Category: Covid-19 Vaccine

The coronavirus disease 2019 (COVID-19) pandemic increased the risk of severe disease and death in multiple categories, including very young infants and pregnant women. The rollout of effective vaccines in late 2020 was posited to prevent severe disease and death, even after acute infection. During this time, vaccination was advised in pregnancy to protect both mother and baby through the transplacental delivery of the antibodies.

However, the differences in protection conferred by maternal COVID-19 vaccination among preterm and full-term babies remain unclear. A new study published in JAMA Network Open reports on the levels of maternal-origin antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in preterm babies.

Study:Timing of Maternal COVID-19 Vaccine and Antibody Concentrations in Infants Born Preterm. Image Credit: SciePro / Shutterstock.com

COVID-19 vaccines have successfully reduced the number of serious illnesses and deaths related to the disease during pregnancy. With vaccination, outcomes like hospitalization, admission to the intensive care unit (ICU), and deaths have significantly declined from the increased rates observed with COVID-19 in pregnancy.

Prior research indicated that vaccinated pregnant women have a lower risk of illness, hospitalization, admission to critical care units (CCUs), stillbirths, and neonatal death as compared to non-vaccinated pregnant women. The antibodies induced by the vaccine are primarily targeted against the viral spike antigen and cross the placenta through active transfer.

Fetal blood contains steadily increasing concentrations of maternal immunoglobulin G (IgG) antibodies transferred across the placenta from 10% of maternal concentrations by mid-pregnancy to 50% by 28-32 weeks. Maternal vaccination against COVID-19 may protect the baby against severe COVID-19; however, there remains a lack of data confirming that maternal vaccination provides sufficient levels of protective anti-spike antibodies in preterm deliveries.

The current study aimed to measure and compare anti-spike antibody levels in cord blood samples from preterm and full-term deliveries with maternal blood samples. To this end, the current study comprised a prospective cohort of pregnant women from whom blood samples were collected, along with cord blood samples from their newly delivered infants between February 2021 and January 2023.

All participants had two or more doses of a messenger ribonucleic acid (mRNA) COVID-19 vaccine prior to delivery. None of the study participants had current or prior COVID-19.

Of the 220 participants, with a median age of 34, there were 36 and 184 preterm and full-term deliveries, respectively. Over 80% of the study participants were White, 12% Asian, and 2% and 6% were Black and Hispanic, respectively.

Women who delivered preterm had a higher body mass index (BMI) value of about 32 as compared to 30 for those who delivered full-term. Women with higher BMI values were also associated with an increased risk of diabetes prior to conception, pre-eclampsia, and chronic hypertension.

The median gestational age for preterm infants was 35 weeks as compared to 39.5 weeks for full-term infants. About 66% of preterm infants were delivered through Cesarean section as compared to 33% of full-term infants.

About 120 and 100 women received two or three vaccine doses each, respectively, before delivery. Among those who delivered preterm infants, about 70% had three or more vaccine doses, compared to 40% for full-term infants.

The time from the last vaccine dose to delivery was about 16 weeks, with the median gestational age at the time of the last dose being 25 weeks for both preterm and full-term pregnancies.

The concentration of anti-spike antibodies in maternal blood was 674 with two doses and more than 10-fold higher at 8,169 with three or more doses. The corresponding concentrations in cord blood samples were 1,000 and about 10,000, respectively.

Maternal blood antibody concentrations were higher in pregnancies that ended prematurely as compared to full-term deliveries. However, cord blood antibody levels were lower in preterm infants, which led to a lower cord-to-maternal antibody ratio in preterm deliveries.

This difference between pregnancies ending in full-term and preterm deliveries was not observed for either maternal antibody levels or cord-to-maternal blood antibody ratios after adjusting for the time of pregnancy at which vaccination was performed. The peak ratio was observed at about 10 weeks from the last vaccine dose.

When adjusted for the time of vaccination and number of vaccine doses, there was no association between preterm delivery and antibody levels.

Cord blood antibody levels in infants born to women who received at least three doses of a COVID-19 mRNA vaccine were ten times higher than in infants born to women who received two doses. Nevertheless, this finding did not correlate with gestational age at the time of delivery. Furthermore, there was no significant difference in antibody levels in cord blood between preterm and full-term deliveries.

While the association of three or more vaccine doses with higher antibody concentrations has been previously reported, this is the first time that it has been compared between preterm and full-term infants.

Despite lower antibody transfer ratios in preterm infants, an increased number of vaccine doses before delivery could improve the final concentration of cord blood antibodies. Thus, it is recommended that the booster dose be administered before the third trimester in women at risk for preterm delivery, while others may receive it approximately 10 weeks before the estimated date of delivery.

