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Costa C, Moniati F. The Epidemiology of COVID-19 Vaccine-Induced Myocarditis. Adv Med 2024; 2024:4470326. [PMID: 38681683 PMCID: PMC11045291 DOI: 10.1155/2024/4470326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/26/2024] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
Background In December 2019, the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) led to the COVID-19 pandemic, with millions of deaths worldwide. Vaccine breakthroughs in late 2020 resulted in the authorization of COVID-19 vaccines. While these vaccines have demonstrated efficacy, evidence from vaccine safety monitoring systems around the globe supported a causal association between COVID-19 vaccines, in particular those using mRNA technology, i.e., Moderna's mRNA-1273 and Pfizer-BioNTech's BNT162b2, and myocarditis. Objective This paper aims to investigate the epidemiology of mRNA COVID-19 vaccine-induced myocarditis, including age, ethnicity, and gender associations with these vaccines. It also discusses the immunopathophysiological mechanisms of mRNA COVID-19 vaccine-associated myocarditis and outlines principles of diagnosis, clinical presentation, and management. Methods A literature review was conducted using PubMed, Embase, and Queen Mary University of London Library Services databases. Search terms included "myocarditis," "coronavirus disease 2019," "SARS-CoV-2," "mRNA Covid-19 vaccines," "Covid vaccine-associated myocarditis," "epidemiology," "potential mechanisms," "myocarditis diagnosis," and "myocarditis management." Results While the definite mechanism of mRNA COVID-19 vaccine-associated myocarditis remains ambiguous, potential mechanisms include molecular mimicry of spike proteins and activation of the adaptive immune response with dysregulated cytokine expression. Male predominance in COVID-19 vaccine-induced myocarditis may be attributed to sex hormones, variations in inflammatory reactions, coagulation states based on gender, and female-specific protective factors. Moreover, an analysis of diagnostic and management strategies reveals a lack of consensus on acute patient presentation management. Conclusion In contrast to viral infections that stand as the predominant etiological factor for myocarditis with more severe consequences, the mRNA COVID-19 vaccination elicits a mild and self-limiting manifestation of the condition. There is currently insufficient evidence to confirm the definite underlying mechanism of COVID-19 vaccine-associated myocarditis. Further research is needed to develop preventive and therapeutic solutions in this context.
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Affiliation(s)
| | - Foteini Moniati
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK
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Gunawardena SA, Dassanayake N, Keerawelle BI, Kanthasamy S, Ranganatha H, Gunawardana JW. The effect of the COVID-19 pandemic on the trends and characteristics of natural and unnatural deaths in an urban Sri Lankan cohort viewed through retrospective analysis of forensic death investigations from 2019 to 2022. Osong Public Health Res Perspect 2023; 14:468-482. [PMID: 38204426 PMCID: PMC10788415 DOI: 10.24171/j.phrp.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on global health. Apart from the disease itself, the strict restrictions and lockdowns enforced to minimize its spread have also substantially disrupted personal and public health. METHODS An analysis of forensic autopsy investigations was conducted between 2019 and 2022 on a selected urban population in Colombo, Sri Lanka, assessing the effects of the COVID-19 pandemic on mortality within these communities. RESULTS During the COVID-19 restrictions, there was a 2.5-fold increase in the total number of deaths, with a significantly higher percentage of female deaths than before. The majority of these deaths were due to cardiovascular causes, while COVID-19-related deaths ranked third overall. The highest proportion of COVID-19 deaths occurred among unvaccinated females. The monthly frequency of deaths from traffic accidents, poisoning, and asphyxiation decreased, while deaths from blunt trauma, sharp trauma, burns, and immersion increased. There was also a rise in blunt homicides and a greater number of femicides during the COVID-19 restrictions than in the pre-pandemic period. A significantly higher percentage of males who received the COVID-19 vaccine died from cardiovascular causes compared to those in the unvaccinated group. CONCLUSION The significant changes in mortality demographics and causes of death within this community during the COVID-19 restrictions underscore the disruption in healthcare, healthseeking behavior, and social interactions during this period. The vulnerability of individuals residing in highly urbanized areas with lower socioeconomic status, particularly women, is brought into sharp focus.
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Affiliation(s)
- Sameera Anuruddha Gunawardena
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- Department of Pathology, School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Nishani Dassanayake
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Shivasankarie Kanthasamy
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Hasini Ranganatha
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Jayani Wathsala Gunawardana
- Department of Forensic Medicine and Toxicology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Ponnaiah M, Bhatnagar T, Abdulkader RS, Elumalai R, Surya J, Jeyashree K, Kumar MS, Govindaraju R, Thangaraj JWV, Aggarwal HK, Balan S, Baruah TD, Basu A, Bavaskar Y, Bhadoria AS, Bhalla A, Bhardwaj P, Bhat R, Chakravarty J, Chandy GM, Gupta BK, Kakkar R, Karnam AHF, Kataria S, Khambholja J, Kumar D, Kumar N, Lyngdoh M, Meena MS, Mehta K, Sheethal MP, Mukherjee S, Mundra A, Murugan A, Narayanan S, Nathan B, Ojah J, Patil P, Pawar S, Ruban ACP, Vadivelu R, Rana RK, Boopathy SN, Priya S, Sahoo SK, Shah A, Shameem M, Shanmugam K, Shivnitwar SK, Singhai A, Srivastava S, Sulgante S, Talukdar A, Verma A, Vohra R, Wani RT, Bathula B, Kumari G, Kumar DS, Narasimhan A, Krupa NC, Senguttuvan T, Surendran P, Tamilmani D, Turuk A, Kumar G, Murkherjee A, Aggarwal R, Murhekar MV. Factors associated with unexplained sudden deaths among adults aged 18-45 years in India - A multicentric matched case-control study. Indian J Med Res 2023; 158:351-362. [PMID: 37988028 DOI: 10.4103/ijmr.ijmr_2105_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND OBJECTIVES In view of anecdotal reports of sudden unexplained deaths in India's apparently healthy young adults, linking to coronavirus disease 2019 (COVID-19) infection or vaccination, we determined the factors associated with such deaths in individuals aged 18-45 years through a multicentric matched case-control study. METHODS This study was conducted through participation of 47 tertiary care hospitals across India. Cases were apparently healthy individuals aged 18-45 years without any known co-morbidity, who suddenly (<24 h of hospitalization or seen apparently healthy 24 h before death) died of unexplained causes during 1 st October 2021-31 st March 2023. Four controls were included per case matched for age, gender and neighborhood. We interviewed/perused records to collect data on COVID-19 vaccination/infection and post-COVID-19 conditions, family history of sudden death, smoking, recreational drug use, alcohol frequency and binge drinking and vigorous-intensity physical activity two days before death/interviews. We developed regression models considering COVID-19 vaccination ≤42 days before outcome, any vaccine received anytime and vaccine doses to compute an adjusted matched odds ratio (aOR) with 95 per cent confidence interval (CI). RESULTS Seven hundred twenty nine cases and 2916 controls were included in the analysis. Receipt of at least one dose of COVID-19 vaccine lowered the odds [aOR (95% CI)] for unexplained sudden death [0.58 (0.37, 0.92)], whereas past COVID-19 hospitalization [3.8 (1.36, 10.61)], family history of sudden death [2.53 (1.52, 4.21)], binge drinking 48 h before death/interview [5.29 (2.57, 10.89)], use of recreational drug/substance [2.92 (1.1, 7.71)] and performing vigorous-intensity physical activity 48 h before death/interview [3.7 (1.36, 10.05)] were positively associated. Two doses lowered the odds of unexplained sudden death [0.51 (0.28, 0.91)], whereas single dose did not. INTERPRETATION CONCLUSIONS COVID-19 vaccination did not increase the risk of unexplained sudden death among young adults in India. Past COVID-19 hospitalization, family history of sudden death and certain lifestyle behaviors increased the likelihood of unexplained sudden death.
