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Vena W, Pigni S, Betella N, Navarra A, Mirani M, Mazziotti G, Lania AG, Bossi AC. COVID-19 vaccines and blood glucose control: Friend or foe? Hum Vaccin Immunother 2024; 20:2363068. [PMID: 38860457 PMCID: PMC11178329 DOI: 10.1080/21645515.2024.2363068] [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: 02/20/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024] Open
Abstract
PURPOSE To overview the recent literature regarding the relationship between COVID-19 vaccines and glycemic control. METHODS Data were extracted from text and tables of all available articles published up to September 2023 in PubMed Database describing glucose homeostasis data in subjects exposed to COVID-19 vaccines, focusing on patients with diabetes mellitus (DM). RESULTS It is debated if the immune system impairment observed in diabetic patients makes them susceptible to lower efficacy of vaccines, but evidence suggests a possible improvement in immune response in those with good glycemic control. Despite their proven protective role lowering infection rates and disease severity, COVID-19 vaccines can result in diabetic ketoacidosis, new-onset diabetes, or episodes of hyper- or hypoglycemia. CONCLUSIONS Evidence with COVID-19 vaccines highlights the strong relationship existing between DM and immune system function. Clinicians should strive to achieve optimal glucose control before vaccination and promptly manage possible glucose homeostasis derangement following vaccine exposure.
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Affiliation(s)
- Walter Vena
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Diabetes Center, Humanitas Gavazzeni Institute, Bergamo, Italy
| | - Stella Pigni
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
| | | | | | - Marco Mirani
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
| | - Gherardo Mazziotti
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
| | - Andrea G. Lania
- Department of Biomedical Sciences, Humanitas University, Milan, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Milan, Rozzano, Italy
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Okon-Umoren A, Yaphe S, Smith A, Passalacqua KD, Budzynska K. Transient Hyperglycemia in a Patient With Type 2 Diabetes After COVID-19 Messenger RNA Vaccination: A Case Report. Cureus 2024; 16:e63983. [PMID: 39105031 PMCID: PMC11299958 DOI: 10.7759/cureus.63983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2024] [Indexed: 08/07/2024] Open
Abstract
The development of new vaccines against the SARS-CoV-2 virus in response to the COVID-19 pandemic represents a milestone in the history of public health. However, due to the rapid development and short duration of these new vaccines, the full spectrum of side effects is not yet known. A 76-year-old man presented to the clinic for follow-up after being discharged from the emergency department for hyperglycemia. His medical history included well-controlled type 2 diabetes for two years, hypertension, and hyperlipidemia. He had recently noticed high home blood glucose readings over 400 mg/dL, and his hemoglobin A1c (mean 90-day glucose level) had increased from 6.5% to 12.6%. Notably, the patient reported having excellent health behaviors, including daily exercise, a closely monitored healthy diet, and regular blood glucose testing. After extensive endocrinology workup, the rapid change in blood glucose was thought to be due to his having recently received the COVID-19 messenger RNA (mRNA) vaccine. He was started on long- and short-acting insulin and a glucagon-like peptide-1 agonist (novel injectable type 2 diabetes medication), with improvement in blood glucose. He was tapered off all medications and remains on metformin 1,000 mg twice daily after one year.Whether the new COVID-19 mRNA vaccines directly incur hyperglycemia within certain groups of patients with diabetes is not known; thus, studies exploring the relationship between vaccine antigen binding and pancreatic function are needed.
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Affiliation(s)
| | - Sean Yaphe
- Family Medicine, Henry Ford Health System, Detroit, USA
| | - Andrea Smith
- Family Medicine, Henry Ford Health System, Detroit, USA
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3
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Alqahtani TMM, Alghamdi MAA, Baig MR, Al-Abbasi FA, Sheikh RA, Almalki NAR, Hejazi MM, Alhayyani S, Asar TO, Kumar V, Anwar F. Recent Patterns and Assessment of Long-term Complications followi ngSARS-CoV-2 Infection and Vaccination in the Context of Diabet esPrevalence among Blood Donors. Curr Diabetes Rev 2024; 20:e110124225520. [PMID: 38415496 DOI: 10.2174/0115733998274390231110050809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/02/2023] [Accepted: 10/13/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Much increasing evidence has suggested that long-term complications post vaccination of SARS-CoV-2 experience a wide range of complication including diabetes. The risk and burden of type 1 diabetes is extensively reported, but type 2 diabetes mellitus (T2D) has yet to be characterized. To address this gap, we aimed to examine trends of long-term complications post SARS-CoV-2 infection and vaccination in diabetes incidence among the Saudi population. METHODS In this cross-sectional hospital-based study, we analyzed the blood profile of first-time blood donors from the University Hospital of King Abdulaziz University, Jeddah. Saudi Arabia. Various blood parameters, HbA1c was measured in the month of May 2023. All the donors were non-diabetic and were never diagnosed with T2D before the current blood donation. 203 healthy subjects donated their blood, out of which 104 had abnormally high HbA1c tending towards diagnosis of T2D and 99 had with blood profiles. The study followed the STROBE reporting guidelines. RESULTS Out of 203 donors 104 (male 50(48.1%), female 54(51.9%)) were diagnosed with increased HbA1c (8.24 in males) compared to 7.61 of HbA1c in females. 35.6% were above ˃65 years, with 52.9% with O+ from the ABO blood group. Liver functions indicated significant p˂0.05, 0.04, increased amount of GGT (46.47 U/L), Alkaline phosphatase (99.93 ±64.26 uL) respectively in HbA1c elevated donors KFT represented significant p˂0.05, 0.02 elevated levels of urea (6.73 ±5.51 mmol/L), creatinine (129.97 ±195.17 umol/L) respectively along with elevated values of Lactate dehydrogenase (LDH) (263.72± 196.70 uL) and triglycerides (1.66 ±0.74mmol/L) when compared to normal value of HbA1c donors. DISCUSSION In the present cross-sectional study, significant increase in HbA1c, trending towards increased cases of T2D post SARS-CoV-2 infection and vaccination. Males are much affected compared to females. Further maximum number of cases were from donors above the age of 65 years with altered partial LFT (GGT, Alkaline phosphatase), KFT (urea, creatinine), lipid profile (TG) and LDH in post SARS-CoV-2 and vaccination blood donors. CONCLUSION Increase in HbA1c in 50% of donors, irrespective of gender, is an alarming figure for health authorities, with altered LFT, KFT and LDH tests and, in the near future, may increase the incidence of T2D. Large-scale population-based studies are required to prevent future incidences of T2D in young children who will be vaccinated.