Maternal antibody concentrations appeared more important than delivery gestational age in determining cord antibody levels.

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Maternal COVID-19 vaccination equally benefits preterm and full-term babies - News-Medical.Net

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A randomized clinical trial conducted in three Asian countries found that a shorter, individualized course of antibiotics guided by clinical response was non-inferior to usual care for patients with ventilator-associated pneumonia (VAP), researchers reported yesterday in The Lancet Respiratory Medicine.

The trial, conducted in 39 intensive care units at six hospitals in Nepal, Singapore, and Thailand, enrolled VAP patients who had been mechanically ventilated for 48 hours and were administered culture-directed antibiotics. Patients were assessed until fever resolution for 48 hours and hemodynamic stability, then randomly assigned to individualized short-course treatment (7 days or less) or usual care (8 days or more). The primary outcome was a 60-day composite end point of death or pneumonia recurrence, with a prespecified non-inferiority margin of 12%.

A total of 461 patients (median age 64 years, 39% female) were enrolled, with 232 randomized to the short-course treatment group and 229 to the usual-care group. Median antibiotic treatment duration for index episodes of VAP was 6 days in the short-course group and 14 days in the usual-care group. In the intention-to-treat population (460 patients), 41% of patients in the short-course group met the primary end point, compared with 44% in the usual-care group, for an absolute risk difference of 3% (one-sided 95% confidence interval [CI], to 5%).

The results were similar in the per-protocol population. Although non-inferiority was met in both analyses, superiority compared with usual care was not established.

In the per-protocol population, antibiotic side effects occurred in 8% of patients in the short-course group, compared with 38% in the usual-care group (absolute risk difference, 31%; 95% CI, 37% to 25%).

The investigators say that the results are noteworthy, because very few trials of antibiotic treatment for VAP have been conducted in low- and middle-income settings, where high rates of VAP are a major driver of antibiotic use and contribute to the presence of multidrug-resistant organisms.

"This strategy based on simple parameters is readily applicable in low-income and middle-income countries and could have a considerable impact on reducing overall antibiotic prescribing, potentially curbing the spread of antimicrobial resistance among the most vulnerable patients," they wrote.

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WHO grants emergency listing for Corbevax COVID vaccine - University of Minnesota Twin Cities

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As the COVID-19 pandemic raged throughout the country in 2020, politics, memes and public messaging converged to dramatically influence individuals' decisions regarding the in-development COVID vaccines, according to a new article by researchers at the University at Albany's Massry School of Business and Washington State University's Carson College of Business.

In "Reexamining health messages in the political age: The politicization of the COVID-19 pandemic and its detrimental effects on vaccine hesitancy," published in the Journal of Consumer Affairs, authors Ionnis Kareklas, Devipsita Bhattacharya, Darrel D. Muehling and Victoria Kissekka examine how voters' political leanings informed their decision to receive a COVID-19 vaccine.

"We explore how radically opposing viewpoints regarding the pandemic may have eroded public trust in government institutions and health science during the months leading up to the 2020 U.S. presidential election," said Kareklas, associate professor and chair of Marketing at UAlbany, who led the investigation.

The authors also reviewed how memes on social media played a role in affecting viewers' attitudes toward health care, especially whether they would get a COVID-19 vaccine. Analysis of the researchers' data revealed that survey respondents relied heavily on social media to get trustworthy vaccine information, yet most vaccination-related memes were anti-vaccine.

Along with survey data, Kareklas and his team analyzed 18,000 tweets containing pictures of COVID-19 anti-vaccine memes/pictures from Twitter between Oct. 30 and Nov. 11, 2020.

They found that the memes generally fell into three categories:

The memes often incorporated logical or rhetorical fallacies, including appealing to anger, suppressing evidence, misleading vividness or deliberate lies.

"These findings from Twitter, along with those of our first survey, prompted us to consider further the potential impact of meme-based, politically persuasive communications on individuals' COVID-19 vaccination decisions," said Kareklas.

The third study assessed participants' level of trust in medical, scientific evidence and government institutions, with the goal of determining if public sentiment could be swayed.

"Here, we observed a striking dichotomy between Trump and Biden voters," continued Kareklas. "Specifically, while Biden (compared to Trump) voters were significantly more likely to indicate that their trust in government had decreased in the last four years, Trump (compared to Biden) voters were significantly more likely to indicate their trust in medical, scientific evidence had decreased. Such polarized positions regarding these vital public health institutions (i.e., science and government) further documents the politicization of health science."

These political and philosophical divisions have created an environment where it has become increasingly challenging for health agencies to fulfill their mission to protect the nation, both during the pandemic and in similar future situations, according to the researchers.