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Affiliation(s)
| | | | | | | | - Janani Surya
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Kathiresan Jeyashree
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Ranjithkumar Govindaraju
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Hari Krishan Aggarwal
- Department of Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Suresh Balan
- Department of Community Medicine, Kanyakumari Government Medical College, Kanyakumari, Tamil Nadu, India
| | - Tridip Dutta Baruah
- Department of General Surgery, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ayan Basu
- Infectious Disease Department, Institute of Post-Graduate Medical Education & Research, West Bengal, India
| | - Yogita Bavaskar
- Department of Community Medicine, Government Medical College, Jalgaon, India
| | - Ajeet Singh Bhadoria
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashish Bhalla
- Department of Internal Medicine, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | - Pankaj Bhardwaj
- SPH and Community Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Rachana Bhat
- Department of Emergency Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Jaya Chakravarty
- Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Gina Maryann Chandy
- Department of Emergency Medicine, Christian Medical College & Hospital, Vellore, Tamil Nadu, India
| | - Bal Kishan Gupta
- Department of Medicine, Sardar Patel Medical College, Bikaner, India
| | - Rakesh Kakkar
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Ali Hasan Faiz Karnam
- Department of Emergency and Critical Care Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sushila Kataria
- Department of Internal Medicine, Medanta, Gurugram, Haryana, India
| | - Janakkumar Khambholja
- Department of General Medicine, Smt. NHL Municipal Medical College, Ahmedabad, India
| | - Dewesh Kumar
- Department of Community Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Nithin Kumar
- Department of Community Medicine, Manipal Academy of Higher Education, Manipal, India
- Department of Community Medicine, Kasturba Medical College, Mangalore, Karnataka, India
| | - Monaliza Lyngdoh
- Department of General Medicine, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | - M Selva Meena
- Department of Community Medicine, Government Medical College, Virudhunagar, Tamil Nadu, India
| | - Kedar Mehta
- Department of Community Medicine, GMERS Medical College, Vadodara, India
| | - M P Sheethal
- Department of Community Medicine, Adichunchanagiri Institute of Medical Sciences, Balagangadharanatha Nagara, Mandya, India
| | - Subhasis Mukherjee
- Department of Respiratory Medicine, College of Medicine & Sagore Dutta Hospital, West Bengal, India
| | - Anuj Mundra
- Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Maharashtra, India
| | - Arun Murugan
- Department of Community Medicine, Government Medical College, Omandurar Government Estate, Chennai, Tamil Nadu, India
| | - Seetharaman Narayanan
- Department of Community Medicine, KMCH Institute of Health Sciences & Research, Coimbatore, Tamil Nadu, India
| | - Balamurugan Nathan
- Department of Emergency Medicine & Trauma, Jawaharlal Institute of Post Graduate Medical Education & Research, Puducherry, India
| | - Jutika Ojah
- Department of Community Medicine, Gauhati Medical College, Guwahati, Assam, India
| | - Pushpa Patil
- Department of Community Medicine, SDM College of Medical Science & Hospital, Dharwad, India
| | - Sunita Pawar
- Department of Community Medicine, Dr. Vasantrao Pawar Medical College, Hospital & Research Center, Nashik, India
| | - A Charles Pon Ruban
- Department of Community Medicine, Tirunelveli Medical College & Hospital, Tirunelveli, Tamil Nadu, India
| | - R Vadivelu
- Department of Cardiology, Velammal Medical College Hospital & Research Institute, Madurai, Tamil Nadu, India
| | - Rishabh Kumar Rana
- Department of PSM/Community Medicine, Shaheed Nirmal Mahato Medical College, Dhanbad, Jharkhand, India
| | - S Nagendra Boopathy
- Department of Cardiology, Sri Ramachandra Institute of Higher Education & Research, Chennai, Tamil Nadu, India
| | - S Priya
- Institute of Community Medicine, Madurai Medical College, Madurai, Tamil Nadu, India
| | - Saroj Kumar Sahoo
- Department of Trauma & Emergency (Division of Cardiology), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arti Shah
- Department of Respiratory Medicine, SBKS MI&RC, Sumandeep Vidyapeeth, Pipariya, Vadodara, India
| | - Mohammad Shameem
- Department of Respiratory Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India
| | - Karthikeyan Shanmugam
- Department of Community Medicine, PSG Institute of Medical Sciences & Research, Coimbatore, Tamil Nadu, India
| | - Sachin K Shivnitwar
- Department of Medicine, Dnyandeo Yashwantrao Patil Medical College, Pune, Maharashtra, India
| | - Abhishek Singhai
- Department of Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Saurabh Srivastava
- Department of Medicine, Government Institute of Medical Sciences, Noida, India
| | - Sudheera Sulgante
- Department of Community Medicine, Bidar Institute of Medical Sciences, Bidar, India
| | - Arunansu Talukdar
- Department of Geriatric Medicine, Medical College Kolkata, West Bengal, India
| | - Alka Verma
- Department of Emergency, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Rajaat Vohra
- Department of Community Medicine, Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan, India
| | - Rabbanie Tariq Wani
- Department of Community Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir
| | | | - Gayathri Kumari
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Divya Saravana Kumar
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - Aishwariya Narasimhan
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | - N C Krupa
- Division of Online Courses, Chennai, Tamil Nadu, India
| | | | - Parvathi Surendran
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
| | | | - Alka Turuk
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | - Gunjan Kumar
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | - Aparna Murkherjee
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | - Rakesh Aggarwal
- Department of Medical Gastroenterology, Jawaharlal Institute of Post Graduate Medical Education & Research, Puducherry, India
| | - Manoj Vasant Murhekar
- Division of Epidemiology and Biostatistics, ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
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BECHINI ANGELA, VANNACCI ALFREDO, SALVATI CRISTINA, CRESCIOLI GIADA, LOMBARDI NICCOLÒ, CHIESI FABRIZIO, SHTYLLA JONIDA, DEL RICCIO MARCO, BONANNI PAOLO, BOCCALINI SARA. Knowledge and training of Italian students in Healthcare Settings on COVID-19 vaccines and vaccination strategies, one year after the immunization campaign. J Prev Med Hyg 2023; 64:E152-E160. [PMID: 37654864 PMCID: PMC10468188 DOI: 10.15167/2421-4248/jpmh2023.64.2.2934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/21/2023] [Indexed: 09/02/2023]
Abstract
Introduction COVID-19 vaccines represent an important opportunity for defeating the disease, as long as high vaccination acceptance rates are achieved. Healthcare workers (HCWs) have a relevant role in the promotion of immunization among the population and since students in healthcare area will be HCWs it is crucial to provide more in-depth knowledge on vaccinations. Therefore, the aim of the study is to assess the knowledge of medical and pharmaceutical area students regarding COVID-19 vaccination and the impact of a specific Elective Teaching Activity (ETA) on the increase of students' knowledge. The ETA was held one year after the immunization campaign in Italy. Methods Students' knowledge was tested with a questionnaire before and after attending the course. Descriptive statistical methods were used to analyse the results obtained. Student's t-tests for paired data were used. Results Overall, 387 students at the University of Florence attended the course and took the same test before and after the ETA on COVID-19 vaccines. Despite achieving satisfactory average scores in the pre-course test (26/32 ± 4.0), all students were able to significantly enhance their final score (+17.1%; p < 0.001), indicating that the ETA was highly effective in improving their knowledge of COVID-19 vaccination. Medical students demonstrated a better comprehension of the role of the medical specialist in public health in the COVID-19 vaccination campaign, while some uncertainties were revealed regarding the role of pharmacists. Conclusions The results of this study confirm that specific training activities on vaccination are effective for implementing the knowledge of future health professionals.
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Affiliation(s)
- ANGELA BECHINI
- Department of Health Sciences, University of Florence, Florence, Italy
| | - ALFREDO VANNACCI
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - CRISTINA SALVATI
- Department of Health Sciences, University of Florence, Florence, Italy
| | - GIADA CRESCIOLI
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - NICCOLÒ LOMBARDI
- Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - JONIDA SHTYLLA
- SIAF - Digital Learning and IT Training Process Unit, Area for the Innovation and Management of Information and Computer Systems, University of Florence, Florence, Italy
| | - MARCO DEL RICCIO
- Department of Health Sciences, University of Florence, Florence, Italy
| | - PAOLO BONANNI
- Department of Health Sciences, University of Florence, Florence, Italy
| | - SARA BOCCALINI
- Department of Health Sciences, University of Florence, Florence, Italy
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5
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Rabdano SO, Ruzanova EA, Pletyukhina IV, Saveliev NS, Kryshen KL, Katelnikova AE, Beltyukov PP, Fakhretdinova LN, Safi AS, Rudakov GO, Arakelov SA, Andreev IV, Kofiadi IA, Khaitov MR, Valenta R, Kryuchko DS, Berzin IA, Belozerova NS, Evtushenko AE, Truhin VP, Skvortsova VI. Immunogenicity and In Vivo Protective Effects of Recombinant Nucleocapsid-Based SARS-CoV-2 Vaccine Convacell ®. Vaccines (Basel) 2023; 11:vaccines11040874. [PMID: 37112786 PMCID: PMC10141225 DOI: 10.3390/vaccines11040874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
The vast majority of SARS-CoV-2 vaccines which are licensed or under development focus on the spike (S) protein and its receptor binding domain (RBD). However, the S protein shows considerable sequence variations among variants of concern. The aim of this study was to develop and characterize a SARS-CoV-2 vaccine targeting the highly conserved nucleocapsid (N) protein. Recombinant N protein was expressed in Escherichia coli, purified to homogeneity by chromatography and characterized by SDS-PAGE, immunoblotting, mass spectrometry, dynamic light scattering and differential scanning calorimetry. The vaccine, formulated as a squalane-based emulsion, was used to immunize Balb/c mice and NOD SCID gamma (NSG) mice engrafted with human PBMCs, rabbits and marmoset monkeys. Safety and immunogenicity of the vaccine was assessed via ELISA, cytokine titer assays and CFSE dilution assays. The protective effect of the vaccine was studied in SARS-CoV-2-infected Syrian hamsters. Immunization induced sustainable N-specific IgG responses and an N-specific mixed Th1/Th2 cytokine response. In marmoset monkeys, an N-specific CD4+/CD8+ T cell response was observed. Vaccinated Syrian hamsters showed reduced lung histopathology, lower virus proliferation, lower lung weight relative to the body, and faster body weight recovery. Convacell® thus is shown to be effective and may augment the existing armamentarium of vaccines against COVID-19.
