Self-Reported Real-World Safety and Reactogenicity of COVID-19 Vaccines: A Vaccine Recipient Survey.

An online survey was conducted to compare the safety, tolerability and reactogenicity of available COVID-19 vaccines in different recipient groups. This survey was launched in February 2021 and ran for 11 days. Recipients of a first COVID-19 vaccine dose ≥7 days prior to survey completion were eligible. The incidence and severity of vaccination side effects were assessed. The survey was completed by 2002 respondents of whom 26.6% had a prior COVID-19 infection. A prior COVID-19 infection was associated with an increased risk of any side effect (risk ratio 1.08, 95% confidence intervals (1.05-1.11)), fever (2.24 (1.86-2.70)), breathlessness (2.05 (1.28-3.29)), flu-like illness (1.78 (1.51-2.10)), fatigue (1.34 (1.20-1.49)) and local reactions (1.10 (1.06-1.15)). It was also associated with an increased risk of severe side effects leading to hospital care (1.56 (1.14-2.12)). While mRNA vaccines were associated with a higher incidence of any side effect (1.06 (1.01-1.11)) compared with viral vector-based vaccines, these were generally milder (p < 0.001), mostly local reactions. Importantly, mRNA vaccine recipients reported a considerably lower incidence of systemic reactions (RR < 0.6) including anaphylaxis, swelling, flu-like illness, breathlessness and fatigue and of side effects requiring hospital care (0.42 (0.31-0.58)). Our study confirms the findings of recent randomised controlled trials (RCTs) demonstrating that COVID-19 vaccines are generally safe with limited severe side effects. For the first time, our study links prior COVID-19 illness with an increased incidence of vaccination side effects and demonstrates that mRNA vaccines cause milder, less frequent systemic side effects but more local reactions.

Cardiovascular disease in women: Executive summary of the expert panel statement of women in cardiology of the hellenic cardiological society.

The perception that women represent a low-risk population for cardiovascular (CV) disease (CVD) needs to be reconsidered. Starting from risk factors, women are more likely to be susceptible to unhealthy behaviors and risk factors that have different impact on CV morbidity and mortality as compared to men. Despite the large body of evidence as regards the effect of lifestyle factors on the CVD onset, the gender-specific effect of traditional and non-traditional risk factors on the prognosis of patients with already established CVD has not been well investigated and understood. Furthermore, CVD in women is often misdiagnosed, underestimated, and undertreated. Women also experience hormonal changes from adolescence till elder life that affect CV physiology. Unfortunately, in most of the clinical trials women are underrepresented, leading to the limited knowledge of CV and systemic impact effects of several treatment modalities on women's health. Thus, in this consensus, a group of female cardiologists from the Hellenic Society of Cardiology presents the special features of CVD in women: the different needs in primary and secondary prevention, as well as therapeutic strategies that may be implemented in daily clinical practice to eliminate underestimation and undertreatment of CVD in the female population.

Novel devices to monitor heart failure and minimize hospitalizations.

INTRODUCTION: Approximately 1-2% of the adult population in developed countries is affected by heart failure. The costs of heart failure are enormous both in Europe and in the US and are expected to rise. New technologies and remote monitoring, are valid tools for the management and treatment of these patients. AREAS COVERED: This review aims to cover both implantable and non-implantable devices available for monitoring various hemodynamic parameters and clinical features of patients, as well as algorithms implemented in the new generation ICDs and CRTs capable of simultaneous acquisition and transmission of multiple parameters that indirectly evaluate clinical and/or hemodynamic status. Both internet and PubMed searches were used in order to acquire the most recent developments in the technology of the field. Expert commentary: As new technology offers an enormous data flow, the key for success in the battle against heart failure and related hospitalizations is understanding the correct way of utilizing the data acquired and their importance for the treatment of each individual person.

[Remote monitoring of atrial fibrillation and heart failure]. / Fibrillazione atriale e scompenso cardiaco nel monitoraggio continuo a distanza.

In the last years, remote monitoring systems have been continuously updated and implemented by new algorithms to ensure proper and highly individualized management of patients with pacemakers or implantable defibrillators. The clinical history of patients with implantable devices is frequently complicated by the presence of atrial fibrillation and heart failure, often coexisting in the same subject, which are frequently responsible for major events. These patients, therefore, are those who benefit most from the remote monitoring of implantable devices. In patients with atrial fibrillation, remote monitoring allows the early detection of even short-term or asymptomatic arrhythmic episodes with a significant impact on treatment choices about thromboembolic and antiarrhythmic prophylaxis. In patients with heart failure, wearing devices for cardiac resynchronization therapy, remote monitoring allows a multiparametric evaluation on the clinical status of the patient including determination of heart rate variability, intrathoracic impedance, physical activity, weight and blood pressure. The early detection of any arrhythmia episodes or significant changes in any of the parameters recorded by remote control can identify patients at risk of acute events and allow us to change therapy quickly and adequately.