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Teh HL, Keowmani T, Tang MM. Risk Factors Associated with Cutaneous Reactions Following COVID-19 Vaccine Immunisation: A Registry-Based Case-Control Study. Malays J Med Sci 2024; 31:133-148. [PMID: 38984235 PMCID: PMC11229573 DOI: 10.21315/mjms2024.31.3.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/24/2023] [Indexed: 07/11/2024] Open
Abstract
Background In Malaysia, following extensive COVID-19 vaccination, Hospital Kuala Lumpur reported an increase in cutaneous reactions post-immunisation. To understand this, a case-control study was initiated to identify potential risk factors. Methods This registry-based, unmatched case-control study encompasses all adverse event following immunisation (AEFI) reports associated with COVID-19 vaccines, received by the Department of Pharmacy at Hospital Kuala Lumpur through the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) AEFI reporting forms. Twenty-four potential risk factors were evaluated, including demographic information, medical history, food allergies, COVID-19 vaccination history and prior SARS-CoV-2 infection, were evaluated using MADRAC AEFI reporting forms. Odds ratio (OR) with 95% confidence interval (CI) were estimated using univariable and multivariable logistic regression. Results Cutaneous reactions were more frequent in middle-aged females, especially after the first COVID-19 vaccine dose. These reactions, primarily mild and generalised, included pruritus and urticaria. Notably, 52% were delayed reactions (more than 4 h post-vaccination). Factors associated with increased risk of cutaneous reaction following COVID-19 immunisation included history of seafood and shellfish allergy (adjusted odds ratio [adjOR]: 2.11; 95% CI: 1.12, 3.96; P = 0.020), history of vaccine allergy (adjOR: 4.07; 95% CI: 1.44, 11.54; P = 0.008), past dermatological diseases (adjOR: 5.48; 95% CI: 2.03, 14.78; P = 0.001), and past medication allergy (adjOR: 2.12; 95% CI: 1.36, 3.31; P = 0.001). Conclusion Self-reported histories of allergies to vaccines, foods or medications were found to increase the likelihood of cutaneous reactions following COVID-19 vaccination. These reactions, which were predominantly mild, did not hinder the administration of the second vaccine dose. The majority of reactions occurred after the first dose, manifesting as generalised pruritus and urticaria. They were effectively managed with oral antihistamines and low-dose corticosteroids, thereby avoiding the need for hospitalisation.
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Affiliation(s)
- Hwei Lin Teh
- Pharmacy Department, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Thamron Keowmani
- Pharmacy Department, Hospital Wanita dan Kanak-Kanak, Sabah, Malaysia
| | - Min Moon Tang
- Department of Dermatology, Sarawak General Hospital, Sarawak, Malaysia
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AlRawi HZ, AlQurashi A, AlDahan D, Alkhudhayri M, Alsharidah AR, Wani T, AlJaroudi D. Association between receiving Covid-19 vaccine and menstrual cycle patterns among childbearing women: A cross-sectional study. Health Sci Rep 2024; 7:e1934. [PMID: 38736480 PMCID: PMC11082084 DOI: 10.1002/hsr2.1934] [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: 06/05/2023] [Revised: 01/09/2024] [Accepted: 02/01/2024] [Indexed: 05/14/2024] Open
Abstract
Background and Aims Many women reported experiencing abnormalities in their cycle after being vaccinated with Covid-19 vaccination. To understand this issue further, our study aimed to evaluate the menstrual cycle patterns among women of childbearing age after receiving COVID-19 vaccinations. Methods A cross-sectional study was conducted to investigate the impact of COVID-19 vaccine on women aged 18 years and above in Saudi Arabia. A self-administered online questionnaire was distributed among participants who had received at least one dose of COVID-19 vaccine. The questionnaire included questions about the participants' demographic characteristics, medical history, and vaccine-related adverse events. Results The study included 383 female participants with an average age of 30.8 ± 8.1 years. The majority of participants, 92.7%, were Saudi, and more than half, 51.4%, were single. Of the participants, 78.9% were disease-free, and a majority of 67.9% had no history of Coronavirus Disease 2019 infection. A significant proportion of participants reported postvaccination changes in the menstrual cycle. Specifically, 43.1% reported changes after the first dose, and 38.4% reported changes after the second dose (p = 0.044). The severity of premenstrual symptoms increased from 44 (11.5%) to 113 (29.5%) after the first dose. Reported pain on the (WONG-BAKER) scale was also significantly elevated from 34 (8.9%) to 87 (22.7%) (p < 0.001) after the first dose. Conclusion A relatively high prevalence of menstrual cycle irregularities was reported by Saudi vaccinated women, particularly young adults. These findings suggest the need to further research and explore the underlying causes of these irregularities and develop interventions that may help mitigate their impact on women's health. It is also recommended that women who observe long-term changes in their menstrual cycles seek follow-up and consultation with healthcare providers to ensure that any potential health concerns are addressed promptly.
