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Category Archives: Corona Virus

How vaccine hesitancy is contributing to rising rates of measles and COVID – PBS NewsHour

Posted: February 29, 2024 at 11:14 pm

How vaccine hesitancy is contributing to rising rates of measles and COVID  PBS NewsHour

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How did COVID-19 impact cancer incidence trends in the US? – News-Medical.Net

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In a recent study published in JAMA Oncology, researchers used data from all 50 United States (US) states and the District of Columbia to compare observed and projected cancer rate patterns from March to December 2020.

Study:Undiagnosed Cancer Cases in the US During the First 10 Months of the COVID-19 Pandemic. Image Credit:Image Point Fr/Shutterstock.com

The coronavirus disease 2019 (COVID-19) significantly influenced cancer identification in the US, with a lack of countrywide studies based on cancer registries.

Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection in 2019 caused enormous disruptions, cancer dangers persisted.

A drop in cancer incidences during 2020 may not imply a decrease in cancer occurrence but rather undiagnosed new tumors.

Although researchers expected the negative correlation of the COVID-19 pandemic responses with cancer detection, the data required to quantify this extent was inaccessible in the United States until recently.

In the present population-level cross-sectional study, researchers used the 2001-2020 United States Cancer Statistics database data to examine the delays and interruptions in cancer diagnosis during the initial COVID-19 wave. The team examined trends utilizing data from invasive cancer diagnostic cases documented by the United States Cancer Statistics between 1 January 2018 and 31 December 2020, age-adjusted for the United States Standard Population in 2000. They studied data from 6 to 28 July 2023.

The study's exposures included age, gender, race, urbanization, and the state's response to the pandemic during the cancer diagnosis period.

The researchers performed time-series forecasting to generate predicted cancer incidences between 1 March and 31 December 2020 based on prepandemic patterns (between January 2018 and February 2020).

They excluded Nevada and Indiana due to 2020 data unavailability and patients with an unclear month of cancer diagnosis. They investigated patients with invasive cancer diagnoses from 2018 to 2020 and calculated monthly all-site cancer incidence.

The team used the World Health Organization's 2008 International Classification of Diseases for Oncology, Third Revision (ICD-O-3) to identify new cancer sites and site groupings.

They identified screenable malignancies based on the United States Preventive Services Task Force recommendations: lung and bronchus, colon and rectum, breast (only in women), and cervix uteri. The researchers assessed incidence rates for the eligible population stratified by age, gender, urbanicity, race, state of residency, and state-level responses to the COVID-19 pandemic and the tumor stage at detection.

They categorized participant age by Medicare criteria (below 65 or 65 years), race using Race Recode variables, and urbanicity using the Rural-Urban Continuum Codes of 2013. The team grouped COVID-19 responses by state of residency based on the duration of stay-at-home rule enforcement in each state in spring 2020.

They converted the monthly age-stratified cancer incidences observed between January 2018 and December 2020 into time series by cancer group and site, fitting the time series to autoregressive integrated moving average (ARIMA) statistical models for analysis.

The study examined 1,297,874 tumor cases recorded in the United States between 1 March and 31 December 2020, yielding a cancer incidence rate of 327 cases per individual.

The observed all-site cancer incidence rates were 29% lower than projected during the peak of the SARS-CoV-2 pandemic response (between March and May 2020), 6.3% lower between June and December 2020, and 13% lower overall over the pandemic's initial ten months. The finding indicates 134,395 probably undetected malignancies throughout that period.

Prostate cancers were the most possibly missed type (22,950 cases), followed by breast cancers (16,870 cases) and lung cancers (16,333 cases). Screenable malignancies had a 14% lower overall rate than predicted.

Breast cancer rates improved from prior patterns after the initial three months of COVID-19, while levels of lung, colorectal, and cervical cancers remained low.

Between March and May 2020, states with highly stringent pandemic responses saw considerably more disruptions; however, these variations were non-significant by December 2020 for all locations except pancreatic, renal, and lung cancers.

