Symptoms after COVID vaccination tied to greater antibody response
A study published late last week in JAMA Network Open links systemic symptoms—those that affect the entire body—after receipt of two doses of mRNA COVID-19 vaccine with stronger SARS-CoV-2 antibody responses than in vaccinees with no or localized symptoms.
In February 2021, a team led by Columbia University researchers invited US adult participants in the Framingham Heart Study, which has been ongoing since 1948, to answer questions on COVID-19 vaccination and symptoms and to submit a dried-blood spot to test their antibody responses to two doses of the Pfizer/BioNTech or Moderna vaccine received at least 2 weeks earlier.
Vaccine-related symptoms were characterized as either systemic (fever, chills, muscle pain, nausea, vomiting, headache, and moderate or severe fatigue) or local (pain at the injection site or rash). Average age of the 928 respondents was 65 years, 39% were men, 96% were White, and 9% reported a previous COVID-19 infection.
After each dose, 48% of participants reported systemic symptoms, while 12% reported only local symptoms, and 40% were asymptomatic. A bivariate analysis tied the presence of symptoms to younger age, female sex, previous infection, and the Moderna vaccine.
Antibody reactivity was detected in 98% of asymptomatic participants, 99% with local-only symptoms, and 99% with systemic symptoms. Adjusted models associated systemic symptoms with a stronger antibody response, but the link weakened after adjustment for potential confounding factors. The results were similar after exclusion of previously infected patients.
The researchers said the findings concur with that of an Aug 16, 2021, study published in JAMA Internal Medicine, which found that US healthcare workers with significant symptoms after mRNA COVID-19 vaccination had higher antibody concentrations.
"In this generalizable cohort, nearly all participants exhibited a positive antibody response to complete mRNA vaccine series," they wrote. "Nonetheless, systemic symptoms remained associated with greater antibody response in multivariable-adjusted models, highlighting unexplained interpersonal variability."
They added, "These findings support reframing postvaccination symptoms as signals of vaccine effectiveness and reinforce guidelines for vaccine boosters in older adults," they concluded.
Oct 21 JAMA Netw Open research letter
Statins may reduce risk of death and COVID-19 severity
Commonly used cholesterol-lowering drugs called statins may reduce the risk of death and the severity of COVID-19 disease, according to a new study of more than 38,000 patients presented at the Anesthesiology annual meeting.
The study was based on electronic medical records from 38,000 Americans hospitalized for COVID-19 at 185 hospitals in the United States from Jan 1 to Sep 30, 2020; 30% of those patients were taking statins to manage cholesterol.
"Statins decrease inflammation, which may help reduce the severity of the disease," said Ettore Crimi, MD, MBA, lead author of the study and a professor at the University of Central Florida, Orlando, in an Academy of Anesthesiologists press release, "Results of our study clearly showed regular statin use is associated with reduced risk of death and improved outcomes in hospitalized COVID-19 patients."
Statin users had a 37% lower risk of dying from COVID-19 than patients not taking the medications, statin users were also less likely to require mechanical ventilation, be discharged to hospice, and require admission into the intensive care unit.
Of the statin users, the mean age was 70.8 years, and 47.1% were women. Of the 70% non-statin users, 48.5% were women, and the mean age was 58.4 years. Chronic statin users showed significantly lower rates of all-cause mortality (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.64 to 0.75), and mortality from COVID-19 (OR, 0.63; 95% CI, 0.58 to 0.69).
"Our results suggest statins could be an additional cost-effective solution against COVID-19 disease severity and should be studied further," said Crimi.
Oct 22 Academy of Anesthesiologists press release