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Affiliation(s)
- Halah Z. AlRawi
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | - Alaa AlQurashi
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | - Doaa AlDahan
- Clinical Trials RegistrySaudi National Institution of Health (SNIH)RiyadhSaudi Arabia
| | - Maha Alkhudhayri
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | | | - Tariq Wani
- Research Center, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
| | - Dania AlJaroudi
- Reproductive Endocrine and Infertility Medicine Department, King Fahad Medical CityRiyadh Second Health ClusterRiyadhSaudi Arabia
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Bhullar SK, Dhalla NS. Adaptive and maladaptive roles of different angiotensin receptors in the development of cardiac hypertrophy and heart failure. Can J Physiol Pharmacol 2024; 102:86-104. [PMID: 37748204 DOI: 10.1139/cjpp-2023-0226] [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] [Indexed: 09/27/2023]
Abstract
Angiotensin II (Ang II) is formed by the action of angiotensin-converting enzyme (ACE) in the renin-angiotensin system. This hormone is known to induce cardiac hypertrophy and heart failure and its actions are mediated by the interaction of both pro- and antihypertrophic Ang II receptors (AT1R and AT2R). Ang II is also metabolized by ACE 2 to Ang-(1-7), which elicits the activation of Mas receptors (MasR) for inducing antihypertrophic actions. Since heart failure under different pathophysiological situations is preceded by adaptive and maladaptive cardiac hypertrophy, we have reviewed the existing literature to gain some information regarding the roles of AT1R, AT2R, and MasR in both acute and chronic conditions of cardiac hypertrophy. It appears that the activation of AT1R may be involved in the development of adaptive and maladaptive cardiac hypertrophy as well as subsequent heart failure because both ACE inhibitors and AT1R antagonists exert beneficial effects. On the other hand, the activation of both AT2R and MasR may prevent the occurrence of maladaptive cardiac hypertrophy and delay the progression of heart failure, and thus therapy with different activators of these antihypertrophic receptors under chronic pathological stages may prove beneficial. Accordingly, it is suggested that a great deal of effort should be made to develop appropriate activators of both AT2R and MasR for the treatment of heart failure subjects.
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Affiliation(s)
- Sukhwinder K Bhullar
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre and Department of Physiology and Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Naranjan S Dhalla
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre and Department of Physiology and Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
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Lott N, Gebhard CE, Bengs S, Haider A, Kuster GM, Regitz-Zagrosek V, Gebhard C. Sex hormones in SARS-CoV-2 susceptibility: key players or confounders? Nat Rev Endocrinol 2023; 19:217-231. [PMID: 36494595 PMCID: PMC9734735 DOI: 10.1038/s41574-022-00780-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 12/14/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a clear sex disparity in clinical outcomes. Hence, the interaction between sex hormones, virus entry receptors and immune responses has attracted major interest as a target for the prevention and treatment of SARS-CoV-2 infections. This Review summarizes the current understanding of the roles of androgens, oestrogens and progesterone in the regulation of virus entry receptors and disease progression of coronavirus disease 2019 (COVID-19) as well as their therapeutic value. Although many experimental and clinical studies have analysed potential mechanisms by which female sex hormones might provide protection against SARS-CoV-2 infectivity, there is currently no clear evidence for a sex-specific expression of virus entry receptors. In addition, reports describing an influence of oestrogen, progesterone and androgens on the course of COVID-19 vary widely. Current data also do not support the administration of oestradiol in COVID-19. The conflicting evidence and lack of consensus results from a paucity of mechanistic studies and clinical trials reporting sex-disaggregated data. Further, the influence of variables beyond biological factors (sex), such as sociocultural factors (gender), on COVID-19 manifestations has not been investigated. Future research will have to fill this knowledge gap as the influence of sex and gender on COVID-19 will be essential to understanding and managing the long-term consequences of this pandemic.