Every cancer location studied exhibited statistically significant disturbances between March and May 2020, with melanoma diagnoses being 43% fewer than predicted.

Disruptions in late-stage lung cancer diagnoses were much higher than in breast and cervical malignancies but equal to those in late-stage colorectal cancer incidence. From March 1 to December 31, 2020, all non-screenable malignancies had statistically significant disturbances in the early and late stages. Between March 1 and May 31, 2020, all-site cancer incidence rates were considerably higher in states with more restricted COVID-19 responses, as well as among those aged 65 and over.

Overall, the study findings showed that the SARS-CoV-2 pandemic in the United States considerably influenced cancer incidence rates, with over 13,000 cases going undiscovered between March and December 2020.

This knowledge is critical for cancer prevention and control efforts, underscoring the importance of future catastrophe preparation in influencing cancer diagnosis.

The study discovered significant decreases in early- and late-stage colorectal cancer incidence, with female breast cancer demonstrating rate recovery during the most stringent pandemic response phase. Government programs should focus on reengaging patients and reducing missed appointments.

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CT-based Assessment at 6-Month Follow-up of COVID-19 Pneumonia patients in China | Scientific Reports – Nature.com

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Participant characteristics

A total of 271 participants (meanSD, 61years12) were assessed, and 113 participants were women (41.7%). The baseline and clinical characteristics are summarized in Table 1. Of the 271 participants, the median body mass index was 21.8kg/m2 (IQR, 17.129.1), and 80 (29.5%) were smokers. 148 participants (54.6%) had different types of comorbidities and common comorbidities included hypertension (82 participants, 30.3%), type II diabetes mellitus (80 participants, 29.5%), ischemic heart disease (61 participants, 22.5%), chronic obstructive pulmonary disease (18 participants, 6.6%) and previous venous thromboembolism (10 participants, 3.7%). The median hospital stay was 12days (IQR, 420days), with 68 participants (25.1%) requiring the highest level of ventilatory support in the form of invasive ventilation or noninvasive positive pressure ventilation. Participants are treated with medications mainly including paxlovid (183 participants, 67.5%), azvudine (60 participants, 22.1%) and glucocorticoid (69 participants, 25.5%).

Compared of baseline and clinical characteristics, age (mean, 58years11 vs 65years12, P<0.001), smoker (42 participants [24.3%] vs 38 participants [38.8%], P=0.04), heart rate (mean, 83 times per minute14 vs 92 times per minute16, P=0.02), respiratory rate (mean, 20 times per minute7 vs 24 times per minute9, P=0.03), oxygen saturation on room air (SaO2, 96%, IQR, 8899% vs 92%, IQR, 8098%, P=0.001), chronic obstructive pulmonary disease (COPD, 10 participants [5.8%] vs 8 participants [8.1%], P=0.02), length of hospital stay (11days, IQR, 414days vs 16days, IQR, 1027days, P<0.001), invasive ventilation (2 participants [1.6%] vs 15 participants [15.3%], P<0.001) and using paxlovid (147 participants [85.0%] vs 36 participants [36.7%], P<0.001) demonstrated a statistically significant difference between participants with normal and abnormal chest CT at 6-month follow-up.

All participants underwent a 6-month follow-up chest CT at a median of 177days (IQR, 155203days) after hospital admission and pulmonary residual abnormalities were found in 98 participants (36.2%). Compared to the initial CT (Table 2), participants with GGO decreased from 270 (99.6%) to 66 (24.4%) and consolidation decreased from 111 (41.0%) to 20 (7.4%) (Fig.2). Meanwhile, participants with reticulation increased from 19 (7.0%) to 57 (21.0%). The ARDS pattern in three participants (1.1%) and crazy paving pattern in two participants (0.7%) at initial CT had disappeared at 6-month follow-up CT. Participants with organizing pneumonia pattern increased from four (1.5%) to seven (2.6%). Among CT evidence of fibrotic-like changes, participants with linear atelectasis increased from four (1.5%) to seven (2.6%) (Fig.3), participants with bronchiectasis and parenchymal bands increased from six (2.2%) to 31 (11.4%) (Fig.4) and 14 (5.2%) (Fig.5) respectively. There was no change in the three participants (1.1%) with honeycombing. In summary, 39 participants (14.4%) demonstrated new suspicious fibrotic-like changes at 6-month follow-up CT.

