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Bell's palsy following vaccination with mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines: a case series and nested case-control study

Eric Yuk Fai Wan, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Esther Wai Yin Chan, Xue Li, Vincent Ka Chun Yan, Le Gao, Qiuyan Yu, Ivan Chun Hang Lam, Raccoon Ka Cheong Chun,  Benjamin John Cowling, Wing Chi Fong, Alexander Yuk Lun Lau, Vincent Chung Tong Mok, Frank Ling Fung Chan, Cheuk Kwong Lee, Lot Sze Tao Chan, Dawin Lo, Kui Kai Lau, Ivan Fan Ngai Hung, Gabriel Matthew Leung, Ian Chi Kei Wong

Published: 16 August 2021
DOI: https://doi.org/10.1016/S1473-3099(21)00451-5

Findings suggest an overall increased risk of Bell's palsy after CoronaVac vaccination. However, the beneficial and protective effects of the inactivated COVID-19 vaccine far outweigh the risk of this generally self-limiting adverse event. Additional studies are needed in other regions to confirm our findings

Adverse event reporting and Bell's palsy risk after COVID-19 vaccination - Authors' reply

Ian Chi Kei Wong, Eric Yuk Fai Wan, Celine Sze Ling Chui, Xue Li, Esther Wai Yin Chan

Published: 1 November 2021

DOI: https://doi.org/10.1016/S1473-3099(21)00631-9

Kwok-Chiu Chang and Fuk-Yip Kong suggest that possible selection bias in our nested case-control study could be due to the control participants (ie, patients admitted to emergency rooms or hospital wards) being older than all participants eligible for vaccination in the general population. However, as we used a matched case-control study design, this concern is irrelevant. 

Two-dose COVID-19 vaccination and possible arthritis flare among patients with rheumatoid arthritis in Hong Kong

Xue Li, Xinning Tong, Winnie Wan Yin Yeung, Peng Kuan, Samson Hin Hei Yum, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Eric Yuk Fai Wan, Carlos King Ho Wong, Esther Wai Yin Chan, Chak Sing Lau, Ian Chi Kei Wong.

Published: 21 October 2021
DOI: http://dx.doi.org/10.1136/annrheumdis-2021-221571

Current evidence does not support that full vaccination of mRNA or inactivated virus COVID-19 vaccines is associated with possible arthritis flare.

Inconsistent Safety Outcome Reporting in Randomized Clinical Trials of COVID-19 Vaccines Complicates Informed Medical Decisions

Joseph E. Blais, Yue Wei, Celine S. L. Chui, Esther W. Chan & Ian C. K. Wong.

Published: 17 August 2021
DOI: https://doi.org/10.1007/s40264-021-01108-5

The early results of COVID-19 vaccines trials published in top medical journals were some of the first publicly available data reporting vaccine safety outcomes, yet the reporting of these outcomes in journal articles should be more consistent, comprehensive, and transparent to allow for informed comparisons between different vaccines. The research team made suggestions based on this situation. 

Comparing self-reported reactogenicity between adolescents and adults following the use of BNT162b2 (Pfizer-BioNTech) messenger RNA COVID-19 vaccine: a prospective cohort study

Edward Wai Wa Chan, Miriam Tim Yin Leung, Lauren Ka Wun Lau, Janice Leung, Dawn Lum, Rosa Sze-Man Wong ,Xue Li, Celine Sze Ling Chui, Eric Yuk Fai Wan, Carlos King Ho Wong, Esther Wai Yin Chan, Patrick Ip, Ian Chi Kei Wong, Francisco Tsz Tsun Lai

 

Published: 26 December 2021

DOI: https://doi.org/10.1016/j.ijid.2021.12.354

Results of this study should be informative to parents considering BNT162b2 vaccination for their children in that moderately increased reactogenicity compared with adults is anticipated.

