Influence of epidemiological and clinical factors in the reactogenicity to Comirnaty® vaccine in health care workers of a Spanish university teaching hospital (COVIVAC study).

OBJECTIVE: Comirnaty® is an mRNA vaccine against COVID-19 which has been administered to millions of people since the end of 2020. Our aim was to study epidemiological and clinical factors influencing reactogenicity and functional limitation after the first two doses of the vaccine in health care workers (HCWs). METHODS: Prospective post-authorization cohort study to monitor safety and effectiveness of the vaccine. RESULTS: Local side effects were mild and presented both with first and second dose of Comirnaty. Systemic side effects were more frequent after 2nd dose. Nevertheless, previous SARS-CoV-2 infection was associated with systemic effects after the first dose of the vaccine (OR ranging from 2 to 6). No severe adverse effects were reported. According to multivariate analysis, the degree of self-reported functional limitation after the first dose increased with age, female sex, previous COVID-19 contact, previous SARS-CoV-2 infection, and Charlson Comorbidity Index (CCI). After the second dose, the degree of functional limitation observed was lower in those with previous SARS-CoV-2 infection, and it was positively associated to the degree of functional limitation after the first dose. CONCLUSIONS: Systemic adverse effects were more frequent after the second dose of Comirnaty. Previous SARS-CoV-2 infection was associated with systemic effects after the first dose. Age, female sex, previous COVID-19, previous isolation due to COVID-19 contact, and CCI showed to be independent predictors of the degree of functional limitation after the 1st dose of Comirnaty®. After the 2nd dose, the degree of functional limitation was lower in those who previously had SARS-CoV-2 infection.

[Pulmonary mucormycosis: a case report and review of the literature]. / Mucormicosis pulmonar: presentación de un caso y revisión bibliográfica.

Mucormycosis is an opportunistic mycotic infection, the frequency of pulmonary infection is 22% and the associated mortality rates were 83% for pulmonary. We present a case of pulmonary mucormycosis survived after the therapy with amphotericin B and surgery.

[Malignant angioendotheliomatosis associated with an acute confusional syndrome: a case report and review of the literature]. / Angioendoteliomatosis maligna asociada a síndrome confusional agudo: presentación de un caso y revisión de la literatura.

We present a case of malignant angioendotheliomatosis (MAE) localized at the central nervous system (CNS) in a 74-years-old male, manifested as an acute confusional syndrome with fever, characteristics of lymphocytic meningitis in the cephalorhachidian liquid (CRL) and dilatation of the left lateral ventricle according to the cranial computerized tomography (CT). The diagnosis was established using post-mortem immunohistological techniques, concluding that it was an intravascular lymphomatous process with secretion of immunoglobulins.

[Discriminative value for AIDS case of erythrocyte sedimentation rate, immunoglobulins IgA and IgM, and beta 2-microglobulin in combination with the CD4+ lymphocyte count]. / Valor discriminante para caso de sida de la velocidad de sedimentación globular (VSG), inmunoglobulinas (IgA e IgM) y beta 2-microglobulina (beta 2M) en combinación con el recuento de linfocitos CD4+.

OBJECTIVE: To establish the probability to discriminate the evolution to "AIDS case" in relation to the common laboratory parametres in the follow-up of the HIV infection. MATERIAL AND METHODS: We have studied a cohort of 118 patients (1986-95) with HIV infection, 14 of them (12%) had clinical criteria for AIDS (CDC/93) during the follow-up. Clinical evaluations and CD4+ and CD8+ lymphocytes, beta 2M, IgG, IgA, IgM and E.S.R determinations were done. Multivariate analysis (RSIGMA) was done. with the initial laboratory values, according to the clinical diagnostic (AIDS and NO AIDS) done during the follow-up. RESULTS: By multiple logistic regression those laboratory variables with more predictor value for "AIDS CASE" were selected. With the initial value of these variables (E.S.R., beta 2M, IgA, IgM and CD4+ lymphocytes) and the clinical diagnostic of AIDS done during the follow-up, we did the linear discriminatory analysis between two groups (AIDS, NO AIDS) obtaining generalized distance between both groups of 3,4609 and a probability of classification error of 4%. A very significant difference (p < 0.001) was obtaining when we compare the variables' mean of each of the clinical groups. CONCLUSION: In the HIV infection the values of ESR, beta 2M, IgA and IgM in combination with the absolute value of the CD4+ lymphocytes allows to discriminate those patients who will develop AIDS with a probability of classifications error of 4%. This has clinical interest in absence of viral load and helps to take therapeutical decisions.