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Affiliation(s)
- Sevastyan O Rabdano
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Ellina A Ruzanova
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Iuliia V Pletyukhina
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Nikita S Saveliev
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | | | | | - Petr P Beltyukov
- Scientific Research Institute of Hygiene, Occupational Pathology and Human Ecology of the Federal Medical-Biological Agency of Russia (SRIHOPHE), Kuzmolovsky 188663, Russia
| | - Liliya N Fakhretdinova
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Ariana S Safi
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - German O Rudakov
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Sergei A Arakelov
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Igor V Andreev
- National Research Center Institute of Immunology (NRCII), Federal Medical-Biological Agency of Russia, Moscow 115522, Russia
| | - Ilya A Kofiadi
- National Research Center Institute of Immunology (NRCII), Federal Medical-Biological Agency of Russia, Moscow 115522, Russia
- Department of Immunology, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow 117997, Russia
| | - Musa R Khaitov
- National Research Center Institute of Immunology (NRCII), Federal Medical-Biological Agency of Russia, Moscow 115522, Russia
- Department of Immunology, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow 117997, Russia
| | - Rudolf Valenta
- National Research Center Institute of Immunology (NRCII), Federal Medical-Biological Agency of Russia, Moscow 115522, Russia
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia
- Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
| | - Daria S Kryuchko
- Federal Medical-Biological Agency of Russia, Moscow 125310, Russia
| | - Igor A Berzin
- Federal Medical-Biological Agency of Russia, Moscow 125310, Russia
| | - Natalia S Belozerova
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Anatoly E Evtushenko
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
| | - Viktor P Truhin
- Saint Petersburg Scientific Research Institute of Vaccines and Serums of the Federal Medical-Biological Agency of Russia (SPbSRIVS), St. Petersburg 198320, Russia
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Gandhi AP, Venkatesh U, Murali N. Serious adverse event following immunization and thromboembolic events associated with COVID19 vaccination: An analysis of nationwide causality assessment from India. Indian Heart J 2023; 75:139-144. [PMID: 36863611 PMCID: PMC9970920 DOI: 10.1016/j.ihj.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/21/2023] [Accepted: 02/26/2023] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Vaccines against the COVID-19 pandemic were introduced in late 2020. The present study has been conducted to study the serious Adverse Events Following Immunization (AEFIs) reported for COVID-19 vaccines from India. METHODS Secondary data analysis of the causality assessment reports for the 1112 serious AEFIs published by the Ministry of Health & Family Welfare, Government of India, was conducted. For the current analysis, all the reports published till 29.03.2022 were included. The primary outcome variables analyzed were the consistent causal association and the thromboembolic events. RESULTS The majority of the serious AEFIs assessed were either coincidental (578, 52%) or vaccine product related (218, 19.6%). All the serious AEFIs were reported among the Covishield (992, 89.2%) and COVAXIN (120, 10.8%) vaccines. Among these, 401 (36.1%) were deaths, and 711 (63.9%) were hospitalized and recovered. On adjusted analysis, females, the younger age group and non-fatal AEFIs showed a statistically significant consistent causal association with COVID-19 vaccination. Thromboembolic events were reported among 209 (18.8%) of the analyzed participants, with a significant association with higher age and case fatality rate. CONCLUSION Deaths reported under serious AEFIs were found to have a relatively lower consistent causal relationship with the COVID-19 vaccines than the recovered hospitalizations in India. No consistent causal association was found between the thromboembolic events and the type of COVID-19 vaccine administered in India.
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Affiliation(s)
- Aravind P Gandhi
- Department of Community Medicine, ESIC Medical College & Hospital, Hyderabad, India.
| | - U Venkatesh
- Department of Community Medicine & Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India.
| | - Naveen Murali
- Department of Pharmacology, PGIMER, Chandigarh, India
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7
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Lassanova M, Lassan S, Liskova S, Tesar T, Cicova M. Analysis of spontaneous reports of suspected adverse reactions after vaccination against COVID-19 in Slovakia. Front Pharmacol 2023; 14:1097890. [PMID: 36726587 PMCID: PMC9886282 DOI: 10.3389/fphar.2023.1097890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
Introduction: The COVID-19 pandemic has resulted in more than 6.5 million deaths worldwide yet. Vaccination against the SARS-CoV-2 virus is a reliable way out of the pandemic, however, vaccination rate reaches only 58% in the Slovak Republic. Concerns about the adverse reactions of vaccines are one of the reasons for the low vaccination rate. Objective: The aim of our analysis was to review reported suspicions of adverse reactions (ARs) of registered COVID-19 vaccines (Comirnaty, Vaxzevria, Spikevax), which State Institute for Drug Control received from healthcare professionals and patients in the period from 1 January 2021 to 31 May 2021. Methods: Data were collected from the State Institute for Drug Control database, a retrospective analysis was carried out focusing on trends in the number of all reports of suspicions of adverse reactions sent to the State Institute for Drug Control during the previously mentioned period. We analysed the Retrieved data were analysed with the usage of descriptive statistics and comparison to historical data on drug adverse reactions in Slovakia was performed. Results: During the evaluation period, 5,763 reported suspicions of adverse reactions were analysed, overall, there was a significant (p < 0.0001) increase in the number of reported adverse reactions fivefold. 93% of ARs (n = 5,346) were reported for COVID-19 vaccines. In comparison of the extentof all adverse reactions, there is clearly a statistically significant difference between all types of vaccines administered at that time (p ≤ 0.0001). No statistically significant difference (p ≤ 0.238) was identified between Spikevax and Comirnaty in the proportion of serious adverse reactions. However, a significantly higher (p ≤ 0.00001) proportion of reported suspicions of serious adverse reactions was observed after the administration of Vaxzevria. Conclusion: This is the first analysis conducted in Slovakia aimed to reported adverse reactions in relation to the administration of COVID-19 vaccines. The rate of spontaneously reported suspected adverse reactions has been insufficient in the past for a long time; during the period from January to May 2021 the reporting rate increased due active calls for adverse reactions reporting. In concordance with European data, Vaxzevria had a significantly higher ratio of reported suspicions of serious adverse reactions.
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Affiliation(s)
- Monika Lassanova
- Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Stefan Lassan
- Department of Pneumology, Phthisiology and Functional Diagnostics, Slovak Medical University and Bratislava University Hospital, Bratislava, Slovakia,*Correspondence: Stefan Lassan, ; Tomas Tesar,
| | - Silvia Liskova
- Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Tomas Tesar
- Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia,*Correspondence: Stefan Lassan, ; Tomas Tesar,
| | - Monika Cicova
- Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia,State Institute for Drug Control, Pharmacovigilance and Clinical Trial Section, Bratislava, Slovakia
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8
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Esposito M, Cocimano G, Vanaria F, Sessa F, Salerno M. Death from COVID-19 in a Fully Vaccinated Subject: A Complete Autopsy Report. Vaccines (Basel) 2023; 11. [PMID: 36679987 DOI: 10.3390/vaccines11010142] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/02/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
A correctly implemented and widely accepted vaccination campaign was the only truly effective weapon to reduce mortality and hospitalizations related to COVID-19. However, it was not 100% effective and has not eliminated COVID-19. Even though more than 60% of the worldwide population is fully vaccinated (meaning that these subjects have completed the recommended vaccine cycle), subjects continue to die from COVID-19, particularly in the presence of comorbidities. In this scenario, autopsies play a crucial role in understanding the pathophysiological mechanisms of SARS-CoV-2 in vaccinated subjects and adapting therapies accordingly. This case report analyzes the death of a fully vaccinated patient who suffered from comorbidities and died from COVID-19; we provide a complete autopsy data set. On microscopic examination, the lungs showed massive interstitial pneumonia, areas of inflammation with interstitial lympho-plasma cell infiltrate, and interstitial edema. The liver showed granulocytes within the hepatic parenchyma. All these elements were consistent with previous published data on unvaccinated patients who had died from COVID-19. The present study is the first that analyzes, through a complete autopsy and a microscopic analysis of all organs, a death related to COVID-19 despite vaccine administration. In this regard, to the best of our knowledge, no other studies have been published reporting a complete autopsy. This study reports, on the one hand, the importance of vaccination programs in the fight against COVID-19, and, on the other hand, it hypothesizes that the vaccine does not offer complete immunity to SARS-CoV-2, particularly in elderly subjects with comorbidities.
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9
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Butt AA, Guerrero MD, Canlas EB, Al-Dwairi H, Alimam ABMA, Mohamad AR, Ali MT, Asaad NA, Alkeldi AASS, Mohammad MFS, Thomas AG, Al-Khal A, Al-Maslamani M, Abou-Samra AB. Evaluation of mortality attributable to SARS-CoV-2 vaccine administration using national level data from Qatar. Nat Commun 2023; 14:24. [PMID: 36596793 PMCID: PMC9808756 DOI: 10.1038/s41467-022-35653-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/16/2022] [Indexed: 01/04/2023] Open
Abstract
Accurate determination of mortality attributable to SARS-CoV-2 vaccination is critical in allaying concerns about their safety. We reviewed every death in Qatar that occurred within 30 days of any SARS-CoV-2 vaccine administration between January 1, 2021 and June 12, 2022. Probability of association with SARS-CoV-2 vaccination was determined by four independent trained reviewers using a modified WHO algorithm. Among 6,928,359 doses administered, 138 deaths occurred within 30 days of vaccination; eight had a high probability (1.15/1,000,000 doses), 15 had intermediate probability (2.38/1,000,000 doses), and 112 had low probability or no association with vaccination. The death rate among those with high probability of relationship to SARS-CoV-2 vaccination was 0.34/100,000 unique vaccine recipients, while death rate among those with either high or intermediate probability of relationship to SARS-CoV-2 vaccination was 0.98/100,000 unique vaccine recipients. In conclusion, deaths attributable to SARS-CoV-2 vaccination are extremely rare and lower than the overall crude mortality rate in Qatar.
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Affiliation(s)
- Adeel A Butt
- Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar. .,Department of Medicine, Weill Cornell Medicine, New York, NY, USA. .,Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA. .,Department of Medicine, Weill Cornell Medicine, Doha, Qatar. .,Department of Population Health Sciences, Weill Cornell Medicine, Doha, Qatar.
| | - Mylai D Guerrero
- Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
| | - Elenor B Canlas
- Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
| | - Husni Al-Dwairi
- Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | | | | | | | - Anil G Thomas
- Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Muna Al-Maslamani
- Communicable Diseases Center, Hamad Medical Corporation, Doha, Qatar
| | - Abdul-Badi Abou-Samra
- Corporate Quality and Patient Safety Department, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine, Doha, Qatar
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10
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Elghazal M, Alhudiri IM, Said M, Elhouderi E, Elzagheid A. Myopericarditis After BNT162b2 mRNA Vaccination With Incidental Intramyocardial Bridging. Cureus 2023; 15:e34452. [PMID: 36874673 PMCID: PMC9982053 DOI: 10.7759/cureus.34452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Myocarditis and pericarditis are inflammatory conditions affecting the myocardium and pericardium, respectively. They are caused by infectious and non-infectious conditions, including autoimmune disorders, drugs, and toxins. Vaccine-induced myocarditis has been reported with viral vaccines, including influenza and smallpox. The BNT162b2 mRNA vaccine (Pfizer-BioNTech) has shown great efficacy against symptomatic, severe coronavirus disease 2019 (COVID-19), hospital admissions, and deaths. The US FDA issued an emergency use authorization for the Pfizer-BioNTech COVID-19 mRNA vaccine for the prevention of COVID-19 in individuals ≥ five years. However, concerns were raised after reports of new cases of myocarditis following mRNA COVID-19 vaccines, especially among adolescents and young adults. Most cases developed symptoms after receiving the second dose. Here, we present a case of a previously healthy 34-year-old male who developed sudden and severe chest pain a week after the second dose of the Pfizer-BioNTech COVID-19 mRNA vaccine. Cardiac catheterization showed no angiographically obstructive coronary artery disease but it revealed intramyocardial bridging. This case report demonstrates that the mRNA COVID-19 vaccine can be associated with acute myopericarditis and the clinical presentation can mimic acute coronary syndrome. Despite that, acute myopericarditis associated with the mRNA COVID-19 vaccine is usually mild and can be managed conservatively. Incidental findings such as intramyocardial bridging should not exclude the diagnosis of myocarditis and should be carefully evaluated. COVID-19 infection has high mortality and morbidity even in young individuals, and all different COVID-19 vaccines were found effective in the prevention of severe COVID-19 infection and in decreasing COVID-19 mortality.