Serial chest CT scans in a 45-year-old man with severe coronavirus disease 2019 pneumonia. (A, B) Initial CT scans obtained on day 5 after the onset of symptoms showed extensive ground-glass opacities (GGO) with some areas of consolidation bilaterally. (C, D) CT scans obtained on day 9 showed extensive consolidation with few GGOs bilaterally. (E, F) CT scans obtained on day 179 showed almost absorption of the abnormalities with mild GGOs and interstitial thickening remaining.

Serial chest CT scans in a 61-year-old man with coronavirus disease 2019 pneumonia. (A, B) Initial CT scans obtained on day 4 after the onset of symptoms showed multiple ground-glass opacities and consolidation bilaterally. (C) CT scans obtained on day 22 showed moderate consolidation and reticulation in the lower lung lobes bilaterally. (D) CT scans obtained on day 191 showed obviously absorption of the abnormalities with subtle reticulation and linear atelectasis (arrow) in the lower lung lobes.

Serial chest CT scans in a 60-year-old man with coronavirus disease 2019 pneumonia. (A, B) Initial CT scans obtained on day 8 after the onset of symptoms showed multiple ground-glass opacities and interstitial thickening bilaterally. (C, D) CT scans obtained on day 180 showed traction bronchiectasis (white arrow) and interlobar pleural traction (black arrow) in the upper lobe of right lung.

Serial chest CT scans in a 54-year-old man with coronavirus disease 2019 pneumonia. (A) Initial CT scans obtained on day 9 after the onset of symptoms showed multiple ground-glass opacities and interstitial thickening bilaterally. (B)CT scans obtained on day 169 showed traction bronchiectasis (white arrow) and parenchymal bands (black arrow) in the lower lung lobes.

In the Chest CT scores (Table 3), a significantly decrease was found for any abnormality (P<0.001), GGO (P<0.001), and consolidation (P<0.001), whereas a significantly increase for fibrotic-like abnormalities (P<0.001) compared with the initial CT scans. Meanwhile, reticulation showed insignificantly change between two CT scans (P=0.33).

In the univariate analysis, paxlovid (odd ratio [OR]: 0.08; 95% CI 0.03, 0.21; P<0.001), invasive ventilation (OR 9.3; 95% CI 2.8, 29; P<0.001), age>60years (OR 6.5; 95% CI 2.7, 17; P<0.001), SaO2 less than 93% at admission (OR 4.5; 95% CI 1.4, 14; P<0.001), hospitalization more than 15days (OR 3.8; 95% CI 1.3, 11; P=0.002), and respiratory rate more than 23 times per minute at admission (OR 3.3; 95% CI 1.3, 8.7; P=0.004) were associated with pulmonary residual abnormalities at 6-month follow-up CT. In the multivariate analysis, the predictive factors were invasive ventilation (OR 13.6; 95% CI 1.9, 45; P<0.001), age>60years (OR 9.1; 95% CI 2.3, 39; P=0.01), paxlovid (OR 0.11; 95% CI 0.04, 0.48; P=0.01), hospitalization more than 15days (OR 6.1; 95% CI 1.2, 26; P=0.002), heart rate greater than 100 times per minute (OR 5.9; 95% CI 1.1, 27; P=0.03), and SaO2 less than 93% at admission (OR 5.6; 95% CI 1.4, 13; P=0.02) (Table 4).