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Affiliation(s)
| | | | - Mirza Rafi Baig
- Department of Clinical Pharmacy & Pharmacotherapeutics, Dubai Pharmacy College for Girls. Dubai Medical University, Dubai, United Arab Emirates
| | - Fahad A Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Ryan Adnan Sheikh
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Naif A R Almalki
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Moayad Mustafa Hejazi
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
| | - Sultan Alhayyani
- Department of Chemistry, College of Sciences & Arts, Rabigh King Abdulaziz University, Jeddah, Saudi Arabia
| | - Turky Omar Asar
- Department of Biology, College of Science and Arts at Alkamil, University of Jeddah, Jeddah, Saudi Arabia
| | - Vikas Kumar
- Natural Product Discovery Laboratory, Department of Pharmaceutical Sciences, Sam Higginbottom Institute of Agriculture, SHUATS, Prayagraj, India
| | - Firoz Anwar
- Department of Biochemistry, Faculty of Science, King Abdul-Aziz University, Jeddah, 21589, Saudi Arabia
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Albedaiwi FB, Alshammari M, Algeffari M, Alfouzan A, Alfouzan Y, Siddiq H, Hussein O. Diabetic Ketoacidosis After COVID-19 Vaccine in Patients with Type 1 Diabetes Mellitus. Int J Endocrinol Metab 2023; 21:e135866. [PMID: 38694238 PMCID: PMC11061715 DOI: 10.5812/ijem-135866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/31/2023] [Accepted: 08/28/2023] [Indexed: 05/04/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) vaccine is one of the few vaccines that obtained emergency authorization to combat the fatal pandemic. Despite the fact that some available literature addressed its short-term side effects, there are still limitations on its effects on type 1 diabetes mellitus (T1DM). Objectives The aim of the present study was to assess the association between COVID-19 vaccination and diabetic ketoacidosis (DKA) among individuals with T1DM. Additionally, the study aimed to determine the effects of the vaccine on glucose control, variability, and risk of hypoglycemia. Methods This retrospective study was conducted at King Fahad Specialist Hospital (KFSH) in Qassim Region, Saudi Arabia. Diabetic ketoacidosis cases admitted to the hospital within February 2020 and August 2022 were included in the study based on specific inclusion criteria. Finally, a total of 49 patients were included in statistical analyses. Results Out of the 62 patients admitted to the hospital, 49 met the diagnostic criteria for DKA and agreed to participate in the study. The majority of the remaining patients (n = 13) refused to participate, and only a few of them lacked complete documentation. Of the 49 patients who were included in the study, 46 cases had a history of T1DM; nevertheless, 3 patients were newly diagnosed with T1DM. Additionally, among these participants, 16 (32.7%), 19 (38.8%), and 14 (28.6%) patients had mild, moderate, and severe DKA, respectively. There were 27 male (55.1%) and 22 female (44.9%) patients. About 91% of the patients were vaccinated against COVID-19, 30.6% of whom were vaccinated within 29 days of being diagnosed with DKA. The pH and bicarbonate levels were observed to be significantly high among those who were diagnosed with DKA within 29 days of vaccination, with p-values of 0.031 and 0.037, respectively. Similarly, pH and random blood sugar (RBS) were observed to be significantly higher among the vaccinated patients than in the non-vaccinated subjects (P = 0.044 and P = 0.032, respectively). Conclusions The study findings revealed that some of the DKA indicators were evident among the vaccinated patients. However, larger-scale and multi-center studies are recommended in order to have more conclusive evidence and generalize the findings.
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Affiliation(s)
| | | | - Metab Algeffari
- Department of Family and Community Medicine, Collage of Medicine, Qassim University, Buraydah, Saudi Arabia
| | | | - Yasmeen Alfouzan
- College of Medicine, Qassim University, Buraydah, Al-Qassim, Saudi Arabia
| | - Hassan Siddiq
- Diabetes and Endocrinology Center, Buraydah, Al-Qassim, Saudi Arabia
| | - Omaima Hussein
- Diabetes and Endocrinology Center, Buraydah, Al-Qassim, Saudi Arabia
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Zilbermint M, Motevalli M, Batty K, Venner-Walcott J, Edwards A, Burley T, Jackson K, Akhtar M, Demidowich AP. Effects of the COVID-19 booster vaccine on glycemia and insulin resistance in people with type 1 diabetes: A prospective pilot study. Diabetes Res Clin Pract 2023; 204:110898. [PMID: 37678726 DOI: 10.1016/j.diabres.2023.110898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 09/09/2023]
Abstract
AIMS Inflammation can trigger hyperglycemia in people with type 1 diabetes (T1D). Vaccines purposefully intend to cause an acute immunogenic response, and booster vaccines may cause even more potent immunologic responses. However, the effects of vaccines on glycemic control and insulin requirements in the days immediately post-vaccination remains poorly understood. The aim of this study was to examine the changes in glycemic control and insulin usage immediately preceding and following a COVID-19 booster vaccine among adults with T1D. METHODS In this prospective cohort study of adults with T1D, participants wore blinded Dexcom G6 Pro continuous glucose monitors for 10 days. After a baseline period, participants received a COVID-19 booster vaccine, and subsequent changes in glycemic indices were evaluated. RESULTS Among the 21 enrolled participants, 38% received a Moderna and 62% Pfizer-BioNTech booster. Compared to baseline (162.9 ± 44.1 mg/dL), mean glucose was significantly increased at Day 2 (172.8 ± 47.0 mg/dL; p = 0.04) and Day 3 (173.1 ± 45.0 mg/dL; p = 0.02) post-vaccination. Insulin resistance was also increased on Day 2 (p = 0.03). There were no differences in outcome metrics between booster vaccine manufacturers. CONCLUSIONS These results suggest that adults with type 1 diabetes may experience transient mild glycemic elevations after receiving a COVID-19 booster vaccination. Studies examining the effects of other vaccines are warranted.
