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1.
Health Affairs ; JOUR(11):1559-1561, 41.
Article in English | ProQuest Central | ID: covidwho-2101206
2.
In Vivo ; 36(6): 2780-2789, 2022.
Article in English | MEDLINE | ID: covidwho-2100679

ABSTRACT

BACKGROUND/AIM: To prospectively evaluate the efficacy and safety of the BNT162b2 vaccine in solid cancer patients undergoing systemic chemotherapy (n=63). PATIENTS AND METHODS: COVID-19 anti-spike protein antibody levels were measured before the first BNT162b2 vaccination, just before the second BNT162b2 vaccination, one month after the second BNT162b2 vaccination, and 3 months after the second BNT162b2 vaccination. Anti-spike protein antibody seropositivity was set at ≥0.8 U/ml. RESULTS: Colorectal cancer was the most commonly observed primary disease (36.5%). ECOG-PS 0 was observed in the majority (52.4%) of patients. The overall response rate and the median (range) anti-spike protein antibody levels in the whole cohort at 3 months after the second BNT162b2 vaccination were 98.4% (62/63) and 206 (0.4-3,813) U/ml. None of the patients required postponement or discontinuation of systemic chemotherapy because of an adverse reaction. CONCLUSION: The BNT162b vaccine in solid cancer patients undergoing systemic chemotherapy is effective and safe.


Subject(s)
COVID-19 , Neoplasms , Vaccines , Humans , Prospective Studies , BNT162 Vaccine , COVID-19/prevention & control , Neoplasms/drug therapy , Vaccines/therapeutic use , Antibodies, Viral
3.
Biomedica ; 42(Sp. 2): 19-31, 2022 10 31.
Article in English, Spanish | MEDLINE | ID: covidwho-2100343

ABSTRACT

INTRODUCTION: Since the emergence of the SARS-CoV-2, there have been efforts to develop vaccines to control the COVID-19 pandemic. OBJECTIVE: The present study assessed the efficacy and safety of the BNT162b2, mRNA-1273, ChAdOx1/AZD1222 and Gam-COVID-Vac rAd26-S/rAd5-S vaccines against the SARS-CoV-2. MATERIALS AND METHODS: We searched PubMed/MEDLINE, Google Scholar, Cochrane, and the WHO International Clinical Trials Registry Platform on March 15, 2021. The search terms used were: "vaccine" OR "vaccination" AND "covid19" OR "coronavirus" OR "sarscov2" AND "bnt162b2" OR "chadox1-S" OR "azd1222" OR "sputnik" OR "Gam-COVID-Vac" OR "mrna" OR "mRNA-1273" . We measured the risk of bias of the studies and the quality of the evidence using GRADE profiles. A qualitative and quantitative analysis of the results of clinical trials is presented. RESULTS: Of the 74 identified studies, 4 were finally included in this review. The efficacies of the BNT162b2, mRNA-1273, ChAdOx1/AZD1222 and Gam-COVID-VacrAd26-S/rAd5-S vaccines against symptomatic COVID-19 were 95,0% (CI95% 90,3-97,6), 94,1% (CI95% 89,3-96,8), 66,7% (CI95% 57,4-74,0), and 91,1% (CI95% 83,8-95,1), respectively. There was moderate certainty of the evidence due to serious indirectness, when we measured the risk of bias of the studies and the quality of the evidence using GRADE profile. The safety profiles were acceptable, and data on serious adverse events (summary RR=0,93; CI95% 0,77-1,12; p=0,16) and deaths from all causes (summary RR=0,70; CI95% 0,33-1,50; p=0,90) showed no significant differences. CONCLUSION: The results of this review support the level of evidence for the efficacy and safety of the COVID-19 vaccines analysed.