"The private and public disagreements among politicians and health experts made it especially difficult to have a coherent policy for addressing the pandemic and consistent messaging regarding how to combat COVID-19," said Kareklas.

The findings do suggest, however that, consistent with the source credibility literature, messaging campaigns that feature a highly credible spokesperson who is perceived to have high levels of expertise and trustworthiness could differentially influence individuals who are hesitant to trust government institutions.

According to former CDC director Tom Frieden, who participated in the focus group, several focus group participants changed their minds about taking the vaccine after hearing the facts without political spin from doctors, as opposed to taking advice from politicians.

More information: Ioannis Kareklas et al, Reexamining health messages in the political age: The politicization of the COVID19 pandemic and its detrimental effects on vaccine hesitancy, Journal of Consumer Affairs (2023). DOI: 10.1111/joca.12553

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Study explores how opposing viewpoints may have impacted vaccine hesitancy - Phys.org

Photo taken on Dec. 8, 2022 shows an exterior view of the headquarters of the European Centre for Disease Prevention and Control (ECDC) in Stockholm, Sweden. (Photo by Wei Xuechao/Xinhua)

Approximately 5.5 million of the vaccine doses were given to people aged 80 or over during the period from Sept. 1, 2023 to Jan. 15, 2024, the ECDC said.

STOCKHOLM, Jan. 26 (Xinhua) -- Around 19.4 million people aged 60 or older in European countries have received a vaccine dose against COVID-19 since September 2023, the European Centre for Disease Prevention and Control (ECDC) said on Friday.

The ECDC has stressed the urgency of revaccinating the elderly against COVID-19. Approximately 5.5 million of the vaccine doses were given to people aged 80 or over during the period from Sept. 1, 2023 to Jan. 15, 2024, the ECDC said.

Vaccination efforts should continue to focus on protecting people at risk of progression to severe disease, for example, people aged over 60 years, other vulnerable individuals irrespective of age, and pregnant women, the ECDC said in a press release.

Healthcare workers should also be considered as a priority group for COVID-19 revaccination, the ECDC added.

The median COVID-19 vaccination coverage among those aged 60 and over was 11.1 percent, with high variation among countries, the ECDC reported.

People walk on a road in Stockholm, Sweden on Jan. 17, 2024. (Xinhua/He Miao)

In three of the 24 reporting countries, coverage was above 50 percent in this age group.

Among those aged 80 and older, the median coverage for vaccination was 16.3 percent, with eight of the 24 countries reporting coverage above 50 percent. Meanwhile, one country had coverage above 80 percent in this age group: Denmark with 88.2 percent.

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ECDC calls on revaccinating elderly against COVID-19 - Xinhua

Study site, population, and study design

The COVID-19 Outcomes in Mother-Infant Pairs (COMP) study is a longitudinal cohort study of pregnant patients who had SARS CoV-2 during gestation and their infants7,13. Pregnant individuals, 16 years old or older, with confirmed SARS-CoV-2 infection by nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR), antigen (Ag) or serology during gestation were eligible for enrollment, regardless of preexisting conditions. Participants were primarily recruited by the Department of Obstetrics at the University of California, Los Angeles (UCLA) from 15 April 2020 to 31 August 2022. Beginning in April 2020, all women admitted to UCLA labor and delivery were screened for SARS-CoV-2 by nasopharyngeal swab. Two-hundred and twenty-one pregnant individuals, aged 16 to 56 years old, and 227 SARS-CoV-2 exposed fetuses were enrolled in our study. This resulted in 199 live births following in utero exposure to COVID-19. Maternal-infant pairs were followed longitudinally until the infants reached 6 months of age. The UCLA Medical Center comprises of multiple teaching hospitals, including tertiary and quaternary referral centers, and services the Los Angeles region in Southern California.

Informed consent for participation was obtained for all participants prior to enrollment. If a participant was incapable to provide consent (i.e., due to an acute hospitalization or intubated), consent was provided by a surrogate decision maker and the participant was re-consented once they regained capacity. Information was obtained directly from participants using RedCap survey software and from clinical chart review using EPIC. Our study was approved by the UCLA Internal Review Board (IRB).