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Affiliation(s)
- Mihail Zilbermint
- Division of Hospital Medicine, Johns Hopkins Community Physicians, Johns Hopkins Medicine, 6225 Smith Ave., Suite B-300, Baltimore, MD 21209, USA; Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA; Suburban Hospital, Johns Hopkins Medicine, 8600 Old Georgetown Road, Bethesda, MD 20814, USA.
| | - Mahsa Motevalli
- Division of Hospital Medicine, Johns Hopkins Community Physicians, Johns Hopkins Medicine, 6225 Smith Ave., Suite B-300, Baltimore, MD 21209, USA; Suburban Hospital, Johns Hopkins Medicine, 8600 Old Georgetown Road, Bethesda, MD 20814, USA.
| | - Kristine Batty
- Division of Hospital Medicine, Johns Hopkins Community Physicians, Johns Hopkins Medicine, 6225 Smith Ave., Suite B-300, Baltimore, MD 21209, USA; Johns Hopkins Howard County Medical Center, Johns Hopkins Medicine, 5755 Cedar Ln, Columbia, MD 20794, USA.
| | - Jemila Venner-Walcott
- Division of Hospital Medicine, Johns Hopkins Community Physicians, Johns Hopkins Medicine, 6225 Smith Ave., Suite B-300, Baltimore, MD 21209, USA; Johns Hopkins Howard County Medical Center, Johns Hopkins Medicine, 5755 Cedar Ln, Columbia, MD 20794, USA.
| | - Alexis Edwards
- Suburban Hospital, Johns Hopkins Medicine, 8600 Old Georgetown Road, Bethesda, MD 20814, USA; Office of Capital Region Research, Johns Hopkins Medicine, 5755 Cedar Ln, Columbia, MD 20794, USA.
| | - Tanya Burley
- Office of Capital Region Research, Johns Hopkins Medicine, 5755 Cedar Ln, Columbia, MD 20794, USA.
| | - Keith Jackson
- Office of Capital Region Research, Johns Hopkins Medicine, 5755 Cedar Ln, Columbia, MD 20794, USA.
| | - Mehro Akhtar
- Office of Capital Region Research, Johns Hopkins Medicine, 5755 Cedar Ln, Columbia, MD 20794, USA.
| | - Andrew P Demidowich
- Division of Hospital Medicine, Johns Hopkins Community Physicians, Johns Hopkins Medicine, 6225 Smith Ave., Suite B-300, Baltimore, MD 21209, USA; Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 333, Baltimore, MD 21287, USA; Johns Hopkins Howard County Medical Center, Johns Hopkins Medicine, 5755 Cedar Ln, Columbia, MD 20794, USA.
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Trimboli M, Zoleo P. Nonketotic hyperglycemic-induced hemichorea-hemiballismus following COVID-19 (BNT162b2) vaccination. J Clin Neurosci 2023; 116:79-80. [PMID: 37651965 DOI: 10.1016/j.jocn.2023.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/02/2023]
Affiliation(s)
- Michele Trimboli
- Institute of Neurology, AOU Renato Dulbecco - Magna Graecia University, Catanzaro, Italy.
| | - Pio Zoleo
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
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Alhawaj SA, Almuhanna AS, Alabbad FS, Almomattin HH, Alsultan RS, Shaiban ZA, Vatte C, Cyrus C. The Impact of COVID-19 Vaccines on the Development of Acute Complications in Type 1 and 2 Diabetes Patients: A Cross-Sectional Study in the Eastern Province of Saudi Arabia. Int J Gen Med 2023; 16:4267-4277. [PMID: 37753440 PMCID: PMC10518259 DOI: 10.2147/ijgm.s431179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
Background COVID-19 vaccines were developed to control the pandemic spread as they have been proven to be efficient and safe. However, the likelihood of such postvaccination effects as poor glycemic control and adverse events has been noted in several studies. Objective To determine the effect of COVID-19 vaccines on the glycemic control and the development of hyperglycemic emergencies among type 1 and 2 diabetes patients. Methods A cross-sectional study was conducted on 409 participants aged 18 years and above with type 1 or 2 diabetes who had received at least a single dose of COVID-19 vaccine. Results Among the 409 diabetes patients, a majority reported general mild postvaccination symptoms regardless of diabetes duration or type. After vaccination, severe diabetic emergencies were mostly reported in long-standing diabetes patients. Diabetes-related complications and emergencies were more profound among those who had received the Pfizer vaccine. Nonetheless, occurrence of adverse events could possibly be due to various factors, including the duration of diabetes and COVID-19 infection status. Conclusion COVID-19 vaccinations have the potential to influence diabetic patients in regard to acute glycemic complications. However, vaccine efficiency and benefits are superior to the side effects of COVID-19 vaccines, as these adverse events only affect a small number of individuals. A need for postvaccination monitoring of diabetes patients is suggested.
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Affiliation(s)
- Sharook A Alhawaj
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alia Saeed Almuhanna
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Ragad S Alsultan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Chittibabu Vatte
- College of medicine, Department of Biochemistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Cyril Cyrus
- College of medicine, Department of Biochemistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Rosca EC, Bilavu R, Cornea A, Simu M. Chorea following SARS-CoV-2 infection and vaccination: a systematic review of reported cases. Int J Infect Dis 2023; 134:256-260. [PMID: 37423421 DOI: 10.1016/j.ijid.2023.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVES Chorea following SARS-CoV-2 infection and vaccination, has been increasingly recognized. We aimed to synthesize clinical and paraclinical characteristics, treatment responses, and outcomes of this neurologic complication. METHODS We systematically reviewed LitCOVID, the World Health Organization database on COVID-19, and MedRxiv up to March 2023, following a published protocol. RESULTS We included 14 chorea cases in patients with SARS-CoV-2 infection and eight following COVID-19 vaccination. Acute or subacute chorea preceded COVID-19 symptoms within 1-3 days or developed up to 3 months after infection. Frequently it was generalized (85.7%), with associated neurological manifestations (encephalopathy 35.7%; other movement disorders 7.1%). After vaccination, chorea had a sudden onset (87.5%) within 2 weeks (75%); 87.5% of cases presented hemichorea, with hemiballismus (37.5%) or other movement disorders; 12.5% presented additional neurological findings. Cerebrospinal fluid was normal in 50% of infected individuals but abnormal in all vaccinated cases. Brain magnetic resonance imaging detected normal basal ganglia in 51.7% of infection cases and 87.5% following vaccination. CONCLUSION In SARS-CoV-2 infection, chorea may present several pathogenic mechanisms: autoimmune response to infection, direct infection-related injury, or an infection-related complication (i.e., acute disseminated encephalomyelitis, cerebral venous sinus thrombosis, hyperglycemia); also, previous Sydenham chorea may relapse. After COVID-19 vaccination, chorea could be due to an autoimmune reaction or other mechanisms (vaccine-induced hyperglycemia, stroke).