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Affiliation(s)
- Nicola Lott
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | | | - Susan Bengs
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland
| | - Ahmed Haider
- Division of Nuclear Medicine and Molecular Imaging, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Gabriela M Kuster
- Department of Cardiology and Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland
| | - Vera Regitz-Zagrosek
- Charité, Universitätsmedizin Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Berlin, Berlin, Germany
| | - Catherine Gebhard
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
- Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.
- Department of Cardiology, Inselspital Bern University Hospital, Bern, Switzerland.
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Costa AJ, Lemes RMR, Bartolomeo CS, Nunes TA, Pereira GC, Oliveira RB, Gomes AL, Smaili SS, Maciel RMDB, Newson L, Ramirez AL, Okuda LH, Prado CM, Stilhano RS, Ureshino RP. Overexpression of estrogen receptor GPER1 and G1 treatment reduces SARS-CoV-2 infection in BEAS-2B bronchial cells. Mol Cell Endocrinol 2022; 558:111775. [PMID: 36096380 PMCID: PMC9458763 DOI: 10.1016/j.mce.2022.111775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 12/15/2022]
Abstract
Gender-bias in COVID-19 severity has been suggested by clinical data. Experimental data in cell and animal models have demonstrated the role of sex hormones, particularly estrogens, in viral infections such as in COVID-19. SARS-CoV-2 uses ACE2 as a receptor to recognize host cells, and the protease TMPRSS2 for priming the Spike protein, facilitating virus entry into cells. However, the involvement of estrogenic receptors in SARS-CoV-2 infection are still being explored. Thus, in order to investigate the role of estrogen and its receptors in COVID-19, the estrogen receptors ERα, ERβ and GPER1 were overexpressed in bronchial BEAS-2B cell, and then infected with SARS-CoV-2. Interestingly, the levels of ACE2 and TMPRSS2 mRNA were higher in SARS-CoV-2-infected cells, but no difference was observed in cells with estrogen receptors overexpression. GPER1 can be involved in virus infection or replication, since its higher levels reduces SARS-CoV-2 load. On the other hand, pharmacological antagonism of GPER1 enhanced viral load. Those data suggest that GPER1 has an important role in SARS-CoV-2 infection.
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Affiliation(s)
- Angelica Jardim Costa
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Pharmacology, São Paulo, SP, Brazil
| | - Robertha Mariana Rodrigues Lemes
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Department of Biological Sciences, Diadema, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil
| | - Cynthia Silva Bartolomeo
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Departament of Biosciences, Santos, SP, Brazil
| | - Tamires Alves Nunes
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Departament of Biosciences, Santos, SP, Brazil
| | - Gabriela Cruz Pereira
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Biochemistry, São Paulo, SP, Brazil
| | - Rafaela Brito Oliveira
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Department of Biological Sciences, Diadema, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil
| | - Alexandre Lopes Gomes
- Instituto Biológico, Secretaria de Agricultura e Abastecimento, São Paulo, SP, Brazil
| | - Soraya Soubhi Smaili
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Pharmacology, São Paulo, SP, Brazil
| | - Rui Monteiro de Barros Maciel
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Medicine, São Paulo, SP, Brazil
| | - Louise Newson
- Newson Health Research and Education, Stratford-Upon-Avon, UK
| | | | - Liria Hiromi Okuda
- Instituto Biológico, Secretaria de Agricultura e Abastecimento, São Paulo, SP, Brazil
| | - Carla Máximo Prado
- Universidade Federal de São Paulo, Instituto de Saúde e Sociedade, Departament of Biosciences, Santos, SP, Brazil
| | - Roberta Sessa Stilhano
- Department of Physiological Sciences, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Portes Ureshino
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Department of Biological Sciences, Diadema, SP, Brazil; Universidade Federal de São Paulo, Escola Paulista de Medicina, Laboratory of Molecular and Translational Endocrinology, São Paulo, SP, Brazil.