Our primary outcome was neonatal RD, which was defined as infants with at least two of the following: respiratory rate of 60 breaths per minute, retractions, nasal flaring, or central cyanosis. Infants were considered premature if they were born at a gestational age less than 37 weeks. Maternal COVID-19 severity was determined by NIH classification14. Briefly, maternal critical illness describes patients with respiratory failure (requiring mechanical ventilation) or signs of multiple organ failure; severe illness was defined as patients with oxygen saturation (SpO2)<94% on room air, a ratio of arterial partial pressure of oxygen to fraction of inspired oxygen (PaO2/FiO2)<300mmHg, a respiratory rate >30 breaths/min, or lung infiltrates >50%; moderate illness was defined as individuals with evidence of lower respiratory disease on clinical assessment or imaging with a SpO294% but did not require supplemental oxygen; mild illness describes symptomatic patients without shortness of breath, dyspnea or abnormal chest imaging; and asymptomatic individuals showed no symptoms14. Women were considered vaccinated if they received at least one dose of an mRNA COVID-19 vaccine prior to infection. Women who received the Janssen/Johnson & Johnson COVID-19 during pregnancy were not included (n=1).

Maternal race and ethnicity were operationalized into three categories (Black, Hispanic, and Latina; Asian, Mixed-Race, and Other; or White) based on self-reported racial identity. We acknowledge that race is a social construct and our categorizations may not adequately reflect an individuals identity. However, we included race in our univariate analysis given the history of systemic racism that has contributed to poor maternal outcomes among black women in the United States43. None of the mothers in our study self-identified as non-binary or transgender, therefore we have used gendered language in our text to refer to pregnant persons.

We compared the demographics of infants born with and without RD using one-way t-tests. We considered variables related to infant characteristics (sex, delivery method, prematurity, low birth weight), maternal predictors (maternal age, ethnicity, preexisting medical conditions), pregnancy complications (e.g., preeclampsia, gestational hypertension, chorioamnionitis, etc.), and COVID-19 predictors (maternal vaccination, trimester of infection, severity, symptoms, treatment, viral variant). The Fisher exact statistical test was used to obtain p-values. We did not adjust for multiple comparisons in our bivariate analyses because it was exploratory. Next, we conducted logistic regression analyses on neonatal RD, prioritizing variables that were significant in the previous t-tests and based on clinical suspicion of intermediate variables and effect modifiers. The following variables were used as predictors in our univariate analysis: maternal ethnicity, trimester of infection, COVID-19 severity, maternal vaccination status, and binary prematurity. We selected variables to include in our final model using a backwards selection and WALDs test. As recommended by ref. l44, we initially included all variables in a model and eliminated each variable above the p-value threshold of 0.25. This process was repeated until the remaining variables had p values below the threshold. We considered potential collinearity or lack of independence among predictor variables using chi-squared tests for independence. Similarly, our final multivariable model did not include maternal COVID-19 severitydespite evidence of significance in univariate regression modelsbecause of the known association between COVID-19 severity and vaccination status. Including both COVID-19 severity and vaccination status would have likely attenuated the strength of our findings. In order to evaluate whether prematurity mediates the effect of maternal COVID-19 on neonatal respiratory distress, we utilized the Valeri and Vanderweele mediation analysis45. Approximately 18% of the risk of neonatal respiratory distress is mediated by prematurity, although not statistically significant (p=0.3). Our final model for neonatal RD included binary maternal vaccination status and infant prematurity as predictors. Finally, we conducted a chart and imaging review to better characterize features of infant RD born to women infected with COVID-19 during pregnancy.

We performed a post-hoc power analysis in which we calculated the power achieved in our study based upon the false positive rate, the effect size of maternal COVID-19 vaccination prior to infection in protecting against adverse perinatal outcomes, and the number of pregnant individuals in our cohort. To carry out the calculation, we needed to supply a value for the effect size that was independent of our cohort. According to a systematic review and meta-analysis, rates of adverse perinatal outcomes were 15% higher in unvaccinated pregnant individuals than among those who were vaccinated46. Therefore, our post-hoc power analysis assumed that the rate of such outcomes would be at least 15% higher among pregnant women who were not vaccinated. The null hypothesis was that the rates of adverse outcomes would be the same among vaccinated and unvaccinated pregnant people. In the present cohort of 227 pregnancies, approximately one-third of the participants were vaccinated before COVID-19 infection.

We carried out a post-hoc power analysis using G*Power 3.1.9.447. Our calculations assumed a 5% false-positive rate and used a two-tailed test of the difference in proportions between the vaccinated and unvaccinated groups. The results indicated that our analysis had 90% power, in other words, the chance of rejecting the null hypothesis if it was false was 90%. This rate is reasonably high and we believe it provides support for our conclusions about this cohort.

Data was analyzed using R language48. Statistical analysis was conducted using a combination of epiDisplay package49, tableone package49, stats base package, and aod package50.