Epidemiology of Acute Myocarditis/Pericarditis in Hong Kong Adolescents Following Comirnaty Vaccination

Gilbert T Chua, Mike Yat Wah Kwan, Celine S L Chui, Robert David Smith, Edmund Chi-Lok Cheung, Tian Tian, Ma, Miriam T Y Leung, Sabrina Siu Ling Tsao, Elaine Kan, Wing Kei Carol Ng, Victor Chi Man Chan, Shuk Mui Tai, Tak Ching Yu, Kwok Piu Lee, Joshua Sung Chih Wong, Ying Kit Lin, Chi Chiu Shek, Agnes Sze Yin Leung, Chit Kwong Chow, Ka Wah Li, Johnny Ma, Wai Yuk Fung, Daniel Lee, Ming Yen Ng, Wilfred Hing Sang Wong, Hing Wai Tsang, Janette Kwok, Daniel Leung, Kin Lai Chung, Chun Bong Chow, Godfrey Chi Fung Chan, Wing Hang Leung, Kelvin Kai Wang To, Kwok Yung Yuen, Yu Lung Lau, Ian Chi Kei Wong

Published: 28 November 2021

DOI: https://doi.org/10.1093/cid/ciab989

There is a significant increase in the risk of acute myocarditis/pericarditis following Comirnaty vaccination among Chinese male adolescents, especially after the second dose.

Multimorbidity and adverse events of special interest associated with Covid-19 vaccines in Hong Kong

Francisco Tsz Tsun Lai, Lei Huang, Celine Sze Ling Chui, Eric Yuk Fai Wan, Xue Li, Carlos King Ho Wong, Edward Wai Wa Chan, Tiantian Ma, Dawn Hei Lum, Janice Ching Nam Leung, Hao Luo, Esther Wai Yin Chan & Ian Chi Kei Wong

 

Published: 20 January 2022

DOI: https://doi.org/10.1038/s41467-022-28068-3

No evidence is found that multimorbidity imposes extra risks of adverse events following Covid-19 vaccination.

Post-Covid-19-vaccination adverse events and healthcare utilization among individuals with or without previous SARS-CoV-2 infection

Francisco Tsz Tsun Lai, Lei Huang, Celine Sze Ling Chui, Eric Yuk Fai Wan, Xue Li, Carlos King Ho Wong, Edward Wai Wa Chan, Tiantian Ma, Dawn Hei Lum, Janice Ching Nam Leung, Hao Luo, Esther Wai Yin Chan & Ian Chi Kei Wong

 

Published: 19 January 2022

DOI: http://dx.doi.org/10.1111/joim.13453

No safety signal of Covid-19 vaccination was detected from the comparison between vaccine recipients with previous SARS-CoV-2 infection and those without infection.

Carditis After COVID-19 Vaccination With a Messenger RNA Vaccine and an Inactivated Virus Vaccine

Francisco Tsz Tsun Lai, Xue Li, Kuan Peng, Lei Huang, Patrick Ip, Xinning Tong, Celine Sze Ling Chui, Eric Yuk Fai Wan, Carlos King Ho Wong, Esther Wai Yin Chan, David Chung Wah Siu, Ian Chi Kei Wong

 

Published: 25 January 2022

DOI: https://doi.org/10.7326/M21-3700

Despite a low absolute risk, there is an increased risk for carditis associated with BNT162b2 vaccination. This elevated risk should be weighed against the benefits of vaccination.

Self-reported reactogenicity of CoronaVac (Sinovac) compared with Comirnaty (Pfizer-BioNTech): A prospective cohort study with intensive monitoring

Francisco Tsz Tsun Lai, Miriam Tim Yin Leung, Edward Wai Wa Chan, Lei Huang, Lauren Ka Wun Lau, Kuan Peng, Janice Ching Nam Leung, Min Fan, Kailin Chen, Dawn Hei Lum, Xue Li, Celine Sze Ling Chui, Eric Yuk Fai Wan, Carlos King Ho Wong, Edwin Fung Shing Lam, Terence Yung Yan Cheung, Benjamin John Cowling, Ian Chi Kei Wong, Esther Wai Yin Chan.

 

Published: 7 February 2022

DOI: https://doi.org/10.1016/j.vaccine.2022.01.062

This post-marketing study comparing the reactogenicity of Covid-19 vaccines suggests a lower risk of self-reported adverse reactions following vaccination with CoronaVac compared with Comirnaty.

