Comparison of antibody immune responses between BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines in naïve and previously infected individuals.

Two mRNA vaccines, Pfizer-BNT162b2 and Moderna-mRNA-1273, obtained the Emergency Use Listing by WHO for preventing COVID-19. However, little is known about the difference in antibody responses induced by these two mRNA vaccines in naïve and previously infected (PI) individuals. We investigated the levels of anti-S-RBD (total, IgG and IgA) levels in naïve and PI individuals, 1-13 (median = 6) weeks following the second dose of either vaccine. Results in the naïve-vaccinated group, the mRNA-1273 vaccine induced significantly higher levels of anti-S-RBD total antibodies (3.5-fold; P < 0.001), IgG (2-fold, P < 0.01) and IgA (2.1-fold, P < 0.001) as compared with the BNT162b2 vaccine. In addition, both vaccines produced significantly higher anti-S-RBD total antibody levels in the PI-group compared with naïve-vaccinated group. The PI group elicited a higher level of anti-S-RBD IgG than the naïve-BNT162b2 (P = 0.05), but not more than the naïve-mRNA-1273 (P = 0.9) group. Interestingly, the PI vaccinated group elicited a comparable level of IgA ratio to the naïve-mRNA-1273 group but significantly higher than the naïve-BNT162b2 group (1.6-fold, P < 0.001). Our results showed that the PI-vaccinated group produces a higher level of antibodies than the naïve vaccinated group, particularly for those vaccinated with BNT162b2

The impact of metformin therapy for gestational diabetes on fetal growth in women with risk factors for fetal growth restriction- a registry-based study from Qatar

Background Gestational diabetes mellitus (GDM) has been the most prevalent medical condition in pregnancy, often managed by a multidisciplinary team. Numerous studies have demonstrated that metformin therapy for GDM offers advantages including a reduced risk of macrosomia, neonatal hypoglycemia, and admission to neonatal intensive care units (NICU). However, its use has been linked to fetal growth restriction (FGR) as well. Our study aims to investigate the effect of metformin when given to women with GDM and additional risk factors for FGR like hypertension, inherited or acquired thrombophilia, anemia, and autoimmune disorders such as anti-phospholipid syndrome, lupus erythematosus. Methods Women who had singleton live births and diagnosed with gestational diabetes (GDM) were selected. They were divided into two groups based on the presence of additional risk factors for FGR during their pregnancies. Each of these groups were further divided based on use of metformin for the management of GDM- resulting in four comparison groups. The outcomes were birthweight (BW), birthweight centiles, small for date baby (SFD), low birth weight (LBW), preterm birth (PTB), large for date baby (LGA), macrosomia, admission to NICU and mode of delivery. Results Of the 4,290 women included in the study, 18% had risk factors for FGR, 27% of whom took metformin for GDM. Among the women with no risk factors, 29% took metformin. In women who were taking metformin, those having risk factors had lower mean BW (3015± 608.1 gms vs 3179.2± 506.2 grams; p Conclusion The results of this study suggest that in women with additional risk factors for FGR, the concurrent use of metformin significantly decreases the birthweight and increases the risk for LBW, SFD, PTB and admission to NICU. The use of metformin in these women should be judicious and increased fetal surveillance during pregnancy is warranted.</p

Human herpes simplex virus-6 (HHV-6) detection and seroprevalence among Qatari nationals and immigrants residing in Qatar