In the univariate analysis, paxlovid (OR 0.11; 95% CI 0.04, 0.32; P<0.001), invasive ventilation (OR 8.8; 95% CI 2.1, 26; P<0.001), smoker (OR 7.4; 95% CI 3.0, 16; P<0.001), SaO2 less than 93% at admission (OR 4.5; 95% CI 1.2, 16; P=0.002) and age>60years (OR 4.2; 95% CI 1.3, 11; P=0.002) were associated with pulmonary fibrotic-like changes at 6-month follow-up CT. In the multivariate analysis, the predictive factors were invasive ventilation (OR 10.3; 95% CI 2.9, 33; P=0.002), smoker (OR 9.9; 95% CI 2.4, 31; P=0.01), paxlovid (OR 0.1; 95% CI 0.03, 0.48; P=0.01), SaO2 less than 93% at admission (OR 7.8; 95% CI 1.5, 19; P=0.02), age>60years (OR 6.1; 95% CI 2.3, 22; P=0.03) and heart rate greater than 100 times per minute (OR 4.9; 95% CI 1.7, 11; P=0.04) (Table 5).

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CT-based Assessment at 6-Month Follow-up of COVID-19 Pneumonia patients in China | Scientific Reports - Nature.com

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Covid in 2024: What to Know About Guidelines, Symptoms and Vaccines – WSJ – The Wall Street Journal

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Covid in 2024: What to Know About Guidelines, Symptoms and Vaccines - WSJ  The Wall Street Journal

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Unlocking coronavirus structure through M protein research – News-Medical.Net

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For centuries, coronaviruses have triggered health crises and economic challenges, with SARS-CoV-2, the coronavirus that spreads COVID-19, being a recent example. One small protein in SARS-CoV-2, the Membrane protein, or M protein, is the most abundant and plays a crucial role in how the virus acquires its spherical structure. Nonetheless, this protein's properties are not well understood.

A research team led by a physicist at the University of California, Riverside, has devised a new method to make large quantities of M protein, and has characterized the protein's physical interactions with the membrane -; the envelope, or "skin," -; of the virus. The team's theoretical modeling and simulations show how these interactions are likely contributing to the virus assembling itself.

The researchers report in their paper published today in Science Advances that when the M protein, which is adjacent to the spike protein on SARS-CoV-2, gets lodged in the membrane, it coaxes the membrane to curve by locally reducing the membrane thickness. This induction of curvature leads to SARS-CoV-2's spherical shape.

"If we can better understand how the virus assembles itself, then, in principle, we can come up with ways to stop that process and control the virus' spread," saidThomas E. Kuhlman, an assistant professor ofphysics and astronomy, who led the research project. "M protein has previously resisted any kind of characterization because it is so hard to make."

Kuhlman and his colleagues overcame this difficulty by using Escherichia coli bacteria as a "factory" to make the M protein in large numbers. Kuhlman explained that although E. coli can make copious amounts of M proteins, the proteins tend to clump together in the E. coli cells, eventually killing them. To circumvent this challenge, the researchers induced the E. coli cells to produce the protein Small Ubiquitin-related Modifier, or SUMO, along with the M protein.

In our experiments, when E. coli makes M protein, it makes SUMO at the same time. The M protein fuses with the SUMO protein, which prevents the M proteins from sticking to one another. The SUMO protein is relatively easy to remove via another protein that simply cuts it off. The M protein is thus purified and separated from SUMO."

Thomas E.Kuhlman, assistant professor ofphysics and astronomy, UCR

The work provides fundamental insights into the mechanisms driving SARS-CoV-2 viral assembly.

"As M proteins are an integral component of other coronaviruses as well, our findings provide useful insights that can enhance our understanding and potentially enable interventions in viral formation not only in SARS-CoV-2 but also in other pathogenic coronaviruses," Kuhlman said.

Next, the researchers plan to study the interactions of the M protein with other SARS-CoV-2 proteins to potentially disrupt these interactions with drugs.

Kuhlman was joined in the research by fellow-UCR physicistsRoya ZandiandUmar Mohideen. Kuhlman was charged with making the M proteins. Mohideen, a distinguished professor of physics and astronomy, used atomic force microscopy and cryogenic electron microscopy to measure how the M protein interacts with the membrane. Zandi, an expert onvirus assemblyand a professor of physics and astronomy, developed simulations of how the M proteins interact with each other and with the membrane.