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Affiliation(s)
- Mohamed Elghazal
- Vaccination Unit, Department of Cardiology, Libyan Biotechnology Research Center, Tripoli, LBY
| | - Inas M Alhudiri
- Department of Genetic Engineering, Libyan Biotechnology Research Center, Tripoli, LBY
| | - Mohamed Said
- Vaccination Unit, Department of Cardiology, Libyan Biotechnology Research Center, Tripoli, LBY
| | - Eiman Elhouderi
- Department of Internal Medicine, Beaumont Health, Dearborn, USA
| | - Adam Elzagheid
- Department of Genetic Engineering, Libyan Biotechnology Research Center, Tripoli, LBY
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11
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Alunni V, Bernardi C, Chevalier N, Cabusat C, Quatrehomme G, Torrents J, Biglia E, Gaillard Y, Drici MD. Postmortem PF4 antibodies confirm a rare case of thrombosis thrombocytopenia syndrome associated with ChAdOx1 nCoV-19 anti-COVID vaccination. Int J Legal Med 2023; 137:487-92. [PMID: 36289074 DOI: 10.1007/s00414-022-02910-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/19/2022] [Indexed: 02/07/2023]
Abstract
We report a case of cerebral venous sinus thrombosis, bilateral adrenal hemorrhage, and thrombocytopenia in a 70-year-old man found dead. He had previously received the ChAdOx1 nCoV-19 vaccine (Vaxzevria®, AstraZeneca) 18 days before, and had since developed unspecific and undiagnosed characteristics of what proved to be a rare case of vaccine-associated thrombocytopenia with thrombosis syndrome (TTS). He was found dead 1 week after the beginning of symptoms (day 25 post-vaccine). Autopsy yielded venous hemorrhagic infarction with the presence of thrombi within dural venous sinuses, and extensive hemorrhagic necrosis of the central part of the adrenal glands. Antibodies against platelet factor 4 (PF4) were strongly positive in postmortem fluids, as measured with an enzyme-linked immunosorbent assay (ELISA). This difficult diagnosis is usually made during the patient's lifetime. After eliminating differential diagnoses, we concluded on a fatal case of vaccine-induced immune TTS with positive anti-PF4 antibodies in cadaveric blood, 3 weeks after ChAdOx1 nCoV-19 vaccination. Specific search for anti-PF4 antibodies in cadaveric blood appears therefore paramount to assess postmortem cases of TTS associated with anti-COVID vaccines.
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12
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Chaves JJ, Bonilla JC, Chaves-Cabezas V, Castro A, Polo JF, Mendoza O, Correa-Rodríguez J, Piedrahita AC, Romero-Fandiño IA, Caro MV, González AC, Sánchez LK, Murcia F, Márquez G, Benavides A, Quiroga MDP, López J, Parra-Medina R. A postmortem study of patients vaccinated for SARS-CoV-2 in Colombia. Rev Esp Patol 2023; 56:4-9. [PMID: 36599599 DOI: 10.1016/j.patol.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/03/2022] [Accepted: 09/09/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION AND OBJECTIVE A new coronavirus produces a disease designated as coronavirus disease 2019 (COVID-19). Vaccination against COVID-19 has resulted in decreased mortality. Postmortems of vaccinated patients play an important part in the forensic analysis of adverse effects after vaccination, which is essential for determining its efficacy and security. The main objective of this study was to describe the results of autopsies of patients vaccinated for SARS-CoV-2 carried out in two major centers in Colombia. MATERIALS AND METHODS A descriptive cross-sectional study of 121 autopsies was performed following Colombian regulations in two main hospitals in Bogotá, Colombia, between March 1st and April 31st, 2021. RESULTS 118 of the 121 patients (97.52%) had been vaccinated with CoronaVac (Sinovac); only 3 had received other vaccines. Sudden cardiac death was the leading cause of death, with pulmonary embolism another critical finding. No relation between the cause of death and vaccination against SARS-CoV-2 was found. CONCLUSIONS A clinical autopsy is a vital for an accurate post-mortem diagnosis. Any relation between the SARS-CoV-2 vaccine and the cause of death should be carefully studied in order to provide the general public with evidence-based information about the safety of the vaccination.
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13
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Moss E, Patterson NA, Seals BF. An Examination of US COVID-19 Vaccine Distribution in New Jersey, Pennsylvania, and New York. Int J Environ Res Public Health 2022; 19:15629. [PMID: 36497703 PMCID: PMC9738558 DOI: 10.3390/ijerph192315629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
COVID-19 quickly spread across the United States (US) while communications and policies at all government levels suffered from inconsistency, misinformation, and lack of coordination. In order to explain the discrepancy between availability and population uptake, a case study was conducted analyzing vaccine rollout plans, social media, and Health Officer/Other Key Informant interviews in New Jersey, New York, and Pennsylvania. Key research questions included, "What were the barriers and facilitators of early COVID vaccine distribution?" and "What mechanisms in the community emerged to alleviate strains in early vaccination?" Findings from this study revealed that pre-existing emergency preparedness infrastructures and plans developed since the 9/11 tragedy were seemingly abandoned. This caused health departments at all levels of government to make impromptu, non-uniform decisions leading to confusion, vaccine hesitancy, and ultimately low uptake. The results indicate that future vaccine rollout best practices must include evidence-based decision-making, coordinated communications, and outreach to high-priority and vulnerable communities.
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14
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Ittiwut C, Mahasirimongkol S, Srisont S, Ittiwut R, Chockjamsai M, Durongkadech P, Sawaengdee W, Khunphon A, Larpadisorn K, Wattanapokayakit S, Wetchaphanphesat S, Arunotong S, Srimahachota S, Pittayawonganon C, Thammawijaya P, Sutdan D, Doungngern P, Khongphatthanayothin A, Kerr SJ, Shotelersuk V. Genetic basis of sudden death after COVID-19 vaccination in Thailand. Heart Rhythm 2022; 19:1874-1879. [PMID: 35934244 PMCID: PMC9352648 DOI: 10.1016/j.hrthm.2022.07.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 vaccination reduces morbidity and mortality associated with coronavirus disease 2019 (COVID-19); unfortunately, it is associated with serious adverse events, including sudden unexplained death (SUD). OBJECTIVE We aimed to study the genetic basis of SUD after COVID-19 vaccination in Thailand. METHODS From April to December 2021, cases with natural but unexplained death within 7 days of COVID-19 vaccination were enrolled for whole exome sequencing. RESULTS Thirteen were recruited, aged between 23 and 72 years; 10 (77%) were men, 12 were Thai; and 1 was Australian. Eight (61%) died after receiving the first dose of vaccine, and 7 (54%) died after receiving ChAdOx1 nCoV-19; however, there were no significant correlations between SUD and either the number or the type of vaccine. Fever was self-reported in 3 cases. Ten (77%) and 11 (85%) died within 24 hours and 3 days of vaccination, respectively. Whole exome sequencing analysis revealed that 5 cases harbored SCN5A variants that had previously been identified in patients with Brugada syndrome, giving an SCN5A variant frequency of 38% (5 of 13). This is a significantly higher rate than that observed in Thai SUD cases occurring 8-30 days after COVID-19 vaccination during the same period (10% [1 of 10]), in a Thai SUD cohort studied before the COVID-19 pandemic (12% [3 of 25]), and in our in-house exome database (12% [386 of 3231]). CONCLUSION These findings suggest that SCN5A variants may be associated with SUD within 7 days of COVID-19 vaccination, regardless of vaccine type, number of vaccine dose, and presence of underlying diseases or postvaccine fever.
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Affiliation(s)
- Chupong Ittiwut
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Surakameth Mahasirimongkol
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Smith Srisont
- Forensic Division, Pathology Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rungnapa Ittiwut
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Manoch Chockjamsai
- Forensic Department, Faculty of Medicine, Chiangmai University, Chiangmai, Thailand
| | | | - Waritta Sawaengdee
- Division of Genomic Medicine and Innovation Support, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Athiwat Khunphon
- Division of Genomic Medicine and Innovation Support, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Kanidsorn Larpadisorn
- Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Sukanya Wattanapokayakit
- Division of Genomic Medicine and Innovation Support, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Suppachok Wetchaphanphesat
- Strategy and Planning Division, Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - Surachet Arunotong
- Office of Disease Prevention and Control Region 1 Chiang Mai, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Chakrarat Pittayawonganon
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Panithee Thammawijaya
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Derek Sutdan
- Strategy and Planning Division, Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | - Pawinee Doungngern
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Apichai Khongphatthanayothin
- Center of Excellence in Arrhythmia Research, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Stephen J Kerr
- Center of Excellence for Biostatistics, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Vorasuk Shotelersuk
- Center of Excellence for Medical Genomics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
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15
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Chan CC, Lin CP, Chang CJ, Chu PH. Case report: Sudden cardiorespiratory collapse in a healthy male after coronavirus disease 2019 vaccination at a vaccination center. Front Cardiovasc Med 2022; 9:1014250. [PMID: 36247451 PMCID: PMC9558135 DOI: 10.3389/fcvm.2022.1014250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022] Open
Abstract
Since 2020, new vaccines were developed to fight the coronavirus disease 2019 (COVID-19). Vaccination is important in preventing mortality and achieving herd immunity. However, due to vast vaccination, fatal adverse events could be seen. We report a case of a previously healthy, young male who had a cardiopulmonary arrest 2 min after receiving the Oxford- AstraZeneca (ChAdOx1 nCoV-19) COVID-19 vaccination. After targeted temperature management, a coronary angiogram was performed after neurological recovery and showed severe stenosis at the proximal left anterior descending artery. Stenting was done and he was discharge. No similar case of sudden cardiorespiratory collapse immediately after COVID-19 vaccination has been reported. Our patient did not have any effort-related angina or dyspnea on exertion before this event. The sudden cardiorespiratory collapse was probably related to underlying coronary artery disease, complicated with a vasovagal event. We stress the importance of coronary angiography in out of hospital cardiac arrest patients after neurological recovery. In the era of COVID-19 vaccination, even though fatal adverse events following immunization are rare, heightened awareness of severe side effects needing medical attention is very important.