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Affiliation(s)
- Elena Cecilia Rosca
- Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; Department of Neurology, Clinical Emergency County Hospital Timisoara, Timisoara, Romania.
| | - Raluca Bilavu
- Department of Neurology, Clinical Emergency County Hospital Timisoara, Timisoara, Romania
| | - Amalia Cornea
- Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; Department of Neurology, Clinical Emergency County Hospital Timisoara, Timisoara, Romania
| | - Mihaela Simu
- Department of Neurology, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; Department of Neurology, Clinical Emergency County Hospital Timisoara, Timisoara, Romania
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Zhu D, Wu T, Yu X, Chen Y, Zhou T, Liu Y, Liu L, Min Z. Associations between laboratory variables and clinical features in patients hospitalized with COVID-19 after non-mRNA vaccination in China: A cross-sectional study. Heliyon 2023; 9:e18167. [PMID: 37539143 PMCID: PMC10393604 DOI: 10.1016/j.heliyon.2023.e18167] [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: 12/04/2022] [Revised: 07/06/2023] [Accepted: 07/10/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives Based on the data during the outbreak of COVID-19 in Wuxi city in China, we explored the relationship between laboratory variables and clinical features in patients hospitalized with COVID-19 after non-mRNA vaccination, and attempted to identify the significant impact of vaccination and COVID-19 infection on humans. Methods A retrospective observational cohort study was carried out. Patients who received non-mRNA COVID-19 vaccines and were hospitalized with COVID-19 between June 28, 2022, and July 24, 2022 were included. The correlation between different vaccine statuses, the time to negative PCR test, and biochemical parameters were investigated. Results All patients had a mild COVID-19 disease. The number of vaccine doses exerted no effects on the time to negative PCR test (P = 0.559). No differences were evident among inactivated, adenoviral-vectored, and recombinant subunit vaccines in the time to negative PCR test.Patients who just received one dose had significantly lower blood glucose levels than those who received three doses (P = 0.024), whereas two doses had no effect on blood glucose levels (one dose vs. two doses, P = 0.223; two doses vs. three doses, P = 0.457).Body temperature (β = 0.168, P = 0.011) and the percentage of lymphocytes (β = -0.219, P = 0.001) were substantially correlated with the time to COVID-19 negative PCR test. The prolonged stay was linked to a rise in GOT that fell within the usual range (P = 0.025).The percentage of lymphocytes (P = 0.007) and serum potassium (P = 0.004) were concordant with the marked change in body temperature. Conclusions The dose and type of vaccination had no effect on the time to COVID-19 negative PCR test in patients with mild COVID-19. Comparing the first dose with the booster dose, the blood glucose levels increased within the normal range. The period at which the COVID-19 nucleic acid turned negative correlated with body temperature, the proportion of lymphocytes, GOT, and serum potassium.
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10
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Joob B, Wiwanitkit V. COVID-19 vaccination and diabetic ketoacidosis. World J Diabetes 2023; 14:560-564. [PMID: 37273244 PMCID: PMC10236999 DOI: 10.4239/wjd.v14.i5.560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/01/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
An efficient coronavirus disease 2019 (COVID-19) vaccine is urgently required to fight the pandemic due to its high transmission rate and quick dissemination. There have been numerous reports on the side effects of the COVID-19 immu-nization, with a focus on its negative effects. Clinical endocrinology is extremely interested in the endocrine issue that arises after receiving the COVID-19 vaccine. As was already mentioned, after receiving the COVID-19 vaccine, many clinical problems could occur. Additionally, there are some compelling reports on diabetes. After receiving the COVID-19 vaccine, a patient experienced hyperosmolar hyperglycemia state, a case of newly-onset type 2 diabetes. There has also been information on a potential connection between the COVID-19 vaccine and diabetic ketoacidosis. Common symptoms include thirst, polydipsia, polyuria, palpitations, a lack of appetite, and weariness. In extremely rare clinical circumstances, a COVID-19 vaccine recipient may develop diabetes complications such as hyperglycemia and ketoacidosis. In these circumstances, routine clinical care has a successful track record. It is advised to give vaccine recipients who are vulnerable to problems, such as those with type 1 diabetes as an underlying illness, extra attention.
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Affiliation(s)
- Beuy Joob
- Academic Center, Sanitation1 Medical Academic Center, Bangkok 1033300, Thailand
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11
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Lin CW, Hung SY, Chen IW. A study of glycemic perturbations following two doses of COVID-19 vaccination for patients with diabetes: the impacts of vaccine type and anti-diabetes drugs. Diabetol Metab Syndr 2023; 15:81. [PMID: 37098548 PMCID: PMC10125862 DOI: 10.1186/s13098-023-01059-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/13/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Glycemic monitoring has become critical during the COVID-19 pandemic because of poor prognosis in diabetes. Vaccines were key in reducing the spread of infection and disease severity but data were lacking on effects on blood sugar levels. The aim of the current study was to investigate the impact of COVID-19 vaccination on glycemic control. METHODS We performed a retrospective study of 455 consecutive patients with diabetes who completed two doses of COVID-19 vaccination and attended a single medical center. Laboratory measurements of metabolic values were assessed before and after vaccination, while the type of vaccine and administrated anti-diabetes drugs were analyzed to find independent risks associated with elevated glycemic levels. RESULTS One hundred and fifty-nine subjects received ChAdOx1 (ChAd) vaccines, 229 received Moderna vaccines, and 67 received Pfizer-BioNtech (BNT) vaccines. The average HbA1c was raised in the BNT group from 7.09 to 7.34% (P = 0.012) and non-significantly raised in ChAd (7.13 to 7.18%, P = 0.279) and Moderna (7.19 to 7.27%, P = 0.196) groups. Both Moderna and BNT groups had around 60% of patients with elevated HbA1c following two doses of COVID-19 vaccination, and the ChAd group had only 49%. Under logistic regression modeling, the Moderna vaccine was found to independently predict the elevation of HbA1c (Odds ratio 1.737, 95% Confidence interval 1.12-2.693, P = 0.014), and sodium-glucose co-transporter 2 inhibitor (SGLT2i) was negatively associated with elevated HbA1c (OR 0.535, 95% CI 0.309-0.927, P = 0.026). CONCLUSIONS Patients with diabetes might have mild glycemic perturbations following two doses of COVID-19 vaccines, particularly with mRNA vaccines. SGLT2i showed some protective effect on glycemic stability. Hesitancy in having vaccinations should not be indicated for diabetic patients with respect to manageable glycemic change. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Cheng-Wei Lin
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Linkou, 5, Fusing St., Guishan Dist, Taoyuan City, 333, Taiwan.
