The Effects of COVID-19 mRNA Vaccine on Adolescence Gynecological Well-being

KEY MESSAGE: Menstruation of adolescent girls might be influenced by Covid-19 mRNA vaccine, however, the ovarian reserve estimated by AMH is not compromised. BACKGROUND: Recent studies have suggested that the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine causes menstrual abnormalities which led to concerns regarding its influence on the reproductive system. This study aims to investigate the influence of the SARS-CoV-2 mRNA vaccine on gynecologic well-being and future fertility of adolescent girls. METHODS: This is a prospective cohort study conducted at a university affiliated medical center between June and July 2021. Adolescent girls aged 12-16 years who were vaccinated by two Pfizer-BioNTech Covid-19 vaccines (21 days apart) were included in the study. All participants completed a computerized questionnaire regarding their general medical and gynecological background at recruitment and 3 months later. Blood samples were collected for AMH levels before and 3 months following the first mRNA vaccine RESULTS: The study group consisted of 35 girls, and of them, follow-up was completed by questionnaire and AMH sampling in 35 (90%) and 22 (56%) girls, respectively. Among the 22/35 girls who reported regular menstruation before vaccination, seven (31.8%) experienced irregularities post-vaccination. Four of the eight pre-menarche girls included in the study reported on menarche on follow-up. Median AMH levels were 3.09 (IQR 1.96-4.82) μg/L and 2.96 (2.21-4.73) μg/L at baseline and after 3 months, respectively (p = 0.07). After controlling for age, BMI and presentation of side effects, no association was demonstrated to the change in AMH levels (AMH2-AMH1). CONCLUSIONS: Although menstruation of adolescent girls might be influenced by Covid-19 mRNA vaccine, it seems that the ovarian reserve estimated by AMH is not compromised

Differential Expression of Novel Adiponectin Receptor-1 Transcripts in Skeletal Muscle of Subjects With Normal Glucose Tolerance and Type 2 Diabetes

OBJECTIVE—Adiponectin receptor-1 (AdipoR1) expression in skeletal muscle has been suggested to play an important role in insulin resistance and diabetes. We aimed at evaluating the presence of novel AdiopR1 splice variants in human muscle and their regulation under physiological and pathophysiological states. RESEARCH DESIGN AND METHODS—AdipoR1 59UTR mRNA transcripts, predicted from bioinformatics data, were eval-uated in fetal and adult human tissues. Expression and function of the identified transcripts were assessed in cultured human skeletal muscle cells and in muscle biopsies obtained from indi-viduals with normal glucose tolerance (NGT) and type 2 diabetes (n = 49). RESULTS—Screening of potential AdipoR1 59UTR splice variants revealed a novel highly abundant muscle transcript (R1T3) in ad-dition to the previously described transcript (R1T1). Unlike R1T1

High physical activity and ovarian reserve: a prospective study of normo-ovulatory professional athletes

Abstract Background This study investigated whether high physical activity affects ovarian reserve in normo-ovulatory, reproductive-age women. Methods This prospective, observational study compared 31 professional female athletes, with 31 women who did not engage in physical activity. It was conducted 2017–2020 in a tertiary medical center. Normo-ovulatory, professional athletes, ages 20–35 years were recruited from The Wingate Institute—the Israeli National Institute for Sport Excellence. They had high International Physical Activity Questionnaire (IPAQ) scores. Non-physically active women, matched by age and body mass index, were recruited from hospital staff. Women were evaluated for ovarian reserve markers on day 2–5 of the menstrual cycle, including follicular stimulating hormone, antral follicle count, anti-Mullerian hormone and Inhibin B. Results The average age of the high physical activity group was 29.9 ± 4.2 years and the nonactive group 31.6 ± 4.2 years (p = 0.062). Body mass index of both groups were similar (22.5 ± 5.0 vs. 21.4 ± 2.5, respectively; p = 0.1). No differences were observed with respect to follicle stimulating hormone (p = 0.12) and anti-Mullerian hormone (p = 0.16). A trend towards higher total antral follicle count in the high physical activity group vs. the non-active group (34.5 ± 12.9 vs. 28.1 ± 15.2, p = 0.08) and lower Inhibin B (68.1 ± 36.8 vs. 89.4 ± 46.1, p = 0.05). Menarche age correlated with anti-Mullerian hormone (r = 0.387, p = 0.003), as did total antral follicle count (r = 0.368, p = 0.004). IPAQ scores and basal follicle stimulating hormone levels were negatively correlated (r = − 0.292, p = 0.005). Conclusions Athletic, normo-ovulatory women have ovarian reserves that are at least as good as those of the general population. As this is the first study examining this issue, it could cautiously reassure women engaged in high physical activity regarding ovarian reserve

The Predictive Value of Serum ACE2 and TMPRSS2 Concentrations in Patients with COVID-19—A Prospective Pilot Study

One of the major challenges for healthcare systems during the Coronavirus-2019 (COVID-19) pandemic was the inability to successfully predict which patients would require mechanical ventilation (MV). Angiotensin-Converting Enzyme 2 (ACE2) and TransMembrane Protease Serine S1 member 2 (TMPRSS2) are enzymes that play crucial roles in SARS-CoV-2 entry into human host cells. However, their predictive value as biomarkers for risk stratification for respiratory deterioration requiring MV has not yet been evaluated. We aimed to evaluate whether serum ACE2 and TMPRSS2 levels are associated with adverse outcomes in COVID-19, and specifically the need for MV. COVID-19 patients admitted to an Israeli tertiary medical center between March--November 2020, were included. Serum samples were obtained shortly after admission (day 0) and again following one week of admission (day 7). ACE2 and TMPRSS2 concentrations were measured with ELISA. Of 72 patients included, 30 (41.6%) ultimately required MV. Serum ACE2 concentrations >7.8 ng/mL at admission were significantly associated with the need for MV (p = 0.036), inotropic support, and renal replacement therapy. In multivariate logistic regression analysis, elevated ACE2 at admission was associated with the need for MV (OR = 7.49; p = 0.014). To conclude, elevated serum ACE2 concentration early in COVID-19 illness correlates with respiratory failure necessitating mechanical ventilation. We suggest that measuring serum ACE2 at admission may be useful for predicting the risk of severe disease

Correlation between serum klotho levels and IGF-1 (as assessed with the Pearson correlation coefficient).

<p>Correlation between serum klotho levels and IGF-1 (as assessed with the Pearson correlation coefficient).</p

Clinical and anthropometric characteristics according to GH status^$.

<p>GH: growth hormone; GHD: growth hormone deficiency; Δ height-SDS: difference between participants’ height SDS and the genetic target height (height-SDS - MPH^‡-SDS); BA/CA: ratio between bone age and chronological age.</p>

Continuous variables were compared using one way ANOVA; categorical variables (gender, pubertal state) were compared using the Chi-square (χ2) test.

*Organic GHD lower than both Idiopathic GHD and GHS.

**Idiopathic GHD higher than both organic GHD and GHS.

***GHS significantly lower than IGHD.

‡

MPH: Mid-parental height (average of the heights of the parents, plus 6.5 cm for male patients and minus 6.5 cm for females).

Clinical and anthropometric characteristics according to GH status^</a>.</p</sup>

Laboratory measurements according to GH status.

<p>OGHD: organic growth hormone deficiency; IGHD: idiopathic growth hormone deficiency.</p><p>*GH sufficient compared to organic and idiopathic GHD.</p><p>**Organic GHD compared to both other groups.</p><p>Laboratory measurements according to GH status.</p