Safety of inactivated SARS-CoV-2 vaccines in myasthenia gravis: A survey-based study.

Background: Vaccination remains the most effective measure to prevent SARS-CoV-2 infection and worse outcomes. However, many myasthenia gravis (MG) patients are hesitant to receive vaccine due to fear of worsening. Methods: MG patients were consecutively enrolled in two MG centers in North China. The "worsening" after vaccination was self-reported by MG patients, and severity was measured with a single simple question. The general characteristics and disease status immediately prior to the first dose were compared between the worsening and non-worsening groups. Independent factors associated with worsening were explored with multivariate regression analysis. Results: One hundred and seven patients were included. Eleven patients (10.3%) reported worsening after vaccination, including eight patients with mild or moderate worsening and three patients with severe worsening. Only one of them (0.9%) needed an escalation of immunosuppressive treatments. There were significant differences between the worsening and non-worsening groups in terms of Myasthenia Gravis Foundation of America classes immediately before the first dose and intervals since the last aggravation. Precipitating factors might contribute to the worsening in some patients. Logistic regression revealed that only interval since the last aggravation ≤6 months was associated with worsening after SARS-CoV-2 vaccination (P = 0.01, OR = 8.62, 95% CI: 1.93-38.46). Conclusion: SARS-CoV-2 vaccines (an overwhelming majority were inactivated vaccines) were found safe in milder Chinese MG patients who finished two doses. Worsening after vaccination was more frequently seen in patients who were presumed as potentially unstable (intervals since last aggravation ≤6 months). However, mild worsening did occur in patients who were presumed to be stable. Precipitating factors should still be sought and treated for better outcome.

Diseases in the Neonatal period among preterm infants: an epidemiological investigation / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore diseases in the neonatal period among hospitalized preterm infants.</p><p><b>METHODS</b>The clinical data of 961 preterm infants who were hospitalized in three hospitals in Changsha in 2008 were retrospectively reviewed.</p><p><b>RESULTS</b>The most common neonatal disease was respiratory system diseases (73.8%), followed by infectious diseases (39.4%) and nervous system diseases (38.3%). With the increase of gestational age and birth weight, the incidence of circulatory system diseases showed no statistically significant differences (all P>0.05), while the incidences of other diseases, such as respiratory system diseases, neonatal infections, nervous system diseases, and the desirable outcome of the preterm infants became significantly different (all P<0.05). Increased birth weight and gestational age were the protective factors while neonatal asphyxia, hyperbilirubinemia and neonatal scleredema were the risk factors for the outcome of preterm infants.</p><p><b>CONCLUSIONS</b>The common neonatal diseases for preterm infants are respiratory system diseases, neonatal infections, and nervous system diseases. The incidence of the common diseases is reduced with the increasing gestational age and birth weight. Interventions should be carefully planned based on the protective factors (increased birth weight and gestational age) and risk factors (neonatal asphyxia, hyperbilirubinemia and scleredema) of the outcomes of these diseases.</p>