| | - Shih-Yuan Hung
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Linkou, 5, Fusing St., Guishan Dist, Taoyuan City, 333, Taiwan
| | - I-Wen Chen
- Division of Endocrinology and Metabolism, Chang Gung Memorial Hospital at Linkou, 5, Fusing St., Guishan Dist, Taoyuan City, 333, Taiwan
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12
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Faruqi J, Balasubramanyam A. COVID-19 and diabetes mellitus: a review of the incidence, pathophysiology and management of diabetes during the pandemic. Expert Rev Endocrinol Metab 2023; 18:167-179. [PMID: 36797835 DOI: 10.1080/17446651.2023.2176300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has changed the landscape of modern medicine on a global scale. An emerging concern is the recognition of a bidirectional relationship between COVID-19 and diabetes. Diabetes is a risk factor for severe COVID-19 illness. Intriguingly, recent epidemiological and in vitro studies suggest that infection with SARS-CoV-2, the causative viral agent of COVID-19, is associated with new-onset diabetes and worsening diabetes control. These factors have affected the management of diabetes. AREAS COVERED This review provides an overview of our current understanding of the incidence and prevalence of diabetes in relation to the COVID-19 pandemic, highlights studies evaluating SARS-CoV-2's beta cell tropism and its effects on insulin secretion and sensitivity and evaluates the impact of the pandemic on diabetes management and metabolic control. EXPERT OPINION Epidemiological studies have noted an increase in the incidence of new-onset diabetes associated with COVID-19 in patients with phenotypes of type 1 diabetes, type 2 diabetes and Ketosis-Prone Diabetes. Prospective studies are needed to fully elucidate the association between COVID-19 and diabetes and to characterize persons at risk of developing diabetes after SARS-CoV-2 infection, identify those who should be screened for diabetes, and determine the natural histories of different forms of diabetes associated with COVID-19.
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Affiliation(s)
- Jordana Faruqi
- Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA
| | - Ashok Balasubramanyam
- Division of Diabetes, Endocrinology and Metabolism, Baylor College of Medicine, Houston, TX, USA
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13
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Hromić-Jahjefendić A, Barh D, Uversky V, Aljabali AA, Tambuwala MM, Alzahrani KJ, Alzahrani FM, Alshammeri S, Lundstrom K. Can COVID-19 Vaccines Induce Premature Non-Communicable Diseases: Where Are We Heading to? Vaccines (Basel) 2023; 11:vaccines11020208. [PMID: 36851087 PMCID: PMC9960675 DOI: 10.3390/vaccines11020208] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/05/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
According to the WHO, as of January 2023, more than 850 million cases and over 6.6 million deaths from COVID-19 have been reported worldwide. Currently, the death rate has been reduced due to the decreased pathogenicity of new SARS-CoV-2 variants, but the major factor in the reduced death rates is the administration of more than 12.8 billion vaccine doses globally. While the COVID-19 vaccines are saving lives, serious side effects have been reported after vaccinations for several premature non-communicable diseases (NCDs). However, the reported adverse events are low in number. The scientific community must investigate the entire spectrum of COVID-19-vaccine-induced complications so that necessary safety measures can be taken, and current vaccines can be re-engineered to avoid or minimize their side effects. We describe in depth severe adverse events for premature metabolic, mental, and neurological disorders; cardiovascular, renal, and autoimmune diseases, and reproductive health issues detected after COVID-19 vaccinations and whether these are causal or incidental. In any case, it has become clear that the benefits of vaccinations outweigh the risks by a large margin. However, pre-existing conditions in vaccinated individuals need to be taken into account in the prevention and treatment of adverse events.
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Affiliation(s)
- Altijana Hromić-Jahjefendić
- Department of Genetics and Bioengineering, Faculty of Engineering and Natural Sciences, International University of Sarajevo, Hrasnicka Cesta 15, 71000 Sarajevo, Bosnia and Herzegovina
| | - Debmalya Barh
- Department of Genetics, Ecology and Evolution, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte 31270-901, Brazil
- Institute of Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur 721172, India
- Correspondence: (D.B.); (K.L.)
| | - Vladimir Uversky
- Department of Molecular Medicine and USF Health Byrd Alzheimer's Institute, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Alaa A. Aljabali
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Yarmouk University, P.O. Box 566, Irbid 21163, Jordan
| | - Murtaza M. Tambuwala
- Lincoln Medical School, Brayford Pool Campus, University of Lincoln, Lincoln LN6 7TS, UK
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Fuad M. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Saleh Alshammeri
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraydah 51452, Saudi Arabia
| | - Kenneth Lundstrom
- PanTherapeutics, Route de Lavaux 49, CH1095 Lutry, Switzerland
- Correspondence: (D.B.); (K.L.)
