complaints and health behaviour. The prevalence of the aforementioned indicators was compared between 2018 and 2021, overall, by gender and age using chi2 test. Results: A significant increase was observed in the percentage of overweight and obese adolescents (according to WHO criteria) evident in the older age groups (15 and 17 years) and the percentage of underweight boys;an increase in the percentage of adolescents negatively assessing their health and well-being (according to the WHO5 scale-score indicating depressive symptoms) in each age group and both genders;frequently experiencing physical and mental health problems-in both genders such as headache, stomach ache, backache, feeling depressed, nervousness, difficulty in falling asleep and dizziness;only in girls-tiredness;in older adolescents-headache, stomach ache, backache, feeling depressed, irritability, nervousness, difficulty in falling asleep and dizziness;in each age group-feeling depressed;only in the youngest-tiredness. There was a significant decrease in the percentage of adolescents undertaking moderate-to-intensive physical activity at the recommended level of 60 minutes per day in both genders and each age group. However, there were positive changes in dietary behaviour: an increase in the percentage of adolescents eating daily with family in each age group, eating vegetables daily in both sexes and each age group, and a decrease in the percentage of adolescents frequently drinking sugary drinks in both sexes and each age group. Furthermore, no change was observed in the rate of frequent consumption of fruit and vegetables. Conclusion: The adverse effects of the pandemic on health and well-being are progressing rapidly, so urgent action is needed to help mitigate the severe effects of the pandemic and safeguard the future of young people.

5.
Pakistan Journal of Medical and Health Sciences ; 15(11):3240-3243, 2021.
Article in English | EMBASE | ID: covidwho-1614675

ABSTRACT

Objective:The primary aim of this study was to retrospectively evaluate the effects of home accidents(HAs) on the traumatic dental injuries(TDIs) of primary teeth. Furthermore, the secondary aim was to bring attention to the importance of preventive measures for HAs, especially in this pandemic period where children all over the world spend most of their time in their homes due to coronavirus(COVID-19) disease. Material and Methods:The records of the patients with TDIs of the primary teeth, aged 6 months-8 years, who applied to the xxxxxxxxxUniversity, Faculty of Dentistry, Department of Pedodontics, between the years 2000 2010 and yyyyyyyyUniversity, Faculty of Dentistry, Department of Pedodontics, between the years 2012- 2019 were investigated. Results:The sample consisted of 504 children that had TDIs to the primary teeth. The age range of the children was 1-8 years(3.5±1.8years old) and 37.3%(n=188) of the patients were girls and 62.7%(n=316) boys. The prevalence of the TDIs due to HAs was found to be 43.25%(n=218). A total of 380 teeth in the 218 patients who were found to have TDIs due to HAs were examined. The highest prevalence of traumatized children was in the age range 2-4 years(63.3%). Collisions with objects(45%) were found to be most common causes of dental trauma and the most common type of injury was found to be lateral luxation(35.8%). Conclusions:Measures to prevent HAs should primarily target preschool children, the riskiest group. Accidents can be largely prevented by taking simple precautions such as providing a safe environment for children's healthy mental and physical development at home.

