501
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Ammirati E, Bizzi E, Veronese G, Groh M, Van de Heyning CM, Lehtonen J, Pineton de Chambrun M, Cereda A, Picchi C, Trotta L, Moslehi JJ, Brucato A. Immunomodulating Therapies in Acute Myocarditis and Recurrent/Acute Pericarditis. Front Med (Lausanne) 2022; 9:838564. [PMID: 35350578 PMCID: PMC8958011 DOI: 10.3389/fmed.2022.838564] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/28/2022] [Indexed: 12/15/2022] Open
Abstract
The field of inflammatory disease of the heart or "cardio-immunology" is rapidly evolving due to the wider use of non-invasive diagnostic tools able to detect and monitor myocardial inflammation. In acute myocarditis, recent data on the use of immunomodulating therapies have been reported both in the setting of systemic autoimmune disorders and in the setting of isolated forms, especially in patients with specific histology (e.g., eosinophilic myocarditis) or with an arrhythmicburden. A role for immunosuppressive therapies has been also shown in severe cases of coronavirus disease 2019 (COVID-19), a condition that can be associated with cardiac injury and acute myocarditis. Furthermore, ongoing clinical trials are assessing the role of high dosage methylprednisolone in the context of acute myocarditis complicated by heart failure or fulminant presentation or the role of anakinra to treat patients with acute myocarditis excluding patients with hemodynamically unstable conditions. In addition, the explosion of immune-mediated therapies in oncology has introduced new pathophysiological entities, such as immune-checkpoint inhibitor-associated myocarditis and new basic research models to understand the interaction between the cardiac and immune systems. Here we provide a broad overview of evolving areas in cardio-immunology. We summarize the use of new imaging tools in combination with endomyocardial biopsy and laboratory parameters such as high sensitivity troponin to monitor the response to immunomodulating therapies based on recent evidence and clinical experience. Concerning pericarditis, the normal composition of pericardial fluid has been recently elucidated, allowing to assess the actual presence of inflammation; indeed, normal pericardial fluid is rich in nucleated cells, protein, albumin, LDH, at levels consistent with inflammatory exudates in other biological fluids. Importantly, recent findings showed how innate immunity plays a pivotal role in the pathogenesis of recurrent pericarditis with raised C-reactive protein, with inflammasome and IL-1 overproduction as drivers for systemic inflammatory response. In the era of tailored medicine, anti-IL-1 agents such as anakinra and rilonacept have been demonstrated highly effective in patients with recurrent pericarditis associated with an inflammatory phenotype.
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Affiliation(s)
- Enrico Ammirati
- De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy
| | - Emanuele Bizzi
- Internal Medicine, Fatebenefratelli Hospital, Milano, Italy
| | - Giacomo Veronese
- Department of Health Sciences, University of Milano-Bicocca, Monza, Italy
| | - Matthieu Groh
- National Reference Center for Hypereosinophilic Syndromes, CEREO, Suresnes, France
- Department of Internal Medicine, Hôpital Foch, Suresnes, France
| | - Caroline M. Van de Heyning
- Department of Cardiology, Antwerp University Hospital, and GENCOR Research Group, Antwerp University, Antwerp, Belgium
| | - Jukka Lehtonen
- Department of Cardiology, Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
| | - Marc Pineton de Chambrun
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital La Pitié-Salpêtrière, Service de Médecine Intensive-Réanimation, Paris, France
- Sorbonne Université, APHP, Hôpital de la Pitié-Salpêtrière, Service de Médecine Interne 2, Centre de Référence National Lupus et SAPL et Autres Maladies Auto-immunes et Systémiques Rares, Paris, France
- Sorbonne Université, INSERM, UMRS_1166-ICAN, ICAN, Paris, France
| | - Alberto Cereda
- Cardiovascular Department, Association Socio Sanitary Territorial Santi Paolo e Carlo, Milano, Italy
| | - Chiara Picchi
- Internal Medicine, Fatebenefratelli Hospital, Milano, Italy
| | - Lucia Trotta
- Internal Medicine, Fatebenefratelli Hospital, Milano, Italy
| | - Javid J. Moslehi
- Section of Cardio-Oncology and Immunology, Division of Cardiology and the Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA, United States
| | - Antonio Brucato
- Internal Medicine, Fatebenefratelli Hospital, Milano, Italy
- Department of Biomedical and Clinical Sciences “Luigi Sacco, ” Fatebenefratelli Hospital, University of Milano, Milano, Italy
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502
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Sciaccaluga C, D'Ascenzi F, Cameli M, Gallotta M, Menci D, Antonelli G, Banchi B, Mochi V, Valente S, Focardi M. Case Report: Two Case Reports of Acute Myopericarditis After mRNA COVID-19 Vaccine. Front Cardiovasc Med 2022; 9:827237. [PMID: 35321100 PMCID: PMC8934973 DOI: 10.3389/fcvm.2022.827237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/03/2022] [Indexed: 12/30/2022] Open
Abstract
Background Cases of myocarditis and myopericarditis after mRNA COVID-19 vaccines have been reported, especially after the second dose and in young males. Their course is generally benign, with symptoms onset after 24–72 h from the dose. Case Summary We report two cases of myopericarditis after the second dose of the mRNA-1273 COVID-19 vaccine in two young males. Both the patients were administered the mRNA-1273 COVID-19 vaccine from the same batch on the same day and experienced fever on the same day of the vaccine, and symptoms consisted of myopericarditis 3 days after the dose. Discussion Myopericarditis is usually considered an uncommon adverse reaction after various vaccinations, reported also after the mRNA COVID-19 vaccine. Several explanations have been proposed, including an abnormal activation of the immune system leading to a pro-inflammatory cascade responsible for myocarditis development. Both patients experienced the same temporal onset as well as the same symptoms, it is also useful to underscore that both vaccines belonged to the same batch of vaccines. However, despite these cases, vaccination against COVID-19 far outweighs the risk linked to COVID-19 infection and remains the best option to overcome this disease.
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Affiliation(s)
- Carlotta Sciaccaluga
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
- *Correspondence: Carlotta Sciaccaluga
| | - Flavio D'Ascenzi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Matteo Cameli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Maddalena Gallotta
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Daniele Menci
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Giovanni Antonelli
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Benedetta Banchi
- Unit of Diagnostic Imaging, University Hospital Santa Maria alle Scotte, Siena, Italy
| | - Veronica Mochi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Serafina Valente
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Marta Focardi
- Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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503
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Shechtman L, Lahad K, Livneh A, Grossman C, Druyan A, Giat E, Lidar M, Freund S, Manor U, Pomerantz A, Veroslavski D, Ben-Zvi I. Safety of the BNT162b2 mRNA COVID-19 vaccine in patients with familial Mediterranean fever. Rheumatology (Oxford) 2022; 61:SI129-SI135. [PMID: 35238382 PMCID: PMC8903441 DOI: 10.1093/rheumatology/keac131] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/22/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Evidence suggests a possible association between the COVID-19 vaccine and autoimmune disease flares or new onset of various autoinflammatory manifestations, such as pericarditis and myocarditis. The objective of this study was to assess the safety of an mRNA-based BNT162b2 anti-COVID-19 vaccine in individuals with familial Mediterranean fever (FMF), a prototypic autoinflammatory disease. METHODS Patients participating in this study fulfilled the criteria for diagnosis of FMF, were older than 18 years, and received at least one dose of the vaccine. Data on baseline characteristics, features of FMF, post-vaccination side effects, and disease flares were acquired using electronic medical files and telephone interviews. RESULTS A total of 273 FMF patients were recruited for the study. More than 95% were vaccinated with two doses of the vaccine. The rates of local reactions following the first and second vaccine doses were 65.5% and 60%, respectively, and 26% and 50.4%, respectively, for systemic adverse events. These rates are lower than those reported for the general population from real-world and clinical trial settings. Postvaccination FMF activity remained stable in most patients. None of the patients reported an attack of pericarditis or myocarditis, considered the most serious vaccine-associated adverse events. Patients with a more active FMF disease and patients harboring the M694V mutation had a significantly higher rate of post-vaccination systemic side effects and attacks. CONCLUSION The BNT162b2 mRNA Covid-19 vaccine is safe in patients with FMF. Our results support the administration of this vaccine to FMF patients according to guidelines applicable to the general population.
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Affiliation(s)
- Liran Shechtman
- Department of Internal Medicine F, Sheba Medical Center, Tel-Hashomer, Israel
| | - Karney Lahad
- Department of Internal Medicine F, Sheba Medical Center, Tel-Hashomer, Israel
| | - Avi Livneh
- Department of Internal Medicine F, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Chagai Grossman
- Department of Internal Medicine F, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Amit Druyan
- Department of Internal Medicine F, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Eitan Giat
- Rheumatology Unit, Sheba Medical Center, Tel-Hashomer, Israel
| | - Merav Lidar
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Rheumatology Unit, Sheba Medical Center, Tel-Hashomer, Israel
| | - Sarit Freund
- Faculty of industrial engineering and management, Ruppin Academic Center, Israel
| | - Uri Manor
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Department of Internal Medicine C, Sheba Medical Center, Tel-Hashomer, Israel
| | - Alon Pomerantz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Ilan Ben-Zvi
- Department of Internal Medicine F, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,The Sheba Talpiot Medical Leadership Program, Tel-Hashomer, Israel
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504
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Fick TA, Cua CL, Lee S. Imaging Findings in Pediatric COVID-19: A Review of Current Literature. Cardiol Ther 2022; 11:185-201. [PMID: 35233725 PMCID: PMC8888132 DOI: 10.1007/s40119-022-00256-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Indexed: 11/12/2022] Open
Abstract
The recent COVID-19 pandemic has afflicted over 200 million individuals to date, with many different organ systems involved. The pediatric involvement has been variable, but of note is the risk of cardiac disease in pediatric COVID-19 patients. We review here the cardiac involvement in pediatric patients with COVID-19. Several studies highlight a possible cardiotropic nature of SARS-CoV-2, and describe the disease severity in myocarditis, both symptomatic and occult, as well as MIS-C. We describe the expected clinical course of these patients and note the lack of long-term follow-up data and the concerning prevalence of continued abnormal findings on follow-up imaging. With this paucity of long-term cardiac data, we recommend consideration of advanced imaging for pediatric patients with cardiac symptoms and/or elevation of cardiac serum biomarkers.
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Affiliation(s)
- Tyler A Fick
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Clifford L Cua
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Simon Lee
- The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
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505
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Assessment of Attitudes, Main Concerns and Sources of Knowledge Regarding COVID-19 Vaccination in Poland in the Unvaccinated Individuals-A Nationwide Survey. Vaccines (Basel) 2022; 10:vaccines10030381. [PMID: 35335013 PMCID: PMC8955026 DOI: 10.3390/vaccines10030381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 01/09/2023] Open
Abstract
Vaccination is the most effective tool to combat the COVID-19 pandemic. However, it is ineffective without appropriate public acceptance. In Poland, 53% of the country's population is vaccinated, which puts us in the last position among the EU countries. Therefore, this study aims to assess the main concerns regarding vaccination in the unvaccinated population of Poland. The study was based on an original questionnaire that was distributed online. There were three phases of the study: Phase 1-before the preventive vaccination plan, Phase 2-2 months after implementation of the programme, Phase 3-after 4 months when the immunisation rate in Poland was 42%. A total of 4459 individuals participated in the study. As many as 1943 participants were excluded from the analysis due to lack of consent (30 subjects) or COVID-19 vaccination (1913 subjects). Out of the remaining 2516 unvaccinated individuals, 463 were participants in the first phase of the study, 1137 in the second phase of the study, and 916 in the third phase. As the preventive vaccination plan in Poland continued, concerns about vaccine adverse events, safety and efficacy were raised. The only lower concern was that about the vaccine transportation rules. Moreover, as the vaccination programme continued, there was an increase in the percentage of individuals declaring their full reluctance towards vaccination against COVID-19. Conclusions: The Internet is the main source of knowledge about the COVID-19 vaccination, so it should be focused on during vaccination campaigns. The public is primarily concerned about adverse events of vaccines and the lack of appropriate tests of the products used. Therefore, it is advisable to popularise the current state of knowledge and promote reliable information concerning the COVID-19 vaccination.