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14
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Al-Ozairi E, Irshad M, Taghadom E, Varghese A, Sojan L, Alkandari J. Effect of COVID-19 vaccine on blood glucose metrics in Arabic people with type 1 diabetes. Front Endocrinol (Lausanne) 2023; 14:1120384. [PMID: 37020598 PMCID: PMC10067894 DOI: 10.3389/fendo.2023.1120384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/28/2023] [Indexed: 03/22/2023] Open
Abstract
INTRODUCTION People with diabetes are at a higher risk for coronavirus disease-19 (COVID-19) and hence are prioritized for vaccination. The aim of the current study was to investigate the effects of COVID-19 vaccination on blood glucose control in Arabic people with type 1 diabetes (T1D). Secondary aim was to compare the responses between the two vaccines approved for use in Kuwait. METHOD This retrospective study compared ambulatory glucose metrics, using a continuous glucose monitoring device, measured for 14 days before, and 7 days and 14 days after, the first and second dose of the COVID-19 vaccine in Arabic people with Type 1 diabetes (T1D). We also explored possible links with vaccine type and other clinical characteristics. Glucose metrics calculated were time in range (TIR, 3.9-10 mmol/L), time above range (TAR, 10.1- 13.9 mmol/L or >13.9 mmol/L), time below range (TBR, 3- 3.9 mmol/L or <3 mmol/L) and glucose variability (CV). RESULTS We enrolled 223 participants in the study. Over the 7 days period after the first vaccination dose there was a decrease in TIR (mean difference (SD) -1.9% ± 14.8%; p = 0.05) and increase in TAR >10 mmol/L (2.2% ± 15.9%; p = 0.04), with no effects on TBR. These effects were not seen after the second dose or 14 days after either dose. There was a decrease in CV over the 7 days period after the first (-1.2% ± 7.4%; p = 0.02) and second vaccine doses (-1.1% ± 6.9%; p = 0.03), with no effects noted 14 days after either dose. In subgroup analysis similar effects on TIR and TAR were also seen in those who had received the viral vector-based vaccine, but not the mRNA-based vaccine, although the decrease in CV was seen in those who had received the mRNA based vaccine but not the viral vector-based vaccine. CONCLUSION We found a temporary impairment in glucose control in the first 7 days, particularly among individuals receiving viral vector vaccines. The group receiving mRNA vaccine was likely to experience an increase in glucose levels above the target range. However, the temporary change in metrics appears to return to pre-vaccination levels after one-week post-vaccination. The effects on glycemic parameters were more neutral after the second dose.
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Affiliation(s)
- Ebaa Al-Ozairi
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Medicine, Faculty of Medicine, Kuwait University, Safat, Kuwait
- *Correspondence: Ebaa Al-Ozairi,
| | | | - Etab Taghadom
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
| | | | - Litty Sojan
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jumana Alkandari
- DAFNE Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait
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15
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Gouda N, Dimitriadou M, Sotiriou G, Christoforidis A. The impact of COVID-19 vaccination on glycaemic control in children and adolescents with type 1 diabetes mellitus on continuous glucose monitoring. Acta Diabetol 2022; 59:1609-1614. [PMID: 36069940 PMCID: PMC9449273 DOI: 10.1007/s00592-022-01968-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022]
Abstract
AIMS To investigate the impact of SARS-COV-2 vaccination on the glycaemic control in children and adolescents with T1DM wearing continuous glucose monitoring (CGM). METHODS Caregivers of children and adolescents with T1DM were questioned regarding SARS-CoV-2 vaccination during their regular visits at the Pediatric Diabetes Outpatient Clinic. Data regarding Time in Range (TIR) (glucose levels: 70-180 mg/dl) 7 days prior and 7 days after a vaccination dose were collected in patients wearing CGM and data regarding insulin daily doses were also obtained for the insulin pump users. RESULTS From a total of 135 patients eligible for SARS-CoV-2 vaccination, 70 (51.9%) children (37 boys, 52.9%) were vaccinated with at least one dose. Seven patients received only one dose, whereas two children received a third booster shot. No statistically significant difference was observed in either TIR (64.19% post vs. 65.53% pre, p = 0.158) or total daily insulin dose (40.08 U/day post vs. 39.32 U/day pre, p = 0,282). Additionally, in ten patients on Hybrid Closed-Loop System the percentage of the automated insulin boluses given post-vaccination was not statistically significant different compared to the boluses given pre-vaccination (15.80% vs. 16.90%, p = 0,491). CONCLUSIONS Vaccination against SARS-CoV-2 in children and adolescents with T1DM is safe and is not associated with immediate glucose imbalance.
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Affiliation(s)
- Niki Gouda
- 1st Paediatric Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, 49 Konstantinoupoleosstr, 54642, Thessaloniki, Greece
| | - Meropi Dimitriadou
- 1st Paediatric Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, 49 Konstantinoupoleosstr, 54642, Thessaloniki, Greece
| | - Georgia Sotiriou
- 1st Paediatric Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, 49 Konstantinoupoleosstr, 54642, Thessaloniki, Greece
| | - Athanasios Christoforidis
- 1st Paediatric Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Ippokratio General Hospital, 49 Konstantinoupoleosstr, 54642, Thessaloniki, Greece.
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16
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Yang Y, Zou S, Xu G. An update on the interaction between COVID-19, vaccines, and diabetic kidney disease. Front Immunol 2022; 13:999534. [DOI: 10.3389/fimmu.2022.999534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/03/2022] [Indexed: 01/08/2023] Open
Abstract
Up to now, coronavirus disease 2019 (COVID-19) is still affecting worldwide due to its highly infectious nature anrapid spread. Diabetic kidney disease (DKD) is an independent risk factor for severe COVID-19 outcomes, and they have a certain correlation in some aspects. Particularly, the activated renin–angiotensin–aldosterone system, chronic inflammation, endothelial dysfunction, and hypercoagulation state play an important role in the underlying mechanism linking COVID-19 to DKD. The dipeptidyl peptidase-4 inhibitor is considered a potential therapy for COVID-19 and has similarly shown organ protection in DKD. In addition, neuropilin-1 as an alternative pathway for angiotensin-converting enzyme 2 also contributes to severe acute respiratory syndrome coronavirus 2 entering the host cells, and its decreased expression can affect podocyte migration and adhesion. Here, we review the pathogenesis and current evidence of the interaction of DKD and COVID-19, as well as focus on elevated blood glucose following vaccination and its possible mechanism. Grasping the pathophysiology of DKD patients with COVID-19 is of great clinical significance for the formulation of therapeutic strategies.