COVID-19 vaccines and risks of hematological abnormalities: nested case-control and self-controlled case series study

Chor-Wing Sing, Casey Tse Lam Tang, Celine Sze Ling Chui, Min Fan, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Carlos King Ho Wong, Esther Wai Yin Chan, Ivan Fan Ngai Hung, Anskar Yu Hung Leung, Ching Lung Cheung, Ian Chi Kei Wong

 

Published: 26 January 2022

DOI: https://doi.org/10.1002/ajh.26478

There was no association between CoronaVac and hematological abnormalities. The benefits of vaccination against COVID-19 still outweigh the risk of hematological abnormalities.

Herpes zoster related hospitalization after inactivated (CoronaVac) and mRNA (BNT162b2) SARS-CoV-2 vaccination: A self-controlled case series and nested case-control study

Eric Yuk Fai Wan, Celine Sze Ling Chui, Yuan Wang, Vanessa Wai Sei Ng, Vincent Ka Chun Yan, Francisco Tsz Tsun Lai, Xue Li, Carlos King Ho Wong, Esther Wai Yin Chan, Christina Sze Man Wong, Kathy Sze Man Leung, Michael Yuxuan Ni, Sophie Alessandra Valkenburg, Joseph Sriyal Malik Peiris, Joseph Tsz Kei Wu, Benjamin John Cowling, Darren M Ashcroft, Ivan Fan Ngai Hung, Gabriel Matthew Leung, Ian Chi Kei Wong

 

Published: 1 February 2022

DOI: https://doi.org/10.1016/j.lanwpc.2022.100393

An increased risk of herpes zoster related hospitalization after CoronaVac and BNT162b2 vaccinations was found. However, the absolute risks of such adverse event after CoronaVac and BNT162b2 vaccinations were very low. In locations where COVID-19 is prevalent, the protective effects on COVID-19 from vaccinations will greatly outweigh the potential side effects of vaccination.

Lack of inflammatory bowel disease flare-up following two-dose BNT162b2 vaccine: a population-based cohort study

Xue Li, Xinning Tong, Ian Chi Kei Wong, Kuan Peng, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Eric Yuk Fai Wan, Carlos King Ho Wong, Wai Keung Leung, Esther Wai Yin Chan

 

Published: 8 February 2022

DOI: http://dx.doi.org/10.1136/gutjnl-2021-326860

We found no increased risk of severe disease flare-ups following the two- dose BNT162b2 vaccine in patients with IBD. These observations substantiate the medium-term safety of BNT162b2 vaccination in patients with IBD.

Safety of inactivated and mRNA COVID-19 vaccination among patients treated for hypothyroidism: a population-based cohort study

Xi Xiong, Carlos King Ho Wong, Ivan Chi Ho Au, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Celine Sze Ling Chui, Esther Wai Yin Chan, Franco Wing Tak Cheng, Kristy Tsz Kwan Lau, Chi Ho Lee, Yu-Cho Woo, David Lui, and Ian Chi Kei Wong

 

Published: 17 May 2022

DOI: https://doi.org/10.1089/thy.2021.0684

CoronaVac vaccination is not associated with unstable thyroid status or an increased risk of adverse outcomes among patients treated for hypothyroidism in general. These reassuring data should encourage them to get vaccinated against COVID-19 for protection from potentially worse COVID-19-related outcomes.

Myocarditis Following COVID-19 BNT162b2 Vaccination Among Adolescents in Hong Kong

Xue Li, Francisco Tsz Tsun Lai, Gilbert T. Chua, Mike Yat Wah Kwan, Yu Lung Lau, Patrick Ip, Ian Chi Kei Wong

 

Published: 25 February 2022

DOI: https://doi.org/10.1001/jamapediatrics.2022.0101

Questions remain about the mechanism of myocarditis following mRNA vaccine. Potential ways to reduce myocarditis risk in adolescents could be the use of single-dose only, a lower dosage for 2 doses as recommended for children aged 5 to 11 years, or a lengthened interval between doses. More laboratory, trial, and postmarketing data may become available to answer these questions. Our study expands the current understanding of dose-response relationship and suggests that COVID-19 vaccination recommendations in adolescents may need to be customized rather than standardized to fit all.

