ABSTRACT
OBJECTIVE: Comirnaty® is an mRNA vaccine against COVID-19 which has been administered to millions of people since the end of 2020. Our aim was to study epidemiological and clinical factors influencing reactogenicity and functional limitation after the first two doses of the vaccine in health care workers (HCWs). METHODS: Prospective post-authorization cohort study to monitor safety and effectiveness of the vaccine. RESULTS: Local side effects were mild and presented both with first and second dose of Comirnaty. Systemic side effects were more frequent after 2nd dose. Nevertheless, previous SARS-CoV-2 infection was associated with systemic effects after the first dose of the vaccine (OR ranging from 2 to 6). No severe adverse effects were reported. According to multivariate analysis, the degree of self-reported functional limitation after the first dose increased with age, female sex, previous COVID-19 contact, previous SARS-CoV-2 infection, and Charlson Comorbidity Index (CCI). After the second dose, the degree of functional limitation observed was lower in those with previous SARS-CoV-2 infection, and it was positively associated to the degree of functional limitation after the first dose. CONCLUSIONS: Systemic adverse effects were more frequent after the second dose of Comirnaty. Previous SARS-CoV-2 infection was associated with systemic effects after the first dose. Age, female sex, previous COVID-19, previous isolation due to COVID-19 contact, and CCI showed to be independent predictors of the degree of functional limitation after the 1st dose of Comirnaty®. After the 2nd dose, the degree of functional limitation was lower in those who previously had SARS-CoV-2 infection.
Subject(s)
COVID-19 Vaccines , COVID-19 , Drug-Related Side Effects and Adverse Reactions , Vaccines , Female , Humans , BNT162 Vaccine , Cohort Studies , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Health Personnel , Hospitals, Teaching , Prospective Studies , SARS-CoV-2 , UniversitiesSubject(s)
Stroke , Administration, Oral , Anticoagulants/administration & dosage , Anticoagulants/therapeutic use , Echocardiography, Doppler , Echocardiography, Transesophageal , Factor V/genetics , Female , Heart Aneurysm/complications , Heart Aneurysm/diagnosis , Heart Aneurysm/diagnostic imaging , Heart Aneurysm/drug therapy , Heart Atria , Heart Septal Defects, Atrial/complications , Heart Septum , Humans , Magnetic Resonance Imaging , Middle Aged , Point Mutation , Prospective Studies , Risk Factors , Stroke/diagnosis , Stroke/diagnostic imaging , Stroke/etiology , Stroke/therapy , Ultrasonography, Doppler, TranscranialABSTRACT
No disponible
Subject(s)
Female , Humans , Stroke/diagnosis , Stroke/etiology , Stroke/therapy , Stroke , Administration, Oral , Anticoagulants/administration & dosage , Anticoagulants/therapeutic use , Echocardiography, Doppler , Echocardiography, Transesophageal , Factor V , Heart Aneurysm/complications , Heart Aneurysm/diagnosis , Heart Aneurysm/drug therapyABSTRACT
No disponible
Subject(s)
Middle Aged , Male , Humans , Arthralgia , Muscular Diseases , Respiratory Paralysis , Lyme DiseaseABSTRACT
No disponible
Subject(s)
Aged , Male , Humans , Adenocarcinoma , ACTH Syndrome, Ectopic , Colonic Neoplasms , Adrenocorticotropic HormoneABSTRACT
No disponible
Subject(s)
Middle Aged , Male , Humans , Disseminated Intravascular Coagulation , Adenocarcinoma , Prostatic NeoplasmsSubject(s)
Hepatitis, Autoimmune/complications , Adult , Aged , Aged, 80 and over , Female , Hepatitis, Autoimmune/classification , Humans , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Middle Aged , Adult , Aged, 80 and over , Aged , Male , Female , Humans , Hepatitis, AutoimmuneSubject(s)
Pellagra/diagnosis , Adult , Alcoholism/complications , Female , Humans , Pellagra/drug therapy , PeriodicitySubject(s)
Basal Ganglia Diseases/etiology , Brain Edema/etiology , Typhoid Fever/complications , Adult , Endotoxins , Female , Humans , MesencephalonSubject(s)
Boutonneuse Fever/diagnosis , Rickettsiaceae Infections/diagnosis , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Three cases of spontaneous peritonitis due to Clostridium perfringens in cirrhotic patients with a fatal outcome are reported. The diagnosis was made clinically in two patients and by post-mortem examination in the third. One patient had elevated values of serum alpha-fetoprotein. These cases are compared with three other reported cases in the literature. Blood cultures were negative in the three patients, a fact that lends support to the theory of transmural migration of bacteria. In the authors' experience C. perfringens is the third most frequent agent responsible for spontaneous peritonitis in cirrhosis, preceded by E. coli and Streptococcus and followed by Klebsiella, a surprising fact given the scarce number of reported cases. Routine abdominal paracentesis is recommended in any cirrhotic patient with ascites, followed by appropriate antibiotic treatment whenever positive cultures are obtained. The efficacy of treatment is probably doubtful. The literature on antibiotic treatment of spontaneous peritonitis in cirrhosis is reviewed.
