Females In Age Group Research Articles

Porphyria: a case report

BackgroundPrompt diagnosis of metabolic disorders in a resource-limited country like Nepal is daunting. Acute intermittent porphyria is a rare but common hepatic porphyria mostly seen in females of the reproductive age group. As its incidence is quite uncommon, conjectures about porphyria diagnosis are often duped into a diagnostic conundrum.Case presentationHere we unravel a case of a 15-year-old Hindu Nepalese girl distraught by the myriad of symptoms in the setting of severe abdominal pain accompanied by constipation and limb pain as the chief complaints. She presented with acute severe hypertension with marked persistent hyponatremia (up to 109 mEq/L). Despite conservative management of hypertension and electrolytes, unresolved electrolyte imbalance led us to the speculation of disturbance in the renin–angiotensin–aldosterone system. Due to her exacerbating neurovisceral status, she also required intensive care during the disease course. After thorough investigations and exemption of presumed provisional diagnoses, based on sustained symptomatic presentation, the clinical suspicion was driven towards a diagnosis of porphyria-related disorders. Positive Watson-Schwartz test substantiated the diagnosis of acute intermittent porphyria. Her symptoms gradually abated after the consumption of high carbohydrate diets.ConclusionThis case highlights the baffling amalgamation of symptoms that simulate common diseases of concern yet are buried in the realm of porphyric disorders. Porphyria can be diagnosed using simple screening tools and timely treatment can diminish serious consequences.

Quality Improvement Attitudes among Saudi Nurses in Hospitals in Qassim, Saudi Arabia: A Cross-Sectional Survey.

This study aimed to provide an overview of perceptions of quality improvement among nurses working in Saudi Arabia. We conducted a descriptive cross-sectional study of 497 Saudi nurses working in public and private hospitals in Al-Qassim Province. Descriptive statistics were computed for quality improvement nursing attitude items and demographic factors. A total of 497 nurses took part in the study; 29.1% of participants were females, and half of the participants were between the ages of 25-30 years. Most respondents were employed in governmental hospitals (98.7%), and 41.9% of participants had work experience ranging between 1 and 5 years. Nurses involved in providing direct patient care recognize the quality improvement attitudes related to changes in the healthcare delivery processes. Saudi nurses' quality improvement nursing attitudes were moderate. Female, married, and older age group nurses and nurses who were working fewer hours per week showed better quality improvement attitudes. Saudi nurses' quality improvement nursing attitudes are found to be moderate. Age, gender, marital status, and working hours of nurses are associated with their quality improvement attitudes. To empower nurses to improve healthcare, nursing administrators need to focus on improving the quality improvement attitudes environment.

Pre-contrast CT calcium score correlation with significant risk factors for coronary artery disease

Computed Tomography (CT) scan is one of the most widely used methods for evaluating the pre-contrast CT calcium scoring. This study aims to assess the correlation of pre-contrast CT calcium scoring with major risk factors for coronary artery disease (CAD). A descriptive study was conducted from Oct 2021 to Jan 2022 and included 109 patients. The mean age of the patients was 54.5 ± 14.1 (range 40–79) years old. The spreadsheet was used to gather the data via Picture Archive and Communication System (PACS) from the radiology department of King Salman Specialist Hospital, Hail (KSSHH). The study showed the percentage of male and female patients were 41.0% and 59.0%, respectively. More than zero calcium score among males was found to be 67.0%, whereas among females, it was at least 50.0%. The male group of 60–79 years old was found to be the most effected age group with more than zero calcium, while the female age group of 70–79 years showed the same zero calcium score. The percentage of calcium prevalence (score >0) in coronary arteries is affected by a number of risk factors. Coronary artery calcium (CAC) has emerged as a consistent means for assessing the risk of primary cardiovascular outcomes, especially for asymptomatic people. This study showed that the patient group with more than one risk factor for coronary heart disease had no evidence of calcium scoring. Study recommends to enlarge sample size in the coming future studies and to perform calcium scoring using CT scan before computed tomography angiofraphy (CTA).