Other coauthors on the paper are Yuanzhong Zhang, Siyu Li, Michael Worcester, Sara Anbir, Joseph McTiernan, Pratyasha Mishra, and Ajay Gopinathan of UCR; and Michael E. Colvin of UC Merced. Co-first authors Zhang and Anbir contributed equally to the work.

The research was supported by a grant from the University of California Office of the President to investigate how the COVID-19 virus assembles itself.

Source:

Journal reference:

Zhang, Y.,et al.(2024) Synthesis, insertion, and characterization of SARS-CoV-2 membrane protein within lipid bilayers.Science Advances. doi.org/10.1126/sciadv.adm7030.

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SARS-CoV-2 fragments may cause problems after infection – National Institutes of Health (NIH) (.gov)

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February 27, 2024

Most COVID-19 cases are mild, but many still lead to life-threatening complications. Severe cases feature an overactive immune response that causes dangerous inflammation. This inflammation affects many different tissues and cell types, including uninfected ones, and resembles that seen in some autoimmune diseases. Its not clear why SARS-CoV-2 can cause such inflammation while other coronaviruses responsible for common colds dont.

One way the immune system fights viruses is by breaking down the viral proteins into small fragments called peptides. An NIH-funded research teamled by Dr. Gerard Wong at the University of California, Los Angeles, in collaboration with Richard L. Gallo at the University of California, San Diegoinvestigated whether these peptides could continue to activate the immune system. Their results were published in Proceedings of the National Academy of Sciences on February 6, 2024.

The team used machine learning to search SARS-CoV-2 proteins for fragments that resemble molecules called antimicrobial peptides (AMPs). The body makes these molecules as part of its defense against infections. Certain AMPs can bind to double-stranded RNA (dsRNA), which is produced during some viral infections. The resulting AMP-dsRNA complexes have been shown to trigger inflammation and have been implicated in autoimmune conditions such as lupus, rheumatoid arthritis, and psoriasis. Among the SARS-CoV-2 AMP-like fragments, the team looked for those that carried a strong positive electric charge. This would allow them to bind dsRNA, which is negatively charged.

The researchers studied three SARS-CoV-2 fragments that both resembled AMPs and had a large positive charge. These fragments were also found in the airways of patients with severe COVID-19. The scientists dubbed these AMP-like peptides xenoAMPs. Notably, SARS-CoV-2 contained more potential xenoAMPs than common cold coronaviruses. SARS-CoV-2 xenoAMPs also mimicked real AMPs more closely than those from common cold coronaviruses.

XenoAMPs bound to dsRNA and caused it to form liquid crystalline structures like those formed when AMPs bind to dsRNA. These structures were the optimal size and shape for binding to certain receptors that control the innate immune response. When tested in various types of human cells, the xenoAMP-dsRNA complexes enhanced inflammatory responses. They also triggered gene activity changes resembling those triggered by SARS-CoV-2 infection. Corresponding peptides from a common cold coronavirus did not bind and form such structures with dsRNA. They also did not enhance inflammation in the cells.

The researchers injected one of the xenoAMP-dsRNA complexes into the bloodstream of mice. After they did, the mice had higher levels of proinflammatory molecules in the blood, similar to those seen in people with COVID-19. They also had higher levels of various immune cells.

These findings could lead to new strategies for treating severe cases of COVID-19. They also suggest a way to determine whether future coronaviruses could cause similar inflammation. More generally, they show how viruses can continue to affect the host even after theyre destroyed by the immune system.

The textbooks tell us that after the virus is destroyed, the sick host wins, and different pieces of virus can be used to train the immune system for future recognition. COVID-19 reminds us that its not this simple, Wong explains. For comparison, if one were to assume that after food gets digested into its molecular components, then its effects on the body are over, it would be very liberating. I wouldnt have to worry about the half-dozen jelly donuts I just ate. However, this simple picture is not correct.

by Brian Doctrow, Ph.D.

