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Soltani S, Matin BK, Gouya MM, Zahraei SM, Moradi G, Chehri O, Soofi M, Moradinazar M, Shadmani FK, Kalantari M, Khajeha H, Emamian MH, Najafi F. A prospective cohort study protocol: monitoring and surveillance of adverse events following heterologous booster doses of Oxford AstraZeneca COVID-19 vaccine in previous recipients of two doses of Sinopharm or Sputnik V vaccines in Iran. BMC Public Health 2023; 23:1415. [PMID: 37488541 PMCID: PMC10364349 DOI: 10.1186/s12889-023-16265-8] [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: 05/19/2023] [Accepted: 07/08/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Regarding the paucity of evidence on the side effects of the booster dose of Oxford AstraZeneca vaccine in vaccinated people with Sinopharm or Sputnik V, we aimed to set up a cohort event monitoring (CEM) study to capture adverse events occurring in individuals who will receive the booster doses of AstraZeneca (either the first or second booster dose) following being vaccinated with Sinopharm or sputnik V vaccines in Iran. METHODS The present study is an active COVID-19 vaccine safety surveillance through an observational prospective cohort study that will be conducted in vaccination centers in Iran. The study will be conducted in twelve provinces of Iran. Study sites are vaccination centers where the AstraZeneca vaccine is administered to the cohort population. The study population includes all individuals who have received two doses of Sinopharm or Sputnik V vaccines and either the first or second booster dose of AstraZeneca according to the national guidelines for immunization in Iran in 2023. We are planning to include 30,000 eligible people in this study. Each individual will be followed up for 13 weeks after either the first or second booster dose of the AstraZeneca vaccine. Furthermore, convenience sampling is used to include participants in the present study. Participation in the study will be strictly voluntary. DISCUSSION With the planned study we will provide a valid epidemiological evidence to improve the understanding of the safety of the booster dose of the AstraZeneca and to better evaluate the effectiveness of public health interventions. This could help policy makers in managing the COVID-19 pandemic according to scientific evidence.
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Affiliation(s)
- Shahin Soltani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Karami Matin
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Mehdi Gouya
- Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Sayed Mohsen Zahraei
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ghobad Moradi
- Social Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Omid Chehri
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Moslem Soofi
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Khosravi Shadmani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Kalantari
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamidreza Khajeha
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Duijster JW, Lieber T, Pacelli S, Van Balveren L, Ruijs LS, Raethke M, Kant A, Van Hunsel F. Sex-disaggregated outcomes of adverse events after COVID-19 vaccination: A Dutch cohort study and review of the literature. Front Immunol 2023; 14:1078736. [PMID: 36793715 PMCID: PMC9922710 DOI: 10.3389/fimmu.2023.1078736] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023] Open
Abstract
Background Albeit the need for sex-disaggregated results of adverse events after immunization (AEFIs) is gaining attention since the COVID-19 pandemic, studies with emphasis on sexual dimorphism in response to COVID-19 vaccination are relatively scarce. This prospective cohort study aimed to assess differences in the incidence and course of reported AEFIs after COVID-19 vaccination between males and females in the Netherlands and provides a summary of sex-disaggregated outcomes in published literature. Methods Patient reported outcomes of AEFIs over a six month period following the first vaccination with BioNTech-Pfizer, AstraZeneca, Moderna or the Johnson&Johnson vaccine were collected in a Cohort Event Monitoring study. Logistic regression was used to assess differences in incidence of 'any AEFI', local reactions and the top ten most reported AEFIs between the sexes. Effects of age, vaccine brand, comorbidities, prior COVID-19 infection and the use of antipyretic drugs were analyzed as well. Also, time-to-onset, time-to-recovery and perceived burden of AEFIs was compared between the sexes. Third, a literature review was done to retrieve sex-disaggregated outcomes of COVID-19 vaccination. Results The cohort included 27,540 vaccinees (38.5% males). Females showed around two-fold higher odds of having any AEFI as compared to males with most pronounced differences after the first dose and for nausea and injection site inflammation. Age was inversely associated with AEFI incidence, whereas a prior COVID-19 infection, the use of antipyretic drugs and several comorbidities were positively associated. The perceived burden of AEFIs and time-to-recovery were slightly higher in females. Discussion The results of this large cohort study correspond to existing evidence and contribute to the knowledge gain necessary to disentangle the magnitude of the effect sex in response to vaccination. Whilst females have a significant higher probability of experiencing an AEFI than males, we observed that the course and burden is only to a minor extent different between the sexes.
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Affiliation(s)
- Janneke W Duijster
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Thomas Lieber
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Silvia Pacelli
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands.,School of Pharmacy, Biotechnology, and Sport Sciences, University of Bologna, Bologna, Italy
| | | | - Loes S Ruijs
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Monika Raethke
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | - Agnes Kant
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
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Pagliano P, Sellitto C, Ascione T, Scarpati G, Folliero V, Piazza O, Franci G, Filippelli A, Conti V. The preclinical discovery and development of molnupiravir for the treatment of SARS-CoV-2 (COVID-19). Expert Opin Drug Discov 2022; 17:1299-1311. [PMID: 36508255 DOI: 10.1080/17460441.2022.2153828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Molnupiravir (MOV) is a broad-spectrum oral antiviral agent approved for the treatment of COVID-19. The results from in vitro and in vivo studies suggested MOV activity against many RNA viruses such as influenza virus and some alphaviruses agents of epidemic encephalitis. MOV is a prodrug metabolized into the ribonucleoside analog β-D-N4-hydroxycytidine. It is incorporated into the viral RNA chain causing mutations impairing coding activity of the virus, thereby inhibiting viral replication. AREAS COVERED This review analyzes the in vitro and in vivo studies that have highlighted the efficacy of MOV and the main pre-authorization randomized controlled trials evaluating its safety, tolerability, and pharmacokinetics, as well as its antiviral efficacy against SARS-COV-2 infection. EXPERT OPINION MOV is an antiviral agent with an excellent tolerability profile with few drug-drug interactions. Treatment of mild-to-moderate COVID-19 can benefit from MOV administration in the precocious phases of the disease, prior to the trigger of an aberrant immune response responsible for the parenchymal damage to pulmonary and extrapulmonary tissues. However, its suspected mutagenic effect can be a factor limiting its use at least in selected populations and studies on its teratogen effects should be planned before it is authorized for use in the pediatric population or in pregnant women.