Hepatitis B DNA quantification in the serum of hepatitis B surface antigen-positive patients in Benghazi

Background: Hepatitis B virus (HBV) infection is a global public health problem, with about 240 million people affected worldwide. Serologic techniques are typically used to diagnose it. However, the decision as to which patient to treat or not remains challenging due to the poor sensitivity of serologic markers as prognostic or severity markers. Viral load (VL) determination using polymerase chain reaction techniques is a useful tool in decision-making.
 Aim: The aim of this study was to determine the pattern of HBV viral load levels in people of different age and sex groups, to predict the risk of hepatocellular carcinoma and liver cirrhosis in HBsAg positive patients in the east of Libya.
 Materials and Methods: This is a retrospective and descriptive study. Only one HBV VL test carried out on patients attending the Benghazi university center (from east of Libya) for specialized medical services prior to any HBV targeted therapy were included in the study over a period of 40 months (January 2014 to April 2018) . Hepatitis B DNA VL determinations were analyzed using Microsoft Excel 2010 and Minitab version 17.
 Results: A total of 431 patients, of whom 51.3% (210) were males and 48.7% (221) were females, were included in the study. Of the 431 patients, 31.3% (135) were below 30 years old, while 68.7% (296) were 30 years old or above. Around 31.1% (134) had measurable assay levels (20 - 2000 (Taq) IU/mL); 21.8% (94) had below 20 IU/mL; and 13.2% (57) had above 2000 IU/ml approximately 21.1% (91) had no detectable HBV DNA in their samples. 12.8% (55) of the patients had levels greater than 20000 IU/mL. The distribution of HBsAg positivity among the patients shows an increasing trend from the lower age group 0-10 to 21-30 in males and from 31-40 in females, then a decreasing trend from 31-40 to 81-90 age group in males and from 41-50 to 81-90 age group in females. A total of 431 patients were investigated for hepatitis B viral load, of whom 90.2% were HBeAg negative and 9.8% were HBeAg positive.

Knowledge, Attitude and Practices Regarding Menstrual Cup Among Females in an Urban Setting of South Kerala.

This study aims to assess the knowledge, attitude, and practices regarding menstrual cups use and the factors associated with it among females of the reproductive age group in an urban setting of South Kerala. We conducted a cross-sectional study from December 2021 to January 2022 among females of the reproductive age group. Data was entered in MS Excel and was analyzed using Statistical Package for Social Sciences version 26.0. The significance of association was tested using the Chi-square test. Binary logistic regression was done to predict the factors associated with knowledge levels regarding menstrual cup. The mean age of study participants was 25.68(SD 6.64) years. Lack of knowledge (22.6%) and fear of insertion (56.2%) were the major reasons for not trying a menstrual cup. Out of the 350 study participants, 258(73.7%) had good knowledge scores and 92(26.3%) had poor knowledge scores. Discomfort and leakage were the most important problems reported by participants. A statistically significant association was found between younger age, educational status, socioeconomic, status, marital status of females in the reproductive age group, and knowledge about the menstrual cup. Most of the participants (93.4%) were aware of menstrual cups. Even though two third of the participants had good knowledge regarding menstrual cups, only 15.1% have tried to use a menstrual cup. Fear of insertion was the most common concern for not trying a menstrual cup. Discomfort and leakage were the most important problems reported by participants. Younger age and higher educational qualifications were found to be independently associated with knowledge levels regarding menstrual cups.