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506
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Leader A, Dagan N, Barda N, Goldberg I, Raanani P, Spectre G, Balicer R, Gafter-Gvili A. Previously undiagnosed cancer in patients with arterial thrombotic events - A population-based cohort study. J Thromb Haemost 2022; 20:635-647. [PMID: 34818468 DOI: 10.1111/jth.15600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Emerging data suggest increased arterial thrombosis risk in the months preceding a cancer diagnosis. OBJECTIVES To assess whether patients without documented vascular risk factors or pre-existing cardiovascular disease have a higher relative risk of cancer 12 months after arterial thrombotic events (ATE), compared to unselected patients. PATIENTS/METHODS A population-based cohort study of Clalit Health Services (CHS) database included CHS members ≥25 years without prior cancer or ATE (n = 2 804 584). An iterative matching process selected 10 potential controls chronologically for each consecutive exposed, age- and sex-matched (actual controls drawn 1:1 from a lot). Study exposure, ATE, was defined as ischemic stroke, transient ischemic attack, myocardial infarction or systemic arterial thromboembolism during hospitalization. The outcome was newly-diagnosed cancer within 12 months, based on Israeli national cancer registry. Cox proportional hazards multivariate regression calculated hazard ratio (HR) for outcomes, adjusted for cancer risk factors. Analysis also performed for three subgroups: age ≤50 years; no cardiovascular risk factors; no prior cardiovascular disease. RESULTS The full ATE and matched control cohorts included 43 108 patients. The 12-month cumulative incidence of cancer (95% confidence interval) was 0.020 (0.019-0.022) in the ATE cohort and 0.012 (0.011-0.013) in controls, corresponding to an adjusted HR of 1.665 (1.489-1.862). The relative risk of cancer was high in all subgroups up to a HR of 3.754 (1.912-7.372) in patients without cardiovascular risk factors. CONCLUSION There is an increased risk of previously undiagnosed cancer at 12 months after ATE, especially in patients without documented vascular risk factors or pre-existent cardiovascular disease.
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Affiliation(s)
- Avi Leader
- Institute of Hematology, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noa Dagan
- Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Noam Barda
- Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Idan Goldberg
- Institute of Hematology, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Pia Raanani
- Institute of Hematology, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Galia Spectre
- Institute of Hematology, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ran Balicer
- Clalit Health Services, Clalit Research Institute, Tel Aviv, Israel
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - Anat Gafter-Gvili
- Institute of Hematology, Rabin Medical Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Internal Medicine A, Rabin Medical Center, Petah Tikva, Israel
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507
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Fatima M, Ahmed Cheema H, Ahmed Khan MH, Shahid H, Saad Ali M, Hassan U, Wahaj Murad M, Aemaz Ur Rehman M, Farooq H. Development of myocarditis and pericarditis after COVID-19 vaccination in adult population: A systematic review. Ann Med Surg (Lond) 2022; 76:103486. [PMID: 35291413 PMCID: PMC8912977 DOI: 10.1016/j.amsu.2022.103486] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/01/2022] [Accepted: 03/06/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives A clear temporal relationship between myocarditis and pericarditis after COVID-19 vaccination has led to the belief that the vaccine may act as a trigger for these cardiologic complications. The aim of this systematic review is to explore the incidence, clinical presentation, management, and association between them. Methods We conducted a systematic literature search on Cochrane, MEDLINE, and EMBASE as per guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews). A total of 41 case reports and case series describing 97 patients, and 5 original articles describing 15,585,309 participants were selected as part of this review. Results Of the 97 reported cases describing vaccine-associated myocarditis/pericarditis, 67 (69%) patients received Pfizer-BioNTech and 25 (25.7%) received Moderna. The mean onset of symptoms after vaccine administration was 3.8 ± 4.5 days with three-quarters developing symptoms after the second dose. Chest pain (n = 88, 90%) and fever (n = 33, 34%) were the most common presenting complaints. Out of 97, 80 (82.5%) patients recovered while 4 (4.1%) patients expired. The pooled incidence of myocarditis and pericarditis extrapolated from original studies is 0.001% and 0.0004%, respectively. In the original studies, nearly all the cases of myocarditis and pericarditis were mild. Chest pain and fever were the most common presenting symptoms. Conclusion Myocarditis and pericarditis after the COVID-19 vaccine have been reported more in young adult males and are most likely to occur after the second dose of mRNA vaccines. The presentation is mild and the majority of the patients recover either completely or partially. Myocarditis and pericarditis have been reported after the COVID-19 vaccine. It is occurs more commonly in males as compared to females. Myocarditis and Pericarditis is more likely to occur after second dose of mRNA vaccine. The presentation is mild, and most of the patients recover either completely or partially. Autoimmunity (molecular mimicry) is thought to be the major pathological mediator.
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508
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Li Z, Zhang L, Jiang K, Zhang Y, Liu Y, Hu G, Song J. Biosafety assessment of delivery systems for clinical nucleic acid therapeutics. BIOSAFETY AND HEALTH 2022. [DOI: 10.1016/j.bsheal.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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509
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Lai FTT, Li X, Peng K, Huang L, Ip P, Tong X, Chui CSL, Wan EYF, Wong CKH, Chan EWY, Siu DCW, Wong ICK. Carditis After COVID-19 Vaccination With a Messenger RNA Vaccine and an Inactivated Virus Vaccine : A Case-Control Study. Ann Intern Med 2022; 175:362-370. [PMID: 35073155 PMCID: PMC8814917 DOI: 10.7326/m21-3700] [Citation(s) in RCA: 91] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Case reports of carditis after BNT162b2 vaccination are accruing worldwide. OBJECTIVE To examine the association of BNT162b2 and CoronaVac (Sinovac) vaccination with carditis. DESIGN Case-control study with hospital control participants. SETTING Territory-wide, public health care database with linkage to population-based vaccination records in Hong Kong. PATIENTS Inpatients aged 12 years or older first diagnosed with carditis were selected as case patients. All other hospitalized patients without carditis were treated as control participants. Ten control participants were randomly matched with each case patient by age, sex, and admission date. INTERVENTION Vaccination with BNT162b2 or CoronaVac. MEASUREMENTS Incident diagnosis of carditis based on the International Classification of Diseases, Ninth Revision, and elevated troponin levels. RESULTS A total of 160 case patients and 1533 control participants were included. Incidence of carditis per 100 000 doses of CoronaVac and BNT162b2 administered was estimated to be 0.31 (95% CI, 0.13 to 0.66) and 0.57 (CI, 0.36 to 0.90), respectively. Multivariable analyses showed that recipients of the BNT162b2 vaccine had higher odds of carditis (adjusted odds ratio [OR], 3.57 [CI, 1.93 to 6.60]) than unvaccinated persons. Stratified by sex, the OR was 4.68 (CI, 2.25 to 9.71) for males and 2.22 (CI, 0.57 to 8.69) for females receiving the BNT162b2 vaccine. The ORs for adults and adolescents receiving the BNT162b2 vaccine were 2.41 (CI, 1.18 to 4.90) and 13.79 (CI, 2.86 to 110.38), respectively. Subanalysis showed an OR of 9.29 (CI, 3.94 to 21.91) for myocarditis and 1.06 (CI, 0.35 to 3.22) for pericarditis associated with BNT162b2. The risk was mainly seen after the second dose of BNT162b2 rather than the first. No association between CoronaVac and carditis with a magnitude similar to that for BNT162b2 was seen. LIMITATION Limited sample size, absence of electrocardiography and other clinical investigative data, and unrecorded overseas vaccination exposure. CONCLUSION Despite a low absolute risk, there is an increased risk for carditis associated with BNT162b2 vaccination. This elevated risk should be weighed against the benefits of vaccination. PRIMARY FUNDING SOURCE Health and Medical Research Fund.
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Affiliation(s)
- Francisco Tsz Tsun Lai
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, and Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China (F.T.T., E.W.Y.)
| | - Xue Li
- Department of Medicine and Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, and Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China (X.L.)
| | - Kuan Peng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China (K.P., L.H.)
| | - Lei Huang
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China (K.P., L.H.)
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China (P.I.)
| | - Xinning Tong
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China (X.T., D.C.W.)
| | - Celine Sze Ling Chui
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, and the School of Nursing and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China (C.S.L.)
| | - Eric Yuk Fai Wan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, and Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, and Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China (E.Y.F., C.K.H.)
| | - Carlos King Ho Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, and Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, and Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China (E.Y.F., C.K.H.)
| | - Esther Wai Yin Chan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, and Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China (F.T.T., E.W.Y.)
| | - David Chung Wah Siu
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China (X.T., D.C.W.)
| | - Ian Chi Kei Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, and Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China, and Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom (I.C.K.)
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510
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Oh Omikron! HAUTNAH 2022. [PMCID: PMC8908757 DOI: 10.1007/s12326-022-00501-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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511
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Chouchana L, Blet A, Al‐Khalaf M, Kafil TS, Nair G, Robblee J, Drici M, Valnet‐Rabier M, Micallef J, Salvo F, Treluyer J, Liu PP. Features of Inflammatory Heart Reactions Following mRNA COVID-19 Vaccination at a Global Level. Clin Pharmacol Ther 2022; 111:605-613. [PMID: 34860360 PMCID: PMC9015432 DOI: 10.1002/cpt.2499] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/25/2021] [Indexed: 12/19/2022]
Abstract
Myocarditis and pericarditis may constitute adverse reactions of mRNA coronavirus disease 2019 (COVID-19) vaccines. This study aimed to document these reactions and to assess the association with patient sex and age. This is as an observational retrospective study using a case-non-case design (also called disproportionality study) on inflammatory heart reactions reported with mRNA COVID-19 vaccines within the World Health Organization (WHO) global safety database (VigiBase), up to June 30, 2021. Results are expressed using reporting odds ratios (RORs) and their 95% confidence interval (95% CI). Of 716,576 reports related to mRNA COVID-19 vaccines, 2,277 were cases of inflammatory heart reactions, including 1241 (55%) myocarditis and 851 (37%) pericarditis. The main age group was 18-29 years (704, 31%), and mostly male patients (1,555, 68%). Pericarditis onset was delayed compared with myocarditis with a median time to onset of 8 (3-21) vs. 3 (2-6) days, respectively (P = 0.001). Regarding myocarditis, an important disproportionate reporting was observed in adolescents (ROR, 22.3, 95% CI 19.2-25.9) and in 18-29 years old (ROR, 6.6, 95% CI 5.9-7.5) compared with older patients, as well as in male patients (ROR, 9.4, 95% CI 8.3-10.6). Reporting rate of myocarditis was increased in young adults and adolescents. Inflammatory heart reactions may rarely occur shortly following mRNA COVID-19 vaccination. Although an important disproportionate reporting of myocarditis was observed among adolescents and young adults, particularly in male patients, reporting rates support a very rare risk, that does not seem to compromise the largely positive benefit-risk balance of these vaccines. Furthermore, this study confirmed the value of disproportionality analyses for estimation of relative risks among subgroups of patients.