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Vidusa L, Kalejs O, Maca-Kaleja A, Strumfa I. Role of Endomyocardial Biopsy in Diagnostics of Myocarditis. Diagnostics (Basel) 2022; 12:diagnostics12092104. [PMID: 36140505 PMCID: PMC9497694 DOI: 10.3390/diagnostics12092104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/29/2022] [Accepted: 08/25/2022] [Indexed: 11/19/2022] Open
Abstract
Endomyocardial biopsy as the cornerstone of diagnostics has been re-evaluated throughout the years, leaving unanswered questions on the precedence of it. The reported incidence of myocarditis has increased during the pandemic of coronavirus disease 2019 (COVID-19), reinforcing discussions on appropriate diagnostics of myocarditis. By analysis of evidence-based literature published within the last demi-decade, we aimed to summarize the most recent information in order to evaluate the current role of endomyocardial biopsy in diagnostics and management of myocarditis. For the most part, research published over the last five years showed ongoing uncertainty regarding the use, informativeness, safety and necessity of performing a biopsy. Special circumstances, such as fulminant clinical course or failure to respond to empirical treatment, were reconfirmed as justified indications, with a growing applicability of non-invasive diagnostic approaches for most other cases. We concluded that endomyocardial biopsy, if performed properly and with adjunct diagnostic methods, holds a critical role for treatment correction in specific histological subtypes of myocarditis and for differential diagnosis between immune-mediated myocarditis and secondary infections due to immunosuppressive treatment. A high level of possible misdiagnosing was detected, indicating the need to review terminology used to describe findings of myocardial inflammation that did not meet Dallas criteria.
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Affiliation(s)
- Liga Vidusa
- Department of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
| | - Oskars Kalejs
- Department of Internal Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
- Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, LV-1002 Riga, Latvia
| | - Aija Maca-Kaleja
- Department of Internal Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
- Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, LV-1002 Riga, Latvia
| | - Ilze Strumfa
- Department of Pathology, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
- Correspondence:
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Stivanello E, Beghelli C, Cardoni F, Giansante C, Marzaroli P, Musti MA, Perlangeli V, Todeschini R, Pandolfi P. Short-term mortality following COVID-19 vaccination in Bologna, Italy: a one-year study. Vaccine 2022; 40:5709-5715. [PMID: 36038407 PMCID: PMC9393158 DOI: 10.1016/j.vaccine.2022.08.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 12/04/2022]
Abstract
The main objective of the study is to assess whether there is an increased risk of mortality in the days following the administration of COVID-19 vaccines in Bologna Health Authority in the first year of COVID-19 vaccination campaign. A secondary objective was to describe causes of deaths occurred in the days after vaccination. We conducted a retrospective observational study on all residents of Bologna Health Authority who received at least one COVID-19 vaccination dose from December 27, 2020 to December 31, 2021 and compared mortality in the 3, 7, 14 30 days after vaccination (risk interval) with the mortality in the period of the same length (3, 7, 14 and 30 days) beyond the 30th day after the last dose of vaccination (control interval). The cohort included 717,538 people. The mortality rate was 2.24 per 100 person-years during the 30 days risk interval vs 2.72 in the control interval with an adjusted incidence rate ratio equal to 0.76 (95% CI: 0.70–0.83, p < 0.001). The risk of mortality is significantly lower (p < 0.001) also in the 3, 7, 14 days risk intervals than in the control intervals. This study shows that there is no increase in mortality in the short-term period after COVID-19 vaccines.
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Affiliation(s)
- Elisa Stivanello
- Department of Public Health, Bologna Health Authority, via del Seminario 1, 40068 San Lazzaro di Savena, Italy.
| | - Chiara Beghelli
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, via G. Massarenti 9, 40138 Bologna, Italy.
| | - Francesco Cardoni
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, via G. Massarenti 9, 40138 Bologna, Italy.
| | - Chiara Giansante
- Department of Public Health, Bologna Health Authority, via del Seminario 1, 40068 San Lazzaro di Savena, Italy.
| | - Paolo Marzaroli
- Department of Public Health, Bologna Health Authority, via del Seminario 1, 40068 San Lazzaro di Savena, Italy.
| | - Muriel Assunta Musti
- Department of Public Health, Bologna Health Authority, via del Seminario 1, 40068 San Lazzaro di Savena, Italy.
| | - Vincenza Perlangeli
- Department of Public Health, Bologna Health Authority, via del Seminario 1, 40068 San Lazzaro di Savena, Italy.
| | - Renato Todeschini
- Department of Public Health, Bologna Health Authority, via del Seminario 1, 40068 San Lazzaro di Savena, Italy.
| | - Paolo Pandolfi
- Department of Public Health, Bologna Health Authority, via del Seminario 1, 40068 San Lazzaro di Savena, Italy.
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Suzuki H, Ro A, Takada A, Saito K, Hayashi K. Autopsy findings of post-COVID-19 vaccination deaths in Tokyo Metropolis, Japan, 2021. Leg Med (Tokyo) 2022; 59:102134. [PMID: 36037554 PMCID: PMC9392553 DOI: 10.1016/j.legalmed.2022.102134] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND COVID-19 vaccines have been used across Japan since 17 February 2021, and as of 17 April 2022, 1690 deaths potentially caused by vaccine-related adverse effects have been reported to the Ministry of Health, Labour and Welfare. However, the causal relationship between vaccination and death could not be fully evaluated because of a lack of sufficient information. METHODS Autopsy cases in which deaths occurred within seven days after COVID-19 vaccination in Tokyo Metropolis and were handled by medical examiners were selected (n = 54). Age, sex, vaccine-related information, cause of death, and possible causal relationship between vaccination and death were examined. RESULTS The mean age of the deceased individuals was 68.1 years, and the study sample consisted of 34 males (63.9%) and 20 females (37.0%). Thirty-seven and six individuals received Comirnaty and Spikevax, respectively (68.5% and 11.1% respectively). The manner of death included natural (n = 43), non-natural (n = 8), and undetermined (n = 3). The most frequent cause of death was ischemic heart disease (n = 16). Regarding causal relationships, 46 cases (85.2%) did not show a causal relationship to vaccination, except for myocarditis (n = 3), thrombosis-related death (n = 4), and others (n = 1). CONCLUSION Although many cases of deaths after COVID-19 vaccination in this study showed no definite causal relationship between the vaccination and deaths, some cases showed possible adverse events such as myocarditis. Autopsies are essential for detecting vaccine-related deaths, and the Japanese death investigation system needs to be reinforced from this viewpoint.
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Affiliation(s)
- Hideto Suzuki
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan. hideto-@qk9.so-net.ne.jp
| | - Ayako Ro
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan; Department of Legal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Aya Takada
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan; Department of Forensic Medicine, Saitama Medical University, Saitama, Japan; Department of Forensic Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kazuyuki Saito
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan; Department of Forensic Medicine, Saitama Medical University, Saitama, Japan; Department of Forensic Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kino Hayashi
- Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo, Japan
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19
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Cadegiani FA. Catecholamines Are the Key Trigger of COVID-19 mRNA Vaccine-Induced Myocarditis: A Compelling Hypothesis Supported by Epidemiological, Anatomopathological, Molecular, and Physiological Findings. Cureus 2022; 14:e27883. [PMID: 35971401 PMCID: PMC9372380 DOI: 10.7759/cureus.27883] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine-induced myocarditis is a rare but well-documented complication in young males. The increased incidence of sudden death among athletes following vaccination has been reported and requires further investigation. Whether the risk of myocarditis, a known major cause of sudden death in young male athletes, also increases after coronavirus disease 2019 (COVID-19) infection is unknown. The severity and implications of these critical adverse effects require a thorough analysis to elucidate their key triggering mechanisms. The present review aimed to evaluate whether there is a justification to hypothesize that catecholamines in a “hypercatecholaminergic” state are the key trigger of SARS-CoV-2 mRNA vaccine-induced myocarditis and related outcomes and whether similar risks are also present following COVID-19 infection. A thorough, structured scoping review of the literature was performed to build the hypothesis through three pillars: detection of myocarditis risk, potential alterations and abnormalities identified after SARS-CoV-2 mRNA vaccination or COVID-19 infection and consequent events, and physiological characteristics of the most affected population. The following terms were searched in indexed and non-indexed peer review articles and recent preprints (<12 months): agent, “SARS-CoV-2” or “COVID-19”; event, “myocarditis” or “sudden death(s)” or “myocarditis+sudden death(s)” or “cardiac event(s)”; underlying cause, “mRNA” or “spike protein” or “infection” or “vaccine”; proposed trigger, “catecholamine(s)” or “adrenaline” or “epinephrine” or “noradrenaline” or “norepinephrine” or “testosterone”; and affected population, “young male(s)” or “athlete(s).” The rationale and data that supported the hypothesis were as follows: SARS-CoV-2 mRNA vaccine-induced myocarditis primarily affected young males, while the risk was not observed following COVID-19 infection; independent autopsies or biopsies of patients who presented post-SARS-CoV-2 mRNA vaccine myocarditis in different geographical regions enabled the conclusion that a primary hypercatecholaminergic state was the key trigger of these events; SARS-CoV-2 mRNA was densely present, and SARS-CoV-2 spike protein was progressively produced in adrenal medulla chromaffin cells, which are responsible for catecholamine production; the dihydroxyphenylalanine decarboxylase enzyme that converts dopamine into noradrenaline was overexpressed in the presence of SARS-CoV-2 mRNA, leading to enhanced noradrenaline activity; catecholamine responses were physiologically higher in young adults and males than in other populations; catecholamine responses and resting catecholamine production were higher in male athletes than in non-athletes; catecholamine responses to stress and its sensitivity were enhanced in the presence of androgens; and catecholamine expressions in young male athletes were already high at baseline, were higher following vaccination, and were higher than those in non-vaccinated athletes. The epidemiological, autopsy, molecular, and physiological findings unanimously and strongly suggest that a hypercatecholaminergic state is the critical trigger of the rare cases of myocarditis due to components from SARS-CoV-2, potentially increasing sudden deaths among elite male athletes.