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Affiliation(s)
- Pasquale Pagliano
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Infectious Diseases, University of Salerno, Baronissi, Italy
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Tiziana Ascione
- Department of Medicine, Service of Infectious Diseases, Cardarelli Hospital, Naples, Italy
| | - Giuliana Scarpati
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Veronica Folliero
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Anesthesiology, University of Salerno, Baronissi, Italy
| | - Gianluigi Franci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," Unit of Microbiology, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Pharmacology, University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana," Unit of Pharmacology, University of Salerno, Baronissi, Italy
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Sellitto C, Corbi G, Bertini N, Ascione T, Costantino M, Scarpati G, Piazza O, Filippelli A, Conti V, Pagliano P. Effect of remdesivir on mortality rate and clinical status of COVID-19 patients: a systematic review with meta-analysis. J Chemother 2022:1-14. [PMID: 36102273 DOI: 10.1080/1120009x.2022.2121091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Remdesivir (RDV) is a broad-spectrum antiviral drug, now approved by Regulatory Agencies for COVID-19 treatment. RDV is associated with improvements in clinical outcomes, but no conclusive studies have shown an effect in reducing mortality. This study aimed to carry out a systematic review with meta-analysis to investigate whether RDV can significantly modify the outcome of COVID-19 patients evaluating its effects on mortality, length of stay, time to clinical improvement and need for oxygen supplementation. No significant improvement in terms of survival in patients treated with standard therapy (ST)+RDV as compared to ST alone (P = 0.24) was found. The duration of oxygen support was significantly lower in patients treated with ST + RDV compared with ST alone (P = 0.03). Further investigations should be planned to assess the real impact of RDV in the management of COVID-19 patients.
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Affiliation(s)
- Carmine Sellitto
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Graziamaria Corbi
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
| | - Nicola Bertini
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Tiziana Ascione
- Department of Medicine, Service of Infectious Diseases, Cardarelli Hospital, Naples, Italy
| | - Maria Costantino
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), Naples, Italy
| | - Giuliana Scarpati
- Unit of Anesthesiology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Ornella Piazza
- Unit of Anesthesiology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Amelia Filippelli
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Valeria Conti
- Unit of Pharmacology, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Pasquale Pagliano
- Unit of Infectious Diseases, Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
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Costantino M, Conti V, Corbi G, Iannelli AA, Marongiu F, Torsiello M, Della Vecchia A, Sellitto C, Genovese A, Moccia G, Filippelli A, De Caro F. Impact and Value of Hospital Antibiotic Stewardship: Retrospective Pre-COVID-19-Pandemic Analysis. J Clin Med 2022; 11:jcm11154412. [PMID: 35956030 PMCID: PMC9369048 DOI: 10.3390/jcm11154412] [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: 06/13/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 01/25/2023] Open
Abstract
Aim: “Antimicrobial stewardship” (AMS) is defined as a healthcare-system-wide approach to promoting and monitoring the judicious use of antimicrobials to preserve their future effectiveness. Therefore, we structured an observational study to monitor the hospital trend of antibiotic consumption and related expenditure before the COVID-19 pandemic and to evaluate how much AMS could affect this trend. Methods: The research covered the antibiotic prescriptions at the University Hospital (U.H.) “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy, comparing data on the therapies prescribed from 1 January to 31 December 2017 (27,384 patients) with those collected during the same period in 2019 (27,047 patients). Results: Unlike national data, our results highlighted a decreasing trend in the consumption of antibiotics that did not concern only carbapenems and fluoroquinolones, but also the third-generation cephalosporins. Noteworthily, there was also a reduction in 2019 compared with 2017 in the consumption of colistin, an antibiotic towards which an increase in bacterial resistance in animals has been found nationally. In agreement with the national data, our research confirms a trend of an increase (+3.7%) in the total antibiotic consumption corresponding to more than 26% and 29% reductions in the total and therapy per-day costs, respectively. Conclusions: The results show a positive impact of the AMS at the University Hospital “San Giovanni di Dio e Ruggi d’Aragona”.
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Affiliation(s)
- Maria Costantino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80078 Naples, Italy;
- Correspondence: or ; Tel.: +39-08965041; Fax: +39-1786070323
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy;
- Italian Society of Gerontology and Geriatrics (SIGG), 50129 Florence, Italy
| | - Alessandra Anna Iannelli
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Francesco Marongiu
- Association Non-Profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and Spa Sciences), 80078 Naples, Italy;
- Department of Industrial Engineering, University of Salerno, 84084 Fisciano, Italy
| | - Martina Torsiello
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
| | - Antonio Della Vecchia
- General Directorate of Health Planning, Office 3—Italian Ministry of Health, 00144 Roma, Italy;
| | - Carmine Sellitto
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Armando Genovese
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Giuseppina Moccia
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
| | - Francesco De Caro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, 84081 Baronissi, Italy; (V.C.); (M.T.); (C.S.); (G.M.); (A.F.); (F.D.C.)
- University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84121 Salerno, Italy; (A.A.I.); (A.G.)
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