Effect of Ayurvedic Treatment Modalities on Recurrent Pregnancy Loss

Recurrent pregnancy Loss is defined as the sequence of 2 or more spontaneous abortions as documented by either sonography or on histopathology before 20 weeks. It is a relatively common event, occurring in 15%-25% of pregnancies, and increasing in prevalence with maternal age. The causes of recurrent abortion are complex & obscure. More than one factor may operate in a case. Identification and treatment of problems significantly increases the successful outcome in most cases. Recurrent pregnancy loss can be correlated with Puthraghni Yonivyapath and Garbhasravivandhya explained in Ayurvedic classics. Puthraghni is a clinical entity characterised by repeated pregnancy loss due to excessive intake of Rooksha Ahara and Vihara which results in repeated pregnancy losses. Ayurveda advises to do Shodhana Karma or purificatory therapies ending with Uttara Vasthi in recurrent losses. The study design was Prospective single arm interventional study conducted in the OPD and IPD of Govt. Ayurveda college hospital for Women and Children, Poojapura, Thiruvananthapuram with the study population of females of age group 20-38, diagnosed with RPL. IP management was done for 1 month followed by internal administration of Phala Sarpis as Vicharana Snehapana 10ml twice daily morning and evening ½ hour before food and Vilwadi Gulika 1 tab twice daily after food was also given for 2 months. After 15 months after the follow up period, Statistical analysis was done and Percentage of live births was assessed. Even though percentage of live births is 42.3, the success rate can be considered as 46.15% as the 1 patient to be delivered has completed 34 weeks of gestation and successfully continuing the pregnancy.

Analysis of Working Posture using Kinovea Software to Identify the Incidence of Forward Head among Bank Employees: A Cross-sectional Study

Background: Navi Mumbai is the most developed city in India and hence home for many banks. Purpose: The analysis was done to identify the Craniovertebral angle and their effects. Method: Hundred bankers who had spent at least one-year on the job participated in this survey. They were recruited by non-probability sample of convenience from various banks situated in Navi Mumbai. Results: Craniovertebral angle of 100 bank employees was measured. Forward head posture is identified by measuring Craniovertebral angle. Measurement of Craniovertebral angle is from C7 spinous process to tragus of ear. Majority of the employees observed as having forward head posture. Forward head posture is common in all age groups, mean age group in males is 22-44 years and normal Craniovertebral angle in them is about 48.8°. Mean age group in females is 23-55 years and normal Craniovertebral angle in them is about 47.6°. Normal Craniovertebral angle is 49.9°.

Evaluation of Pre Menstrual Syndrome among Female Students Age Group (18-25) Years

Evaluation of Pre Menstrual Syndrome among Female Students Age Group (18-25) Years

A PROSPECTIVE OBSERVATIONAL STUDY ON PREVALENCE AND TREATMENT OF URINARY TRACT INFECTIONS IN A TERTIARY CARE TEACHING HOSPITAL IN TELANGANA STATE

Objective: To study the Prevalence of urinary tract infections and related risk factors and to study the Management of urinary tract infections. Methods: This was a prospective observational study conducted in General Medicine Department, Osmania General Hospital (OGH), a tertiary care teaching hospital in Telangana State, where patients presenting or highly suspicious of having UTIs were included in the study. Pregnant women, Children, Patients who are not willing to participate were excluded from the study. Data was collected in predesigned Data collection forms. Results: Over a period of 6 Mo a total of 75 UTI cases were observed in General Medicine Department of OGH, which included 33 Males, and 42 Females. High prevalence of UTI were observed in Females in the middle age group i.e. 31-45 y, whereas in Males, in senior adult group i.e.,>60 y. The age group 18-30 y have shown the dominance of Uncomplicated UTIs(19%) and Primary UTIs (17%) and the age group>60 y have shown the dominance of Complicated UTIs (25%) and Recurrent UTIs(23%). The most common causative organism was found to be E. coli (69.3%). It was confirmed that the most common risk factor was found to be Diabetes Mellitus, followed by Hypertension and Chronic Kidney Disease. The most common antibiotic prescribed for UTI was Piperacillin+Tazobactum and for fungal UTIs, an antifungal drug i.e., Fluconazole was prescribed. Conclusion: E. coli are the major cause of UTIs among patients It is discovered that UTI is common among females. Hospitalisation, married individuals, Diabetes mellitus, genitourinary tract abnormalities, congestive cardiac failure, hypertension, prostatitis and female gender are the most important risk factors of UTIs. Appropriate measures may help to reduce UTIs due to these associated factors.