The present data is reanalyzed from a dataset previously published by our group7. We conducted a proteomic reanalysis to explore potential associations between respiratory distress and canonical pathways possibly associated with SARS CoV-2 in a subset of infants for whom proteomics was performed. We analyzed a subset of 45 SEU infants born in the first year of the pandemic (April 2020 to March 2021) matched to seven control infants born to unexposed healthy women at the pandemic onset, for a total of 52 infants (Fig.1). Controls were from a convenience sample of healthy mothers who did not have SARS-CoV-2 exposure and for whom infant specimens were available. Infants were matched based on gestational age. This analysis utilizes peripheral infant blood specimens collected between 24 and 48h of life. This timeframe was selected to coincide with routine bilirubin checks in order to minimize blood draws. The SEU infant cohort was clustered according to RD outcome and gestational age, resulting in four groups: no RD term infants (n=27), no RD preterm infants (n=3), RD term infants (n=4), and RD preterm infants (n=11). Significant differentially expressed proteins between healthy and the four COVID-19-exposed infant groups were determined by two-tailed Mann Whitney U test using the R base package, t.test, considering fold-change 2 and FDR-adjusted p value<0.05. Enrichment analysis was conducted using the online platform Enricher51. Comparisons between multiple groups using 1-way ANOVA with uncorrected Fishers test in GraphPad Prism v9.4.0. Network and pathways analyses were performed using QIAGEN Ingenuity Pathway Analysis (IPA) v01-19-007,42.

This research was conducted locally in Los Angeles, California and was approved by the UCLA Internal Review Board. The authors come from diverse socioeconomic backgrounds and have expertise in a variety of disciplines across medicine and public health. This manuscript cites prior studies from across the United States, including Los Angeles, with an emphasis on sources about maternal and child health. Our results are locally relevant with the goal of providing physicians and patients more information about the benefits of COVID-19 vaccination. Furthermore, it can help guide future research and understandings of the long-term sequelae of SARS-CoV-2.

The roles and responsibilities of the authors were agreed upon prior to conducting the analysis. This project and future projects have been designed with special attention to continue to train medical students, medical residents and fellows, graduate students, and post doctorial researchers.

The data collection process and analysis methods did not result in increased stigmatization, incrimination, discrimination, or other personal risks to our study participants. This study did not cause increased health, safety, or security risks to the researchers or participants. No animal welfare, environmental protection, or biorisk-related regulations were violated by our study. Our study did not involve the transfer of biological materials, cultural artefacts, or associated traditional knowledge.

Further information on research design is available in theNature Portfolio Reporting Summary linked to this article.

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Respiratory distress in SARS-CoV-2 exposed uninfected neonates followed in the COVID Outcomes in Mother-Infant ... - Nature.com

Infection with the virus that causes COVID-19 increases a person's risk for heart-related complications, including pericarditis (inflammation of the heart's outer lining) and myocarditis (inflammation of the heart muscle).

Receiving a COVID-19 vaccine has also been associated, albeit rarely, with potential adverse heart-related effects, namely myocarditis and pericarditis.

Though pericarditis and myocarditis are both inflammatory heart conditions and can coexist (called myopericarditis), this article focuses mainly on the link between pericarditis and the COVID-19 infection and vaccine.

andreswd / Getty Images

Pericarditis is inflammation of the pericardium, a thin sac surrounding the heart. The purpose of the pericardium is to stabilize the heart's position in the chest and minimize friction between the heart and nearby organs/structures like the lungs.

Pericarditis causes sharp or stabbing chest pain that worsens with breathing and typically improves when sitting up or leaning forward.

There are multiple potential causes of pericarditis, including viral infections like COVID-19, as well as autoimmune diseases (e.g., lupus), cancer, and kidney failure.

COVID-19-induced pericarditis is believed to be caused by three processes:

In addition to COVID-19 infection possibly causing pericarditis, rare cases of pericarditis have been observed after receiving the COVID-19 vaccine. Specifically, research has also found a causal link between pericarditis and the mRNA COVID-19 vaccines, Pfizer-BioNTech and Moderna.

Moreover, findings from clinical studies and vaccine safety monitoring outside of the United States suggest an elevated risk of pericarditis after receiving the Novavax vaccine, a protein-based vaccine.

Heart-related conditions, including pericarditis, are a potential consequence of COVID-19 infection.

A study whose statistical findings were reviewed by the Centers for Disease Control and Prevention (CDC) analyzed over 800,000 people infected with COVID-19 from 40 healthcare systems in the United States.

In males, results revealed the incidence of myocarditis or pericarditis seven to 21 days after infection to be:

In females, the results included:

This article uses the terms for sex or gender from the cited studies and sources. In those sources, they generally pertain to sex assigned at birth.

The development of pericarditis (and myocarditis) after receiving the COVID-19 vaccine is very rare but has still been reported more often than expected.