Introducción. Desde que surgió el virus SARS-CoV-2, se han realizado esfuerzos para desarrollar vacunas para controlar la pandemia por COVID-19. Objetivo. Evaluar los datos de la eficacia y seguridad de las vacunas BNT162b2, mRNA-1273, ChAdOx1/AZD1222 y Gam-COVID-Vac rAd26-S/rAd5-S contra el SARS-CoV-2. Materiales y métodos. Se realizaron búsquedas en PubMed/MEDLINE, Google Scholar, Cochrane y la Plataforma de Registro Internacional de Ensayos Clínicos de la OMS el 15 de marzo de 2021. Los términos usados fueron: "vaccine" OR "vaccination" AND "covid19" OR "coronavirus" OR "sarscov2" AND "bnt162b2" OR "chadox1-S" OR "azd1222" OR "sputnik" OR "Gam-COVID-Vac" OR "mrna" OR "mRNA-1273". Se midió el riesgo de sesgo de los estudios y la calidad de la información por medio de los perfiles GRADE. Se presenta un análisis cualitativo y cuantitativo de los resultados de los estudios clínicos. Resultados. Se identificaron 74 estudios y se incluyeron 4 en la revisión. La eficacia de las vacunas BNT162b2, mRNA-1273, ChAdOx1/AZD1222 y Gam-COVID-VacrAd26-S/rAd5-S contra la COVID-19 sintomática fue del 95,0 % (IC95% 90,3-97,6), 94,1 % (IC95% 89,3-96,8), 66,7 % (IC95% 57,4-74,0) y 91,1 % (IC95% 83,8-95,1), respectivamente, y hubo una certeza moderada de la información debido a la falta de evidencia directa. Los perfiles de seguridad fueron aceptables, y los eventos adversos graves (RR resumido=0,93; IC95% 0,77-1,12; p=0,16) y muerte por todas las causas (RR resumido=0,70; IC95% 0,33-1,50; p=0,90) no mostraron diferencias significativas. Conclusión. Los resultados de esta revisión respaldan el nivel de evidencia de la eficacia y seguridad de las vacunas COVID-19 que fueron analizadas.


Subject(s)
COVID-19 , Humans , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , SARS-CoV-2 , Pandemics/prevention & control , Vaccination
4.
Front Med (Lausanne) ; 9: 901788, 2022.
Article in English | MEDLINE | ID: covidwho-2099163

ABSTRACT

During the Covid-19 health emergency, telemedicine was an essential asset through which health systems strengthened their response during the critical phase of the pandemic. According to the post-pandemic economic reform plans of many countries, telemedicine will not be limited to a tool for responding to an emergency condition but it will become a structural resource that will contribute to the reorganization of Healthcare Systems and enable the transfer of part of health care from the hospital to the home-based care. However, scientific evidences have shown that health care delivered through telemedicine can be burdened by numerous ethical and legal issues. Although there is an emerging discussion on patient safety issues related to the use of telemedicine, there is a lack of reseraches specifically designed to investigate patient safety. On the contrary, it would be necessary to determine standards and specific application rules in order to ensure safety. This paper examines the telemedicine-risk profiles and proposes a position statement for clinical risk management to support continuous improvement in the safety of health care delivered through telemedicine.

5.
Front Digit Health ; 4: 944860, 2022.
Article in English | MEDLINE | ID: covidwho-2099119

ABSTRACT

Objectives: The start of the COVID-19 pandemic led the Los Angeles safety net health system to dramatically reduce in-person visits and transition abruptly to telehealth/telemedicine services to deliver clinical care (remote telephone and video visits). However, safety net patients and the settings that serve them face a "digital divide" that could impact effective implementation of such digital care. The study objective was to examine attitudes and perspectives of leadership and frontline staff regarding telehealth integration in the Los Angeles safety net, with a focus on telemedicine video visits. Methods: This qualitative study took place in the Los Angeles County Department of Health Services (LAC DHS), the second-largest safety net health system in the US. This system disproportionately serves the uninsured, Medicaid, racial/ethnic minority, low-income, and Limited English Proficient (LEP) patient populations of Los Angeles County. Staff and leadership personnel from each of the five major LAC DHS hospital center clinics, and community-based clinics from the LAC DHS Ambulatory Care Network (ACN) were individually interviewed (video or phone calls), and discussions were recorded. Interview guides were based on the Consolidated Framework for Implementation Research (CFIR), and included questions about the video visit technology platform and its usability, staff resources, clinic needs, and facilitators and barriers to general telehealth implementation and use. Interviews were analyzed for summary of major themes. Results: Twenty semi-structured interviews were conducted in August to October 2020. Participants included LAC DHS physicians, nurses, medical assistants, and physical therapists with clinical and/or administrative roles. Narrative themes surrounding telehealth implementation, with video visits as the case study, were identified and then categorized at the patient, clinic (including provider), and health system levels. Conclusions: Patient, clinic, and health system level factors must be considered when disseminating telehealth services across the safety net. Participant discussions illustrated how multilevel facilitators and barriers influenced the feasibility of video visits and other telehealth encounters. Future research should explore proposed solutions from frontline stakeholders as testable interventions towards advancing equity in telehealth implementation: from patient training and support, to standardized workflows that leverage the expertise of multidisciplinary teams.