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Affiliation(s)
- Laurent Chouchana
- Regional Center of PharmacovigilanceDepartment of PharmacologyCochin HospitalAP‐HP.Centre – Université de ParisParisFrance
| | - Alice Blet
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
- Department of AnesthesiologyCritical Care and Burn CenterLariboisière – Saint‐Louis HospitalsDMU ParabolAP–HP NordUniversity of ParisParisFrance
- Inserm UMR‐S 942Cardiovascular Markers in Stress Conditions (MASCOT)University of ParisParisFrance
| | - Mohammad Al‐Khalaf
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - Tahir S. Kafil
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - Girish Nair
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - James Robblee
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
| | - Milou‐Daniel Drici
- Regional Center of PharmacovigilanceDepartment of PharmacologyNice University HospitalNiceFrance
| | | | - Joëlle Micallef
- UMR 1106InsermInstitute of Neurosciences SystemAix‐Marseille UniversityMarseilleFrance
- Regional Center of PharmacovigilanceDepartment of Clinical Pharmacology and PharmacovigilanceUniversity Hospitals of MarseilleMarseilleFrance
| | - Francesco Salvo
- INSERMBPHUniversity of BordeauxBordeauxFrance
- CHU de BordeauxPôle de Santé PubliqueService de Pharmacologie MédicaleCentre Régional de PharmacovigilanceBordeauxFrance
| | - Jean‐Marc Treluyer
- Regional Center of PharmacovigilanceDepartment of PharmacologyCochin HospitalAP‐HP.Centre – Université de ParisParisFrance
- University of ParisParisFrance
| | - Peter P. Liu
- Departments of Medicine and Cellular & Molecular MedicineUniversity of Ottawa Heart InstituteUniversity of OttawaOttawaONCanada
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512
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Deux années de Covid-19 : premières leçons de cette pandémie. MÉDECINE DES MALADIES MÉTABOLIQUES 2022. [PMCID: PMC8768022 DOI: 10.1016/j.mmm.2022.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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513
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Moroni F, Mbualungu J, Abbate A. Myocarditis after RNA-based COVID-19 vaccines: Where do we stand? Int J Cardiol 2022; 356:81-82. [PMID: 35288197 PMCID: PMC8915449 DOI: 10.1016/j.ijcard.2022.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Francesco Moroni
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
| | - James Mbualungu
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Antonio Abbate
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
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514
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Ota M. SARS-CoV-2 mRNA vaccination and subsequent herpes zoster: possible immune reconstitution by mRNA vaccination. JAAD Case Rep 2022; 23:166-167. [PMID: 35261919 PMCID: PMC8890790 DOI: 10.1016/j.jdcr.2022.02.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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515
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Ishibashi K, Yatsuka H, Haruta M, Kimoto K, Yoshida S, Kubota T. Branch Retinal Artery Occlusions, Paracentral Acute Middle Maculopathy and Acute Macular Neuroretinopathy After COVID-19 Vaccinations. Clin Ophthalmol 2022; 16:987-992. [PMID: 35392428 PMCID: PMC8980294 DOI: 10.2147/opth.s357359] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/08/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Potential retinal adverse events after COVID-19 vaccinations reported previously include paracentral acute middle maculopathy (PAMM), acute macular neuroretinopathy (AMN), and central serous chorioretinopathy. We report four cases of branch retinal artery occlusion (BRAO), one case of PAMM, and one case of AMN that occurred after administration of the Pfizer-BioNTech COVID-19 vaccine. Patients and Methods We retrospectively reviewed the medical records of six patients who presented to Yame General Hospital or Oita University Hospital from July through October 2021. Results Four patients (2 males) presented with visual field defects associated with BRAO, one male patient with PAMM, and one female patient with AMN after receiving the Pfizer-BioNTech COVID-19 vaccine. The mean age was 59.3 years; the mean best-corrected visual acuity was 20/21. The mean time from the last vaccination to the onset of visual field defect was 22.8 days. Five patients had received two doses of the vaccine and one patient one dose. Patients’ medical history included diabetes mellitus in case 2, hypertension in cases 2, 3 and 6, and Alport syndrome and end-stage renal disease in case 6 for which the patient was undergoing regular hemodialysis. Conclusion Although rare, retinal adverse events may occur after COVID-19 vaccinations. Further studies with a larger sample size should determine whether these retinal abnormalities are causally associated with COVID-19 vaccinations or just coincidental. Potential risks of BRAO/PAMM/AMN after COVID-19 vaccinations must be carefully weighed against the substantial benefit of COVID-19 vaccinations.
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Affiliation(s)
- Koki Ishibashi
- Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan
- Department of Ophthalmology, Yame General Hospital, Yame, Japan
| | - Hiroyuki Yatsuka
- Department of Ophthalmology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Masatoshi Haruta
- Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan
- Correspondence: Masatoshi Haruta, Department of Ophthalmology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan, Tel +81 942 31 7574, Fax +81 942 37 0324, Email
| | - Kenichi Kimoto
- Department of Ophthalmology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, Kurume, Japan
| | - Toshiaki Kubota
- Department of Ophthalmology, Faculty of Medicine, Oita University, Yufu, Japan
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516
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Gluckman TJ, Bhave NM, Allen LA, Chung EH, Spatz ES, Ammirati E, Baggish AL, Bozkurt B, Cornwell WK, Harmon KG, Kim JH, Lala A, Levine BD, Martinez MW, Onuma O, Phelan D, Puntmann VO, Rajpal S, Taub PR, Verma AK. 2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play. J Am Coll Cardiol 2022; 79:1717-1756. [PMID: 35307156 PMCID: PMC8926109 DOI: 10.1016/j.jacc.2022.02.003] [Citation(s) in RCA: 179] [Impact Index Per Article: 89.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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517
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Mogi M. Is COVID-19 vaccination beneficial or harmful to endothelial cells? Hypertens Res 2022; 45:920-921. [PMID: 35228713 PMCID: PMC8883243 DOI: 10.1038/s41440-022-00878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 11/25/2022]
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518
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Nishimoto M, Sogabe N, Hino M. Visceral disseminated varicella zoster virus infection following COVID-19 vaccination in an allogeneic stem cell transplant recipient. Transpl Infect Dis 2022; 24:e13810. [PMID: 35213772 PMCID: PMC9115351 DOI: 10.1111/tid.13810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 01/24/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Mitsutaka Nishimoto
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Nobuhiro Sogabe
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Masayuki Hino
- Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
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519
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Intracellular Reverse Transcription of Pfizer BioNTech COVID-19 mRNA Vaccine BNT162b2 In Vitro in Human Liver Cell Line. Curr Issues Mol Biol 2022; 44:1115-1126. [PMID: 35723296 PMCID: PMC8946961 DOI: 10.3390/cimb44030073] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/19/2022] [Accepted: 02/23/2022] [Indexed: 12/25/2022] Open
Abstract
Preclinical studies of COVID-19 mRNA vaccine BNT162b2, developed by Pfizer and BioNTech, showed reversible hepatic effects in animals that received the BNT162b2 injection. Furthermore, a recent study showed that SARS-CoV-2 RNA can be reverse-transcribed and integrated into the genome of human cells. In this study, we investigated the effect of BNT162b2 on the human liver cell line Huh7 in vitro. Huh7 cells were exposed to BNT162b2, and quantitative PCR was performed on RNA extracted from the cells. We detected high levels of BNT162b2 in Huh7 cells and changes in gene expression of long interspersed nuclear element-1 (LINE-1), which is an endogenous reverse transcriptase. Immunohistochemistry using antibody binding to LINE-1 open reading frame-1 RNA-binding protein (ORFp1) on Huh7 cells treated with BNT162b2 indicated increased nucleus distribution of LINE-1. PCR on genomic DNA of Huh7 cells exposed to BNT162b2 amplified the DNA sequence unique to BNT162b2. Our results indicate a fast up-take of BNT162b2 into human liver cell line Huh7, leading to changes in LINE-1 expression and distribution. We also show that BNT162b2 mRNA is reverse transcribed intracellularly into DNA in as fast as 6 h upon BNT162b2 exposure.
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520
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Comparative Evaluation of Rapid Isothermal Amplification and Antigen Assays for Screening Testing of SARS-CoV-2. Viruses 2022; 14:v14030468. [PMID: 35336875 PMCID: PMC8951466 DOI: 10.3390/v14030468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/17/2022] Open
Abstract
Human transmission of SARS-CoV-2 and emergent variants of concern continue to occur globally, despite mass vaccination campaigns. Public health strategies to reduce virus spread should therefore rely, in part, on frequent screening with rapid, inexpensive, and sensitive tests. We evaluated two digitally integrated rapid tests and assessed their performance using stored nasal swab specimens collected from individuals with or without COVID-19. An isothermal amplification assay combined with a lateral flow test had a limit of detection of 10 RNA copies per reaction, and a positive percent agreement (PPA)/negative percent agreement (NPA) during the asymptomatic and symptomatic phases of 100%/100% and 95.83/100%, respectively. Comparatively, an antigen-based lateral flow test had a limit of detection of 30,000 copies and a PPA/NPA during the asymptomatic and symptomatic phases of 82.86%/98.68% and 91.67/100%, respectively. Both the isothermal amplification and antigen-based lateral flow tests had optimized detection of SARS-CoV-2 during the peak period of transmission; however, the antigen-based test had reduced sensitivity in clinical samples with qPCR Ct values greater than 29.8. Low-cost, high-throughput screening enabled by isothermal amplification or antigen-based techniques have value for outbreak control.
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521
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yap J, Tham MY, Poh J, Toh D, Chan CL, Lim TW, Lim SL, Chia YW, Lim YT, Choo J, Ding ZP, Foo LL, Kuo S, Lau YH, Lee A, Yeo KK. Pericarditis and myocarditis after COVID-19 mRNA vaccination in a nationwide setting. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2022. [DOI: 10.47102/annals-acadmedsg.2021425] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Despite reports suggesting an association between COVID-19 mRNA vaccination and pericarditis and myocarditis, detailed nationwide population-based data are sparsely available. We describe the incidence of pericarditis and myocarditis by age categories and sex after COVID-19 mRNA vaccination from a nationwide mass vaccination programme in Singapore.
Methods: The incidence of adjudicated cases of pericarditis and myocarditis following COVID-19 mRNA vaccination that were reported to the vaccine safety committee between January to July 2021 was compared with the background incidence of myocarditis in Singapore.
Results: As of end July 2021, a total of 34 cases were reported (9 pericarditis only, 14 myocarditis only, and 11 concomitant pericarditis and myocarditis) with 7,183,889 doses of COVID-19 mRNA vaccine administered. Of the 9 cases of pericarditis only, all were male except one. The highest incidence of pericarditis was in males aged 12–19 years with an incidence of 1.11 cases per 100,000 doses. Of the 25 cases of myocarditis, 80% (20 cases) were male and the median age was 23 years (range 12–55 years) with 16 cases after the second dose. A higher-than-expected number of cases were seen in males aged 12–19 and 20–29 years, with incidence rates of 3.72 and 0.98 case per 100,000 doses, respectively.
Conclusion: Data from the national registry in Singapore indicate an increased incidence of pericarditis and myocarditis in younger men after COVID-19 mRNA vaccination.