References:Viralafterlife: SARS-CoV-2 as a reservoir of immunomimetic peptides that reassemble into proinflammatory supramolecular complexes. Zhang Y, Bharathi V, Dokoshi T, de Anda J, Ursery LT, Kulkarni NN, Nakamura Y, Chen J, Luo EWC, Wang L, Xu H, Coady A, Zurich R, Lee MW, Matsui T, Lee H, Chan LC, Schepmoes AA, Lipton MS, Zhao R, Adkins JN, Clair GC, Thurlow LR, Schisler JC, Wolfgang MC, Hagan RS, Yeaman MR, Weiss TM, Chen X, Li MMH, Nizet V, Antoniak S, Mackman N, Gallo RL, Wong GCL. Proc Natl Acad Sci U S A. 2024 Feb 6;121(6):e2300644120. doi: 10.1073/pnas.2300644120. Epub 2024 Feb 2. PMID:38306481.

Funding:NIHs National Institute of Allergy and Infectious Diseases (NIAID), National Heart, Lung, and Blood Institute (NHLBI), National Cancer Institute (NCI), National Institute of General Medical Sciences (NIGMS), and Office of the Director (OD); National Science Foundation; W. M. Keck Foundation; Rapidly Emerging Antiviral Drug Development Initiative.

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People 65 and up should now get another COVID-19 vaccine, CDC recommends – cleveland.com

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People 65 and up should now get another COVID-19 vaccine, CDC recommends  cleveland.com

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Welcome to the 2024 CFA Annual Report | Covid-19 | news-journal.com – Longview News-Journal

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Longview, TX (75601) Today

Cloudy with light rain this evening. Thunder possible. Low 43F. Winds light and variable. Chance of rain 70%..

Cloudy with light rain this evening. Thunder possible. Low 43F. Winds light and variable. Chance of rain 70%.

Updated: February 29, 2024 @ 9:32 pm

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Exploring the reported adverse effects of COVID-19 vaccines among vaccinated Arab populations: a multi-national … – Nature.com

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Since the beginning of the COVID-19 pandemic, the focus of research has primarily been on COVID-19 symptoms and vaccinations. Despite the widespread administration of millions of vaccine doses worldwide, concerns about the safety and efficacy of vaccinations continue to be raised. To address this, our study aimed to investigate the adverse events (AEs) associated with different types and doses of COVID-19 vaccines across six Arabic countries during the fourth wave of the pandemic.

The variation in the number of vaccinated participants among the studied Arab countries reflects differences in vaccine availability and compulsory vaccine regulations. For example, Saudi Arabia initiated vaccination for children aged 12 and older in July 2021 and mandated that all citizens and residents receive a booster dose by February 2022. In contrast, compulsory vaccination policies and booster doses had not been implemented in the remaining five countries at the time of data collection46,47,48.

The pattern of AEs after each dose aligns with previous reports49. This may be attributed to the cumulative immunological effect of the second dose rather than a direct immunological response50. We observed a lower frequency of AEs after the second dose with many types of vaccines compared to the first dose. However, we reported an increase in the frequency of AEs after the Sputnik V vaccine, local AEs after the Sinopharm vaccine, systemic AEs after the Pfizer-BioNTech vaccine, and serious AEs after the Johnson & Johnson (J&J) vaccine. Previous studies have shown different trends, with higher local and systemic AEs reported after the second dose of Pfizer-BioNTech and AstraZeneca vaccines26,50,51,52.

In our study, the most prevalent local AEs, such as pain, redness, and swelling at the injection site, were reported after the Pfizer-BioNTech, AstraZeneca, and Sinopharm vaccines. Previous studies conducted in the reported varying percentages were reported after the first and second doses20,26,53. The most commonly reported general AEs were fatigue, body aches, fever, headache, and myalgia, which is in line with published studies20,49.

