RESUMO
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.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Vacinas , Feminino , Humanos , Vacina BNT162 , Estudos de Coortes , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/administração & dosagem , Vacinas contra COVID-19/efeitos adversos , Pessoal de Saúde , Hospitais de Ensino , Estudos Prospectivos , SARS-CoV-2 , UniversidadesAssuntos
Acidente Vascular Cerebral , Administração Oral , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Ecocardiografia Doppler , Ecocardiografia Transesofagiana , Fator V/genética , Feminino , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/diagnóstico por imagem , Aneurisma Cardíaco/tratamento farmacológico , Átrios do Coração , Comunicação Interatrial/complicações , Septos Cardíacos , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Mutação Puntual , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/terapia , Ultrassonografia Doppler TranscranianaRESUMO
No disponible
Assuntos
Feminino , Humanos , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/terapia , Acidente Vascular Cerebral , Administração Oral , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Ecocardiografia Doppler , Ecocardiografia Transesofagiana , Fator V , Aneurisma Cardíaco/complicações , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/tratamento farmacológicoRESUMO
No disponible
Assuntos
Pessoa de Meia-Idade , Masculino , Humanos , Artralgia , Doenças Musculares , Paralisia Respiratória , Doença de LymeRESUMO
No disponible
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Idoso , Masculino , Humanos , Adenocarcinoma , Síndrome de ACTH Ectópico , Neoplasias do Colo , Hormônio AdrenocorticotrópicoRESUMO
No disponible
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Pessoa de Meia-Idade , Masculino , Humanos , Coagulação Intravascular Disseminada , Adenocarcinoma , Neoplasias da PróstataRESUMO
No disponible
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Pessoa de Meia-Idade , Adulto , Idoso de 80 Anos ou mais , Idoso , Masculino , Feminino , Humanos , Hepatite AutoimuneAssuntos
Pelagra/diagnóstico , Adulto , Alcoolismo/complicações , Feminino , Humanos , Pelagra/tratamento farmacológico , PeriodicidadeAssuntos
Febre Botonosa/diagnóstico , Infecções por Rickettsiaceae/diagnóstico , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
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.
