Adverse events of COVID-19 vaccination among Japanese University Students suppressed by breakfast consumption and favorable sleeping habits (preprint)

Despite the evidence of effectiveness of vaccines in preventing SARS-CoV-2 infection-associated serious illness, hospitalization, and death, there is some hesitation towards COVID-19 vaccination in young adults because of concerns regarding adverse events. A retrospective cohort study was conducted in Gifu University students receiving the mRNA-1273 vaccine and boosters to elucidate the real incidence of adverse events and factors that prevent them. We examined the adverse events and identified potential risk factors through a self-administered questionnaire reporting their physical condition after COVID-19 vaccination. A higher number of vaccinations, female sex, and low body mass index were significantly associated with the occurrence of adverse events on the day of or after receiving the COVID-19 vaccine. Regular breakfast consumption was significantly associated with a decreased incidence of post-vaccination itching, abdominal pain, and diarrhea. Sufficient sleep duration was significantly associated with a decreased incidence of post-vaccination abdominal pain and diarrhea. Focal/systemic adverse events were highly frequent among university students after receiving the COVID-19 vaccine, with no life-threatening cases or hospitalizations. A higher number of vaccinations, female sex, and lower body mass index were associated with an increased incidence of adverse events. Contrastingly, regular breakfast and sufficient sleep were associated with fewer adverse events.

C-reactive protein and lactate dehydrogenase are useful biomarkers for predicting the requirement for oxygen therapy in outpatients with coronavirus disease 2019 (preprint)

Background It is critical for clinicians seeing outpatients with coronavirus disease 2019 (COVID-19) to identify those who will require oxygen therapy after the hospital visit. Although many studies on biomarkers predicting the study outcomes, including intensive care unit admission, ventilator requirement, or mortality, in hospitalized patients with COVID-19 have been conducted, research on biomarkers predicting the need for oxygen therapy in outpatients is sparse. Methods Patients with COVID-19 who visited Asahikawa City Hospital on an outpatient basis were included in the study. In total, 287 new outpatients visited between April 2021 and September 2021, and 142 underwent blood testing. All blood tests were performed before any treatments for COVID-19 were started. Demographic information, laboratory data, and clinical treatment information were extracted from the electronic medical records. Risk factors associated with oxygen therapy were explored. Results In total, 40 of 142 patients who underwent blood testing required oxygen therapy within 7 days after blood samples were taken, and all other patients recovered without oxygen therapy. C-reactive protein (CRP) and lactate dehydrogenase (LDH) levels were significantly higher in patients who required oxygen therapy, and their cutoffs were 36 mg/L (sensitivity, 0.802; specificity, 0.725) and 267 U/L (sensitivity, 0.713; specificity, 0.750), respectively. Multivariate logistic regression identified age, body mass index, CRP [≥] 36 mg/L, and LDH [≥] 267 U/L as significant risk factors for oxygen therapy. Conclusion This study suggests that elevated CRP and LDH levels are useful biomarkers for predicting the need for oxygen therapy in outpatients with COVID-19. Further confirmatory studies are needed.

Impact of Antibody Cocktail Therapy Combined with Casirivimab and Imdevimab on Clinical Outcome for Covid-19 patients in A Real-Life Setting: A Single Institute Analysis (preprint)

BackgroundRecent data from clinical trial suggest that antibody cocktail therapy, a combination of the monoclonal antibodies casirivimab and imdevimab, has been shown to rapidly reduce the viral load and markedly decrease the risk of hospitalization or death among high-risk patients with coronavirus disease 2019 (Covid-19). However, it remains unclear how effective in a real-life clinical setting the therapy is. MethodsWe retrospectively analyzed mild to moderate Covid-19 patients with one or more high-risk factors for severe disease who consecutively underwent the antibody cocktail therapy of the disease in our institute in June 2021 through early September 2021, compared to those with high-risk factors who were isolated in non-medical facilities consecutively during the same period, thereby being not given the antibody cocktail therapy there. The key outcome was the percentage of patients with Covid-19-related deterioration which needed additional medical interventions, such as oxygen support or other antiviral therapies. ResultsData from 55 patients with initially receiving antibody cocktail therapy and 53 patients with isolation into non-medical facilities are analyzed. 22 (41.5 %) of 53 patients with isolation facilities were finally hospitalized to receive medical interventions. On the other hand, 13 (23.6 %) of 55 patients with antibody cocktail therapy in our hospital subsequently underwent further medical interventions because of the progression. In multivariate analysis with variables of age, BMI, and high-risk factors, the antibody cocktail therapy significantly reduced 70 % in the need for further medical interventions compared to the initial isolation in the non-medical facilities (odds ratio=0.30, 95%CI [0.10-0.87], p=0.027). Furthermore, patients with 96% or above of SPO2 were significantly more favorable for the therapy than those with 95% or below of SPO2. ConclusionThe treatment of antibody cocktail was closely linked to reduction in the need for further medical interventions. The result indicates that the antibody cocktail therapy is associated with reducing the strain on hospitals, which is related to the improvement of medical management for public health care in Covid-19 pandemic era.