Adverse Events of Special Interest Following the Use of BNT162b2 in Adolescents: A Population-Based Retrospective Cohort Study

Francisco Tsz Tsun Lai, Gilbert T Chua, Edward Wai Wa Chan, Lei Huang, Mike Yat Wah Kwan, Tiantian Ma, Xiwen Qin, Celine Sze Ling Chui, Xue Li, Eric Yuk Fai Wan, Carlos King Ho Wong, Esther Wai Yin Chan, Ian Chi Kei Wong, Patrick Ip

 

Published: 21 March 2022

DOI: https://doi.org/10.1080/22221751.2022.2050952

With myocarditis excluded as AESIs, no significantly elevated risk of AESIs as a composite outcome associated with vaccination was observed. To conclude, the overall absolute risk of AESIs was low with no evidence of an increased risk of AESIs except myocarditis and sleeping disturbances/disorders.

Impact of a delayed second dose of mRNA vaccine (BNT162b2) and inactivated SARS-CoV-2 vaccine (CoronaVac) on risks of all-cause mortality, emergency department visit, and unscheduled hospitalization

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Carlos King Ho Wong, Xi Xiong, Kristy Tsz Kwan Lau, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Xue Li, Esther Wai Yin Chan, Eric Yuk Fai Wan, Ivan Chi Ho Au, Benjamin John Cowling, Cheuk Kwong Lee & Ian Chi Kei Wong

 

Published: 17 March 2022

DOI: https://doi.org/10.1186/s12916-022-02321-4

No significant association between delayed second dose of BNT162b2 or CoronaVac and all-cause mortality, ED visit, and unscheduled hospitalization was observed in the present cohort. Regardless of the recommended or delayed schedule for SARS-CoV-2 vaccination, a second dose of both vaccines should be administered to obtain better protection against infection and serious disease. The second dose should be administered within the recommended interval following the manufacturer’s product information, until further studies support the benefits of delaying vaccination outweighing the risks.

Autoimmune conditions following mRNA (BNT162b2) and inactivated (CoronaVac) COVID-19 vaccination:
A descriptive cohort study among 1.1 million vaccinated people in Hong Kong

Xue Li, Le Gao, Xinning Tong, Vivien K.Y. Chan, Celine S.L. Chui, Francisco T.T. Lai, Carlos K.H. Wong, Eric Y.F. Wan, Esther W.Y. Chan, Kui Kai Lau, Chak Sing Lau, Ian C.K.Wong

 

Published: 14 April 2022

DOI: https://doi.org/10.1016/j.jaut.2022.102830

Autoimmune conditions requiring hospital care are rare following mRNA and inactivated COVID-19 vaccination with similar incidence to non-vaccinated individuals. The association between first dose BNT162b2 vaccination and immune-related sleeping disorders requires further research. Population-based robust safety surveillance is essential to detect rare and unexpected vaccine safety events.

Safety of two-dose COVID-19 vaccination (BNT162b2 and CoronaVac) in adults with cancer: a territory-wide cohort study

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Wei Kang, Jessica J. P. Shami, Vincent K. C. Yan, Xuxiao Ye, Joseph E. Blais, Xue Li, Victor H. F. Lee, Celine S. L. Chui, Francisco T. T. Lai, Eric Y. F. Wan, Carlos K. H. Wong, Ian C. K. Wong & Esther W. Chan

Published: 19 May 2022

DOI: https://doi.org/10.1186/s13045-022-01265-9

The incidence of AESI following vaccination with two doses of either BNT162b2 or CoronaVac vaccines was low. The findings of this study can reassure clinicians and patients with cancer about the overall safety of BNT162b2 and CoronaVac in patients with cancer, which could increase the COVID-19 vaccination rate in this vulnerable group of patients.

Messenger RNA Coronavirus Disease 2019 (COVID-19) Vaccination With BNT162b2 Increased Risk of Bell’s Palsy:
A Nested Case-Control and Self-Controlled Case Series Study 

Eric Yuk Fai Wan, Celine Sze Ling Chui, Vanessa Wai Sei Ng, Yuan Wang, Vincent Ka Chun Yan, Ivan Chun Hang Lam, Min Fan, Francisco Tsz Tsun Lai, Esther Wai Yin Chan, Xue Li, Carlos King Ho Wong, Raccoon Ka Cheong Chung, Benjamin John Cowling, Wing Chi Fong, Alexander Yuk Lun Lau, Vincent Chung Tong Mok, Frank Ling Fung Chan, Cheuk Kwong Lee, Lot Sze Tao Chan, Dawin Lo, Kui Kai Lau, Ivan Fan Ngai Hung, Chak Sing Lau, Gabriel Matthew Leung, Ian Chi Kei Wong

Published: 8 June 2022

DOI: http://doi.org/10.1093/cid/ciac460

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There is an overall increased risk of Bell’s palsy following BNT162b2 vaccination, particularly within the first 14 days after the second dose, but the absolute risk was very low.