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20
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Lo Giudice A, Asmundo MG, Cimino S, Russo GI. Impact of the COVID-19 Pandemic on Global Diseases and Human Well-Being. J Clin Med 2022; 11:4489. [PMID: 35956106 PMCID: PMC9369330 DOI: 10.3390/jcm11154489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 02/01/2023] Open
Abstract
This editorial of the Special Issue “Impact of SARS-CoV-2 Pandemic on Global Diseases and Human Well-Being” aims to portray the repercussions of the novel COVID-19 emergency on a wide range of health issues [...]
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21
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Baronti A, Gentile F, Manetti AC, Scatena A, Pellegrini S, Pucci A, Franzini M, Castiglione V, Maiese A, Giannoni A, Pistello M, Emdin M, Aquaro GD, Di Paolo M. Myocardial Infarction Following COVID-19 Vaccine Administration: Post Hoc, Ergo Propter Hoc? Viruses 2022; 14:v14081644. [PMID: 36016266 PMCID: PMC9413746 DOI: 10.3390/v14081644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/13/2022] Open
Abstract
Vaccination against coronavirus disease 2019 (COVID-19) is the safest and most effective strategy for controlling the pandemic. However, some cases of acute cardiac events following vaccine administration have been reported, including myocarditis and myocardial infarction (MI). While post-vaccine myocarditis has been widely discussed, information about post-vaccine MI is scarce and heterogenous, often lacking in histopathological and pathophysiological details. We hereby present five cases (four men, mean age 64 years, range 50–76) of sudden death secondary to MI and tightly temporally related to COVID-19 vaccination. In each case, comprehensive macro- and microscopic pathological analyses were performed, including post-mortem cardiac magnetic resonance, to ascertain the cause of death. To investigate the pathophysiological determinants of MI, toxicological and tryptase analyses were performed, yielding negative results, while the absence of anti-platelet factor 4 antibodies ruled out vaccine-induced thrombotic thrombocytopenia. Finally, genetic testing disclosed that all subjects were carriers of at least one pro-thrombotic mutation. Although the presented cases do not allow us to establish any causative relation, they should foster further research to investigate the possible link between COVID-19 vaccination, pro-thrombotic genotypes, and acute cardiovascular events.
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Affiliation(s)
- Arianna Baronti
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Francesco Gentile
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
| | - Alice Chiara Manetti
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Andrea Scatena
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Silvia Pellegrini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
| | - Angela Pucci
- Department of Histopathology, University of Pisa, 56126 Pisa, Italy;
| | - Maria Franzini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56126 Pisa, Italy;
| | - Vincenzo Castiglione
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Aniello Maiese
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
| | - Alberto Giannoni
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
| | - Mauro Pistello
- Retrovirus Center and Virology Section, Department of Translational Research, University of Pisa, 56126 Pisa, Italy;
| | - Michele Emdin
- Fondazione Toscana G. Monasterio, 56124 Pisa, Italy; (F.G.); (V.C.); (A.G.); (G.D.A.)
- Health Science Interdisciplinary Center, Scuola Superiore Sant’Anna, 56127 Pisa, Italy
- Correspondence: or
| | | | - Marco Di Paolo
- Institute of Legal Medicine, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (A.B.); (A.C.M.); (A.S.); (A.M.); (M.D.P.)
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22
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Boyle J, Nowak G, Kinder R, Iachan R, Dayton J. Better Understanding Adult COVID-19 Vaccination Hesitancy and Refusal: The Influence of Broader Beliefs about Vaccines. Int J Environ Res Public Health 2022; 19:ijerph19116838. [PMID: 35682421 PMCID: PMC9180283 DOI: 10.3390/ijerph19116838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022]
Abstract
Published surveys in the United States provide much evidence that COVID-19 vaccination is influenced by disease and vaccine-related risk perceptions. However, there has been little examination of whether individual’s general beliefs about vaccines are also related to COVID-19 vaccination, especially among unvaccinated adults. This study used an August 2021 national survey of 1000 U.S. adults to examine whether general beliefs about vaccines were associated with COVID-19 vaccination status. In addition, it used multivariate analyses to assess the relative contribution of individual vaccine beliefs to current vaccine status independently of COVID-19-specific attitudes and experiences, and demographics. The findings indicated that, collectively, general vaccine beliefs mattered more than demographics, COVID-19-specific risk perceptions, confidence in government, or trust in public health agencies in COVID-19 vaccination status. Overall, the findings affirm the importance of vaccine education and communication efforts that help people understand why vaccines are needed, how vaccine safety is established and monitored, and how vaccines provide protection from infectious diseases. To achieve success among vaccine-hesitant individuals, communication strategies should target vaccine beliefs that most influence vaccination outcomes.
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Affiliation(s)
- John Boyle
- ICF International, Rockville, MD 20850, USA; (J.B.); (R.I.); (J.D.)
| | - Glen Nowak
- Center for Health & Risk Communication, College of Journalism and Mass Communication, University of Georgia, Athens, GA 30602, USA;
| | - Rachel Kinder
- ICF International, Rockville, MD 20850, USA; (J.B.); (R.I.); (J.D.)
- Correspondence:
| | - Ronaldo Iachan
- ICF International, Rockville, MD 20850, USA; (J.B.); (R.I.); (J.D.)
| | - James Dayton
- ICF International, Rockville, MD 20850, USA; (J.B.); (R.I.); (J.D.)
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23
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Rania N, Coppola I, Brucci M, Lagomarsino F. Attitudes and Beliefs of the Italian Population towards COVID-19 Vaccinations. Int J Environ Res Public Health 2022; 19:ijerph19106139. [PMID: 35627676 PMCID: PMC9141803 DOI: 10.3390/ijerph19106139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/09/2022] [Accepted: 05/14/2022] [Indexed: 11/16/2022]
Abstract
Background: Despite the numerous campaigns to encourage vaccination against COVID-19, the public debate and often conflicting information have left many individuals uncertain about the decision to make on whether or not to vaccinate. Methods: This research aims to analyze the attitudes and beliefs of the Italian population towards COVID-19 and other vaccinations through a quantitative methodology. In all, 500 adults (Age M = 39.52) participated in this exploratory study with an online questionnaire conducted in April 2021. Results: most participants believe vaccination is necessary to defeat COVID-19; there is an age-related difference in getting vaccinations, and women were more afraid of unexpected future effects than men; older participants have expressed a greater willingness to pay to be vaccinated against COVID-19 (4). Conclusion: In light of these results, it is necessary to pay greater attention to the perplexity and fears expressed by the population, especially women and youth, in relation to vaccinations; in fact, it would help to achieve a wider adherence to the tools designed to contain the spread of viruses at the base of severe health crises.
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24
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Garcia C, Compagnon B, Poëtte M, Gratacap MP, Lapébie FX, Voisin S, Minville V, Payrastre B, Vardon-Bounes F, Ribes A. Platelet Versus Megakaryocyte: Who Is the Real Bandleader of Thromboinflammation in Sepsis? Cells 2022; 11:1507. [PMID: 35563812 PMCID: PMC9104300 DOI: 10.3390/cells11091507] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Platelets are mainly known for their key role in hemostasis and thrombosis. However, studies over the last two decades have shown their strong implication in mechanisms associated with inflammation, thrombosis, and the immune system in various neoplastic, inflammatory, autoimmune, and infectious diseases. During sepsis, platelets amplify the recruitment and activation of innate immune cells at the site of infection and contribute to the elimination of pathogens. In certain conditions, these mechanisms can lead to thromboinflammation resulting in severe organ dysfunction. Here, we discuss the interactions of platelets with leukocytes, neutrophil extracellular traps (NETs), and endothelial cells during sepsis. The intrinsic properties of platelets that generate an inflammatory signal through the NOD-like receptor family, pyrin domain-containing 3 (NLRP3) inflammasome are discussed. As an example of immunothrombosis, the implication of platelets in vaccine-induced immune thrombotic thrombocytopenia is documented. Finally, we discuss the role of megakaryocytes (MKs) in thromboinflammation and their adaptive responses.
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Affiliation(s)
- Cédric Garcia
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France; (C.G.); (S.V.); (B.P.)
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR1297 and Université Toulouse 3, 31024 Toulouse, France; (B.C.); (M.P.); (M.-P.G.); (F.V.-B.)
| | - Baptiste Compagnon
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR1297 and Université Toulouse 3, 31024 Toulouse, France; (B.C.); (M.P.); (M.-P.G.); (F.V.-B.)
- Pôle Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France;
| | - Michaël Poëtte
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR1297 and Université Toulouse 3, 31024 Toulouse, France; (B.C.); (M.P.); (M.-P.G.); (F.V.-B.)
- Pôle Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France;
| | - Marie-Pierre Gratacap
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR1297 and Université Toulouse 3, 31024 Toulouse, France; (B.C.); (M.P.); (M.-P.G.); (F.V.-B.)
| | - François-Xavier Lapébie
- Service de Médecine Vasculaire, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France;
| | - Sophie Voisin
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France; (C.G.); (S.V.); (B.P.)
| | - Vincent Minville
- Pôle Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France;
| | - Bernard Payrastre
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France; (C.G.); (S.V.); (B.P.)