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Sharp GC, Fraser A, Sawyer G, Kountourides G, Easey KE, Ford G, Olszewska Z, Howe LD, Lawlor DA, Alvergne A, Maybin JA. The COVID-19 pandemic and the menstrual cycle: research gaps and opportunities. Int J Epidemiol 2022; 51:691-700. [PMID: 34865021 PMCID: PMC8690231 DOI: 10.1093/ije/dyab239] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/26/2021] [Indexed: 12/26/2022] Open
Affiliation(s)
- Gemma C Sharp
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Abigail Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Gemma Sawyer
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Kayleigh E Easey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Gemma Ford
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Laura D Howe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
| | - Alexandra Alvergne
- School of Anthropology, University of Oxford, Oxford, UK
- Institut des Sciences de l'Évolution, Université de Montpellier, Montpellier, France
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Profili F, Seghieri G, Francesconi P. Effect of diabetes on short-term mortality and incidence of first hospitalizations for cardiovascular events after recovery from SARS-CoV-2 infection. Diabetes Res Clin Pract 2022; 187:109872. [PMID: 35429573 PMCID: PMC9006403 DOI: 10.1016/j.diabres.2022.109872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/06/2022] [Accepted: 04/10/2022] [Indexed: 11/16/2022]
Abstract
AIM To evaluate the impact of diabetes and COVID-19 on all-cause-mortality and first hospitalizations for cardiovascular events (CVE): myocardial infarction or stroke, within six months after being tested positive and having recovered from SARS-CoV-2 infection. METHODS Resident population in Tuscany, Italy of age 45-94 yr without prior hospitalization for CVE, tested positive for SARS-CoV-2 by March 1st, 2020 and afterwards recovering from COVID-19 was compared with age, gender and diabetes matched controls without infection, for incidence rate ratio (IRR) of all-cause-deaths or first CVE at six months follow up. RESULTS 46,152 subjects of whom 4,597 with diabetes, tested positive and recovered from SARS-CoV-2 were compared with 1:1 age, gender and diabetes matched controls without infection. COVID-19 was associated with higher all-cause-mortality: IRR:1.92(95 %CI:1.63-2.25) while diabetes with increased risk of first CVE hospitalizations: IRR:2.24(2.18-4.25). Co-presence of COVID-19 and diabetes didn't add any additional excess risk. Being women and statins' use significantly reduced death risk. CONCLUSIONS After recovery from COVID-19, independently of diabetes, all-cause-mortality risk at six months was twofold increased, while risk of first CVE hospitalization remained unmodified. Diabetes, independently of prior COVID-19, resulted in higher six-months risk of first CVE not of death. Female gender and statins' use reduced both excess risks.
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Qaderi K, Golezar MH, Mardani A, Mallah MA, Moradi B, Kavoussi H, Shamsabadi A, Golezar S. Cutaneous adverse reactions of COVID-19 vaccines: a systematic review. Dermatol Ther 2022; 35:e15391. [PMID: 35194894 PMCID: PMC9111405 DOI: 10.1111/dth.15391] [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: 10/26/2021] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Numerous vaccines are under clinical development and implementation for the prevention of severe course and lethal outcomes of coronavirus disease 2019 (COVID-19). This systematic review aims to summarize and integrated the findings of studies regarding cutaneous side effects of COVID-19 vaccines. METHODS This systematic review conducted by searching the scientific databases of PubMed, Scopus, Science direct, and Web of knowledge from the beginning of the COVID-19 to10/5/2021. Articles were reviewed and analyzed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. RESULTS 17 studies on cutaneous side effects of COVID-19 vaccines were included after the screening of search results based on to the eligibility criteria. The results showed that the most common injection site reactions and delayed large local reactions, arising from all vaccine types, were redness/ erythema (39%), followed by: itchiness (28%), urticarial rash (17%) on the neck, upper limbs, and trunk, morbilliform eruptions (6.5%), Pityriasis rosea (3%), swelling, and burning, etc. Most cutaneous reactions occurred in women (84%), and middle aged people, after the first dose of vaccine, with the onset ranged from 1-21 days after vaccination. In addition, cutaneous reactions were generally self-limiting, and needed little or no therapeutic intervention, that were not regarded as a barrier to injecting a second dose. CONCLUSION In conclusion, severe cutaneous side effects are very rare and approved vaccines have satisfactory safety profiles. Therefore, mild or moderate cutaneous reactions should not discourage people from vaccination. In certain groups such as patients with allergies and a history of local injection reactions, pre-vaccination counseling and assurance, also use of appropriate medications may be helpful. However, more studies are needed to investigate the side effect profile of all COVID-19 vaccines.