“TO STUDY PATTERN OF DRUG USE AND SAFETY OF MEDICATION USED IN LIVER DISEASE PATIENT AT TERTIARY CARE TEACHING HOSPITAL.”

Background and objectives: Liver disease is one of the major non communicable diseases which leads to change inpharmacokinetics of many drugs requiring monitoring and dose adjustment to improve the efcacy and safety of the patients. Hence present study is undertaken to evaluate the drug usage pattern and its safety prole in liver disease patients. Patients and method:An observational and cross-sectional study was conducted in department of medicine in a tertiary care teaching hospital from January 2020 to January 2021 after getting approval from ethics committee. All the 100 patients including male and female (age group ≥ 12 years) diagnosed with liver disease were included. Demographic data, clinical details, drugs prescribed, WHO prescribing core indicators and adverse drug reactions were analyzed using descriptive statistics. Results: Non-alcoholic fatty liver disease was the most common form of liver disease seen in the study population (n=100). Males (74%) between age group 41-50 years were more prone to liver disease. Average number of drugs prescribed was 8.17 and 77% patients received antibiotics. Gastroprotectives were more mostly prescribed class of drugs (23.9%) followed by antibiotics (17.25%). Among the antibiotics cefotaxime was highly prescribed (79%) followed by metronidazole (32%). Majority of adverse drug reactions reported were due to the antibiotics like diarrhea, nausea, skin rashes and AKT induced hepatitis. Conclusions:As liver is the principal organ for metabolism of many drugs, possible disease -drug interaction may follow with indiscriminate use of many drugs.

A Retrospective Study of Demographic, Clinical, and Histopathological Profiles of Cutaneous Tumors

Background: In 2007, skin cancers were third most common malignancies in Indonesia. However, profile of cutaneous tumors in our institution has not been studied. Purpose: To evaluate profile of cutaneous tumors in Dermatology and Venerology Outpatient Clinic, Dr. Soetomo General Hospital, Surabaya, Indonesia. Methods: This is a descriptive retrospective study. Inclusion criteria was new cutaneous tumor patients. Exclusion criteria was incomplete data. Medical record and photograph database from 2019-2020 were assessed for demography, clinical features, histopathological examination and final diagnosis. Results: There were 379 (5,5%) cutaneous tumors among 6896 new patients at Dermatology and Venereology Outpatient Clinic. Overall, there were more female patients (53.7%) and age group of 0-45 years old (70.4%). Cutaneous tumors more commonly presented as papular (50.4%), multiple (56.5%), nonpigmented (58.3%), asymptomatic lesions (62.5%), with time from onset 0-24 months (66.2%) and location on head and face (61.2%). Benign cutaneous tumors showed similar findings. Malignant cutaneous tumors showed differences including predominantly male sex, age above 45 years old, nodular, solitary, pigmented and easily bleeding lesions. Malignant tumors were less common (6.9%). Most common malignant tumor was BCC. Most common benign and overall cutaneous tumor was seborrheic keratosis. Conclusion: Cutaneous tumors presented across gender and ages, showing heterogenous clinical manifestations. Malignant and benign cutaneous tumors showed similarity on time from onset and location of lesions. However, differences were seen in demographic profiles and majority of clinical features. BCC was the most common malignant cutaneous tumors, while seborrheic keratosis was the most common benign and overall cutaneous tumors.