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR1297 and Université Toulouse 3, 31024 Toulouse, France; (B.C.); (M.P.); (M.-P.G.); (F.V.-B.)
| | - Fanny Vardon-Bounes
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR1297 and Université Toulouse 3, 31024 Toulouse, France; (B.C.); (M.P.); (M.-P.G.); (F.V.-B.)
- Pôle Anesthésie-Réanimation, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France;
| | - Agnès Ribes
- Laboratoire d’Hématologie, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France; (C.G.); (S.V.); (B.P.)
- Institut des Maladies Métaboliques et Cardiovasculaires, Inserm UMR1297 and Université Toulouse 3, 31024 Toulouse, France; (B.C.); (M.P.); (M.-P.G.); (F.V.-B.)
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25
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Yoshimura Y, Sasaki H, Miyata N, Miyazaki K, Okudela K, Tateishi Y, Hayashi H, Kawana-Tachikawa A, Iwashita H, Maeda K, Ihama Y, Hatayama Y, Ryo A, Tachikawa N. An autopsy case of COVID-19-like acute respiratory distress syndrome after mRNA-1273 SARS-CoV-2 vaccination. Int J Infect Dis 2022; 121:98-101. [PMID: 35500794 PMCID: PMC9054706 DOI: 10.1016/j.ijid.2022.04.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 02/03/2023] Open
Abstract
We report the first case with COVID-19-like acute respiratory distress syndrome after mRNA-1273 SARS-CoV-2 vaccination. An 88-year-old woman developed dyspnea several hours after vaccination with the second dose of mRNA-1273. She was hospitalized on day nine due to worsening dyspnea. Chest computed tomography showed bilateral ground-glass opacities and consolidations, mainly in the peripheral lung areas. Repeat polymerase chain reaction tests for SARS-CoV-2 were negative, although the serum level of antibodies against spike protein was extremely elevated. Her condition did not improve with high-dose corticosteroids and high-flow nasal cannula oxygen therapy; she died on day 18. Autopsy findings revealed very early-phase diffuse alveolar damage in the whole lung without other lung diseases. The clinical and pathological findings suggested vaccine-induced acute respiratory distress syndrome. Serological and pathological tests might be useful to differentiate the disease from COVID-19.
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Affiliation(s)
- Yukihiro Yoshimura
- Department of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan.
| | - Hiroaki Sasaki
- Department of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan
| | - Nobuyuki Miyata
- Department of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan
| | - Kazuhito Miyazaki
- Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan
| | - Koji Okudela
- Department of Pathology Yokohama City University Graduate School of Medicine, Yokohama city, Japan
| | - Yoko Tateishi
- Department of Pathology, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan
| | - Hiroyuki Hayashi
- Department of Pathology, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan
| | - Ai Kawana-Tachikawa
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiromichi Iwashita
- Department of Pathology Yokohama City University Graduate School of Medicine, Yokohama city, Japan
| | - Kazuho Maeda
- Department of Legal Medicine, Yokohama City University Graduate School of Medicine, Yokohama city, Japan
| | - Yoko Ihama
- Department of Legal Medicine, Yokohama City University Graduate School of Medicine, Yokohama city, Japan
| | - Yasuyoshi Hatayama
- Department of Microbiology, Yokohama City University School of Medicine, Yokohama city, Japan
| | - Akihide Ryo
- Department of Microbiology, Yokohama City University School of Medicine, Yokohama city, Japan
| | - Natsuo Tachikawa
- Department of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan
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26
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Abstract
Clinical course and outcomes of myocarditis after COVID-19 vaccination remain variable. We retrospectively collected data on patients > 12 years old from 01/01/2021 to 12/30/2021 who received COVID-19 messenger RNA (mRNA) vaccination and were diagnosed with myocarditis within 60 days of vaccination. Myocarditis cases were based on case definitions by authors. We report on 238 patients of whom most were male (n = 208; 87.1%). The mean age was 27.4 ± 16 (range 12–80) years. Females presented at older ages (41.3 ± 21.5 years) than men 25.7 ± 14 years (p = 0.001). In patients > 20 years of age, the mean duration from vaccination to symptoms was 4.8 days ± 5.5 days, but in < 20, it was 3.0 ± 3.3 days (p = 0.04). Myocarditis occurred most commonly after the Pfizer-BioNTech mRNA vaccine (n = 183; 76.45) and after the second dose (n = 182; 80%). Symptoms started 3.95 ± 4.5 days after vaccination. The commonest symptom was chest pain (n = 221; 93%). Patients were treated with non-steroidal anti-inflammatory drugs (n = 105; 58.3%), colchicine (n = 38; 21.1%), or glucocorticoids (n = 23; 12.7%). About 30% of the patients had left ventricular ejection fraction but more than half recovered the on repeat imaging. Abnormal cardiac MRIs were common; 168 patients (96% of 175 patients that had MRI) had late gadolinium enhancement, while 120 patients (68.5%) had myocardial edema. Heart failure guideline-directed medical therapy use was common (n = 27; 15%). Eleven patients had cardiogenic shock; and 4 patients required mechanical circulatory support. Five patients (1.7%) died; of these, 3 patients had endomyocardial biopsy/autopsy-confirmed myocarditis. Most cases of COVID-19 vaccine myocarditis are mild. Females presented at older ages than men and duration from vaccination to symptoms was longer in patients > 20 years. Cardiogenic shock requiring mechanical circulatory support was seen and mortality was low. Future studies are needed to better evaluate risk factors, and long-term outcomes of COVID-19 mRNA vaccine myocarditis.
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27
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Gattinger P, Kratzer B, Tulaeva I, Niespodziana K, Ohradanova‐Repic A, Gebetsberger L, Borochova K, Garner‐Spitzer E, Trapin D, Hofer G, Keller W, Baumgartner I, Tancevski I, Khaitov M, Karaulov A, Stockinger H, Wiedermann U, Pickl W, Valenta R. Vaccine based on folded RBD-PreS fusion protein with potential to induce sterilizing immunity to SARS-CoV-2 variants. Allergy 2022; 77:2431-2445. [PMID: 35357709 PMCID: PMC9111473 DOI: 10.1111/all.15305] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/28/2022] [Accepted: 03/07/2022] [Indexed: 12/28/2022]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is responsible for the ongoing global COVID‐19 pandemic. One possibility to control the pandemic is to induce sterilizing immunity through the induction and maintenance of neutralizing antibodies preventing SARS‐CoV‐2 from entering human cells to replicate in. Methods We report the construction and in vitro and in vivo characterization of a SARS‐CoV‐2 subunit vaccine (PreS‐RBD) based on a structurally folded recombinant fusion protein consisting of two SARS‐CoV‐2 Spike protein receptor‐binding domains (RBD) fused to the N‐ and C‐terminus of hepatitis B virus (HBV) surface antigen PreS to enable the two unrelated proteins serving as immunologic carriers for each other. Results PreS‐RBD, but not RBD alone, induced a robust and uniform RBD‐specific IgG response in rabbits. Currently available genetic SARS‐CoV‐2 vaccines induce mainly transient IgG1 responses in vaccinated subjects whereas the PreS‐RBD vaccine induced RBD‐specific IgG antibodies consisting of an early IgG1 and sustained IgG4 antibody response in a SARS‐CoV‐2 naive subject. PreS‐RBD‐specific IgG antibodies were detected in serum and mucosal secretions, reacted with SARS‐CoV‐2 variants, including the omicron variant of concern and the HBV receptor‐binding sites on PreS of currently known HBV genotypes. PreS‐RBD‐specific antibodies of the immunized subject more potently inhibited the interaction of RBD with its human receptor ACE2 and their virus‐neutralizing titers (VNTs) were higher than median VNTs in a random sample of healthy subjects fully immunized with registered SARS‐CoV‐2 vaccines or in COVID‐19 convalescent subjects. Conclusion The PreS‐RBD vaccine has the potential to serve as a combination vaccine for inducing sterilizing immunity against SARS‐CoV‐2 and HBV by stopping viral replication through the inhibition of cellular virus entry.