A study that analyzed data from 40 healthcare systems in the United States (same as above) found the incidence of pericarditis or myocarditis after the mRNA COVID-19 vaccine to be the following across all age groups and after any vaccine dose:

For males:

For females:

Current research has found that the risk of pericarditis is significantly higher after a COVID-19 infection than after an mRNA COVID-19 vaccination for males and females in all age groups.

Regarding pericarditis from the Novavax COVID-19 vaccine, data is scant, and more investigation is required, although cases have been reported in the United States and worldwide.

In a review article collecting data from 33 studies, COVID-19-related pericarditis was found to affect individuals at any age and be twice as common in males compared to females.

Also, nearly 50% of people with COVID-19-related pericarditis had reported a history of high blood pressure, followed by diabetes and high cholesterol, suggesting that certain underlying health conditions could increase a person's risk for this heart complication.

Regarding the COVID-19 vaccines, an increased risk for pericarditis was observed among individualsparticularly adolescent and young adult maleswithin seven days after receiving the second dose of an mRNA COVID-19 vaccine.

Data is still limited regarding links between pericarditis and the Novavax vaccine. However, one study analyzing reports to the World Health Organization (WHO) found that most cases of myopericarditis after the Novavax vaccine involved males with a median age of 35.5 years.

Similar to the mRNA vaccines, most cases of pericarditis also occurred after the second Novavax vaccine dose.

COVID-19 infection can present itself in many different ways, ranging from no symptoms to a mild cold to severe illness, including respiratory failure (the inability to breathe on your own) and multiple organ failure.

Though most people with COVID-19 fully recover, a significant number of affected individuals experience long-term health complicationswhat's known as long COVID or post-COVID-19 syndrome.

Symptoms of long COVID-19 may start during or after the acute illness and can last for weeks, months, or even years.

Possible heart-related manifestations of long COVID-19 include:

Other examples of potential long COVID-19 health manifestations include:

The most commonly reported symptoms of pericarditis associated with COVID-19 infection are:

Other reported symptoms include cough, fatigue, muscle aches, and diarrhea.

According to the CDC, young children with pericarditis (or myocarditis) may have irritability, vomiting, poor feeding, rapid breathing, or lethargy.

According to the American Heart Association, individuals should seek immediate medical attention for the following symptoms:

Pericarditis may develop when a person is acutely ill with COVID-19 or after they have recovered from the infection.

Specifically, one study reported that in people with COVID-19-related pericarditis, the condition was diagnosed between five and 56 days after infection.

Another study of people who had received the COVID-19 vaccination found an increased risk of pericarditis in the one to 28 days following a positive COVID-19 test.

Cases of pericarditis after receiving the Moderna or Pfizer-BioNTech COVID-19 vaccine most commonly developed within seven days after receiving the second dose.

Minimal data regarding pericarditis after the Novavax vaccine suggest a timeline similar to that of the mRNA vaccines, with symptom onset beginning eight to 10 days after the second dose.

Scientific data has found that the incidence of pericarditis developing in people with COVID-19 who are hospitalized is less than 0.5%.

That said, people hospitalized with COVID-19-induced pericarditis have higher mortality (death) rates than those hospitalized with COVID-19 without pericarditis.

Moreover, hospitalized people infected with COVID-19 with pericarditis were more likely to stay in the hospital longer. They also had a higher chance of developing complications, namely cardiac arrest and acute kidney injury.

There is no defined or predominant strategy for treating COVID-19-induced pericarditis, although any treatment aims to ease the inflammation of the pericardium and alleviate symptoms, namely chest pain.

Studies of COVID-19-induced pericarditis found that most affected individuals were safely and effectively treated to reduce inflammation with colchicine, a nonsteroidal anti-inflammatory drug (NSAID), or a combination of these drugs.

The NSAIDs typically used were:

Less commonly, corticosteroids ("steroids"), which also work to reduce inflammation, were used.

Interventional therapies were only implemented when people developed cardiac tamponade, a complication of pericarditis wherein extra fluid collects around the heart, impairing the heart's function.

The treatment of cardiac tamponade involves urgent draining of the excess fluid surrounding the heart, which is usually performed using a needle or, less commonly, surgery.

The complications of long COVID are diverse and sometimes debilitating. To best cope, experts recommend devising a personalized care plan under the guidance of one or more healthcare providers.

Try to make the most of your appointments by preparing beforehand with a list of your symptoms, medications, and past medical conditions. Also, consider bringing a loved one to your appointments for support and perhaps help detailing what you are going through.

In addition to managing physical symptoms (e.g., intense fatigue, breathlessness, and muscle pain, among many possible others), it's also important to acknowledge the various emotional challenges of living with long COVID. You might feel anger, frustration, or anxiety over the impact this illness has had on your daily functioning and quality of life.