Evaluation of Personal Hygiene among Female Students Age Group (18-22) Years

Evaluation of Personal Hygiene among Female Students Age Group (18-22) Years

Prevalence of anemia and its associated factors among women of reproductive age group attending Gaur Provincial Hospital: A cross-sectional study

Background: Anemia is a principal public health concern. Worldwide one-third of women of reproductive age are affected. A 2016 survey showed that 41% of women in Nepal had anemia with the highest prevalence in Pradesh two. A complex interaction among socio-political, biological, and ecological elements determines anemia. Assessing the factors would help in minimizing anemia and its consequences. The study aimed to determine the prevalence of anemia in the reproductive age group and the factors affecting anemia. Methods: A hospital-based cross-sectional study was conducted among women of the reproductive age group (15–45) from 15th April to 15th June 2022 after ethical clearance was obtained from the Nepal health research council (Ref. 2737/2022). Regarding data collection, 375 women participants were selected via a simple random sampling technique. Participants underwent an interview after informed written consent followed by blood sample collection. Through a semi-structured questionnaire, the data was obtained. Then data entry and its analysis were performed via Microsoft Excel 2019 and Statistical Package for Social Sciences version 22.0. Results: The study showed that 229 (61.3%) females of the reproductive age group had anemia. Inadequate nutrition (OR 3.0, 1.9–5.0), breastfeeding (OR 7.3, 4.5–11.9), and rural place of residence (OR 4.2, 2.5–7.0) were significantly associated with anemia, with a corresponding odds ratio at 95% confidence each. Conclusions: The prevalence of anemia was higher among women of the reproductive age group compared to provincial and national prevalence. The interventions should be focused on breastfeeding, nutrition, and rural women to combat anemia.

Retrospective comparative study of laboratory parameters in Covid-19 positive deceased and non-deceased cases

Covid 19 infection came into existence in 2019 and hence the name. It started from a city in China named Wuhan. It continued to affect the whole world, so in 2020 it was declared as a pandemic outbreak and is prevalent worldwide till date. India is still suffering and struggling through its dreadful impact. The objective of this retrospective study is to analyze the laboratory parameters and to predict the severity/mortality related to the infection. A total of 312 hospitalized COVID-19 RTPCR positive patients from 1st April - 15 May 2021 were enrolled. Patients were categorized into deceased and non-deceased groups and their demographic as well as laboratory parameters were collected and compared. Out of 312 patients, 100 succumbed to disease. Majorities were males between 55 to 60 years. The laboratory values of TLC (p<0.0001), Neutrophil count (p<0.0001), Lymphocyte count (p<0.0001), Platelet count (p<0.0001), Neutrophil to Lymphocyte Ratio(NLR) (p<0.0001), plasma D-dimer(p=0.007717), serum CRP level (p=0.000174), serum Lactate dehydrogenase(LDH) level (p<0.0001), serum SGOT (p<0.0001), serum Ferritin (p=0.000085) were statistically significant for deceased as compared to non-deceased group. Serum SGPT was statistically insignificant. The attained results showed deranged laboratory parameters among COVID-19 positive patients. The mortality rate was found to be higher in elderly males as compared to females of same age group. There was significant correlation between the markedly abnormal laboratory values and severity/mortality of the COVID-19 infection, which could help in predicting the outcome of the disease in patients admitted to the hospitals.

Disease burden measured by patient-reported outcomes: does psoriatic arthritis feel worse than rheumatoid arthritis? A cross-sectional nationwide study.

To study the subjective disease burden of patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA), using patient-reported outcomes (PROs) cross-sectionally. Data of 3598 patients with PsA and 13913 with RA were extracted from the database. Measures included the VAS-values of pain, fatigue and patient global assessment (PGA), HAQ, and disease activity at the most recent visit/remote contact in the period 1.2020 to 9.2021. Values were compared between patients with PsA and RA overall, and by sex and age (<50, 50-59, 60-69 and ≥70 years). Regression analyses were applied. The overall median (IQR)-values for pain were 29 (10, 56) for PsA and 26 (10, 51) for RA, 29 (9, 60) and 28 (8, 54) for fatigue, 28 (10, 52) and 29 (11, 51) for PGA, 0.4 (0, 0.9) and 0.5 (0, 1.0) for HAQ (p<0.001 for all comparisons; adjusted for sex and age). The median (IQR)-values for pain, fatigue, PGA and HAQ were higher for PsA vs. RA in most age groups for males and females. All PROs were higher in older patients with both diagnoses. The median values for DAS28, doctor global assessment, ESR and CRP were 1.9 vs. 2.0, 8 vs. 8, 7 vs. 8 and 2 vs. 3 in PsA and RA, respectively. Overall, both PsA and RA groups showed moderate disease control by patients' perspective, but the burden of disease was higher especially in women with PsA compared to RA. Disease activity was similar and low in both diseases.