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Affiliation(s)
- Kowsar Qaderi
- Midwifery and Reproductive Health Department, Nursing and Midwifery school, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | | | - Abbas Mardani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Manthar Ali Mallah
- College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhongyuan District, Zhengzhou, China
| | - Bagher Moradi
- Department of health information technology, Esfarayen Faculty of Medical Science, Esfarayen, Iran
| | - Hossein Kavoussi
- Dermatology Department, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
| | - Ahmadreza Shamsabadi
- Department of health information technology, Esfarayen Faculty of Medical Science, Esfarayen, Iran
| | - Samira Golezar
- Midwifery and Reproductive Health Department, Nursing and Midwifery school, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
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Aksoyalp ZŞ, Nemutlu-Samur D. Sex-related susceptibility in coronavirus disease 2019 (COVID-19): Proposed mechanisms. Eur J Pharmacol 2021; 912:174548. [PMID: 34606834 PMCID: PMC8486578 DOI: 10.1016/j.ejphar.2021.174548] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/07/2021] [Accepted: 09/29/2021] [Indexed: 12/23/2022]
Abstract
The importance of sex differences is increasingly acknowledged in the incidence and treatment of disease. Accumulating clinical evidence demonstrates that sex differences are noticeable in COVID-19, and the prevalence, severity, and mortality rate of COVID-19 are higher among males than females. Sex-related genetic and hormonal factors and immunological responses may underlie the sex bias in COVID-19 patients. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease/serine subfamily member 2 (TMPRSS2) are essential proteins involved in the cell entry of SARS-CoV-2. Since ACE2 is encoded on the X-chromosome, a double copy of ACE2 in females may compensate for virus-mediated downregulation of ACE2, and thus ACE2-mediated cellular protection is greater in females. The X chromosome also contains the largest immune-related genes leading females to develop more robust immune responses than males. Toll-like receptor-7 (TLR-7), one of the key players in innate immunity, is linked to sex differences in autoimmunity and vaccine efficacy, and its expression is greater in females. Sex steroids also affect immune cell function. Estrogen contributes to higher CD4+ and CD8+ T cell activation levels, and females have more B cells than males. Sex differences not only affect the severity and progression of the disease, but also alter the efficacy of pharmacological treatment and adverse events related to the drugs/vaccines used against COVID-19. Administration of different drugs/vaccines in different doses or intervals may be useful to eliminate sex differences in efficacy and side/adverse effects. It should be noted that studies should include sex-specific analyses to develop further sex-specific treatments for COVID-19.
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Affiliation(s)
- Zinnet Şevval Aksoyalp
- Izmir Katip Celebi University, Faculty of Pharmacy, Department of Pharmacology, 35620, Izmir, Turkey.
| | - Dilara Nemutlu-Samur
- Alanya Alaaddin Keykubat University, Faculty of Medicine, Department of Pharmacology, 07450, Antalya, Turkey.
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Markiewicz-Gospodarek A, Wdowiak P, Czeczelewski M, Forma A, Flieger J, Januszewski J, Radzikowska-Büchner E, Baj J. The Impact of SARS-CoV-2 Infection on Fertility and Female and Male Reproductive Systems. J Clin Med 2021; 10:4520. [PMID: 34640536 PMCID: PMC8509208 DOI: 10.3390/jcm10194520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 12/21/2022] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remains a huge challenge for contemporary healthcare systems. Apart from widely reported acute respiratory distress syndrome (ARDS), the virus affects many other systems inducing a vast number of symptoms such as gastrointestinal, neurological, dermatological, cardiovascular, and many more. Currently it has also been hypothesized that the virus might affect female and male reproductive systems; SARS-CoV-2 infection could also have a role in potential disturbances to human fertility. In this article, we aimed to review the latest literature regarding the potential effects of SARS-CoV-2 infection on female and male reproductive systems as well as fertility, in general.
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Affiliation(s)
| | - Paulina Wdowiak
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (A.M.-G.); (P.W.); (M.C.)
| | - Marcin Czeczelewski
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (A.M.-G.); (P.W.); (M.C.)
| | - Alicja Forma
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Jacek Januszewski
- Department of Plastic, Reconstructive and Maxillary Surgery, Central Clinical Hospital MSWiA, 02-507 Warsaw, Poland; (J.J.); (E.R.-B.)
| | - Elżbieta Radzikowska-Büchner
- Department of Plastic, Reconstructive and Maxillary Surgery, Central Clinical Hospital MSWiA, 02-507 Warsaw, Poland; (J.J.); (E.R.-B.)
| | - Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (A.M.-G.); (P.W.); (M.C.)
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