6.
Work ; 2022 Oct 27.
Article in English | MEDLINE | ID: covidwho-2099078

ABSTRACT

BACKGROUND: Agricultural labor-intensive activities have been threatened by COVID-19. Wearing a face mask has been introduced as one of the personal protective equipment (PPE) to reduce COVID-19 risk. OBJECTIVE: The present study aimed to investigate the safety behavior of urban green space workers around wearing a face mask in the time of COVID-19 before vaccination. METHODS: The personal and safety backgrounds of 61 male participants were collected using a designed questionnaire. The nonparametric correlation coefficient of Spearman and logistic regressions were used to investigate the relationships among variables. RESULTS: Above one-third of workers (37.7%) got COVID-19 in the past year. Although all of the participants were aware of wearing a face mask is a protocol against COVID-19, only about half of them (50.8%) completely wear face mask at work. Non-smoking participants were 5.5 times more likely to influence their personal preference on wearing the mask. CONCLUSION: Safety attitude may be a key variable in relation to the factors that influence the wearing face mask. The causes of face mask-wearing during a pandemic such as COVID-19 as well as safety attitudes may be behind the factors studied in this study. Although some significant linkages were found, they were not enough to conclude a comprehensive action program. This concern is still open to discovering factors that influence wearing face mask.

7.
J Egypt Public Health Assoc ; 97(1): 21, 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2098478

ABSTRACT

BACKGROUND: The world is facing an extraordinarily unprecedented threat from the COVID-19 pandemic triggered by the SARS-CoV-2 virus. Global life has turned upside down, and that several countries closed their borders, simultaneously with the blockage of life cycle as a result of the shutdown of the majority of workplaces except the food stores and some few industries. MAIN BODY: In this review, we are casting light on the nature of COVID-19 infection and spread, the persistence of SARS-CoV-2 virus in food products, and revealing the threats arising from the transmission of COVID-19 in food environment between stakeholders and even customers. Furthermore, we are exploring and identifying some practical aspects that must be followed to minimize infection and maintain a safe food environment. We also present and discuss some World Health Organization (WHO) guidelines-based regulations in food safety codes, destined to sustain the health safety of all professionals working in the food industry under this current pandemic. CONCLUSION: The information compiled in this manuscript is supporting and consolidating the safety attributes in food environment, for a prospective positive impact on consumer confidence in food safety and the citizens' public health in society. Some research is suggested on evaluating the use and potentiality of native and chemical modified basic proteins as possible practices aiming at protecting food from bacterial and viral contamination including COVID-19.

8.
Ren Replace Ther ; 8(1): 14, 2022.
Article in English | MEDLINE | ID: covidwho-2098468

ABSTRACT

Background: The mortality rate of novel coronaviral disease (COVID-19) patients undergoing dialysis is considerably higher than that of patients with normal kidney function. As of August 2021, only remdesivir has been approved in Japan as an antiviral drug for the treatment of COVID-19. However, in cases of kidney failure, remdesivir administration should be considered only if the therapeutic benefits outweigh the risks because of concern about the accumulation of its solubilizing excipient sulfobutylether-beta-cyclodextrin and subsequent renal tubular injury or liver injury. Recently, reports from overseas indicating the safety of the use of remdesivir for COVID-19 patients on dialysis have been gathered. Case presentation: From June 2021, in our hospital, we started the administration of remdesivir to patients with moderate cases of COVID-19 undergoing hemodialysis, with careful consideration of the dosage and timing. Since then, six out of seven COVID-19 patients on hemodialysis who had received remdesivir have completely recovered. In a patient who died, the initial dose of remdesivir was administered after the case developed into severe COVID-19. All six patients who were able to start receiving remdesivir immediately at the stage of moderate COVID-19 recovered and were discharged without the need for mechanical ventilation. While, two out of four patients before May 2021 who had not been administered remdesivir at admission became severe, transferred to another tertiary hospital, and died. During and after remdesivir administration, no increase in serum transaminase to five times or more of the normal upper limit was observed in any of the cases. There were no other adverse drug reactions, such as infusion reaction, gastrointestinal symptoms, or anemia. Conclusions: We were able to administer remdesivir to six Japanese patients with moderate COVID-19 on hemodialysis safely. It is expected that the safe use of remdesivir will bring an increase in treatment options for moderate cases of COVID-19 in dialysis patients as well as subsequent improvement in treatment outcomes. However, to confirm the efficacy and safety of such use, further careful observation in more cases is required.