6.
Blood ; 138:3894, 2021.
Article in English | EMBASE | ID: covidwho-1582227

ABSTRACT

Background: Vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been approved rapidly. However, pivotal studies have been conducted in healthy volunteers, while recipients of allogeneic hematopoietic cell transplantations (allo-HCT) may have different dynamics and patterns of response to the vaccine and data in this cohort is lacking. Methods: Here, we examined longitudinal antibody (AB) titers to SARS-CoV-2 vaccination with BNT162b (Comirnaty ®) or mRNA-1273 (Moderna Covid-19 Vaccine ®) in allo-HCT recipients who had undergone allo-HCT >3months (m) ago and in healthy controls (hospital employers). Serial AB titers (prior to (T0);1m after 1 st dose (T1);1m (T2), 3m (T3), 6m (T4) post 2 nd dose) were measured with an in-house developed multiplex Antibody CORonavirus Assay (ABCORA) that measures SARS-CoV-2 IgG, IgA, and IgM reactivities against RBD (receptor binding domain), S1 (subunit 1 of the spike protein), S2 (subunit 2 of the spike protein) and N (nucleoprotein), thereby allowing to differentiate immunity after vaccination versus immunity after infection. As neutralization activity correlates well with S1 AB binding, the potency of the AB response was defined as the sum of S1 IgG, IgA and IgM reactivities (cumulative S1 (cS1)). Based on computational methods high neutralization potency was predicted above a cS1 threshold of 17. Results: We enrolled 114 allo-HCT patients (median age 57y (range 18y-74y)) between March 9th 2021 and May 31st 2021 at the University Hospital Zurich, Switzerland. Currently, AB responses at T1, T2, and T3 are available for 99, 95 and 89 patients, respectively. Patients were grouped into those (A) 3-6m post-HCT (T1: n=25 at, T2: n=23, T3: n=20);(B) 6-12m post-HCT (T1: n=13, T2: n=13, T3: n=12);and (C) >12m post-HCT (T1: n=61, T2: n=59, T3: n=57). In addition, AB responses are available for healthy controls (median age 35y (range 23y-64y)) (T1: n=75, T2: n=69, T3: n=48). There were 10 patients and 5 healthy subjects with a reported or detected SARS-CoV-2 infection. There was a statistically significant difference of cS1 AB levels between the 4 groups at T1, T2, and T3 (ANOVA p-values (p) <0.001, respectively, Fig 1) with the lowest AB response in group A (cS1 median value 0.957 at T1, 5.22 at T2, 1.90 at T3) and B (cS1 median value 0.973 at T1, 4.76 at T2, 11.9 at T3) compared to group C (cS1 median value 6.21 at T1, 199 at T2, 76.4 at T3) and healthy controls (cS1 median value 54.9 at T1, 228 at T2, 91.1 at T3). Using a multivariate linear regression analysis adjusted on age and gender, we found that patients in groups A and B had significantly lower cS1 levels than groups C and healthy subjects (p<0.001, p<0.001, p=0.034 of healthy versus groups A, B, C respectively at T2, and p<0.001, p=0.004, p=0.12 at T3), and that preinfected patients had higher cS1 levels at T2 and T3 respectively (p=0.003 and 0.006). The dynamics of the AB response were more diverse in allo-HCT recipients. In a multivariate linear regression analysis (Fig 2) assessing factors associated with humoral immune responses in allo-HCT recipients, we found consistently lower cS1 responses in patients early post-HCT (group A+B (p=0.002)) and higher cS1 levels in those who had been preinfected with SARS-CoV-2 (p=0.012). Patients under immunosuppressive treatment (IST) and those who had relapsed disease post-HCT showed significantly lower cS1 immune responses (p=0.028 and 0.005, respectively). The presence of moderate or severe chronic GVHD was not a statistically significant factor influencing AB levels. This may be explained by (i) the heterogeneity of the condition of chronic GVHD and low patient numbers;(ii) the late time point >12m post-HCT with generally higher AB levels. Consistent with other reports age >65y was also associated with lower cS1 responses (p=0.03). Conclusion: Allo-HCT recipients early post-transplant, those of older age, and those given IST displayed insufficient AB titers to the vaccine. Such knowledge is of critical importance to transplant recipients and th ir physicians to guide treatment decisions regarding re-vaccination, and social behavior during this pandemic. Monitoring AB development in all allo-HCT recipients and vulnerable patients with other immunocompromising conditions may be crucial to determine those at increased risk for infection and for the timing of booster vaccines. [Formula presented] Disclosures: Manz: CDR-Life Inc: Consultancy, Current holder of stock options in a privately-held company;University of Zurich: Patents & Royalties: CD117xCD3 TEA.

7.
Italian Journal of Medicine ; 15(3):39, 2021.
Article in English | EMBASE | ID: covidwho-1567516

ABSTRACT

Case report: A 67-year-old male presented to our hospital with a sudden eruption of pruritic, erythematous-to-violaceous purpura and plaques distributed along the lower and upper extremities and low back. Ten days prior he was vaccinated with Vaxzevria. No systemic involvement or manifestation was perceived. He had no prior history of allergy or purpuric skin eruption and had not recently started any new medication. Laboratory tests (included autoimmunity screening) and instrumental examinations were normal, except for a mild pericardial effusion. Biopsies obtained from the left arm both showed a picture compatible with leucocytoclastic vasculitis. After discussing risks and benefits the patient was discharged with topical steroids and a prednisone taper. Discussion: Vasculitis exacerbation has been reported secondary to multiple vaccines. However, this relationship is rare and it has yet to be determined. A possible mechanism might be vessel damage likely secondary to abnormal immunological activation with vaccine-related antigens promoting antibody development and immune complex deposition. Despite systemic steroids cause variable effects on immunity, up to 20 mg/day of prednisone seems to not have any effect on patients' immune response to vaccines. For the CoViD-19 vaccine, it is speculated that regardless of the type of vaccine, systemic corticosteroids have no or minimal risk in patients' immune response. Conclusions: It is important for healthcare providers to be aware that the CoViD-19 vaccine can potentially precipitate or exacerbate cutaneous inflammation.

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