ABSTRACT
Given the vulnerability of people with chronic kidney disease to COVID-19, nephrology societies have issued statements calling for prioritization of these patients for vaccination. It is not yet known whether COVID-19 vaccines confer the same high level of protection in patients with kidney disease. The aims of this study were to evaluate the safety measured by the events supposedly attributed to vaccines and the effectiveness evaluated by the presence of antibodies in dialysis patients immunized with the COVID-19 Sputnik V vaccine. Methodsmulticenter, observational and analytical study of a prospective cohort of hemodialysis patients in the Autonomous City of Buenos Aires with a vaccination plan. Patients older than 18 years on dialysis who received both components of the COVID-19 vaccine were included. Results491 patients included in the safety analysis. ESAVI with either the first or second component was detected in 186 (37.9% 95% CI 33.6%-42.34%). The effectiveness analysis measures of antibodies against SARS-Cov-2 were performed in 102 patients, 98% had positive IgG against SARS-Cov-2 antibodies 21 days after the second component .In patients with COVID-19 prior to vaccination, antibodies at day 21 after the first component reached almost the highest levels compared to those patients who did not have COVID-19, and the rise between the last measures was lower than patients without COVID-19. ConclusionDialysis patients constitute a vulnerable population for SARS-Cov-2 infection, beyond the recommendations that were implemented by dialysis units, full vaccination is a priority and necessary. The Sputnik V vaccine has been shown to be safe and effective in this patient population.
ABSTRACT
The durability of the antibody response following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections has not been fully elucidated. We have performed a cross-sectional study in one of the largest slums of Buenos Aires, Barrio Padre Mugica in June 2020, detecting a seroprevalence of 53.4%. To evaluate the persistence of the humoral response against SARS-CoV-2 in this area, we designed a second study assessing only the people that were IgG positive in the first survey. The IgG levels against the full spike (S) protein in 175 individuals that were seropositive, at least 6 months before, were evaluated in a second survey. The positivity rate was 92.0%, 161 from 175 individuals remained IgG positive. We observed a contraction in the overall IgG levels measured by ELISA. The median IgG dropped 62% from June to December 2020. Most of the individuals tested (87%) reported to be asymptomatic or oligo-symptomatic. No difference was found between men and women, but people aged less than 50 showed a lower IgG level in each period compared to older individuals. Our data indicate sustained humoral immunity for at least 6 months in a specific socio-economical setting in a population that was mainly asymptomatic for COVID-19.
ABSTRACT
OBJECTIVES: Information technology is an essential tool to improve patient safety and the quality of care, and to reduce healthcare costs. There is a scarcity of large sustainable implementations in developing countries. The objective of this paper is to review the challenges faced by developing countries to achieve sustainable implementations in health informatics and possible ways to address them. METHODS: In this non-systematic review of the literature, articles were searched using the keywords medical informatics, developing countries, implementation, and challenges in PubMed, LILACS, CINAHL, Scopus, and EMBASE. The authors, after reading the literature, reached a consensus to classify the challenges into six broad categories. RESULTS: The authors describe the problems faced by developing countries arising from the lack of adequate infrastructure and the ways these can be bypassed; the fundamental need to develop nationwide e-Health agendas to achieve sustainable implementations; ways to overcome public uncertainty with respect to privacy and security; the difficulties shared with developed countries in achieving interoperability; the need for a trained workforce in health informatics and existing initiatives for its development; and strategies to achieve regional integration. CONCLUSIONS: Central to the success of any implementation in health informatics is knowledge of the challenges to be faced. This is even more important in developing countries, where uncertainty and instability are common. The authors hope this article will assist policy makers, healthcare managers, and project leaders to successfully plan their implementations and make them sustainable, avoiding unexpected barriers and making better use of their resources.