9.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2022 Sep 19.
Article in English | MEDLINE | ID: covidwho-2097569

ABSTRACT

PURPOSE: This paper explores the role of hospital cleaners and their contribution to healthcare safety. Few studies have examined the activities and input of hospital cleaners, rendering them largely invisible in healthcare research. Yet, as coronavirus disease 2019 (COVID-19) has demonstrated, this sizeable workforce carries out tasks critical to healthcare facilities and wider health system functioning. DESIGN/METHODOLOGY/APPROACH: Drawing on the work of Habermas, the authors examine the literature surrounding cleaners and quality and safety in healthcare. The authors theorise cleaners' work as both instrumental and communicative and examine the perceptions of healthcare professionals and managers, as well as cleaners themselves, of healthcare professionals and managers' role and contribution to quality and safety. FINDINGS: Cleaners are generally perceived by the literature as performing repetitive - albeit important - tasks in isolation from patients. Cleaners are not considered part of the "healthcare team" and are excluded from decision-making and interprofessional communication. Yet, cleaners can contribute to patient care; ubiquity and proximity of cleaners to patients offer insights and untapped potential for involvement in hospital safety. ORIGINALITY/VALUE: This paper brings an overdue focus to this labour force by examining the nature and potential of their work. This paper offers a new application of Habermas' work to this domain, rendering visible how the framing of cleaners' role works to exclude this important workforce from participation in the patient safety agenda.


Subject(s)
COVID-19 , COVID-19/epidemiology , Hospitals , Humans , Patient Safety , Personnel, Hospital , Workforce
10.
Clin Infect Dis ; 2022 Oct 31.
Article in English | MEDLINE | ID: covidwho-2097331

ABSTRACT

BACKGROUND: Adults previously infected with SARS-CoV-2 develop short-term immunity and may have increased reactogenicity to COVID-19 vaccines. This prospective, multi-center active surveillance cohort study examined the short-term safety of COVID-19 vaccines in adults with a prior history of SARS-CoV-2. METHODS: Canadian adults vaccinated between December 22, 2020 and November 27, 2021 were sent an electronic questionnaire 7 days post dose 1, dose 2 and dose 3 vaccination. The main outcome was health events occurring in the first 7 days after each vaccination that prevented daily activities, resulted in work absenteeism or required a medical consultation, including hospitalization. RESULTS: Among 684,998 vaccinated individuals, 2.6% (18,127/684,998) reported a prior history of SARS-CoV-2 infection a median of 4 months (interquartile range 2-6 months) previously. After dose 1, individuals with moderate (bedridden) to severe (hospitalized) COVID-19 who received BNT162b2, mRNA1273 or ChAdox1-S vaccines had higher odds of a health event preventing daily activities, resulting in work absenteeism or requiring medical consultation; adjusted odds ratio (AOR) 3.96 (95% CI 3.67-4.28) for BNT162b2, 5.01 (4.57-5.50) for mRNA1273 and 1.84 (1.54-2.20) for ChAdox1-S compared to no infection. Following dose 2 and 3, the greater risk associated with previous infection was also present but attenuated compared to dose 1. For all doses, the association was lower or absent after mild or asymptomatic infection. CONCLUSION: Adults with moderate or severe previous SARS-CoV-2 infection were more likely to have a health event sufficient to impact routine activities or require medical assessment in the week following each vaccine doses.

11.
Expert Rev Vaccines ; : 1-11, 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2097133

ABSTRACT

BACKGROUND: The immune persistence of neutralizing antibodies elicited by BBIBP-CorV vaccines on day 0-14, 0-21 and 0-28 schedule, and the immunogenicity and safety of a homologous booster dose after different priming vaccination regimens is scarcely reported. METHODS: : Responders (GMT≥16) at day 28, after priming with the two-dose vaccine, were followed up at 3, 6, and 10 months. Eligible participants received a homologous booster dose at month 10 and were followed-up 28 days post-booster. RESULTS: The GMT of neutralizing antibodies in 0-28d-10 m and 0-21d-10 m group were significantly higher than 0-14d-10 m group from month 3 (71.6 & 64.2 vs 46.4, p < 0.001) to month 10 (32.4 & 28.8 vs 20.3, p < 0.001) after the second dose. On day 28 post-booster, a remarkable rebound in neutralizing antibodies (246.2, 277.5, and 288.6, respectively) was observed in the three groups. All adverse reactions were mild after booster injection. CONCLUSIONS: The priming two-dose BBIBP-CorV vaccine with 0-28 days and 0-21 days schedule could lead to a longer persistence of neutralizing antibody than the 0-14 days schedule. Regardless of the priming vaccination regimens, a homologous booster dose led to a strong rebound in neutralizing antibodies and might persist for at least 18 months.