Genotypic Frequency of RHC Antigen in Women of Reproductive Age in Pakistan

Objective: To determine the genotypic frequency of RHC antigen in females of reproductive age.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Armed Forces Institute of Transfusion (AFIT) and Pak Emirates Military Hospital, (PEMH) in collaboration with NUMS Pakistan, from Dec 2020 to Dec 2021.&#x0D; Methodology: Females aged 16 to 45 years were recruited in the study. Demographic data, including age, parity, ethnicity etc.,was recorded on a proforma. Venous blood samples were collected in EDTA tubes, and DNA was extracted using 5% Chelex TM. A conventional Polymerase chain reaction and amplified products were subjected to Polyacrylamide Gel electrophoresis. &#x0D; Results: Amongst 200 females, 172(86%) had the expression of RHC antigen, while 28(14%) were negative for the respective antigen. These results were valuable in predicting the risk of hemolytic disease in fetuses and newborns and alloimmunization in our population.&#x0D; Conclusion: Females in the reproductive age group had RHC positivity of 86%. This data will help predict the risk of HDFN in future pregnancies and individuals at risk of alloimmunization in RHC-negative women.

Differences in COVID-19 mortality in males and females: Is estrogen hormone attributing to sex differences?

Objectives: Globally, the case fatality ratio is more in males versus females. Some studies have suggested estrogen hormone decreases susceptibility to SARS CoV-2. We have analyzed the observed sex differences in COVID-19 behavior in males and females and the clinical profiles of females of different age groups of COVID-19 patients and discussed their symptoms, laboratory evaluations, and associated comorbidities. Material and Methods: The patients were tested for COVID-19 through real-time RT-PCR (Reverse Transcription Polymerase Chain Reaction) assay. The data obtained were studied for the epidemiological, clinical, and laboratory characteristics from their medical records. Results: The mortality rate in females was 12.33% (36/292) whereas mortality in males was 19.63% (84/428). In between group analysis, 8.7% (14/161) of females died in the &lt;40 years age group versus 16.8% (22/131) in more than 40 years age group whereas in males, the mortality was 13.7% (21/153) in &lt;40 years versus 22.9%(63/275). The mortality rate in women older than 40 years was greater than mortality in younger females emphasizing the protection provided by estrogen hormone in them. The proportion of patients who expired due to COVID-19 significantly differs by age cutoff of 40 years, X2 (1, n = 428). The difference is statistically significant at P &lt; 0.05. Males more than 40 years are more likely to expire. Conclusion: Sex-related differences in coronavirus pandemic have been found pointing toward the protective role of estrogen hormone and other differences in immunological behavior in males and females. Downregulation of ACE2 expression, thereby reducing viral entry, might also be contributory to decreasing mortality in females.

Pattern of Deaths among Women of Reproductive Age in Major Autopsy Centres of Capital Cities of the Seven Provinces of Nepal.