Keywords: COVID-19 vaccine, myocarditis, pericarditis
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Annie Lee
- National Heart Centre Singapore, Singapore
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522
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Iba T, Levy JH. Thrombosis and thrombocytopenia in COVID-19 and after COVID-19 vaccination. Trends Cardiovasc Med 2022; 32:249-256. [PMID: 35202800 PMCID: PMC8861143 DOI: 10.1016/j.tcm.2022.02.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 12/30/2022]
Abstract
Thrombosis that occurs in coronavirus disease 19 (COVID-19) is a serious complication and a critical aspect of pathogenesis in the disease progression. Although thrombocytopenia is uncommon in the initial presentation, it may also reflect disease severity due to the ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to activate platelets. This occurs directly through the spike protein-angiotensin converting enzyme 2 (ACE2) interaction and indirectly by coagulation and inflammation activation. Dysregulation in both innate and adaptive immune systems is another critical factor that causes thrombosis and thrombocytopenia in COVID-19. Vaccination is the most potent and effective tool to mitigate COVID-19; however, rare side effects, namely vaccine-induced immune thrombotic thrombocytopenia (VITT)/thrombosis with thrombocytopenia syndrome (TTS) can occur following adenovirus-vectored vaccine administration. VITT/TTS is rare, and thrombocytopenia can be the clue to detect this serious complication. It is important to consider that thrombocytopenia and/or thromboembolism are not events limited to post-vaccination with vectored vaccine, but are also seen rarely after vaccination with other vaccines. Various conditions mimic VITT/TTS, and it is vital to achieving the correct diagnosis at an earlier stage. Antiplatelet factor 4 (PF4) antibody detection by the enzyme-linked immunosorbent assay (ELISA) is used for diagnosing VITT/TTS. However, false-positive rates also occur in vaccinated people, who do not show any thrombosis or thrombocytopenia. Vaccinated people with messenger RNA vaccine can show positive but low density and non-functional in terms of platelet aggregation, it is vital to check the optical density. If anti-PF4 ELISA is not available, discriminating other conditions such as antiphospholipid syndrome, thrombotic thrombocytopenic purpura, immune thrombocytopenic purpura, systemic lupus erythematosus, and hemophagocytic syndrome/hemophagocytic lymphohistiocytosis is critical when the patients show thrombosis with thrombocytopenia after COVID-19 vaccination.
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Affiliation(s)
- Toshiaki Iba
- Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Jerrold H Levy
- Departments of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, USA.
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523
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Mohapatra RK, Kuppili S, Kumar Suvvari T, Kandi V, Behera A, Verma S, Kudrat‐E‐Zahan, Biswal SK, Al‐Noor TH, El‐ajaily MM, Sarangi AK, Dhama K. SARS‐CoV‐2 and its variants of concern including Omicron: looks like a never ending pandemic. Chem Biol Drug Des 2022; 99:769-788. [PMID: 35184391 PMCID: PMC9111768 DOI: 10.1111/cbdd.14035] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/12/2022] [Accepted: 02/16/2022] [Indexed: 12/15/2022]
Abstract
The ongoing COVID‐19 pandemic caused by SARS‐CoV‐2 is associated with high morbidity and mortality. This zoonotic virus has emerged in Wuhan of China in December 2019 from bats and pangolins probably and continuing the human‐to‐human transmission globally since last two years. As there is no efficient approved treatment, a number of vaccines were developed at an unprecedented speed to counter the pandemic. Moreover, vaccine hesitancy is observed that may be another possible reason for this never ending pandemic. In the meantime, several variants and mutations were identified and causing multiple waves globally. Now the safety and efficacy of these vaccines are debatable and recommended to determine whether vaccines are able to interrupt transmission of SARS‐CoV‐2 variant of concern (VOC). Moreover, the VOCs continue to emerge that appear more transmissible and less sensitive to virus‐specific immune responses. In this overview, we have highlighted various drugs and vaccines used to counter this pandemic along with their reported side effects. Moreover, the preliminary data for the novel VOC “Omicron” are discussed with the existing animal models.
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Affiliation(s)
- Ranjan K. Mohapatra
- Department of Chemistry Government College of Engineering Keonjhar‐758002 Odisha India
| | | | | | - Venkataramana Kandi
- Department of Microbiology Prathima Institute of Medical Sciences Karimnagar‐505417 Telangana India
| | - Ajit Behera
- Department of Metallurgical & Materials Engineering National Institute of Technology Rourkela‐769008 India
| | - Sarika Verma
- Council of Scientific and Industrial Research‐Advanced Materials and Processes Research Institute Bhopal MP 462026 India
- Academy of council Scientific and Industrial Research ‐ Advanced Materials and Processes Research Institute (AMPRI) Hoshangabad Road Bhopal (M.P) 462026 India
| | - Kudrat‐E‐Zahan
- Department of Chemistry Rajshahi University Rajshahi Bangladesh
| | - Susanta K. Biswal
- Department of Chemistry School of Applied Sciences Centurion University of Technology and Management Odisha India
| | - Taghreed H. Al‐Noor
- Chemistry Department Ibn‐Al‐Haithem College of Education for Pure Science Baghdad University Baghdad Iraq
| | - Marei M. El‐ajaily
- Chemistry Department Faculty of Science Benghazi University Benghazi Libya
| | - Ashish K. Sarangi
- Department of Chemistry School of Applied Sciences Centurion University of Technology and Management Odisha India
| | - Kuldeep Dhama
- Division of Pathology ICAR‐Indian Veterinary Research Institute Uttar Pradesh Bareilly India
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524
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Thurm C, Reinhold A, Borucki K, Kahlfuss S, Feist E, Schreiber J, Reinhold D, Schraven B. Homologous and Heterologous Anti-COVID-19 Vaccination Does Not Induce New-Onset Formation of Autoantibodies Typically Accompanying Lupus Erythematodes, Rheumatoid Arthritis, Celiac Disease and Antiphospholipid Syndrome. Vaccines (Basel) 2022; 10:vaccines10020333. [PMID: 35214790 PMCID: PMC8880348 DOI: 10.3390/vaccines10020333] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemics has caused the death of almost six million people worldwide. In order to establish collective immunity, the first vaccines that were approved in Germany were the vector virus-based vaccine Vaxzevria and the mRNA vaccines Comirnaty and Spikevax, respectively. As it was reported that SARS-CoV-2 can trigger autoimmunity, it is of significant interest to investigate whether COVID-19 vaccines evoke the formation of autoantibodies and subsequent autoimmunity. Here, we analyzed immune responses after different vaccination regimens (mRNA/mRNA, Vector/Vector or Vector/mRNA) with respect to anti-SARS-CoV-2-specific immunity and the development of autoantibodies well known for their appearance in distinct autoimmune diseases. We found that anti-SARS-CoV-2 antibody levels were 90% lower after Vector/Vector vaccination compared to the other vaccinations and that Vector/mRNA vaccination was more effective than mRNA/mRNA vaccination in terms of IgM and IgA responses. However, until 4 months after booster vaccination we only detected increases in autoantibodies in participants with already pre-existing autoantibodies whereas vaccinees showing no autoantibody formation before vaccination did not respond with sustained autoantibody production. Taken together, our study suggests that all used COVID-19 vaccines do not significantly foster the appearance of autoantibodies commonly associated with lupus erythematodes, rheumatoid arthritis, Celiac disease and antiphospholipid-syndrome but provide immunity to SARS-CoV-2.
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Affiliation(s)
- Christoph Thurm
- Institute of Molecular and Clinical Immunology, Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (C.T.); (A.R.); (S.K.); (D.R.)
- ChaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University, 39106 Magdeburg, Germany
| | - Annegret Reinhold
- Institute of Molecular and Clinical Immunology, Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (C.T.); (A.R.); (S.K.); (D.R.)
- ChaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University, 39106 Magdeburg, Germany
- Health Campus Immunology, Infectiology and Inflammation (GC-I3), Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (E.F.); (J.S.)
| | - Katrin Borucki
- Institute of Clinical Chemistry and Pathobiochemistry, Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany;
| | - Sascha Kahlfuss
- Institute of Molecular and Clinical Immunology, Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (C.T.); (A.R.); (S.K.); (D.R.)
- ChaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University, 39106 Magdeburg, Germany
- Health Campus Immunology, Infectiology and Inflammation (GC-I3), Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (E.F.); (J.S.)
- Institute of Medical Microbiology and Hospital Hygiene, Medical Faculty, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Eugen Feist
- Health Campus Immunology, Infectiology and Inflammation (GC-I3), Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (E.F.); (J.S.)
- Department of Rheumatology, Helios Specialist Hospital Vogelsang, 39245 Gommern, Germany
| | - Jens Schreiber
- Health Campus Immunology, Infectiology and Inflammation (GC-I3), Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (E.F.); (J.S.)
- Department of Pneumology, University Hospital, Otto-von-Guericke-University, 39120 Magdeburg, Germany
| | - Dirk Reinhold
- Institute of Molecular and Clinical Immunology, Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (C.T.); (A.R.); (S.K.); (D.R.)
- ChaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University, 39106 Magdeburg, Germany
- Health Campus Immunology, Infectiology and Inflammation (GC-I3), Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (E.F.); (J.S.)
| | - Burkhart Schraven
- Institute of Molecular and Clinical Immunology, Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (C.T.); (A.R.); (S.K.); (D.R.)
- ChaMP, Center for Health and Medical Prevention, Otto-von-Guericke-University, 39106 Magdeburg, Germany
- Health Campus Immunology, Infectiology and Inflammation (GC-I3), Medical Faculty, Otto-von-Guericke-University, 39120 Magdeburg, Germany; (E.F.); (J.S.)
- Correspondence: ; Tel.: +49-391-67-15800
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525
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Bello N, Merz CNB, Cheng S. A Scientific Imperative as Seen Through a Sharpened Lens: Sex, Gender, and the Cardiovascular Condition. Circ Res 2022; 130:433-435. [PMID: 35175842 PMCID: PMC8869790 DOI: 10.1161/circresaha.122.320825] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Natalie Bello
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - C. Noel Bairey Merz
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA,Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA
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526
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Yuniar CT, Pratiwi B, Ihsan AF, Laksono BT, Risfayanti I, Fathadina A, Jeong Y, Kim E. Adverse Events Reporting Quality of Randomized Controlled Trials of COVID-19 Vaccine Using the CONSORT Criteria for Reporting Harms: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10020313. [PMID: 35214773 PMCID: PMC8875800 DOI: 10.3390/vaccines10020313] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/13/2022] [Accepted: 02/15/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Assessing the quality of evidence from vaccine clinical trials is essential to ensure the safety and efficacy of the vaccine and further enhance public acceptance. This study aims to summarize and critically evaluate the quality of harm reporting on randomized controlled trials for the COVID-19 vaccine and determine the factors associated with reporting quality. Methods: We systematically searched the literature using PRISMA guidelines for randomized controlled trials (RCT) on COVID-19 Vaccine until 30 December 2021. Published articles were searched from electronic databases such as PubMed, Science Direct, Google Scholar, and Bibliovid. Bias analysis was performed using RoB-2 tools. The quality of reporting was assessed by the Consolidated Standards of Reporting Trials (CONSORT) harm extension modified into 21 items. Results: A total of 61 RCT studies (402,014 patients) were analyzed. Over half the studies demonstrated adequate reporting (59.02%), and 21 studies (34.4%) reported a low risk of bias. All studies reported death and serious adverse events (AEs), but only six studies mentioned how to handle the recurrent AEs. Reporting of AEs in subgroup analysis was also poor (25%). Conclusion: The RCTs on the COVID-19 vaccine were less biased with good quality on reporting harm based on the modified CONSORT harm extension. However, study quality must be considered, especially for a balance of information between effectivity and safety.