12.
World Neurosurg ; 2022 Nov 02.
Article in English | MEDLINE | ID: covidwho-2096139

ABSTRACT

BACKGROUND: Increasing evidence supports the effectiveness of venous sinus stenting (VSS) with favorable outcomes, safety, and expenses compared to shunting for idiopathic intracranial hypertension. Yet, no evidence is available regarding optimal postoperative recovery, which has growing importance with the burdens on healthcare imposed by the COVID pandemic. We examined adverse events and costs after VSS and propose an optimal recovery pathway to maximize patient safety while reducing stress on healthcare resources. METHODS: Retrospective review of elective VSS operations performed from May 2008 to August 2021 at a single institution. Primary data included hospital length of stay (LOS), intensive care unit (ICU) LOS, adverse events, need for ICU interventions, and hospital costs. RESULTS: 53 patients (98.1% female) met inclusion criteria. Of these, 51 patients (96.2%) discharged on post-operative day-1 (POD-1) and 2 patients discharged on POD-2. Both POD-2 patients remained because of groin hematomas from femoral artery access. There were no major complications nor care that required an ICU. There were 8 patients (15.1%) lateralized to other ICUs or remained in a post-anesthesia care unit due to the neurosciences ICU (NSICU) being above capacity. Total estimated cost for initial recovery day in a NSICU room was $2,361 versus $882 for a neurosurgery/neurology ward room. In our cohort, ward convalescence would save an estimated $79,866 for bed placement alone and increase ICU bed availability. CONCLUSION: Our findings reaffirm the safety of VSS. These patients should recover on a neurosurgery/neurology ward, which would save healthcare costs and increase ICU bed availability.

13.
Vaccine ; 2022 Nov 03.
Article in English | MEDLINE | ID: covidwho-2096115

ABSTRACT

BACKGROUND: Studies combining data from digital surveys and electronic health records (EHR) can be used to conduct comprehensive assessments on COVID-19 vaccine safety. METHODS: We conducted an observational study using data from a digital survey and EHR of children aged 5-11 years vaccinated with Pfizer-BioNTech COVID-19 mRNA vaccine across Kaiser Permanente Southern California during November 4, 2021-February 28, 2022. Parents/guardians who enrolled their children were sent a 14-day survey on reactions. Survey results were combined with EHR, and medical encounters were described for children whose parents or guardians indicated seeking medical care for vaccine-related symptoms. This study describes self-reported reactions (local and systemic) and additional symptoms (chest pain, tachycardia, and pre-syncope). RESULTS: The study recruited 7,077 participants aged 5-11 years who received the Pfizer-BioNTech COVID-19 mRNA vaccine. Of 6,247 participants with survey responses after dose 1, 2,176 (35 %) reported at least one systemic reaction, and 1,076 (32 %) of 3,401 respondents following dose 2 reported at least one systemic reaction. Local reactions were reported less frequently following dose 2 (1,113, 33 %) than dose 1 (3,140, 50 %). The most frequently reported reactions after dose 1 were pain at the injection site (48 %), fatigue (20 %), headache (12 %), myalgia (9 %) and fever (5 %). The most frequently reported symptoms after dose 2 were also pain at the injection site (30 %), fatigue (19 %), headache (13 %), myalgia (10 %) and fever (9 %). Post-vaccination reactions occurred most frequently-one day following vaccination. Chest pain or tachycardia were reported infrequently (1 %). EHR demonstrated that parents rarely sought care for post-vaccination symptoms, and among those seeking care, the most common symptoms documented in EHR were fever and nausea, comprising<0.5 % of children. No encounters were related to myocarditis. CONCLUSION: While post-vaccination reactions to the Pfizer-BioNTech COVID-19 mRNA vaccine were common in children aged 5-11 years, our data showed that in most cases they were transient and did not require medical care.