The females in the reproductive age group are vulnerable to injuries and diseases. There is no reliable evidence of the pattern of deaths in reproductive age group females from Nepal. This study was conducted to explore the patterns of deaths of females of the reproductive age group in Nepal. A multicentric quantitative cross-sectional study was conducted among the 611 deceased females of age 15 to 49 years who had undergone medico-legal autopsy in major autopsy centers of the capital cities of seven provinces of Nepal in a duration of one year. The demographic, clinical, and causes of death data were retrieved from the records and analyzed. The intentional and unintentional causes were compared with the marital status, age groups, ethnicity, and deceased of rural and urban communities. Female reproductive age group deaths constituted 611 (20·64%) of the total autopsies. Suicide was the most common manner of death (413, 67·59%) followed by accident (121, 19·80%). The most common cause of suicide was hanging (258, 62·47%) followed by poisoning (149, 36·08%) whereas road traffic accident (72, 59·5%) was the commonest cause of accidental death. Intentional deaths were associated with higher risk to the females of younger age groups (p<0·001), ethnicity of the hilly region (p<0·001), and unmarried women (p=0·001). Suicide was the commonest manner of death among the autopsies of females of the reproductive age group in Nepal. Appropriate preventive strategies need to be developed to uplift the overall health, socioeconomic status, and general wellbeing of the females.

An observational study on benign breast diseases in a tertiary healthcare centre in Chengalpettu district

Background: Benign breast disorders constitute the majority of breast complaints presented by young females to a surgical OPD. It is 10 times more common than cancerous conditions and deserves attention due to its high prevalence, impact on woman’s life associated anxiety and possibility of some turning into cancerous conditions. It is divided into aberrations and abnormalities in development, epithelial and stromal proliferations, inflammations and neoplasms. In this study we aim at finding the prevalence, age, clinical presentation of commonest benign breast conditions and its correlation with pathological and radiological studies.Methods: The 98 cases of benign breast diseases between the age group of 15-45 years underwent triple assessment consisting of clinical examination, ultrasonography and fine needle aspiration cytology. Patients who were diagnosed with malignancy were excluded from the study.Results: Out of 98 breast lesions the commonest presentation was breast lump and found most commonly in right upper quadrant. The most common age was 20-30 years and fibroadenosis was most common benign lesion followed by fibroadenoma, mastalgia, breast abscess and nipple discharge.Conclusions: BBDS are a common problem among females in the reproductive age group. It is important to differentiate between fibroadenoma and fibroadenosis. FNAC and ultrasonography are a useful aid in diagnosis of benign breast lesions.

The risk factors of SARS-CoV-2 antibody level differences in healthcare workers post vaccination in Siloam hospitals: A nationwide multicenter study

BackgroundSeveral vaccines have been approved against COVID-19, and five have been used in Indonesia. Due to the decrease in antibody levels three to six months after the second dose of CoronaVac, healthcare workers received the third booster of mRNA vaccine (mRNA-1273) to increase the antibody level. This study aimed to evaluate the risk factors of anti-S-RBD IgG levels differences in healthcare workers.MethodsThis study is a retrospective cohort study of 576 healthcare workers without previous SARS-CoV-2 infection who received two doses of CoronaVac and the third dose of mRNA-1273 six months after the second dose. Blood samples were obtained 2nd, 6th, 12th, and 24th weeks after the second dose of CoronaVac vaccine administration, with mRNA-1273 booster on week 20. Quantitative measurements of IgG antibodies were performed with Elecsys Anti-SARS-CoV-2 S immunoassay. We identify the baseline factors predicting post-vaccination antibody titers using univariate and multivariate linear regression analysis.ResultsThis study comprised 576 participants aged 32 years old, 72.05% female, and 45.84% from high-risk occupation subgroups. The median antibodies titer level on the 2nd, 6th, 12th, and 24th weeks after the second vaccine dose administration were 40.99 u/mL, 42.01 u/mL, 54.78 u/mL, and 23,225 u/mL. Antibody levels trended highest in female and younger age group (20-29 years old).ConclusionThe third dose of vaccine increased the quantitative SARS-CoV-2 spike IgG antibody titers and eliminated differences in antibodies titer by gender. Keywords: Antibodies titer, COVID-19, Immune response, S-RBD IgG, Vaccine