Headache was reported in more than 50% of participants after the AstraZeneca vaccine54,55,56. There are no details about the pathophysiologic mechanisms, whether the intracellularly synthesized spike protein is produced by using mRNA vaccines, or the protein triggers the immune response from activated anti-inflammatory mediators such as prostaglandins, nitric oxide, and cytokines. Headache is the leading symptom of cerebrovascular thrombosis (CVT), including vaccine-induced ones. So, it's important to distinguish between vaccine-induced headaches and those caused by cerebrovascular thrombosis54,55,56.

Visual disturbances were reported by a small number of participants. There are reported cases of transient loss in the visual field due to possible acute vasospasm of the artery in the postchiasmatic visual pathway, triggered by the COVID-19 vaccine that resolved after two hours57. In other cases, macular detachment and severe choroidal thickening were detected causing visual loss and suggesting a potential inflammatory or autoimmune response to the vaccine58,59,60.

Elevations in blood pressure were observed among some vaccinated participants, which is consistent with reports of blood pressure surges after mRNA vaccines and an increase in home blood pressure after the first mRNA vaccine dose. Some patients required modification of anti-hypertensive drugs. This may be attributed to nervousness or white-coat hypertension. However there was no baseline data, and BP follow-up over a long period after vaccination is very important56,61.

Menstrual changes were reported among vaccinated females and it is noteworthy that by September 2, 2021, over 30,000 COVID-19-vaccinated females had reported menstrual changes to the United Kingdoms Medicines and Healthcare Products Regulatory Agency (MHRA) Yellow Card surveillance system12,62. This might be a result of immunological effects on the hormones that regulate the menstrual cycle or biological effects of immune cells on the uterus lining, which contribute to the tissue's cyclical building and breaking down12,63.

Rheumatological symptoms such as bone pain, myalgia, body aches, and weariness were reported in our study, similar to some studies conducted in Italy, Libya, Iran, China, and Turkey61,63,64,65,66,67. These symptoms might be attributed to the immune response triggered by the vaccine, leading to transient inflammation and musculoskeletal discomfort26,68. It is important to note that these symptoms are generally self-limiting and resolve within a few days after vaccination. The association between COVID-19 vaccination and the occurrence of certain symptoms remains uncertain when compared to other vaccines. The hyper-inflammatory response triggered by the COVID-19 vaccine raises concerns about its potential as a risk factor for inflammatory musculoskeletal disorders. This cytokine activation can be attributed to the SARS-CoV-2 spike protein, other components of the vaccine, or the adenoviral vector used67,68.

New-onset autoimmune manifestations, including Guillain-Barr syndrome (GBS), rheumatoid arthritis, and systemic lupus erythematosus, have been reported in eleven cases following COVID-19 vaccination, particularly after the first dose. The precise nature of the link between the COVID-19 vaccine and autoimmune symptoms is still unclear, whether it is coincidental or causal. Molecular mimicry, the generation of specific autoantibodies, and the influence of specific vaccination adjuvants are all thought to play a role in the development of autoimmune diseases63,69. For instance, we documented one case of GBS, a rare autoimmune neurological disorder that affects the peripheral nerves and nerve roots. GBS has been associated with other vaccines such as rabies, hepatitis A and B, influenza, and more recently, the COVID-19 vaccine70,71.

In this study, we documented the occurrence of symptoms suggesting vaccine-induced myocarditis and pericarditis, including chest pain (88 cases), shortness of breath (103 cases), and sensations of a fast-beating, fluttering, or pounding heart (34 cases). These presentations align with the CDC report on these conditions72. Our findings are consistent with previous research indicating that COVID-19 vaccine-related myocarditis primarily affects young men and is more commonly associated with mRNA vaccines such as those developed by Pfizer-BioNTech and Moderna73.