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Affiliation(s)
- Cindra Tri Yuniar
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Bhekti Pratiwi
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Ardika Fajrul Ihsan
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Bambang Tri Laksono
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Iffa Risfayanti
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Annisa Fathadina
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, Institut Teknologi Bandung, Bandung 40132, Indonesia; (C.T.Y.); (B.P.); (A.F.I.); (B.T.L.); (I.R.); (A.F.)
| | - Yeonseon Jeong
- Clinical Data Analysis, Evidence-Based Clinical Research Laboratory, Department of Health Science & Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
| | - Eunyoung Kim
- Clinical Data Analysis, Evidence-Based Clinical Research Laboratory, Department of Health Science & Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul 06974, Korea;
- Correspondence: ; Tel.: +82-2-820-5791
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527
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The Safety of mRNA-1273, BNT162b2 and JNJ-78436735 COVID-19 Vaccines: Safety Monitoring for Adverse Events Using Real-World Data. Vaccines (Basel) 2022; 10:vaccines10020320. [PMID: 35214779 PMCID: PMC8879025 DOI: 10.3390/vaccines10020320] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/14/2022] [Accepted: 02/14/2022] [Indexed: 02/05/2023] Open
Abstract
Two mRNA COVID-19 vaccines (mRNA-1273, Moderna; and BNT162b2, Pfizer-BioNTech) and one viral vector vaccine (JNJ-78436735, Janssen/Johnson and Johnson) are authorized in the US to hinder COVID-19 infections. We analyzed severe and common adverse events in response to COVID-19 vaccines using real-world, Vaccine Adverse Effect Reporting System (VAERS) data. From 14 December 2020 to 30 September 2021, 481,172 (50.7 ± 17.5 years, males 27.89%, 12.35 per 100,000 people) individuals reported adverse events (AEs). The median time to severe AEs was 2 days after injection. The risk of severe AEs following the one viral vector vaccine (OR = 1.044, 95% CI = 1.005–1.086) was significantly higher than that after the two mRNA vaccines, and the risk among males (OR = 1.374, 95% CI = 1.342–1.406) was higher than among females, except for anaphylaxis. For common AEs, however, the risk to males (OR = 0.621, 95% CI = 0.612–0.63) was lower than to females. In conclusion, we provided medical insight and clinical guidance about vaccine types by characterizing AEs using real-world data. In particular, COVID-19 mRNA vaccines are safer than viral vector vaccines with regard to coagulation disorders, whereas inflammation-related AEs are lower in the viral vaccine. The risk–benefit ratio of vaccines should be carefully considered, and close monitoring and management of severe AEs is needed.
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528
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Préta LH, Contejean A, Salvo F, Treluyer JM, Charlier C, Chouchana L. Association study between herpes zoster reporting and mRNA COVID-19 vaccines (BNT162b2 and mRNA-1273). Br J Clin Pharmacol 2022; 88:3529-3534. [PMID: 35174524 PMCID: PMC9111438 DOI: 10.1111/bcp.15280] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/04/2022] [Accepted: 02/10/2022] [Indexed: 12/01/2022] Open
Abstract
Several cases of herpes zoster (HZ) following mRNA COVID‐19 vaccination (BNT162b2 and mRNA‐1273) have been reported, and the first epidemiological evidence suggests an increased risk. We used the worldwide pharmacovigilance database VigiBase to describe HZ cases following mRNA COVID‐19 vaccination. We performed disproportionality analyses (case/non‐case statistical approach) to assess the relative risk of HZ reporting in mRNA COVID‐19 vaccine recipients compared to influenza vaccine recipients and according to patient age. To 30 June 2021, of 716 928 reports with mRNA COVID‐19 vaccines, we found 7728 HZ cases. When compared to influenza vaccines, mRNA COVID‐19 vaccines were associated with a significantly higher reporting of HZ (reporting odds ratio 1.9, 95% CI 1.8–2.1). Furthermore, we found a reduced risk of reporting HZ among under 40‐year‐old persons compared to older persons (reporting odds ratio 0.39, 95% CI 0.36–0.41). Mild and infrequent HZ reactions may occur shortly after mRNA COVID‐19 vaccination, at higher frequency than reported with influenza vaccination, especially in patients over 40 years old. Further analyses are needed to confirm this risk.
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Affiliation(s)
- Laure-Hélène Préta
- Département de Pharmacologie, Centre Régional de Pharmacovigilance, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, France
| | - Adrien Contejean
- Equipe mobile d'infectiologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, France.,Université Paris Descartes, Paris, France
| | - Francesco Salvo
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, Team Pharmacoepidemiology, UMR 1219, Bordeaux, France.,CHU de Bordeaux, Service de Pharmacologie Médicale, Centre Régional de Pharmacovigilance de Bordeaux, Bordeaux, France
| | - Jean-Marc Treluyer
- Département de Pharmacologie, Centre Régional de Pharmacovigilance, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, France.,Université Paris Descartes, Paris, France
| | - Caroline Charlier
- Equipe mobile d'infectiologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, France.,Université Paris Descartes, Paris, France
| | - Laurent Chouchana
- Département de Pharmacologie, Centre Régional de Pharmacovigilance, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, France.,Université Paris Descartes, Paris, France
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529
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Li LL, Zheng C, La J, Do NV, Monach PA, Strymish JM, Fillmore NR, Branch-Elliman W. Impact of prior SARS-CoV-2 infection on incidence of hospitalization and adverse events following mRNA SARS-CoV-2 vaccination: A nationwide, retrospective cohort study. Vaccine 2022; 40:1082-1089. [PMID: 35078665 PMCID: PMC8768509 DOI: 10.1016/j.vaccine.2022.01.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies evaluated the SARS-CoV-2 vaccine safety or compared adverse events following vaccination to those from infection. Limited data about the impact of prior infection on post-vaccine adverse events are available. The objective of this study was to evaluate the impact of prior SARS-CoV-2 infection on outcomes shortly after vaccination using a longitudinal design. METHODS Nationwide, multicenter, retrospective cohort study of hospitalization, death, and pre-specified adverse event rates among Veterans who received mRNA vaccines within the Veterans Health Administration between 12/11/2020 and 8/31/2021. Daily incidence rates were compared before and after vaccine doses, stratified by history of microbiologically-confirmed SARS-CoV-2. RESULTS 3,118,802 patients received a first dose and 2,979,326 a second, including 102,829 with a history of SARS-CoV-2 infection. Daily incident hospitalization rates were unchanged before and after the second dose among patients without previous infection (28.8/100,000 post-dose versus 28.6/100,000 pre-dose, p = 0.92). In previously-infected patients, the hospitalization rate increased above baseline one day following vaccination (158.2/100,000 after dose 2 versus 57.3/100,000 pre-dose, p < 0.001), then returned to baseline. Chart review indicated vaccine side effects, such as fever, constitutional symptoms, weakness, or falls, as the definite (39%) or possible (18%) cause of hospitalization. Affected patients had mean age 75, and 90% had at least one serious comorbidity. Hospitalizations were brief (median 2 days), with rapid return to baseline health. Worse baseline health among previously-infected patients prevented conclusions about mortality risk. CONCLUSIONS Two-dose mRNA vaccine regimens are safe in a population with many comorbidities. Transient increased risks of hospitalization were identified among patients with prior SARS-CoV-2, absolute risk ∼1:1000. Findings support additional study regarding the optimal dosing schedule in this population. FUNDING None.
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Affiliation(s)
- Lucy L Li
- Beth Israel Deaconess Medical Center, Department of Medicine, Boston, MA, United States
| | - Chunlei Zheng
- VA Boston MAVERIC, United States; Boston University School of Medicine, Boston, MA, United States
| | | | - Nhan V Do
- VA Boston MAVERIC, United States; VA Boston Healthcare System, Department of Medicine, Boston, MA, United States; Boston University School of Medicine, Boston, MA, United States
| | - Paul A Monach
- VA Boston MAVERIC, United States; VA Boston Healthcare System, Department of Medicine, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Judith M Strymish
- VA Boston Healthcare System, Department of Medicine, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Nathanael R Fillmore
- VA Boston MAVERIC, United States; Harvard Medical School, Boston, MA, United States; Dana Farber Cancer Institute, Boston, MA, United States
| | - Westyn Branch-Elliman
- VA Boston Healthcare System, Department of Medicine, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; VA Boston Center for Healthcare Organization and Implementation Research. Boston, MA, United States.
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530
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Le T, Sun C, Chang J, Zhang G, Yin X. mRNA Vaccine Development for Emerging Animal and Zoonotic Diseases. Viruses 2022; 14:401. [PMID: 35215994 PMCID: PMC8877136 DOI: 10.3390/v14020401] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023] Open
Abstract
In the prevention and treatment of infectious diseases, mRNA vaccines hold great promise because of their low risk of insertional mutagenesis, high potency, accelerated development cycles, and potential for low-cost manufacture. In past years, several mRNA vaccines have entered clinical trials and have shown promise for offering solutions to combat emerging and re-emerging infectious diseases such as rabies, Zika, and influenza. Recently, the successful application of mRNA vaccines against COVID-19 has further validated the platform and opened the floodgates to mRNA vaccine's potential in infectious disease prevention, especially in the veterinary field. In this review, we describe our current understanding of the mRNA vaccines and the technologies used for mRNA vaccine development. We also provide an overview of mRNA vaccines developed for animal infectious diseases and discuss directions and challenges for the future applications of this promising vaccine platform in the veterinary field.
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Affiliation(s)
- Ting Le
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
| | - Chao Sun
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
| | - Jitao Chang
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
| | - Guijie Zhang
- Departments of Animal Science, School of Agriculture, Ningxia University, Yinchuan 750021, China
| | - Xin Yin
- State Key Laboratory of Veterinary Biotechnology, Harbin Veterinary Research Institute, The Chinese Academy of Agricultural Sciences, Harbin 150069, China; (T.L.); (C.S.)
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531
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Raman B, Neubauer S. Post-Vaccine Myocarditis: A Risk Worth the Reward? Radiology 2022; 304:563-565. [PMID: 35166589 PMCID: PMC8855313 DOI: 10.1148/radiol.220252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Betty Raman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC), Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
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532
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Nunn S, Kersten J, Tadic M, Wolf A, Gonska B, Hüll E, Dietenberger H, Rottbauer W, Buckert D. Case Report: Myocarditis After COVID-19 Vaccination - Case Series and Literature Review. Front Med (Lausanne) 2022; 9:836620. [PMID: 35237634 PMCID: PMC8882906 DOI: 10.3389/fmed.2022.836620] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/20/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The ongoing COVID-19 pandemic demands a series of measures and, above all, the vaccination of a substantial proportion of the population. Acute myocarditis is a rare complication of the widely used mRNA-based vaccines. CASE PRESENTATION We present a case series of four patients (three men and one woman, 16 to 47 years old) with acute pericarditis/myocarditis 3 to 17 days after mRNA vaccination. They presented with chest pain, fever, and flu-like symptoms. Diagnosis was made based on the synopsis of clinical presentation, elevated levels of troponin T and NT-proBNP, impaired systolic function on echocardiography, and findings in non-invasive tissue characterization by cardiovascular magnetic resonance imaging. Two patients also underwent endomyocardial biopsies. As none of the patients showed signs of cardiogenic shock, they were discharged from ward care only a few days after their initial presentations. CONCLUSIONS Our data are consistent with other case reports of myocarditis early after mRNA vaccination and demonstrate the need for multimodal diagnostics. In view of its rarity and mild course, the risk-benefit ratio of vaccination remains positive compared to potential SARS-CoV-2 infection.
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Affiliation(s)
- Samuel Nunn
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Johannes Kersten
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Marijana Tadic
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Alexander Wolf
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Birgid Gonska
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | - Elina Hüll
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
| | | | | | - Dominik Buckert
- Department for Internal Medicine II, University of Ulm, Ulm, Germany
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533
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Abrignani MG, Murrone A, De Luca L, Roncon L, Di Lenarda A, Valente S, Caldarola P, Riccio C, Oliva F, Gulizia MM, Gabrielli D, Colivicchi F. COVID-19, Vaccines, and Thrombotic Events: A Narrative Review. J Clin Med 2022; 11:948. [PMID: 35207220 PMCID: PMC8880092 DOI: 10.3390/jcm11040948] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), a deadly pandemic that has affected millions of people worldwide, is associated with cardiovascular complications, including venous and arterial thromboembolic events. Viral spike proteins, in fact, may promote the release of prothrombotic and inflammatory mediators. Vaccines, coding for the spike protein, are the primary means for preventing COVID-19. However, some unexpected thrombotic events at unusual sites, most frequently located in the cerebral venous sinus but also splanchnic, with associated thrombocytopenia, have emerged in subjects who received adenovirus-based vaccines, especially in fertile women. This clinical entity was soon recognized as a new syndrome, named vaccine-induced immune thrombotic thrombocytopenia, probably caused by cross-reacting anti-platelet factor-4 antibodies activating platelets. For this reason, the regulatory agencies of various countries restricted the use of adenovirus-based vaccines to some age groups. The prevailing opinion of most experts, however, is that the risk of developing COVID-19, including thrombotic complications, clearly outweighs this potential risk. This point-of-view aims at providing a narrative review of epidemiological issues, clinical data, and pathogenetic hypotheses of thrombosis linked to both COVID-19 and its vaccines, helping medical practitioners to offer up-to-date and evidence-based counseling to their often-alarmed patients with acute or chronic cardiovascular thrombotic events.