Adverse events of special interest and mortality following vaccination with mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines in Hong Kong:
A retrospective study

Carlos King Ho Wong, Kristy Tsz Kwan Lau, Xi Xiong, Ivan Chi Ho Au, Francisco Tsz Tsun Lai, Eric Yuk Fai Wan, Celine Sze Ling Chui, Xue Li, Esther Wai Yin Chan, Le Gao, Franco Wing Tak Cheng, Sydney Chi Wai Tang, Ian Chi Kei Wong 

Published: 21 June 2022

DOI: https://doi.org/10.1371/journal.pmed.1004018

We observed that the incidences of AESIs (cumulative incidence rate of 0.06%–0.09%) and mortality following the first and second doses of CoronaVac and BNT162b2 vaccination were very low. The safety profiles of the vaccines were generally comparable, except for a significantly higher incidence rate of Bell palsy, but lower incidence rates of anaphylaxis and sleeping disturbance or disorder, following first dose CoronaVac versus BNT162b2 vaccination. Our results could help inform the choice of inactivated COVID-19 vaccines, mainly administered in low- and middle-income countries with large populations, in comparison to the safety of mRNA vaccines. Long-term surveillance on the safety profile of COVID-19 vaccines should continue.

Association between BNT162b2 or CoronaVac COVID-19 vaccines and major adverse cardiovascular events among individuals with cardiovascular disease 

Xuxiao Ye, Tiantian Ma, Joseph E. Blais, Vincent K.C. Yan, Wei Kang, Celine S.L. Chui, Francisco T.T. Lai, Xue Li, Eric Y.F. Wan, Carlos K.H. Wong, Hung-Fat Tse, Chung-Wah Siu, Ian C.K. Wong, Esther W. Chan

Published: 22 June 2022

DOI: https://doi.org/10.1093/cvr/cvac068

Our findings showed no evidence of an increased risk of MACE after vaccination with BNT162b2 or CoronaVac in patients with CVD. Future research is required to monitor the risk after the third dose of each vaccine.

Thromboembolic events and hemorrhagic stroke after mRNA (BNT162b2) and inactivated (CoronaVac) covid-19 vaccination: A self-controlled case series study

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This study aims to evaluate the association between thromboembolic events and hemorrhagic stroke following BNT162b2 and CoronaVac vaccination.

Risk of acute liver injury following the mRNA (BNT162b2) and inactivated (CoronaVac) COVID-19 vaccines

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There was no evidence of an increased risk of ALI associated with BNT162b2 or CoronaVac vaccination. Based on all current available evidence from previous studies and our study, the benefit of mass vaccination far outweighs the ALI risk from vaccination and SARS-CoV-2 infection.

Safety of an inactivated, whole-virion COVID-19 vaccine (CoronaVac) in people aged 60 years or older in Hong Kong: a modified self-controlled case series

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Because older age is associated with poor outcomes after SARS-CoV-2 infection, the benefits of CoronaVac vaccination in older adults outweigh the risks in regions where COVID-19 is prevalent. Ongoing monitoring of vaccine safety is warranted.