14.
Vaccine ; 2022 Nov 01.
Article in English | MEDLINE | ID: covidwho-2096113

ABSTRACT

BACKGROUND: Risk of experiencing a systemic adverse event (AE) after mRNA coronavirus disease 2019 (COVID-19) vaccination may be greater among persons with a history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; data on serious events are limited. We assessed if adults reporting systemic AEs resulting in emergency department visits or hospitalizations during days 0-7 after mRNA COVID-19 vaccine dose 1 were more likely to have a history of prior SARS-CoV-2 infection compared with persons who reported no or non-severe systemic AEs. METHODS: We conducted a nested case-control study using v-safe surveillance data. Participants were ≥ 18 years and received dose 1 during December 14, 2020─May 9, 2021. Cases reported severe systemic AEs 0-7 days after vaccination. Three controls were frequency matched per case by age, vaccination date, and days since vaccination. Follow-up surveys collected SARS-CoV-2 histories. RESULTS: Follow-up survey response rates were 38.6 % (potential cases) and 56.8 % (potential controls). In multivariable analyses including 3,862 case-patients and 11,586 controls, the odds of experiencing a severe systemic AE were 2.4 (Moderna, mRNA-1273; 95 % confidence interval [CI]: 1.89, 3.09) and 1.5 (Pfizer-BioNTech, BNT162b2; 95 % CI: 1.17, 2.02) times higher among participants with pre-vaccination SARS-CoV-2 histories compared with those without. Medical attention of any kind for symptoms during days 0-7 following dose 2 was not common among case-patients or controls. CONCLUSIONS: History of SARS-CoV-2 infection was significantly associated with severe systemic AEs following dose 1 of mRNA COVID-19 vaccine; the effect varied by vaccine received. Most participants who experienced severe systemic AEs following dose 1 did not require medical attention of any kind for symptoms following dose 2. Vaccine providers can use these findings to counsel patients who had pre-vaccination SARS-CoV-2 infection histories, experienced severe systemic AEs following dose 1, and are considering not receiving additional mRNA COVID-19 vaccine doses.

15.
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.

16.
J Am Coll Cardiol ; 80(20): 1900-1908, 2022 Nov 15.
Article in English | MEDLINE | ID: covidwho-2095536

ABSTRACT

BACKGROUND: Postmarketing evaluations have linked myocarditis to COVID-19 mRNA vaccines. However, few population-based analyses have directly compared the safety of the 2 mRNA COVID-19 vaccines. OBJECTIVES: This study aimed to compare the risk of myocarditis, pericarditis, and myopericarditis between BNT162b2 and mRNA-1273. METHODS: We used data from the British Columbia COVID-19 Cohort (BCC19C), a population-based cohort study. The exposure was the second dose of an mRNA vaccine. The outcome was diagnosis of myocarditis, pericarditis, or myopericarditis during a hospitalization or an emergency department visit within 21 days of the second vaccination dose. We performed multivariable logistic regression to assess the association between vaccine product and the outcomes of interest. RESULTS: The rates of myocarditis and pericarditis per million second doses were higher for mRNA-1273 (n = 31, rate 35.6; 95% CI: 24.1-50.5; and n = 20, rate 22.9; 95% CI: 14.0-35.4, respectively) than BNT162b2 (n = 28, rate 12.6; 95% CI: 8.4-18.2 and n = 21, rate 9.4; 95% CI: 5.8-14.4, respectively). mRNA-1273 vs BNT162b2 had significantly higher odds of myocarditis (adjusted OR [aOR]: 2.78; 95% CI: 1.67-4.62), pericarditis (aOR: 2.42; 95% CI: 1.31-4.46) and myopericarditis (aOR: 2.63; 95% CI: 1.76-3.93). The association between mRNA-1273 and myocarditis was stronger for men (aOR: 3.21; 95% CI: 1.77-5.83) and younger age group (18-39 years; aOR: 5.09; 95% CI: 2.68-9.66). CONCLUSIONS: Myocarditis/pericarditis following mRNA COVID-19 vaccines is rare, but we observed a 2- to 3-fold higher odds among individuals who received mRNA-1273 vs BNT162b2. The rate of myocarditis following mRNA-1273 receipt is highest among younger men (age 18-39 years) and does not seem to be present at older ages. Our findings may have policy implications regarding the choice of vaccine offered.