BackgroundHuman herpes simplex virus-6 (HHV-6) is the causative agent of exanthema subitum. Transmission mainly occurs through salivary secretions, yet blood transfusions and organ transplantations have also been reported as routes of transmission. Studies of seroprevalence of HHV-6 in the Middle East and North Africa (MENA) region and other parts of Asia are scarce. As such, this study aimed to estimate the seroprevalence of HHV-6 among healthy blood donors in Qatar. MethodsIn total, 620 healthy blood donors from different nationalities residing in Qatar, mainly from the MENA region and Southeast Asia, were tested using a commercial anti-HHV-6 immunoglobulin G (IgG) enzyme-linked immunosorbent assay kit. In addition, HHV-6 DNA from randomly selected samples was tested and quantified using quantitative reverse transcriptase polymerase chain reaction. ResultsAnti-HHV-6 IgG was detected in 71.7% (445/620) [95% confidence interval (CI) 68.2–75.3%] of the tested samples, while 24.3% (61/251) (95% CI 20.0–29.6%) had detectable HHV-6 viraemia. Only 22.5% of individuals with positive IgG status had detectable HHV-6 DNA in their blood, indicating a weak association between viraemia and IgG positivity (P=0.08). Furthermore, no significant difference was associated between HHV-6 viraemia and demographic characteristics, except for nationality. ConclusionThe seroprevalence of HHV-6 in Qatar was found to be similar to rates reported in other parts of the world.This work was made possible by collaborative grant number M-QJRC-2020-5 from Qatar University

Impact of timing and severity of COVID-19 infection in pregnancy on intrauterine fetal growth- a registry-based study from Doha-Qatar

Background The novel coronavirus disease (COVID-19) pandemic has impacted pregnant women, increasing maternal and neonatal morbidity. The placenta is a potential target for the pathophysiological processes due to the increased thrombotic inflammatory activation and inadequate uteroplacental perfusion and oxygenation, potentially causing intrauterine growth restriction. This study investigates the impact of gestational age at diagnosis of COVID-19 and the presence of symptoms on intrauterine fetal growth in pregnant women. Methods A retrospective review of COVID-19 positive pregnant women in Qatar from March 2020 to March 2021 was conducted. They were divided based on trimester of pregnancy in which they were infected. The outcomes included birthweight, customised fetal birthweight centiles, small for gestational age (SGA) baby and daily growth increments, compared between the trimesters and between symptomatic and asymptomatic women. Results In our cohort, 218 women (20.5%) were infected in the first trimester, 399 (37.5%) in the second and 446 (42%) in the third. Women in the second trimester were significantly younger and symptomatic. Women infected in the first trimester were least likely to have diabetes. The mean birthweight,risk of SGA (11.5% vs 10% vs 14.6%, p=0.302), and median customized growth centiles (47.6% vs 45.9% vs 46.1%)were similar between the groups.. Symptomatic women had significantly lower mean birthweight (3147 gms vs 3222 gms) and median birthweight centiles (43.9% vs 54.0%)compared to the asymptomatic (p Conclusion This study shows that women with symptomatic disease had lower birth centiles and birth weights. This was regardless of the gestational age at which they were infected. Early symptomatic disease seems to have an impact on fetal growth velocity; however, larger studies are needed to corroborate these findings.</p

Cytomegalovirus-induced Hemorrhagic Colitis in a Patient with Chronic Myeloid Leukemia (Chronic Phase) on Dasatinib as an Upfront Therapy

Dasatinib is a kinase inhibitor indicated for the treatment of newly diagnosed adults with Philadelphia chromosome–positive (Ph+) chronic myeloid leukemia (CML) in chronic phase and accelerated (myeloid or lymphoid blast) phase, and CML with resistance or intolerance to prior therapy including imatinib and in adults with Ph+ acute lymphoblastic leukemia 1 The most common adverse reactions (≥15%) in patients with newly diagnosed chronic-phase (CP) CML include myelosuppression, fluid retention, and diarrhea, whereas in patients with resistance or intolerance to prior imatinib therapy, side effects include myelosuppression, fluid retention, diarrhea, headache, dyspnea, skin rash, fatigue, nausea, and hemorrhage. We report a 39-year-old Ethiopian female patient who received dasatinib as upfront therapy for the treatment of CP-CML who experienced chronic diarrhea for two months, which progressed to hemorrhagic colitis due to cytomegalovirus (CMV) infection of the colon. To our knowledge, this is the first case of CMV colitis in a patient receiving dasatinib as upfront therapy