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Affiliation(s)
| | - Adriano Murrone
- Cardiology-UTIC, Hospitals of Città di Castello and Gubbio-Gualdo Tadino, AUSL Umbria 1, 06100 Perugia, Italy;
| | - Leonardo De Luca
- Cardiology, Cardio-Thoraco-Vascular Department, San Camillo Forlanini Hospital, 00100 Rome, Italy; (L.D.L.); (D.G.)
| | - Loris Roncon
- Cardiology Department, Santa Maria della Misericordia Hospital, 45100 Rovigo, Italy;
| | - Andrea Di Lenarda
- Cardiovascular and Sports Medicine Department, Azienda Sanitaria Universitaria Giuliano Isontina-ASUGI, 34100 Trieste, Italy;
| | - Serafina Valente
- Clinical Surgical Cardiology (UTIC), A.O.U. Senese, Santa Maria alle Scotte Hospital, 53100 Siena, Italy;
| | | | - Carmine Riccio
- Follow-Up of the Post-Acute Patient Unit, Cardio-Vascular Department, A.O.R.N. Sant’Anna and San Sebastiano, 81000 Caserta, Italy;
| | - Fabrizio Oliva
- Cardiology 1-Hemodynamics, Cardiological Intensive Care Unit, Cardiothoracovascular Department “A. De Gasperis”, ASST Grande Ospedale Metropolitano Niguarda, 20100 Milan, Italy;
| | - Michele M. Gulizia
- Cardiology Department, Garibaldi-Nesima Hospital, Company of National Importance and High Specialization “Garibaldi”, 95100 Catania, Italy;
- Heart Care Foundation, 50121 Florence, Italy
| | - Domenico Gabrielli
- Cardiology, Cardio-Thoraco-Vascular Department, San Camillo Forlanini Hospital, 00100 Rome, Italy; (L.D.L.); (D.G.)
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Department, Presidio Ospedaliero San Filippo Neri—ASL Roma 1, 00100 Rome, Italy;
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534
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Famularo G, Macciomei MC. COVID-19 Vaccine-Associated Pericarditis. Ann Pharmacother 2022; 56:1188-1189. [PMID: 35130746 DOI: 10.1177/10600280211073970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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535
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Song C, Li Z, Li C, Huang M, Liu J, Fang Q, Cao Z, Zhang L, Gao P, Nie W, Luo X, Kang J, Xie S, Lyu J, Zhu X. SARS-CoV-2: The Monster Causes COVID-19. Front Cell Infect Microbiol 2022; 12:835750. [PMID: 35211423 PMCID: PMC8861077 DOI: 10.3389/fcimb.2022.835750] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/19/2022] [Indexed: 01/08/2023] Open
Abstract
Coronaviruses are viruses whose particles look like crowns. SARS-CoV-2 is the seventh member of the human coronavirus family to cause COVID-19 which is regarded as a once-in-a-century pandemic worldwide. It holds has the characteristics of a pandemic, which has broy -55ught many serious negative impacts to human beings. It may take time for humans to fight the pandemic. In addition to humans, SARS-CoV-2 also infects animals such as cats. This review introduces the origins, structures, pathogenic mechanisms, characteristics of transmission, detection and diagnosis, evolution and variation of SARS-CoV-2. We summarized the clinical characteristics, the strategies for treatment and prevention of COVID-19, and analyzed the problems and challenges we face.
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Affiliation(s)
- Chang Song
- School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, China
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Zesong Li
- Guangdong Provincial Key Laboratory of Systems Biology and Synthetic Biology for Urogenital Tumors, Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital (Shenzhen Institute of Translational Medicine), Shenzhen, China
- Shenzhen Key Laboratory of Genitourinary Tumor, Department of Urology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital (Shenzhen Institute of Translational Medicine), Shenzhen, China
| | - Chen Li
- Department of Biology, Chemistry, Pharmacy, Free University of Berlin, Berlin, Germany
| | - Meiying Huang
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Jianhong Liu
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Qiuping Fang
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Zitong Cao
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Lin Zhang
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Pengbo Gao
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Wendi Nie
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Xueyao Luo
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Jianhao Kang
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Shimin Xie
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
| | - Jianxin Lyu
- School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, China
- *Correspondence: Xiao Zhu, ; Jianxin Lyu,
| | - Xiao Zhu
- School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, China
- Zhu’s Team, Guangdong Medical University, Zhanjiang, China
- *Correspondence: Xiao Zhu, ; Jianxin Lyu,
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536
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Herpes zoster related hospitalization after inactivated (CoronaVac) and mRNA (BNT162b2) SARS-CoV-2 vaccination: A self-controlled case series and nested case-control study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 21:100393. [PMID: 35128500 PMCID: PMC8808060 DOI: 10.1016/j.lanwpc.2022.100393] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Stimulation of immunity by vaccination may elicit adverse events. There is currently inconclusive evidence on the relationship between herpes zoster related hospitalization and COVID-19 vaccination. This study aimed to evaluate the effect of inactivated virus (CoronaVac, Sinovac) and mRNA (BNT162b2, BioNTech/Fosun Pharma) COVID-19 vaccine on the risk of herpes zoster related hospitalization. Methods Self-controlled case series (SCCS) analysis was conducted using the data from the electronic health records in Hospital Authority and COVID-19 vaccination records in the Department of Health in Hong Kong. We conducted the SCCS analysis including patients with a first primary diagnosis of herpes zoster in the hospital inpatient setting between February 23 and July 31, 2021. A confirmatory analysis by nested case-control method was also conducted. Each herpes zoster case was randomly matched with ten controls according to sex, age, Charlson comorbidity index, and date of hospital admission. Conditional Poisson regression and logistic regression models were used to assess the potential excess rates of herpes zoster after vaccination. Findings From February 23 to July 31, 2021, a total of 16 and 27 patients were identified with a first primary hospital diagnosis of herpes zoster within 28 days after CoronaVac and BNT162b2 vaccinations. The incidence of herpes zoster was 7.9 (95% Confidence interval [CI]: 5.2-11.5) for CoronaVac and 7.1 (95% CI: 4.1-11.5) for BNT162b2 per 1,000,000 doses administered. In SCCS analysis, CoronaVac vaccination was associated with significantly higher risk of herpes zoster within 14 days after first dose (adjusted incidence rate ratio [aIRR]=2.67, 95% CI: 1.08-6.59) but not in other periods afterwards compared to the baseline period. Regarding BNT162b2 vaccination, a significantly increased risk of herpes zoster was observed after first dose up to 14 days after second dose (0-13 days after first dose: aIRR=5.23, 95% CI: 1.61-17.03; 14-27 days after first dose: aIRR=5.82, 95% CI: 1.62-20.91; 0-13 days after second dose: aIRR=5.14, 95% CI: 1.29-20.47). Using these relative rates, we estimated that there has been an excess of approximately 5 and 7 cases of hospitalization as a result of herpes zoster after every 1,000,000 doses of CoronaVac and BNT162b2 vaccination, respectively. The findings in the nested case control analysis showed similar results. Interpretation We identified an increased risk of herpes zoster related hospitalization after CoronaVac and BNT162b2 vaccinations. However, the absolute risks of such adverse event after CoronaVac and BNT162b2 vaccinations were very low. In locations where COVID-19 is prevalent, the protective effects on COVID-19 from vaccinations will greatly outweigh the potential side effects of vaccination. Funding The project was funded by Research Grant from the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region (Ref. No.COVID19F01). FTTL (Francisco Tsz Tsun Lai) and ICKW (Ian Chi Kei Wong)'s posts were partly funded by D24H; hence this work was partly supported by AIR@InnoHK administered by Innovation and Technology Commission.
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537
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Chu CW, Jiesisibieke ZL, Yang YP, Wu PC, Lin HL, Tung TH. Association of COVID-19 vaccination with herpes zoster: a systematic review and meta-analysis. Expert Rev Vaccines 2022; 21:601-608. [PMID: 35112938 DOI: 10.1080/14760584.2022.2036128] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Following COVID-19 vaccination, several herpes zoster cases have been reported, making it critical to explore the association between herpes zoster and COVID-19 vaccination. This is especially true in the context of increasing the number of participants enrolled to receive COVID-19 vaccination. RESEARCH DESIGN AND METHODS Three databases, including the Cochrane Library, PubMed, and EMBASE, were searched for relevant studies before December 25, 2021, according to preliminarily determined inclusion and exclusion criteria without any language limitations. Four cohort studies were included in this systematic review and meta-analysis. RESULTS Compared with the placebo group, there was no evidence that the COVID-19 vaccination group was associated with increased incidence of herpes zoster (Risk ratio [RR]: 1.06; 95% confidence interval [CI]: 0.91 to 1.24). There is no evidence that the COVID-19 vaccination from Moderna is associated with the incidence of herpes zoster compared with vaccination from Pfizer (RR: 0.20; 95% CI: 0.01 to 2.99). CONCLUSIONS To date, there is no evidence of an association between covid-19 vaccination and herpes zoster.
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Affiliation(s)
- Chia-Wei Chu
- School of Pharmacy, College of Pharmacy, Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Yu-Pei Yang
- Department of Hematology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, China
| | - Pao-Chu Wu
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hong-Liang Lin
- School of Pharmacy, College of Pharmacy, Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang 317000, China
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538
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Pecetta S, Kratochvil S, Kato Y, Vadivelu K, Rappuoli R. Immunology and Technology of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccines. Pharmacol Rev 2022; 74:313-339. [PMID: 35101964 DOI: 10.1124/pharmrev.120.000285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
We have experienced an enormous cohesive effort of the scientific community to understand how the immune system reacts to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and how to elicit protective immunity via vaccination. This effort resulted in the development of vaccines in record time with high levels of safety, efficacy, and real-life effectiveness. However, the rapid diffusion of viral variants that escape protective antibodies prompted new studies to understand SARS-CoV-2 vulnerabilities and strategies to guide follow-up actions to increase, and maintain, the protection offered by vaccines. In this review, we report the main findings on human immunity to SARS-CoV-2 after natural infection and vaccination; we dissect the immunogenicity and efficacy of the different vaccination strategies that resulted in products widely used in the population; and we describe the impact of viral variants on vaccine-elicited immunity, summarizing the main discoveries and challenges to stay ahead of SARS-CoV-2 evolution. SIGNIFICANCE STATEMENT: This study reviewed findings on human immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), analyzed the immunogenicity and efficacy of the various vaccines currently used in large vaccination campaigns or candidates in advanced clinical development, and discussed the challenging task to ensure high protective efficacy against the rapidly evolving SARS-CoV-2 virus. This manuscript was completed prior to the emergence of the Omicron variant and to global vaccine boosting efforts.