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Affiliation(s)
- Pia Gattinger
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Bernhard Kratzer
- Center for Pathophysiology, Infectiology and Immunology Institute of Immunology Medical University of Vienna Vienna Austria
| | - Inna Tulaeva
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Laboratory for Immunopathology Department of Clinical Immunology and Allergology Sechenov First Moscow State Medical University Moscow Russia
| | - Katarzyna Niespodziana
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Anna Ohradanova‐Repic
- Center for Pathophysiology, Infectiology and Immunology Institute for Hygiene and Applied Immunology Medical University of Vienna Vienna Austria
| | - Laura Gebetsberger
- Center for Pathophysiology, Infectiology and Immunology Institute for Hygiene and Applied Immunology Medical University of Vienna Vienna Austria
| | - Kristina Borochova
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
| | - Erika Garner‐Spitzer
- Institute of Specific Prophylaxis and Tropical Medicine Medical University of Vienna Vienna Austria
| | - Doris Trapin
- Center for Pathophysiology, Infectiology and Immunology Institute of Immunology Medical University of Vienna Vienna Austria
| | - Gerhard Hofer
- Department of Materials and Environmental Chemistry University of Stockholm Stockholm Sweden
| | - Walter Keller
- Institute of Molecular Biosciences, BioTechMed Graz University of Graz Graz Austria
| | | | - Ivan Tancevski
- Department of Internal Medicine II Medical University of Innsbruck Innsbruck Austria
| | - Musa Khaitov
- NRC Institute of Immunology FMBA of Russia Moscow Russia
- Pirogov Russian National Research Medical University Moscow Russia
| | - Alexander Karaulov
- Laboratory for Immunopathology Department of Clinical Immunology and Allergology Sechenov First Moscow State Medical University Moscow Russia
| | - Hannes Stockinger
- Center for Pathophysiology, Infectiology and Immunology Institute for Hygiene and Applied Immunology Medical University of Vienna Vienna Austria
| | - Ursula Wiedermann
- Institute of Specific Prophylaxis and Tropical Medicine Medical University of Vienna Vienna Austria
| | - Winfried F. Pickl
- Center for Pathophysiology, Infectiology and Immunology Institute of Immunology Medical University of Vienna Vienna Austria
- Karl Landsteiner University of Health Sciences Krems Austria
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research Division of Immunopathology Center for Pathophysiology, Infectiology and Immunology Medical University of Vienna Vienna Austria
- Laboratory for Immunopathology Department of Clinical Immunology and Allergology Sechenov First Moscow State Medical University Moscow Russia
- Karl Landsteiner University of Health Sciences Krems Austria
- NRC Institute of Immunology FMBA of Russia Moscow Russia
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Tomassini L, Paolini D, Petrasso PEY, Maria Manta A, Piersanti V, Straccamore M, Ciallella C. What about cerebral venous sinus thrombosis? A series of three autopsy cases. Leg Med (Tokyo) 2022; 56:102052. [PMID: 35276490 PMCID: PMC9553194 DOI: 10.1016/j.legalmed.2022.102052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/10/2022] [Accepted: 03/02/2022] [Indexed: 12/03/2022]
Abstract
Cerebral venous sinus thrombosis (CVST) is an uncommon cerebrovascular disorder that gained massive media attention in 2021, when an association between COVID-19 and its vaccines was found in several reported cases, raising the suspicion of a causative relation that is still debated. Three cases of CVST unrelated to COVID-19 are reported in this article to highlight the difficulty in the early recognition and management of this condition, as it occurs in a variety of diseases with different clinical and pathological manifestations. When the diagnosis cannot be achieved in the clinical setting, the role of the pathologist becomes essential in the determination of the cause of death and in the identification of the etiology of CVST. During the autopsy, coordination between the physician and the forensic pathologist is crucial to correlate the clinical presentation with the pathological picture.
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29
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Kemeugni Ngandjon J, Ostermann T, Kenmoe V, Laengler A. Insights into Predictors of Vaccine Hesitancy and Promoting Factors in Childhood Immunization Programs-A Cross-Sectional Survey in Cameroon. Int J Environ Res Public Health 2022; 19:ijerph19052721. [PMID: 35270416 PMCID: PMC8910338 DOI: 10.3390/ijerph19052721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 12/10/2022]
Abstract
Background: Vaccination is claimed to be a key intervention against the COVID-19 pandemic. A major challenge today is to increase vaccine acceptance as vaccine hesitancy has delayed the eradication of polio. This study aimed to identify predictors associated with vaccine acceptance in the context of the Expanded Program on Immunization among parents of children between the ages of 12 to 23 months in the Foumbot district, Cameroon. Methods: The design of this study is a cross-sectional survey. A total of 160 mothers of children between the ages of 12 to 23 months were selected using a simple random sampling technique. A pre-tested structured questionnaire was used for data collection. Incomplete vaccination status was considered “vaccine hesitancy”. Data was analyzed along with 95% confidence intervals and the p-value < 0.05. The results showed 60% vaccine acceptance and 40% vaccine hesitancy. Factors such as age-appropriate vaccination, knowledge of vaccine-preventable diseases (VPD), and religion were associated with vaccine acceptance. Conclusion: Poor knowledge of VPDs is a matter of concern as it contributes to vaccine hesitancy. The study findings provide the basis to heighten health education, the public perceived threat of the VPDs, and the consequences if no measures are taken to ensure health.
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Affiliation(s)
- Jonas Kemeugni Ngandjon
- Institute of Pediatric, Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany
- Correspondence: ; Tel.: +49-9131-605-5913
| | - Thomas Ostermann
- Department for Psychology and Statistics, Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany;
| | - Virgile Kenmoe
- Department for Human Medicine , Faculty of Health, Université des Montagnes, Bangangté BP 208, Cameroon;
| | - Alfred Laengler
- Department for Human Medicine, Institute of Pediatric, Faculty of Health, University of Witten/Herdecke, 58448 Witten, Germany;
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Esposito M, Salerno M, Scoto E, Di Nunno N, Sessa F. The Impact of the COVID-19 Pandemic on the Practice of Forensic Medicine: An Overview. Healthcare (Basel) 2022; 10:healthcare10020319. [PMID: 35206933 PMCID: PMC8871677 DOI: 10.3390/healthcare10020319] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/12/2022] Open
Abstract
During the COVID-19 pandemic, forensic sciences, on the one hand, contributed to gaining knowledge about different aspects of the pandemic, while on the other hand, forensic professionals were called on to quickly adapt their activities to respond adequately to the changes imposed by the pandemic. This review aims to clarify the state of the art in forensic medicine at the time of COVID-19, discussing the following: the influence of external factors on forensic activities, the impact of autopsy practice on COVID-19 and vice-versa, the persistence of SARS-CoV-2 RNA in post-mortem samples, forensic personnel activities during the SARS-CoV-2 pandemic, the global vaccination program and forensic sciences, forensic undergraduate education during and after the imposed COVID-19 lockdown, and the medico-legal implications in medical malpractice claims during the COVID-19 pandemic. The COVID-19 pandemic has greatly influenced different aspects of human life, and, accordingly, the practical activities of forensic sciences that are defined as multidisciplinary, involving different expertise. Indeed, the activities are very different, including crime scene investigation (CSI), external examination, autopsy, and genetic and toxicological examinations of tissues and/or biological fluids. At the same time, forensic professionals may have direct contact with subjects in life, such as in the case of abuse victims (in some cases involving children), collecting biological samples from suspects, or visiting subjects in the case of physical examinations. In this scenario, forensic professionals are called on to implement methods to prevent the SARS-CoV-2 infection risk, wearing adequate PPE, and working in environments with a reduced risk of infection. Consequently, in the pandemic era, the costs involved for forensic sciences were substantially increased.
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Affiliation(s)
- Massimiliano Esposito
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (E.S.)
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (E.S.)
| | - Edmondo Scoto
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (E.S.)
| | - Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy;
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
- Correspondence: ; Tel.: +39-881-736926
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31
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Esposito M, Salerno M, Di Nunno N, Ministeri F, Liberto A, Sessa F. The Risk of COVID-19 Infection in Prisons and Prevention Strategies: A Systematic Review and a New Strategic Protocol of Prevention. Healthcare (Basel) 2022; 10:270. [PMID: 35206884 PMCID: PMC8872582 DOI: 10.3390/healthcare10020270] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/14/2022] Open
Abstract
Health risks within prisons are well known and have worsened with the 2019 coronavirus pandemic (COVID-19), becoming a public health emergency. To date, there are more than 10 million inmates in the world; in most cases, conditions are bad and health care is scarce. A SARS-CoV-2 outbreak inside a prison is extremely rapid. The aim of this systematic review was to analyze all possible prevention techniques to reduce the risk of COVID-19 related infection within prisons. A systematic review of the literature was performed according to the PRISMA guidelines. Scopus, Web of Science, PubMed, and Google Scholar were used as search engines from 1 January 2020 to 1 November 2021 to evaluate the prevention of COVID-19 in prisoners. A total of 1757 articles were collected. Of them, 486 duplicates were removed. A total of 1250 articles did not meet the inclusion criteria. In conclusion, 21 articles were included in the present systematic review. From this analysis, it emerged that the most common COVID-19 prevention methods were the screening of the entire population (prisoners and workers) inside the prison through swab analysis and the reduction in overcrowding in prisons. Few studies concerned the prevention of COVID-19 infection through vaccination and the implementation of quarantine. To our knowledge, this is the first systematic review that evaluates the prevention of COVID-19 within jails and the real effectiveness of all possible methods used and published in the literature. Finally, a very useful strategic protocol is provided to reduce the incidence of infection and to control and manage COVID-19 in prisons.
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Affiliation(s)
- Massimiliano Esposito
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy;
| | - Federica Ministeri
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Aldo Liberto
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95121 Catania, Italy; (M.E.); (M.S.); (F.M.); (A.L.)
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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32
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Chin SE, Bhavsar SM, Corson A, Ghersin ZJ, Kim HS. Cardiac Complications Associated with COVID-19, MIS-C, and mRNA COVID-19 Vaccination. Pediatr Cardiol 2022; 43:483-488. [PMID: 35258639 PMCID: PMC8902276 DOI: 10.1007/s00246-022-02851-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/12/2022] [Indexed: 12/29/2022]
Abstract
The COVID-19 vaccine is now approved for individuals greater than 5 years of age, but vaccination rates remain lower than expected in the pediatric age group. Misinformation and widespread reporting of vaccine-related myocarditis are contributing to vaccine hesitancy. When compared to severe cardiac complications that are associated with COVID-19, vaccine-related myocarditis has a milder presentation, is easily treated, and has a good prognosis. Acute COVID-19 has been associated with higher rates of myocarditis and myocardial injury. Multisystem inflammatory syndrome in children occurs weeks after initial infection with SARS-CoV-2 and can be associated with severe cardiovascular complications and death. Cardiac complications associated with acute COVID-19 and MIS-C are more severe and occur more frequently than myocarditis after mRNA COVID-19 vaccination. Furthermore, some of the academic and social disruptions caused by the pandemic expect to be eased by widespread vaccination. For all these reasons, COVID-19 vaccination is strongly recommended for all eligible age groups.
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Affiliation(s)
- Stephanie E Chin
- K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ, USA.
- Hackensack Meridian School of Medicine, Nutley, NJ, USA.
- Alpert Zales Castro Pediatric Cardiology, 1623 Route 88, Brick, NJ, 08724, USA.
| | - Sejal M Bhavsar
- Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, NJ, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Andrew Corson
- K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Zelda J Ghersin
- K. Hovnanian Children's Hospital at Jersey Shore University Medical Center, Neptune, NJ, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Hannah S Kim
- Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, Hackensack, NJ, USA
- Hackensack Meridian School of Medicine, Nutley, NJ, USA
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