RESUMEN
Background There is paucity of real-world data on COVID-19 vaccine effectiveness from cohort designs. Variable vaccine performance has been observed in test-negative case-control designs. There is also scarce real-world data of health issues in individuals receiving vaccines after prior COVID-19, and of adverse events of significant concern (AESCs) in the vaccinated. Methods: A cohort study was conducted from July 2021 to December 2021 in a tertiary hospital of North India. The primary outcome was vaccine effectiveness against COVID-19 during the second wave in India. Secondary outcomes were AESCs, and persistent health issues in those receiving COVID-19 vaccines. Regression analyses were performed to determine risk factors of COVID-19 outcomes and persistent health issues. Results: Of the 2760 health care workers included, 2544 had received COVID-19 vaccines, with COVISHIELD (rChAdOx1-nCoV-19 vaccine) received by 2476 (97.3%) and COVAXIN (inactivated SARS-CoV-2 vaccine) by 64 (2.5%). A total of 2691 HCWs were included in the vaccine effectiveness analysis, and 973 COVID-19 events were reported during the period of analysis. Maximum effectiveness of two doses of vaccine in preventing COVID-19 occurrence was 17% across three different strategies of analysis adopted for robustness of data. One-dose recipients were at 1.27-times increased risk of COVID-19. Prior SARS-CoV-2 infection was a strong independent protective factor against COVID-19 (aOR 0.66). Full vaccination reduced moderate-severe COVID-19 by 57%. Those with lung disease were at 2.54-times increased risk of moderate-severe COVID-19, independent of vaccination status. AESCs were observed in 33/2544 (1.3%) vaccinees, including one case each of myocarditis and severe hypersensitivity. Individuals with hypothyroidism were at 5-times higher risk and those receiving a vaccine after recovery from COVID-19 were at 3-times higher risk of persistent health issues. Conclusions: COVID-19 vaccination reduced COVID-19 severity but offered marginal protection against occurrence. The possible relationship of asthma and hypothyroidism with COVID-19 outcomes necessitates focused research. With independent protection of SARS-CoV-2 infection, and high-risk of persistent health issues in individuals receiving vaccine after recovery from SARS-CoV-2 infection, the recommendation of vaccinating those with prior SARS-CoV-2 infection needs reconsideration.
RESUMEN
Background and Objectives: Type 2 diabetes has multifactorial causation, with obesity and metabolic dysregulation being two of them. Personality traits are also known to influence many metabolic processes and have been associated with the pathogenesis of diabetes as well as obesity. The objective of the study was to analyze the differences in the big five personality traits of normal-weight type 2 diabetes mellitus, obese type 2 diabetes mellitus patients, and healthy controls. Methods: A total of 70 subjects were included in the study after outpatient-based screening, of which 40 were type 2 diabetes patients (20 obese and 20 normal weight) and 30 were healthy controls. After the anthropometric screening, the personality assessment of the subjects was done using the Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness-Five Factor Inventory (NEO-FFI). The differences in the scores of each trait for every group were analyzed by analysis of variance (ANOVA) with Tukey's honest significant difference (HSD) post hoc corrections. The difference in the scores between controls and diabetes patients was also compared by independent samples t-test. Results: The neuroticism score was significantly higher in both the normal-weight diabetes group (P = 0.01) and obese diabetes group (P = 0.02) as compared to the control group. All diabetes patients when compared with healthy controls had a significantly higher neuroticism score (P = 0.00) while their score of openness was significantly lower (P = 0.035) than healthy controls. Interpretation and Conclusion: This study identifies the association of personality with type 2 diabetes mellitus. The diabetes patients have higher neuroticism and lesser openness to experience as traits of personality. Importantly, this association is present irrespective of the obesity status of the patients.