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Affiliation(s)
- Simone Pecetta
- Research and Development Centre, GSK, Siena, Italy (S.P., K.V., R.R.); Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, Massachusetts (S.K.); IconOVir Bio, San Diego, California (Y.K.); and La Jolla Institute for Immunology, La Jolla, California (Y.K.)
| | - Sven Kratochvil
- Research and Development Centre, GSK, Siena, Italy (S.P., K.V., R.R.); Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, Massachusetts (S.K.); IconOVir Bio, San Diego, California (Y.K.); and La Jolla Institute for Immunology, La Jolla, California (Y.K.)
| | - Yu Kato
- Research and Development Centre, GSK, Siena, Italy (S.P., K.V., R.R.); Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, Massachusetts (S.K.); IconOVir Bio, San Diego, California (Y.K.); and La Jolla Institute for Immunology, La Jolla, California (Y.K.)
| | - Kumaran Vadivelu
- Research and Development Centre, GSK, Siena, Italy (S.P., K.V., R.R.); Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, Massachusetts (S.K.); IconOVir Bio, San Diego, California (Y.K.); and La Jolla Institute for Immunology, La Jolla, California (Y.K.)
| | - Rino Rappuoli
- Research and Development Centre, GSK, Siena, Italy (S.P., K.V., R.R.); Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology, and Harvard University, Cambridge, Massachusetts (S.K.); IconOVir Bio, San Diego, California (Y.K.); and La Jolla Institute for Immunology, La Jolla, California (Y.K.)
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539
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Sano M, Murai R, Kim K, Furukawa Y. Cardiac magnetic resonance findings in acute myocarditis after mRNA COVID-19 vaccination. J Cardiol Cases 2022; 26:17-20. [PMID: 35169401 PMCID: PMC8831126 DOI: 10.1016/j.jccase.2022.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/14/2022] [Accepted: 01/21/2022] [Indexed: 01/08/2023] Open
Abstract
There is increasing evidence for myocarditis as a complication of the mRNA coronavirus disease 2019 (COVID-19) vaccination. We report the case of a 20-year-old previously healthy man who presented with fever and chest pain 2 days after the second dose of mRNA-1273 vaccine. Electrocardiogram and laboratory studies showed extensive ST-segment elevation accompanied by elevated cardiac biomarkers. Cardiac magnetic resonance (CMR) revealed late gadolinium enhancement (LGE) characteristics of myocarditis. The patient rapidly improved with conservative management and was discharged on hospital day 6. As an advantage over previous reports, we performed a 1-month follow-up CMR. It showed improvement in myocardial edema but persistence of LGE which may indicate irreversible fibrosis. CMR may be useful not only for diagnosis but also for prognostic evaluation of myocarditis after COVID-19 mRNA vaccination. <Learning objective: With the expansion of coronavirus disease 2019 (COVID-19) vaccine administration, the number of cases of myocarditis as a complication has been increasing. Cardiac magnetic resonance imaging can be useful for the diagnosis and follow-up of patients with myocarditis after mRNA COVID-19 vaccination. Persistent late gadolinium enhancement may indicate irreversible myocardial fibrosis, and it is also associated with poor prognosis, similar to previously reported cases of other acute myocarditis.>
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540
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Interstitial lung disease after receiving the mRNA-based COVID-19 vaccine tozinameran. Respir Med Case Rep 2022; 36:101618. [PMID: 35223425 PMCID: PMC8858430 DOI: 10.1016/j.rmcr.2022.101618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/03/2022] Open
Abstract
Tozinameran, a messenger ribonucleic acid (mRNA)-based coronavirus disease 19 (COVID-19) vaccine, has a favorable safety profile and is highly efficacious in preventing COVID-19. Adverse reactions such as pain at the vaccination site, fever, malaise, headache, rash, and anaphylaxis have been commonly reported for mRNA-based COVID-19 vaccines. We report a case involving a 71-year-old Japanese woman who developed interstitial lung disease (ILD) after receiving an mRNA-based COVID-19 vaccine. We also review case reports of COVID-19 mRNA vaccine-associated ILD. Dyspnea or hypoxia that develops within 1–3 days after COVID-19 mRNA vaccination should be differentiated from ILD. Further studies to elucidate mechanisms and risk factors of rare adverse reactions such as ILD are warranted.
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541
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Bellos I, Karageorgiou V, Viskin D. Myocarditis following mRNA Covid-19 vaccination: a pooled analysis. Vaccine 2022; 40:1768-1774. [PMID: 35153093 PMCID: PMC8818354 DOI: 10.1016/j.vaccine.2022.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/22/2022] [Accepted: 02/02/2022] [Indexed: 12/15/2022]
Abstract
Background Methods Results Conclusions
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542
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First Presentation of Systemic Lupus Erythematosus in a 24-Year-Old Male following mRNA COVID-19 Vaccine. Case Rep Rheumatol 2022; 2022:9698138. [PMID: 35154842 PMCID: PMC8825270 DOI: 10.1155/2022/9698138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 01/08/2022] [Indexed: 01/11/2023] Open
Abstract
The SARS-CoV-2 viral pandemic has had an immeasurable global impact, resulting in over 5 million deaths worldwide. Numerous vaccines were developed in an attempt to quell viral dissemination and reduce symptom severity among those infected. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of antinuclear autoantibodies (ANAs) with heterogenic clinical manifestations, secondary to immune complex deposition in a multitude of organ systems. There are scarcely reported cases of SLE development following COVID-19 mRNA vaccination. We present a case of a 24-year-old male without preexisting conditions or family history of autoimmune disorders, presenting with SLE following the first dose of the SARS-CoV-2 Pfizer-BioNTech mRNA vaccine.
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543
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Andrews NJ, Stowe J, Ramsay MEB, Miller E. Risk of venous thrombotic events and thrombocytopenia in sequential time periods after ChAdOx1 and BNT162b2 COVID-19 vaccines: A national cohort study in England. THE LANCET REGIONAL HEALTH. EUROPE 2022; 13:100260. [PMID: 34927118 PMCID: PMC8668159 DOI: 10.1016/j.lanepe.2021.100260] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Thrombosis with thrombocytopenia, or thrombocytopenia on its own, have been reported after Covid-19 vaccines. We assessed the risk after ChAdOx1 adenovirus-vector and BNT162b2 mRNA vaccines in a national cohort study in England. METHODS Hospital admissions for a cerebral venous thrombosis (CVT), other venous thrombosis or thrombocytopenia between 30th November 2020 and 18th April 2021 were linked to the national Covid-19 immunisation register. The incidence of events by dose in pre-defined post-vaccination risk periods relative to the unvaccinated cohort was estimated after adjustment for age, gender, co-morbidities, care home residency and health/social care worker status. Elevated relative incidence (RI) estimates with p<0.001 were considered strong evidence of an association. FINDINGS The RI for CVT after a first ChAdOx1 dose in 15-39 and 40-64 year olds was 8.7 (95% confidence interval 5.8-13.0) and 2.2 (1.4-3.2) respectively, p<0.001. The elevated risk period in 15-39 year olds was highest 4-13 days post-vaccination (16.3, 9.9-27.0). The attributable risk (AR) was 16.1 per million doses for 15-39 and 3.2 per million for 40-64 year olds. RIs for other thrombosis admissions were elevated in these age groups with ARs of 36.3 and 16.4 per million respectively as were RIs for thrombocytopenia, with ARs of 11.3 and 10.1 per million respectively. No elevated RIs were found for 65+ year olds or after a second ChAdOx1 dose, nor for BNT162b2 vaccine recipients of any age. INTERPRETATION This epidemiological study shows an increased risk of thrombotic episodes and thrombocytopenia in adults under 65 years of age within a month of a first dose of ChAdOx1 vaccine but not after the BNT162b2 vaccine. FUNDING EM receives support from the National Institute for Health Research (NIHR) Health Protection Research Unit in Immunisation at the London School of Hygiene and Tropical Medicine in partnership with Public Health England (Grant Reference NIHR200929).
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Affiliation(s)
- Nick J Andrews
- Immunisation and Countermeasures Division, UK Health Security Agency, 61 Colindale Avenue London NW9 5EQ, UK
| | - Julia Stowe
- Immunisation and Countermeasures Division, UK Health Security Agency, 61 Colindale Avenue London NW9 5EQ, UK
| | - Mary EB Ramsay
- Immunisation and Countermeasures Division, UK Health Security Agency, 61 Colindale Avenue London NW9 5EQ, UK
| | - Elizabeth Miller
- Immunisation and Countermeasures Division, UK Health Security Agency, 61 Colindale Avenue London NW9 5EQ, UK
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
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544
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Kerr C, O’Neill S, Szucs A, Darmody O, Williamson C, Bannan C, Merry C. Zoster meningitis in an immunocompetent young patient post first dose of BNT162b2 mRNA COVID-19 vaccine, a Case Report. IDCases 2022; 27:e01452. [PMID: 35186672 PMCID: PMC8837498 DOI: 10.1016/j.idcr.2022.e01452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/08/2022] [Accepted: 02/11/2022] [Indexed: 12/30/2022] Open
Abstract
Recently published observational data suggests an increased risk of herpes zoster infection post-vaccination with the BNT162b2 mRNA vaccine. We describe the case of VZV meningitis post BNT162b2 mRNA vaccination in a young immunocompetent patient. A 39-year-old patient with no medical history presented with a vesicular rash, headache, nausea and fever, days after receiving BNT162b2 mRNA vaccination. CSF analysis revealed a pleocytosis, and VZV DNA was confirmed by PCR testing. The patient received intravenous aciclovir with resolution of symptoms within 48 h. He was discharged after 14 days of treatment. Case reports of herpes zoster reactivation post vaccination and details of subsequent successful vaccination course completion have allowed us to recommend the patient receive his second dose of the BNT162b2 mRNA vaccine. At the time of writing, however, the patient has declined to receive further vaccination due to fears of an adverse event. To the best of our knowledge, this is the first reported case in a young patient of herpes zoster meningitis following COVID-19 mRNA vaccination. The sharing of clinical experiences and reporting of suspected side effects, particularly for vaccines that employ novel technology, increases knowledge of the safety profile of these vaccines and allows clinicians to better aid patients make informed decisions with regard to commencing and completing vaccination.
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545
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Patone M, Mei XW, Handunnetthi L, Dixon S, Zaccardi F, Shankar-Hari M, Watkinson P, Khunti K, Harnden A, Coupland CAC, Channon KM, Mills NL, Sheikh A, Hippisley-Cox J. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection. Nat Med 2022; 28:410-422. [PMID: 34907393 PMCID: PMC8863574 DOI: 10.1038/s41591-021-01630-0] [Citation(s) in RCA: 332] [Impact Index Per Article: 166.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/15/2021] [Indexed: 12/12/2022]
Abstract
Although myocarditis and pericarditis were not observed as adverse events in coronavirus disease 2019 (COVID-19) vaccine trials, there have been numerous reports of suspected cases following vaccination in the general population. We undertook a self-controlled case series study of people aged 16 or older vaccinated for COVID-19 in England between 1 December 2020 and 24 August 2021 to investigate hospital admission or death from myocarditis, pericarditis and cardiac arrhythmias in the 1-28 days following adenovirus (ChAdOx1, n = 20,615,911) or messenger RNA-based (BNT162b2, n = 16,993,389; mRNA-1273, n = 1,006,191) vaccines or a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (n = 3,028,867). We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1-28 days postvaccination period, and after a SARS-CoV-2 positive test. We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test. We also observed increased risks of pericarditis and cardiac arrhythmias following a positive SARS-CoV-2 test. Similar associations were not observed with any of the COVID-19 vaccines, apart from an increased risk of arrhythmia following a second dose of mRNA-1273. Subgroup analyses by age showed the increased risk of myocarditis associated with the two mRNA vaccines was present only in those younger than 40.
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Affiliation(s)
- Martina Patone
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Xue W Mei
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | | | - Sharon Dixon
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Francesco Zaccardi
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Manu Shankar-Hari
- Usher Institute, University of Edinburgh, Edinburgh, UK
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
- School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Peter Watkinson
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- NIHR Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Kamlesh Khunti
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Anthony Harnden
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
| | - Carol A C Coupland
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
- Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK
| | - Keith M Channon
- British Heart Foundation Centre of Research Excellence, NIHR Oxford Biomedical Research Centre, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Nicholas L Mills
- Usher Institute, University of Edinburgh, Edinburgh, UK
- BHF/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Julia Hippisley-Cox
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK.