To combat negative feelings and thoughts, reach out to trusted friends, family members, or colleagues for comfort. Also, talk with a healthcare provider because you may benefit from medication or a referral to atherapist.

Pericarditisthe inflammation of the tissue surrounding the heartcan develop during an acute COVID-19 infection or after recovery. Other heart-related consequences of COVID-19 include myocarditis, heart failure, heart attack, and arrhythmia.

Pericarditis may also rarely occur following receipt of an mRNA COVID-19 vaccine (Moderna or Pfizer-BioNTech), with the risk being highest in adolescent and young adult males after receiving the second dose. Data regarding the risk of pericarditis from the Novavax protein-based vaccine is still emerging.

Overall, experts have found that the risk of pericarditis is higher from getting infected with COVID-19 than receiving the COVID-19 vaccine for people of any sex across all age groups. As such, the CDC recommends staying up to date on COVID-19 vaccination for all eligible individuals.

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Pericarditis, COVID, and Vaccines: What's the Link? - Verywell Health

Vitiligo typically presents as a sporadic condition with genetic and autoimmune influences. While viral infections have been implicated as triggers for vitiligo, the role of COVID-19 vaccination in its onset remains underexplored. A recent study presents a unique case of sudden-onset vitiligo following the COVID-19 vaccination, along with a systematic review of existing literature to shed light on the potential link between vaccination and vitiligo development.

Case Presentation

A 62-year-old woman, with no history of autoimmune disease, developed a depigmented rash within 24 hours of receiving her first Pfizer-BioNTech SARS-CoV-2 vaccination. The rash extended to her face, arms, and chest and worsened after the second dose. Despite oral and topical steroid treatments, as well as tacrolimus cream, the patient reported only subjective improvement in her skin lesions. While vitiligo typically arises sporadically, the temporal relationship between vaccination and depigmentation suggests a potential link, urging clinicians to investigate and share similar cases.

Literature Review

A systematic review of literature found in the PubMed, Embase, Scopus, and Web of Science databases focused on vitiligo onset postCOVID-19 infection or vaccination. The search revealed a total of 17 reported cases. Of these, 15 cases (88.2%) were associated with vaccination, and 2 cases (11.8%) followed primary COVID-19 infection. Most patients experienced a new onset of vitiligo (88.2%), while 2 cases reported worsening of preexisting vitiligo. The depigmentation varied in location, with 64.7% reporting generalized vitiligo and 35.3% presenting with local vitiligo. Locations of depigmentation varied among the 17 patients, and many reported pigment changes in more than one region of their bodies.

In the cases following vaccination, 53.3% described hypopigmented lesions after the first dose and 40.0% reported onset after the second dose. Only 23.5% of the total cases had a history of autoimmune disease. Diagnostic methods included Woods lamp examination (76.5%), biopsy (11.8%), Woods lamp and biopsy (5.9%), or clinical diagnosis alone (5.9%). Treatment outcomes were variable, with no complete improvement reported, 23.5% reporting some improvement, 11.8% showing no improvement, and 64.7% lacking follow-up data.

Pearls From Past Research

Vitiligos pathogenesis involves the destruction of melanocytes, and while its exact cause remains unknown, proposed triggers include physical injury, emotional stress, and autoimmune conditions. In the presented case and others in the literature, the temporal relationship between COVID-19 vaccination and vitiligo onset raises questions about a potential causal link.

The prevailing autoimmune theory suggests the involvement of cytotoxic T cells in the destruction of melanocytes. Biopsies in vitiligo cases have shown infiltrating cytotoxic CD8+ lymphocytes, leading to melanocyte apoptosis. Additionally, elevated levels of cytokines like tumor necrosis factor-alpha (TNF-), interferon gamma, and interleukin (IL)-10 and IL-17 have been implicated in melanocyte destruction. Notably, the Pfizer-BioNTech vaccine has been associated with an inflammatory response involving upregulation of type 1 helper T cells and increased levels of IL-2, interferon gamma, and TNF-, suggesting a potential link to vitiligo development.

The literature also reports new-onset autoimmune diseases following COVID-19 vaccination, including lichen planus, Guillain-Barr syndrome, systemic lupus erythematosus, and immune thrombotic thrombocytopenia. Notably, one case included in our study described an eruption of lichen planus after the first dose of the COVID-19 vaccine, which worsened after the second dose. Additionally, the patient developed vitiligo macules in several areas after the second dose, study authors wrote.

Molecular mimicry, where autoantibodies or vaccine adjuvants contribute to autoimmunity, has been proposed as a potential mechanism.

