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COVID-19 Scan for Jul 23, 2021

Side effects after Pfizer COVID vaccine more common after COVID-19

Patients with a history of COVID-19 were more likely to have side effects after their first dose of the Pfizer/BioNTech COVID-19 vaccine than those who were never infected, according to a Vaccine study yesterday.

The researchers conducted a prospective observational study consisting of 311 healthcare workers from a university tertiary care hospital in France. From Jan 27 to Feb 5, they self-reported demographics and symptoms 21 to 28 days after their first vaccination and before their second.

The mean age was 55.4 years, and 60% of respondents were women. Twenty (6.4%) had a history of COVID-19, and 19 were symptomatic, but none were hospitalized. The mean duration between COVID-19 infection and their first vaccine dose was 10.3 months.

About 74% of participants (229) had at least one side effect, affecting 95% of those with prior COVID-19 and 70% of coronavirus-naive recipients. Systemic reactions, which 37% experienced, were most commonly fatigue (18%), headache (14%), and muscle pain (20%). Of the 66% who had a local reaction, site injection pain was more frequent than erythema (skin redness; 63% vs 8%). No side effects required additional medical attention.

“Vaccine recipients with prior COVID 19 infection experienced systemic side effects with a significantly higher frequency than naive patients,” write the researchers. “However, symptom intensity was not different between the 2 groups, [except] for headache.” Three of six people with headaches who previously had COVID-19 had severe headaches, compared with 3 of 37 people without prior infection.
Jul 22 Vaccine study


Malnutrition linked to worse COVID-19 outcomes

Adults and children with COVID-19 and a history of malnutrition may be more likely to die of their infections or need mechanical ventilation, according to a study yesterday in Scientific Reports.

The researchers looked at 8,604 children (mean age, 6 years) and 94,495 adults (mean age, 53 years) hospitalized with COVID-19 across 56 US hospitals from March to June 2020 and compared those with a malnutrition history from 2015 to 2019 with those without. Twenty-one children and 4,706 adults died.

Children with malnutrition made up 7.5% of severe pediatric COVID-19 cases (39 of 520) and 1.5% of mild pediatric COVID-19 cases (125 of 7,959). As for adults, those with malnutrition made up 4% of severe COVID-19 cases (453 of 11,423), and 1.8% of mild cases (1,557 of 81,515).

Overall, 1.9% of pediatric patients (164) and 2.1% of adult patients (2,010) in the cohort had a history of malnutrition.

Data indicated that children older than 5 and adults ages 18 to 78 with previous malnutrition were more likely to have severe COVID-19 than the same age-groups without. While children younger than 5 and those older than 79 had higher odds of severe COVID-19 if they were not malnourished, the researchers say this could be due to a lack of medical data and a general high risk for COVID-19 infection, respectively.

“Emphasis has been placed very early into the pandemic on the impact of age and comorbidities on the risk of severe COVID-19 and obesity has been the focus of the nutrition conversation,” the researchers write.

“This study established that the long-term effect of (or preexisting) malnutrition is also a critically important piece of the puzzle. While the COVID-19 pandemic may lead to increased incidence of malnutrition, malnourished patients or patients at risk of malnutrition are also at risk of suffering more severe forms of the disease.”
Jul 22 Sci Rep study

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