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17
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Vasilev G, Kabakchieva P, Miteva D, Batselova H, Velikova T. Effectiveness and safety of COVID-19 vaccines in patients with diabetes as a factor for vaccine hesitancy. World J Diabetes 2022; 13:738-751. [PMID: 36188150 PMCID: PMC9521442 DOI: 10.4239/wjd.v13.i9.738] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/06/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus is one of the most common comorbid conditions encountered in patients with severe acute respiratory syndrome coronavirus 2 infection accompanied by significantly increased mortality, prolonged hospital stay, and requirement of invasive mechanical ventilation. This review aims to present the effectiveness and safety profile of available coronavirus disease 2019 (COVID-19) vaccines in people with diabetes as a potential cause of hesitancy for vaccination. Data from published research proves a robust immune response following immunization for COVID-19 in diabetic patients with substantial production of virus-neutralizing antibodies; however, the observed immune response was unequivocally weaker than that in individuals without diabetes. This observation was further enhanced by the findings that worse glycemic control was associated with more suppressed antibody production. In contrast, individuals with optimal glycemic control performed similarly to healthy controls. In addition to the need for strict glucose monitoring and adequate diabetes treatment, those findings reinforce the concept of diabetes-induced secondary immune deficiency and necessitate the application of booster doses to diabetic patients with priority. Nevertheless, after vaccination, reported adverse events were not different from those in the general population. No increase in severe adverse events was documented. While single case reports detected transient increases in blood glucose post-vaccination, more extensive trials could not replicate such a relationship.
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Affiliation(s)
- Georgi Vasilev
- Faculty of Medicine, Medical University of Plovdiv, Plovdiv 4000, Bulgaria
| | - Plamena Kabakchieva
- Clinic of Endocrinology, University Hospital “Alexandrovska,” Department of Internal Medicine, Medical Faculty, Medical University, Sofia 1431, Bulgaria
- Clinic of Internal Diseases, Naval Hospital-Varna, Military Medical Academy, Varna 9010, Bulgaria
| | - Dimitrina Miteva
- Department of Genetics, Sofia University “St. Kliment Ohridski,” Faculty of Biology, Sofia 1164, Bulgaria
| | - Hristiana Batselova
- Department of Epidemiology and Disaster Medicine, Medical University, University Hospital “St George,” Plovdiv 4000, Bulgaria
| | - Tsvetelina Velikova
- Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
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18
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Akarsu GD. Determining the Health Problems Experienced by Young Adults in Turkey, Who Received the COVID-19 Vaccine. Vaccines (Basel) 2022; 10:vaccines10091526. [PMID: 36146604 PMCID: PMC9502422 DOI: 10.3390/vaccines10091526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 01/08/2023] Open
Abstract
Aim: The aim of this study was to determine the health problems experienced by young adults after the COVID-19 vaccine. Method: This study is a quantitative and descriptive study and was completed with 590 undergraduate students studying at a state university in Central Anatolia in the spring semester of the 2021–2022 academic year. The data were collected by the researcher through a one-to-one interview with the students and a questionnaire prepared in line with the literature. Number, percentage and chi-square tests were used in the analysis of the data. Results: A total of 81.4% of the students participating in the study had the BioNTech–Pfizer vaccine. A total of 67.3% of them had two doses of COVID-19 vaccine, 35.9% of the vaccinated students experienced some health problems in the days following the vaccination, and the most common health problems were fatigue, a cough, sleep disturbance, psychological discomfort, a heart ache feeling and sweating. Most of the post-vaccine health problems lasted for 2 days, 3.7% of the participants were diagnosed with hypertension, 2.7% were diagnosed with diabetes mellitus and 10.52% of the female participants went to the doctor due to menstrual irregularity and received treatment. It was determined that 12.2% of the vaccinated students gained weight after vaccination and 63.89% of those who gained weight attributed this to increased appetite, 9.2% continued to have a cough and 9.2% used herbal products. Conclusion: It was determined that one out of every three young adults experienced a health problem after the COVID-19 vaccine. It is recommended that studies be conducted in different sample groups.
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Affiliation(s)
- Gökhan Doğukan Akarsu
- Department of Pharmacy Services, Vocational School of Health Services, Yozgat Bozok University, Yozgat 66100, Turkey
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19
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Infante M, Fabbri A, Padilla N, Pacifici F, Di Perna P, Vitiello L, Feraco A, Giuliano M, Passeri M, Caprio M, Ricordi C, Della-Morte D, Uccioli L. BNT162b2 mRNA COVID-19 Vaccine Does Not Impact the Honeymoon Phase in Type 1 Diabetes: A Case Report. Vaccines (Basel) 2022; 10:vaccines10071096. [PMID: 35891261 PMCID: PMC9319173 DOI: 10.3390/vaccines10071096] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/21/2022] [Accepted: 07/04/2022] [Indexed: 01/27/2023] Open
Abstract
Type 1 diabetes (T1D), which is caused by the autoimmune destruction of insulin-secreting pancreatic beta cells, represents a high-risk category requiring COVID-19 vaccine prioritization. Although COVID-19 vaccination can lead to transient hyperglycemia (vaccination-induced hyperglycemia; ViHG), its influence on the course of the clinical remission phase of T1D (a.k.a. “honeymoon phase”) is currently unknown. Recently, there has been an increasing concern that COVID-19 vaccination may trigger autoimmune phenomena. We describe the case of a 24-year-old young Italian man with T1D who received two doses of the BNT162b2 mRNA (Pfizer-BioNTech) COVID-19 vaccine during a prolonged honeymoon phase. He experienced a transient impairment in glucose control (as evidenced by continuous glucose monitoring) that was not associated with substantial changes in stimulated C-peptide levels and islet autoantibody titers. Nonetheless, large prospective studies are needed to confirm the safety and the immunometabolic impact of the BNT162b2 vaccine in T1D patients during the honeymoon phase. Thus far, T1D patients who are going to receive COVID-19 vaccination should be warned about the possible occurrence of transient ViHG and should undergo strict postvaccination surveillance.
