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Background: Adults with congenital heart disease (ACHD) are a vulnerable population. Routine vaccination is the only strategy to prevent a lifethreatening infection. However, concerns on the cardiac safety and efficacy of COVID-19 vaccines have been raised. Aim(s): To assess safety and efficacy of available COVID-19 vaccines in ACHD patients. Method(s): Data on COVID-19 infection and vaccines including booster doses and any suspected or confirmed adverse events were prospectively collected for all ACHD patients attending our tertiary centre from the beginning of the vaccination campaign (March 2021). A group of 75 healthy volunteers, matched per age and sex, was included for comparison. Antispike IgG titre was routinely obtained at the ACHD clinic. Patients' attitude towards COVID-19 was explored with a questionnaire. Result(s): As of February 2022, 498 ACHD patients (36.7+/-16 years, 54% male,69% with moderate-complex defects, 48% with advanced physiological stage) were enrolled. Four hundred and sixty-one (92%) were fully vaccinated: The type of vaccine was Pfizer-BioNTech for 399 (86%) patients, Moderna for 20 (4%) and AstraZeneca for 26 (6%), 9 received a mixed vaccine regimen (2%). Forty-two (9%) had a history of previous COVID-19 infection and therefore received only one dose. Two-hundred and sixty-nine (58%) patients received a booster dose. Adverse events were mainly mild and transient. One patient complaining of chest pain following administration of mRNA-based vaccination was diagnosed with acute pericarditis, which made full remission after appropriate therapy. Two patients reported a non-specific increment of inflammatory markers. No other severe adverse events were reported. Thirty-seven (7%) refused COVID-19 vaccination being scared of potential cardiac/extra-cardiac adverse events. Among those not-vaccinated, 9 (24%) had a history of previous mild COVID-19 infection. IgG titre was measured in 243 patients at 1915 [835-5934] BAU/ml, which was significantly higher compared to controls (1196 [827-2048] BAU/ml, p=0.002). Three ACHD patients contracted COVID-19 infection after the first dose, while 65 (14%) fully vaccinated patients tested positive for COVID-19, all with mild to moderate symptoms. COVID-19 symptoms duration was significantly longer in case of infection before vaccination (10 [2.7-15] vs 3 [1.2-7], p=0.03). One Fontan patient was tested positive for COVID-19 twice, before and after COVID-19 vaccination, requiring hospitalization in both cases. Four hundred and seven patients completed the questionnaire: 128 (31%) declared to be scared of potential cardiac effects of the vaccine and that the discussion with the ACHD cardiologist was crucial to decide to undergo COVID-19 vaccination. Conclusion(s): Our data provide real-world evidence on COVID-19 vaccines safety and efficacy in ACHD patients. Patients' education from the ACHD team may play a key role in vaccine acceptance in this vulnerable population.
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In “Surviving the Fugue: Reflections on Pandemic Storytelling” the actor/director Erica Terpening-Romeo examines the nation’s attempt to find a story, a narrative, to come to terms with the fugue-like complications of the Covid-19 pandemic. A source of her own attempt was research on the autonomic nervous system, where in a ventral state our focus in response to danger is on “connection, communication, and interpretation” (story making), and she links this with the work of a director devising a concept for a stage production. All of us, “the bodily politic, ” as she adjusts the phrase, “caught in the paroxysms triggered by the pandemic, ” create stories marked either by “dissonance” (making national unity impossible) or “consonance” (with the hope of a shared experience). She herself builds “stories from scraps right now” but envisions a time when the “noise [will] resolve back into music.” © 2022 selection and editorial matter, Sidney Homan;individual chapters, the contributors.
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The work aims at exploring the role of ICT in fostering value co-creation mechanisms and social well-being, during the Covid-19 pandemic. According to the Service-dominant logic principles and view, the role of ICT in “MascherinAmica”—a social nonprofit enterprise—will be described. The empirical research adopts a case study methodology. The results identify ICT levers to encourage value co-creation during the lockdown and the different resources and co-creation practices emerging from the various actor’s engagement. This work has both theoretical and managerial implications. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Background: The cancer population seems to be more susceptible to COVID-19 infection and have worse outcomes. Front of this pandemic, we had to adapt our patient care to protect our patients without compromising their prognosis related to their cancer. The national PRATICOVID study aims to describe the modification of the medical and surgical patient care for this population, according to the recommendations in this context of pandemic, within our hospitals which are strongly mobilized. Methods: We analyzed data from 9 different institutions, 3 Military Hospitals, 4 Academics Hospital, 2 Private Hospital, from oncologists, surgeons, radiotherapists. The primary endpoint was to assess the prevalence of adapted patient care during pandemic. The secondary endpoints were to describe the point of view of clinicians and patients during and after the pandemic. Results: We analyzed 435 medical care between 9th of March and 30th of April. The median age was 69 years (range, 24-99), 54% was male. 167 patients (38.4%) were newly diagnosed and only 4% were included in a clinical trial. Because of COVID-19 pandemic, 47.6% of the outpatients had modified patient care. The main primary tumor site was breast cancer (22.7%) at a metastatic stage. 24.6% have postponed surgery, or not receive perioperative chemotherapy, 18.4% received hypofractioned schedule and 57% had an adaptive systemic protocol (stopped, oral protocol, spacing between cures). 70% of physicians are used telemedicine. During this period, 67% of the physicians were relaxed to taking care of their patients. 57% of the patients have seen to be relaxed or low worried about the pandemic. However, 71% are worried after the lockdown, because of future patient care, stage at diagnosis, access to clinical trial, our abilities to receive in the same time all the patients. Conclusions: PRATICOVID study is the first to assess modification of patients cares during an epidemic in cancer outpatients. Faces with this unprecedented crisis, physicians were able to adapt their practice in order to protect their patients against the virus and while ensuring the course of patient care. But physicians are worried after de lockdown because of the care pathway’s issues. Clinical trial identification: CNIL;reference number: 2217722v0. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.