Further Research Needed

While the reported cases of vitiligo following COVID-19 vaccination are rare, the temporal relationship observed in this and other cases prompts consideration of a potential link between the vaccine and the onset of vitiligo. It is crucial for clinicians to be aware of the possibility of developing or worsening skin diseases post vaccination or infection. Despite the limited sample size and heterogeneity of reported data, the potential risk of skin diseases should be weighed against the substantial benefits of COVID-19 vaccination.

Further research is necessary to establish a definitive causal relationship between COVID-19 vaccination and vitiligo onset. In the interim, clinicians should remain vigilant for similar reactions and treat them appropriately. The benefits of COVID-19 vaccination in preventing severe infection and its associated risks outweigh the rare occurrences of skin conditions. Continued monitoring and investigation will contribute to our understanding of the complex interplay between vaccination, autoimmune responses, and dermatological outcomes.

This story first appeared in Dermatology Times

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Study Examines the Correlation Between COVID-19 Vaccination and Vitiligo Onset - Managed Healthcare Executive

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Rates of death, vision loss, and pediatric intensive care unit (PICU) admissions among diabetes patients spiked during the pandemic, finds a systematic review of 138 studies from around the world.

Researchers from the University of Massachusetts (UMass) and the University of Leicester in England analyzed data from 138 studies on the effects of COVID-related disruptions on the clinical outcomes of diabetes patients published from January 2020 to June 2023. The studies, which included more than 1 million diabetes patients, compared prepandemic with pandemic periods.

The studies were from North America (39 studies), Western Europe (39), Asia (17), Eastern Europe (14), South America (4), Egypt (1), Australia (1), and multiple regions (33).

The review is published in The Lancet Diabetes & Endocrinology.

The six studies that examined all-cause death and the 13 on diabetes-related death showed consistent increases in both, with six finding increases in vision loss. Adult and mixed samples indicated a rise in the frequency or severity of diabetic ketoacidosis (a potentially life-threatening complication)some cases due to new-onset diabetesamong children and adolescents but not adults (69 studies). Data from 35 studies suggested a decline in adult hospitalization but higher rates of diabetes-related PICU admissions.

The data on pediatric ICU admissions and pediatric diabetes ketoacidosis is probably the most striking thing that comes out of this review.

Rates of new-onset type 1 diabetes were higher than expected, and children with this type of disease were much sicker during than before the pandemic. Pandemic-related effects were most evident in females, younger people, and racial minority groups. "Further studies are needed to investigate the longer-term impact of the pandemic on potential differential impacts, which risk further exacerbating existing inequalities within people with diabetes," the authors wrote.

In a UMass press release, co-lead author Jamie Hartmann-Boyce, DPhil, assistant professor of health policy at UMass, said "The data on pediatric ICU admissions and pediatric diabetes ketoacidosis is probably the most striking thing that comes out of this review," she said. "It was very consistent across countries, and a pediatric ICU admission is a major event for kids and their families."

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Study: Vaccinated patients have lower risk of long COVID - University of Minnesota Twin Cities

A healthcare facility lost its bid to dismiss a former employees religious discrimination claims over its Covid-19 vaccine policy.

Katina E. Hernandez sued Bayhealth Medical Center Inc. after the company terminated her for refusing to get the vaccine, the US District Court for the District of Delaware said. The medical center mandated Hernandez either get vaccinated or obtain a medical or religious exemption.

Hernandez said she doesnt support vaccines that have abortion-derived origins and asserted that the vaccine utilized fetal cells obtained from aborted babies, which violates her religious beliefs. Other district courts handling similar religious discrimination cases involving the ...

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Health Worker Can Proceed With Religious Bias Suit Over Vaccine - Bloomberg Law

(Precision Vaccinations News)

According to the U.S. Centers for Disease Control and Prevention (CDC)COVIDVaxView data, about 11% (CI 10.1 to 11.8) of children under the age of 18 are up to date with their COVID-19 vaccinations.

From a state perspective, as of January 23, 2024,Massachusetts has reached about a third of children with COVID-19 vaccinations.

Furthermore, Louisana was the lowest-ranked state, with only3.1% (CI 1.2 to 5.0) of children up to date.

The CDC says up to date with the updated 2023-24 COVID-19 vaccine is defined as receipt of at least one vaccination since September 14, 2023, for children 5 years; for children <5 years, up-to-date status was defined based on the current recommendations that also take into account number of doses and brand of vaccine.

Up-to-date status was determined by survey questions on the month and year of the most recent COVID vaccine, and for children <5 years, the total number of COVID vaccinations received and brand of the most recent COVID vaccine.

Each week, estimates for prior weeks are recalculated by the CDC using the additional interviews conducted that week.

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About 11% of Children Current with COVID-19 Vaccinations - Precision Vaccinations