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Affiliation(s)
- Marco Infante
- CTO Andrea Alesini Hospital, Division of Endocrinology and Diabetes, Department of Systems Medicine, University of Rome Tor Vergata, Via San Nemesio 21, 00145 Rome, Italy; (P.D.P.); (M.G.); (M.P.); (L.U.)
- Cell Transplant Center, Diabetes Research Institute (DRI), University of Miami Miller School of Medicine, 1450 NW 10th Ave, Miami, FL 33136, USA;
- Section of Diabetology, UniCamillus, Saint Camillus International University of Health Sciences, Via di Sant’Alessandro 8, 00131 Rome, Italy
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Via Cola di Rienzo 28, 00192 Rome, Italy
- Correspondence: or or
| | - Andrea Fabbri
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.F.); (F.P.); (D.D.-M.)
| | - Nathalia Padilla
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Colonia Centroamérica L-823, Managua 14048, Nicaragua;
| | - Francesca Pacifici
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.F.); (F.P.); (D.D.-M.)
| | - Pasquale Di Perna
- CTO Andrea Alesini Hospital, Division of Endocrinology and Diabetes, Department of Systems Medicine, University of Rome Tor Vergata, Via San Nemesio 21, 00145 Rome, Italy; (P.D.P.); (M.G.); (M.P.); (L.U.)
| | - Laura Vitiello
- Laboratory of Flow Cytometry, IRCCS San Raffaele, Via di Val Cannuta 247, 00166 Rome, Italy;
| | - Alessandra Feraco
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Via di Val Cannuta 247, 00166 Rome, Italy; (A.F.); (M.C.)
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Maria Giuliano
- CTO Andrea Alesini Hospital, Division of Endocrinology and Diabetes, Department of Systems Medicine, University of Rome Tor Vergata, Via San Nemesio 21, 00145 Rome, Italy; (P.D.P.); (M.G.); (M.P.); (L.U.)
| | - Marina Passeri
- CTO Andrea Alesini Hospital, Division of Endocrinology and Diabetes, Department of Systems Medicine, University of Rome Tor Vergata, Via San Nemesio 21, 00145 Rome, Italy; (P.D.P.); (M.G.); (M.P.); (L.U.)
| | - Massimiliano Caprio
- Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele, Via di Val Cannuta 247, 00166 Rome, Italy; (A.F.); (M.C.)
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Camillo Ricordi
- Cell Transplant Center, Diabetes Research Institute (DRI), University of Miami Miller School of Medicine, 1450 NW 10th Ave, Miami, FL 33136, USA;
| | - David Della-Morte
- Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.F.); (F.P.); (D.D.-M.)
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via di Val Cannuta 247, 00166 Rome, Italy
- Department of Neurology, Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, 1120 NW 14th St, Miami, FL 33136, USA
| | - Luigi Uccioli
- CTO Andrea Alesini Hospital, Division of Endocrinology and Diabetes, Department of Systems Medicine, University of Rome Tor Vergata, Via San Nemesio 21, 00145 Rome, Italy; (P.D.P.); (M.G.); (M.P.); (L.U.)
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20
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di Mauro G, Mascolo A, Longo M, Maiorino MI, Scappaticcio L, Bellastella G, Esposito K, Capuano A. European Safety Analysis of mRNA and Viral Vector COVID-19 Vaccines on Glucose Metabolism Events. Pharmaceuticals (Basel) 2022; 15:ph15060677. [PMID: 35745596 PMCID: PMC9229409 DOI: 10.3390/ph15060677] [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: 04/20/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 12/10/2022] Open
Abstract
Few data have been published on the effects of impaired glucose metabolism induced by COVID-19 vaccines. We decided to perform a study to describe Individual Case Safety Reports (ICSRs) of impaired glucose metabolism events reported in the European database (Eudravigilance, EV). ICSRs were retrieved from the online website of Eudravigilance. The reporting odds ratios (ROR) were computed to assess the reporting frequency for COVID-19 mRNA vaccines compared to COVID-19 viral vector-based vaccines. A total of 3917 ICSRs with a COVID-19 vaccine suspected were retrieved, with a total of 4275 impaired glucose metabolism events. Overall, the most reported events were related to “high glucose levels” (2012; 47.06%). The mRNA vaccines were associated with an increased reporting frequency of “type 1 diabetes mellitus” (ROR 1.86; 95% CI 1.33–2.60), “type 2 diabetes mellitus” (ROR 1.58; 95% CI 1.03–2.42), “high glucose levels” (ROR 1.16; 95% CI 1.06–1.27), “diabetes mellitus inadequate control” (ROR 1.63; 95% CI 1.25–2.11), and “hypoglycemia” (ROR 1.62; 95% CI 1.41–1.86) compared to viral vector-based vaccines. mRNA COVID-19 vaccines were associated with an increased reporting frequency of alterations of glucose homeostasis compared to viral-vector COVID-19 vaccines. Clinicians should be aware of these events to better manage glycemic perturbations. Larger nationwide studies are warranted to verify these findings.
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Affiliation(s)
- Gabriella di Mauro
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (G.d.M.); (A.C.)
- Department of Experimental Medicine, Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Annamaria Mascolo
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (G.d.M.); (A.C.)
- Department of Experimental Medicine, Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-0815-667-652
| | - Miriam Longo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.L.); (M.I.M.); (L.S.); (G.B.); (K.E.)
- Division of Endocrinology and Metabolic Diseases, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maria Ida Maiorino
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.L.); (M.I.M.); (L.S.); (G.B.); (K.E.)
- Division of Endocrinology and Metabolic Diseases, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Lorenzo Scappaticcio
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.L.); (M.I.M.); (L.S.); (G.B.); (K.E.)
| | - Giuseppe Bellastella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.L.); (M.I.M.); (L.S.); (G.B.); (K.E.)
- Division of Endocrinology and Metabolic Diseases, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (M.L.); (M.I.M.); (L.S.); (G.B.); (K.E.)
- Division of Endocrinology and Metabolic Diseases, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Annalisa Capuano
- Campania Regional Centre for Pharmacovigilance and Pharmacoepidemiology, 80138 Naples, Italy; (G.d.M.); (A.C.)
- Department of Experimental Medicine, Section of Pharmacology “L. Donatelli”, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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