The effectiveness and safety of mRNA (BNT162b2) and inactivated (CoronaVac) COVID-19 vaccines among individuals with chronic kidney diseases

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The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious threat to individuals with underlying chronic kidney disease (CKD). People with CKD are immunocompromised and therefore result in poorer outcomes including increased risk of hospitalization and mortality after COVID-19. Despite the availability of COVID-19 vaccines, current data on the vaccine efficacy in individuals with CKD are limited to surrogate endpoints such as antibody titers. As a result, a dedicated study is required to evaluate the effectiveness and safety of COVID-19 vaccines for the CKD population.

mRNA (BNT162b2) and Inactivated (CoronaVac) COVID-19 Vaccination and Risk of Adverse Events and Acute Diabetic Complications in Patients with Type 2 Diabetes Mellitus:
A Population-Based Study

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In Hong Kong, CoronaVac and BNT162b2 have been approved for emergency use owing to the coronavirus disease 2019 (COVID-19) pandemic. Reactions towards the vaccine and the risk of post-vaccination adverse events may be different between recipients with and without type 2 diabetes mellitus (T2DM).

Association between the risk of seizure and COVID-19 vaccinations: A self-controlled case-series study

Eric Yuk Fai Wan, Vanessa Wai Sei Ng, Richard Shek-Kwan Chang, Vincent Ka Chun Yan, Celine Sze Ling Chui, Carlos King Ho Wong, Xue Li, Francisco Tsz Tsun Lai, Esther Wai Yin Chan, Ivan Fan Ngai Hung, Kui Kai Lau, Ian Chi Kei Wong

Published: 13 October 2022

DOI: https://doi.org/10.1111/epi.17436

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The risk of seizure following BNT162b2 and CoronaVac vaccinations has been sparsely investigated. This study aimed to evaluate this association.

Risk of thyroid dysfunction associated with mRNA and inactivated COVID-19 vaccines: a population-based study of 2.3 million vaccine recipients

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In view of accumulating case reports of thyroid dysfunction following COVID-19 vaccination, we evaluated the risks of incident thyroid dysfunction following inactivated (CoronaVac) and mRNA (BNT162b2) COVID-19 vaccines using a population-based dataset.

Risk of glomerular diseases, proteinuria and hematuria following mRNA (BNT162b2) and inactivated (CoronaVac) SARS-CoV-2 vaccines

Franco Wing Tak Cheng, Carlos King Ho Wong, Simon Xiwen Qin, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Xue Li, Eric Yuk Fai Wan, Esther W Chan, Chi Ho Au, Xuxiao Ye, Sydney Chi Wai Tang, Ian Chi Kei Wong

Published: 28 October 2022

DOI: https://doi.org/10.1093/ndt/gfac292

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With accruing case reports on de novo or relapsing glomerular diseases (GD) following different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines, we evaluated the risk of GD following BNT162b2 and CoronaVac vaccines.

Prognosis of Myocarditis Developing After mRNA COVID-19 Vaccination Compared With Viral Myocarditis

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This study found a significantly lower rate of mortality among individuals with myocarditis after mRNA vaccination compared with those with viral infection–related myocarditis. Prognosis of this iatrogenic condition may be less severe than naturally acquired viral infection–related myocarditis.

Tuberculosis following two-dose SARS-CoV-2 vaccination with messenger RNA vaccine (BNT162b2) and inactivated virus vaccine (CoronaVac)

Xue Li, Kuan Peng, Franco W.T. Cheng, David C.L. Lam, Ching Lung Cheung, Celine S.L. Chui, Francisco T.T. Lai, Eric Y.F. Wan, Carlos K.H. Wong, Tiantian Ma, Samson H.H. Yum, Esther W.Y. Chan, Jian Dong Huang, Chak Sing Lau, Mary S.M. Ip, Ian C.K. Wong

Published: 16 December 2022

DOI: https://doi.org/10.1016/j.jinf.2022.12.016

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Although the waning of antibodies is anticipated after two-dose SARS-CoV-2 vaccination, the cellular response, especially the Th1 cell response that promotes T-cell immunity, has been reported recently. Development of the T-cell and cellular immune response triggers long-term memory with potential cross-pathogen protection – known as trained immunity. Animal and epidemiological studies showed a cross-protection effect from Bacille Calmette-Guerin (BCG) vaccination on COVID-19 by inducing trained immunity. We hypothesize that SARS-CoV-2 vaccination could also trigger trained immunity and offer protection against tuberculosis (TB) through a similar mechanism.