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546
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Fiolet T, Kherabi Y, MacDonald CJ, Ghosn J, Peiffer-Smadja N. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review. Clin Microbiol Infect 2022; 28:202-221. [PMID: 34715347 PMCID: PMC8548286 DOI: 10.1016/j.cmi.2021.10.005] [Citation(s) in RCA: 501] [Impact Index Per Article: 250.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/07/2021] [Accepted: 10/16/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Vaccines are critical cost-effective tools to control the coronavirus disease 2019 (COVID-19) pandemic. However, the emergence of variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may threaten the global impact of mass vaccination campaigns. AIMS The objective of this study was to provide an up-to-date comparative analysis of the characteristics, adverse events, efficacy, effectiveness and impact of the variants of concern for 19 COVID-19 vaccines. SOURCES References for this review were identified through searches of PubMed, Google Scholar, BioRxiv, MedRxiv, regulatory drug agencies and pharmaceutical companies' websites up to 22nd September 2021. CONTENT Overall, all COVID-19 vaccines had a high efficacy against the original strain and the variants of concern, and were well tolerated. BNT162b2, mRNA-1273 and Sputnik V after two doses had the highest efficacy (>90%) in preventing symptomatic cases in phase III trials. mRNA vaccines, AZD1222, and CoronaVac were effective in preventing symptomatic COVID-19 and severe infections against Alpha, Beta, Gamma or Delta variants. Regarding observational real-life data, full immunization with mRNA vaccines and AZD1222 seems to effectively prevent SARS-CoV-2 infection against the original strain and Alpha and Beta variants but with reduced effectiveness against the Delta strain. A decline in infection protection was observed at 6 months for BNT162b2 and AZD1222. Serious adverse event rates were rare for mRNA vaccines-anaphylaxis 2.5-4.7 cases per million doses, myocarditis 3.5 cases per million doses-and were similarly rare for all other vaccines. Prices for the different vaccines varied from $2.15 to $29.75 per dose. IMPLICATIONS All vaccines appear to be safe and effective tools to prevent severe COVID-19, hospitalization, and death against all variants of concern, but the quality of evidence greatly varies depending on the vaccines considered. Questions remain regarding a booster dose and waning immunity, the duration of immunity, and heterologous vaccination. The benefits of COVID-19 vaccination outweigh the risks, despite rare serious adverse effects.
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Affiliation(s)
- Thibault Fiolet
- Paris-Saclay University, UVSQ, INSERM, Gustave Roussy, ‘Exposome and Heredity’ team, CESP UMR1018, Villejuif, France,Corresponding author. Thibault Fiolet
| | - Yousra Kherabi
- Université de Paris, IAME, INSERM, Paris, France,Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Conor-James MacDonald
- Paris-Saclay University, UVSQ, INSERM, Gustave Roussy, ‘Exposome and Heredity’ team, CESP UMR1018, Villejuif, France
| | - Jade Ghosn
- Université de Paris, IAME, INSERM, Paris, France,Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Nathan Peiffer-Smadja
- Université de Paris, IAME, INSERM, Paris, France,Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, AP-HP, Paris, France,National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London, UK
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547
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Catella J, Joly M, Pernod G. Is pulmonary embolism occurring after SARS COV-2 vaccination provoked or unprovoked? Thromb Res 2022; 213:8. [PMID: 35276508 PMCID: PMC8864059 DOI: 10.1016/j.thromres.2022.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Judith Catella
- Department of Vascular Medicine, Lyon University Hospital, Lyon, France
| | - Marion Joly
- Department of Vascular Medicine, Grenoble University Hospital, Grenoble, France
| | - Gilles Pernod
- Department of Vascular Medicine, Grenoble University Hospital, Grenoble, France; Grenoble Alpes University, Grenoble, France.
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548
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Hiroi Y, Ohtsu H, Uemura Y, Hayakawa K, Asai Y, Kutsuna S, Terada M, Sugiura W, Ohmagari N. Cardiovascular Complications of Hospitalized Patients With Coronavirus Disease 2019 in a Japanese Registry in 2020. Circ J 2022; 86:464-471. [DOI: 10.1253/circj.cj-21-0687] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Yukio Hiroi
- Department of Cardiology, National Center for Global Health and Medicine
| | - Hiroshi Ohtsu
- Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Yukari Uemura
- Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Yusuke Asai
- AMR Clinical Reference Center, National Center for Global Health and Medicine
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Mari Terada
- Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine
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549
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Sexson Tejtel SK, Munoz FM, Al-Ammouri I, Savorgnan F, Guggilla RK, Khuri-Bulos N, Phillips L, Engler RJM. Myocarditis and pericarditis: Case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2022; 40:1499-1511. [PMID: 35105494 DOI: 10.1016/j.vaccine.2021.11.074] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/24/2021] [Indexed: 02/07/2023]
Abstract
Myocarditis and/or pericarditis (also known as myopericarditis) are inflammatory diseases involving the myocardium (with non-ischemic myocyte necrosis) and/or the pericardial sac. Myocarditis/pericarditis (MPC) may present with variable clinical signs, symptoms, etiologies and outcomes, including acute heart failure, sudden death, and chronic dilated cardiomyopathy. Possible undiagnosed and/or subclinical acute myocarditis, with undefined potential for delayed manifestations, presents further challenges for diagnosing an acute disease and may go undetected in the setting of infection as well as adverse drug/vaccine reactions. The most common causes of MPC are viral, with non-infectious, drug/vaccine associated hypersensitivity and/or autoimmune causes being less well defined and with potentially different inflammatory mechanisms and treatment responses. Potential cardiac adverse events following immunization (AEFIs) encompass a larger scope of diagnoses such as triggering or exacerbating ischemic cardiac events, cardiomyopathy with potential heart failure, arrhythmias and sudden death. The current published experience does not support a potential causal association with vaccines based on epidemiologic evidence of relative risk increases compared with background unvaccinated incidence. The only evidence supporting a possible causal association of MPC with a vaccine comes from case reports. Hypersensitivity MPC as a drug/vaccine induced cardiac adverse event has long been a concern for post-licensure safety surveillance, as well as safety data submission for licensure. Other cardiac adverse events, such as dilated cardiomyopathy, were also defined in the CDC definitions for adverse events after smallpox vaccination in 2006. In addition, several groups have attempted to develop and improve the definition and adjudication of post-vaccination cardiovascular events. We developed the current case definitions for myocarditis and pericarditis as an AEFI building on experience and lessons learnt, as well as a comprehensive literature review. Considerations of other etiologies and causal relationships are outside the scope of this document.
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Affiliation(s)
| | - Flor M Munoz
- Departments of Pediatrics, Section of Infectious Diseases, and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Iyad Al-Ammouri
- Pediatric Cardiology, The University of Jordan. Amman, Jordan
| | - Fabio Savorgnan
- Department of Pediatrics, Section of Pediatric Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Rama K Guggilla
- Department of Population Medicine and Lifestyle Diseases Prevention, Faculty of Medicine with the Division of Dentistry and Division of Medical Education in English, Medical University of Bialystok, Poland
| | - Najwa Khuri-Bulos
- Pediatric Infectious Diseases, Vaccines, The University of Jordan, Amman, Jordan
| | - Lee Phillips
- Pharmaco-epidemiology, Cardiovascular Drug Safety, USA
| | - Renata J M Engler
- Allergy-Immunology-Immunizations, Department of Medicine, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, and Immunization Healthcare Division, Defense Health Agency, Bethesda, MD, USA
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550
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Ursini F, Ruscitti P, Raimondo V, De Angelis R, Cacciapaglia F, Pigatto E, Olivo D, Di Cola I, Galluccio F, Francioso F, Foti R, Tavoni AG, D’Angelo S, Campochiaro C, Motta F, De Santis M, Bilia S, Bruno C, De Luca G, Visentini M, Ciaffi J, Mancarella L, Brusi V, D’Onghia M, Cuomo G, Fusaro E, Cipriani P, Dagna L, Guiducci S, Meliconi R, Iannone F, Iagnocco A, Giacomelli R, Ferri C. Systemic syndromes of rheumatological interest with onset after COVID-19 vaccine administration: a report of 30 cases. Clin Rheumatol 2022; 41:2261-2267. [PMID: 35091783 PMCID: PMC8799447 DOI: 10.1007/s10067-022-06078-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Francesco Ursini
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Piero Ruscitti
- Department of Biotechnological and Applied Clinical Sciences, Rheumatology Unit, Università degli studi Dell’Aquila, L’Aquila, Italy
| | - Vincenzo Raimondo
- Rheumatology Unit, Rheumatology Hospital “Madonna Dello Scoglio,” Traversa Mola, 88836 Cotronei, KR Italy
| | - Rossella De Angelis
- Rheumatology Clinic, Università Politecnica Delle Marche, Ospedale “Carlo Urbani”, Jesi, Italy
| | - Fabio Cacciapaglia
- Department of Emergence Medicine and Transplantation (DETO), Rheumatology Unit, University of Bari Aldo Moro, Bari, Italy
| | - Erika Pigatto
- Rheumatology Outpatient Clinic, Ospedale Villa Salus, Mestre, Italy
| | - Domenico Olivo
- Rheumatology Outpatient Clinic, San Giovanni di Dio Hospital, Crotone, Italy
| | - Ilenia Di Cola
- Department of Biotechnological and Applied Clinical Sciences, Rheumatology Unit, Università degli studi Dell’Aquila, L’Aquila, Italy
| | - Felice Galluccio
- Department of Rheumatology, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - Francesca Francioso
- Rheumatology Clinic, Università Politecnica Delle Marche, Ospedale “Carlo Urbani”, Jesi, Italy
| | - Rosario Foti
- Rheumatology Unit, A.O.U. Policlinico S. Marco - University of Catania, Catania, Italy
| | | | - Salvatore D’Angelo
- Rheumatology Institute of Lucania (IReL)-Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna Delle Grazie Hospital of Matera, Potenza, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele & Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Motta
- Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Maria De Santis
- Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Silvia Bilia
- Department of Clinical Immunology, University of Pisa, Pisa, Italy
| | - Caterina Bruno
- Rheumatology Outpatient Clinic, Azienda Ospedaliera “Pugliese-Ciaccio”, Catanzaro, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele & Vita-Salute San Raffaele University, Milan, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Jacopo Ciaffi
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luana Mancarella
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Veronica Brusi
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Martina D’Onghia
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giovanna Cuomo
- Clinical Immunology Outpatient Clinic, Department of Medicine, “Luigi Vanvitelli” University of Campania, Napoli, Italy
| | - Enrico Fusaro
- Rheumatology Unit, Azienda Ospedaliero Universitaria Città Della Salute E Della Scienza Di Torino, Torino, Italy
| | - Paola Cipriani
- Department of Biotechnological and Applied Clinical Sciences, Rheumatology Unit, Università degli studi Dell’Aquila, L’Aquila, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele & Vita-Salute San Raffaele University, Milan, Italy
| | - Serena Guiducci
- Department of Rheumatology, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - Riccardo Meliconi
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Florenzo Iannone
- Department of Emergence Medicine and Transplantation (DETO), Rheumatology Unit, University of Bari Aldo Moro, Bari, Italy
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, MFRU, Dipartimento Scienze Cliniche E Biologiche, Università Degli Studi Di Torino, Torino, Italy
| | - Roberto Giacomelli
- Unit of Allergology, Immunology, Rheumatology, Università Campus Bio-Medico Di Roma, Roma, Italy
| | - Clodoveo Ferri
- Rheumatology Unit, Rheumatology Hospital “Madonna Dello Scoglio,” Traversa Mola, 88836 Cotronei, KR Italy
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
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