We observed a statistically significant difference in the occurrence of serious adverse events (AEs) among different vaccine types. We identified 10 cases of VITT out of 3,239 vaccine doses, which is a rare syndrome involving venous or arterial thrombosis at unusual sites such as cerebral venous thrombosis (CVT) and splenic thrombosis. Additionally, we found 10 cases of thrombosis out of 3,239 vaccine doses, a comparable rate to reports from the US (17 cases of VITT, 14 cases of thrombosis out of 7,000 participants after the J&J vaccine) and lower than the European Medicines Agency (EMA) (222 cases of thrombosis out of 35 million participants after the AstraZeneca vaccine)74,75. VITT occurs when DNA leaks from the imperfect adenoviral vector used in AstraZeneca and J&J vaccines, infects cells, binds to platelet factor 4 (PF4), and triggers the production of anti-PF4 autoantibodies76.

We also discovered a significant increase in post-vaccination COVID-19 cases among individuals previously infected with COVID-19. Such findings may raise the issue of the benefit of vaccines for people who were previously infected with SARS-CoV-2. It is noteworthy that a study conducted in Kentucky (MayJune 2021), reported an odds ratio of 2.34 (95% CI 1.583.47) of re-infection among unvaccinated participants compared to those who were fully vaccinated, suggesting that full vaccinations after a past SARS-CoV-2 infection provide additional protection by decreasing its transmissibility by shortening the duration of infectivity and so decrease the transmissibility77. Therefore, vaccination should be offered to all eligible individuals regardless of their previous infection status. While there is limited epidemiological evidence supporting the benefits of vaccination for previously infected individuals, our study supports the notion.

Regarding the frequency of post-vaccination COVID-19 in relation to the number of doses, the interpretation of the increase in infections after the second dose is still uncertain. Cumulatively, they were part of the sample that received the first dose, resulting in a significantly lower difference. Notably, the second dose can cause up to a tenfold increase in antibody levels, a stronger T-cell response, as well as more changes in the immune cells. Moreover, multiple variants of SARS-CoV-2 have emerged, primarily focused on the spike protein, a crucial element for developing vaccine candidates. Diverse vaccinations are currently undergoing clinical trials and demonstrating remarkable outcomes, however, their effectiveness still requires evaluation in various SARS-CoV-2 variants4,20.

We carried out a multicenter study in six Arab countries that included the assessment of AEs associated with eight different vaccine types. We were able to identify several associated factors with post-vaccination AEs, which can aid in monitoring and follow-up efforts during and after vaccination campaigns. Additionally, our study included patients from a previous wave of COVID-19, allowing us to track AEs across different vaccine doses. However, it is important to acknowledge the limitations of our study. Firstly, being an observational study, it is susceptible to bias and confounding issues. Secondly, the use of an online self-administered survey introduces limitations such as data accuracy concerns due to recall bias, sampling bias (as more than 80% of participants were well-educated), and availability bias (excluding individuals who couldn't access or use the Internet, and those who were illiterate or deceased). Thus, our study population may not represent the entire population. Furthermore, assessing SARS-CoV-2 infection rates after vaccination is complicated by the presence of the delta variant and other variants of concern, especially as the immunity from previous vaccinations may be waning. The timing between the first and second doses is relatively close together, but the interval between the second and third doses can vary widely across countries. The availability of COVID-19 confirmatory testing in the studied countries also affects the diagnosis of infection rates, potentially missing asymptomatic cases. Another limitation is the lack of assessment of participants' pre-COVID-19 vaccine health status, making it challenging to differentiate pre-existing health issues from those related to the COVID-19 vaccine. The use of a reporting system for the participants to report the AEs themselves can introduce bias in exaggerating or underreporting some AEs. Although these limitations exist, our findings are consistent with those of other international studies. Lastly, the variation in response rate among countries with a low number of responses in some e.g. Syria may be due to the method of sample collection using an online questionnaire, compounded by political unrest in some countries (e.g. Syria) hindering internet access. It is important to interpret the data of vaccine and AE rates while considering such political conditions for further extensive studies. Such variation can affect the generalizability and comparisons of results among such countries.

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R.I. COVID-19 cases increased by 337 last week, with 2 deaths – Providence Business News

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