Subject(s)
COVID-19 Vaccines , COVID-19 , Myocarditis , Pericarditis , Adolescent , Adult , Humans , Male , Young Adult , 2019-nCoV Vaccine mRNA-1273 , BNT162 Vaccine , Cohort Studies , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Myocarditis/epidemiology , Myocarditis/etiology , Myocarditis/diagnosis , Pericarditis/epidemiology , Pericarditis/etiology , Pericarditis/diagnosis , Vaccination , Vaccines
17.
Revista Espanola De Salud Publica ; JOUR, 96.
Article in English | Web of Science | ID: covidwho-2092165

ABSTRACT

After about a year and a half (at the moment these lines are being written) since the start of the massive vaccination campaign in which, thanks to the high coverage achieved in all groups eligible for vaccination, it has been possible to significantly reduce the morbidity and mortality due to COVID-19, it is important to review the scientific basics that have supported the recommendations implemented to date and those that could be adopted in the near future taking into consideration the epidemiological situation. The objective of this article is, therefore, to address the foundations of some of the technical decisions proposed by the Committee on Programme and Registry of Vaccinations (National Immunization Technical Advisory Group in Spain) and the Technical Working Group on Vaccination against COVID-19. Throughout the eleven updates of the Vaccination Strategy against COVID-19 in Spain, several issues pose intense debate as the vaccination intervals between doses, the convenience of using different types of vaccines, the use of heterologous schemes of vaccination, the benefits of hybrid immunity and the use of a fourth dose (second booster dose) for se-lected populations. All this without forgetting essential aspects of safety of vaccines. This article is divided into the following sections: Vaccination intervals;Heterologous or mixed scheme;Hybrid immunity (vaccination after infection and infection after vaccination [breakthrough]);Second booster dose.

18.
Child's Health ; JOUR(3):155-166, 7.
Article in Ukrainian | Scopus | ID: covidwho-2091358

ABSTRACT

Background. Telemedicine is defined as “the use of electronic information and communications technologies to provide and support health care when participants are separated” (Field M.J., 1998). The technologies range from standard telephone audio consultations to virtual reality scenarios. The accelerated uptake of telemedicine during the coronavirus disease 2019 pandemic has resulted in valuable experience and evidence on the delivery of telemedicine for pediatric patients. Despite the well-documented benefits of telephone medicine in both triage and disease management, the complexity of medically related telephone communications leaves patients vulnerable to errors in management. The purpose of our work was to describe medical errors related to the use of the telephone during communication between the patient/parents of the patient and the doctor, and the means of countering these errors in pediatrics. Materials and methods. The PubMed Central® database was searched using the keywords “telemedicine”, “telephone consultation”, “pediatrics”, “children”, and “patient safety”. Results. According to literature, the main types of mistakes were absence of records of the virtual consultation episode, incorrect triage decisions, incorrect diagnosis, failure to recognize the potential seriousness of repeat calls, lack of telephone consultation protocols and insufficient patient information. Measures to increase patient safety were presented: the use of empirical rules and protocols, experience and intuition, taking into account the thoughts and wishes of parents, non-medical factors and the accessibility of health care for the family, the use of a “safety net”. Conclusions. Further researches that would examine specific ways of the delivering and use of telemedicine are needed to develop evidence-based guidelines for virtual pediatric care. © 2022. The Authors. This is an open access article under the terms of the Creative Commons Attribution 4.0 International License, CC BY.

19.
Fortschritte der Neurologie Psychiatrie ; JOUR:388-390, 90(9).
Article in German | EMBASE | ID: covidwho-2087353
20.
Emerg Infect Dis ; 28(11): 1-8, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2089722

ABSTRACT

During 2020-2021, countries in Latin America and the Caribbean reported clinical emergence of carbapenemase-producing Enterobacterales that had not been previously characterized locally, increased prevalence of carbapenemases that had previously been detected, and co-production of multiple carbapenemases in some isolates. These increases were likely fueled by changes related to the COVID-19 pandemic, including empirical antibiotic use for potential COVID-19-related bacterial infections and healthcare limitations resulting from the rapid rise in COVID-19 cases. Strengthening antimicrobial resistance surveillance, epidemiologic research, and infection prevention and control programs and antimicrobial stewardship in clinical settings can help prevent emergence and transmission of carbapenemase-producing Enterobacterales.


Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Latin America/epidemiology , beta-Lactamases/genetics , Bacterial Proteins/genetics , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria
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