Risk of carditis after three doses of vaccination with mRNA (BNT162b2) or inactivated (CoronaVac) covid-19 vaccination: a self-controlled cases series and a case–control study

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Min FanFrancisco Tsz Tsun Lai, Franco Wing Tak Cheng, Natalie Tsz Ying Tsie, Xue Li, Eric Yuk Fai Wan, Carlos King Ho Wong, Esther Wai Yin Chan, Kai Hang Yiu, Ian Chi Kei Wong, Celine Sze Ling Chui

Published: 25 March 2023

DOI: https://doi.org/10.1016/j.lanwpc.2023.100745

Large-scale comparative research exploring the risk after the third dose and after inactivated covid-19 vaccination is limited. This study aimed to assess the risk of carditis following three doses of BNT162b2 or CoronaVac.

Incidence of diabetes following COVID-19 vaccination and SARS-CoV-2 infection in Hong Kong: A population-based cohort study

Xi Xiong, David Tak Wai Lui, Matthew Shing Hin Chung, Ivan Chi Ho Au, Francisco Tsz Tsun Lai, Eric Yuk Fan Wan, Celine 

Sze Ling Chui, Xue Li, Franco Wing Tak Cheng, Ching-Lung Cheung, Esther Wai Yin Chan, Chi Ho Lee, Yu Cho Woo, Kathryn Choon Beng Tan, Carlos King Ho Wong, Ian Chi Kei Wong

Published: 24 July 2023

DOI: https://doi.org/10.1371/journal.pmed.1004274

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The risk of incident diabetes following Coronavirus Disease 2019 (COVID-19) vaccination remains to be elucidated. Also, it is unclear whether the risk of incident diabetes after Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection is modified by vaccination status or differs by SARS-CoV-2 variants. We evaluated the incidence of diabetes following mRNA (BNT162b2), inactivated (CoronaVac) COVID-19 vaccines, and after SARS-CoV-2 infection.

Molnupiravir and nirmatrelvir–ritonavir reduce mortality risk during post-acute COVID-19 phase

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The findings of this study demonstrate the survival benefits of treatment with the COVID-19 oral antivirals, molnupiravir and nirmatrelvir–ritonavir, in reducing the risk of mortality in the post-acute phase in hospitalized patients, especially in older adults. These benefits are observed in both, vaccinated and unvaccinated patients. Moreover, treatment with nirmatrelvir–ritonavir may also be beneficial in lowering the likelihood of requiring hospitalization or A&E visits. Further study in larger cohorts (especially younger patients) is warranted.

Sex-based differences in risk of ischaemic stroke or systemic embolism after BNT162b2 or CoronaVac COVID-19 vaccination in patients with atrial fibrillation: a self-controlled case series and nested case-control study

Xuxiao Ye, Caige Huang, Vincent Ka Chun Yan, Wei Kang, Min Fan, Gigi Kwan Chi Tsang, Clarissa Mung Yee Ho, Gregory Y H Lip, Kai-Hang Yiu, Hung-Fat Tse, 

Tiantian Ma, Xiwen Qin, Celine Sze Ling Chui, Francisco Tsz Tsun Lai, Carlos King Ho Wong, Eric Yuk Fai Wan, Xue Li, Cheuk Kwong Lee, Ivan Fan Ngai Hung, Ian Chi Kei Wong, Esther Wai Yin Chan

Published: 14 March 2023

DOI: https://doi.org/10.1093/ehjcvp/pvad015

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The risk of ischaemic stroke or systemic embolism after COVID-19 vaccination was only increased in female patients with atrial fibrillation (AF). However, as the risk after COVID-19 was even higher, proactive uptake of COVID-19 vaccines is recommended to prevent the potential severe outcomes after infection.

Effectiveness of Molnupiravir and Nirmatrelvir–Ritonavir in Hospitalized Patients With COVID-19

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Molnupiravir and nirmatrelvir–ritonavir reduced all-cause mortality in both vaccinated and unvaccinated hospitalized patients. No significant reduction in ICU admission or the need for ventilatory support was observed.

Risk of Adverse Events and Delirium after COVID-19 Vaccination in Patients Living with Dementia

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The findings provide evidence for the safe use of COVID-19 vaccines in older patients with dementia. In the short run, benefit appears to outweigh the harm due to vaccine; however, longer follow-up should be continued to identify remote adverse events.

Long-term post-acute sequelae of COVID-19 infection:
a retrospective, multi-database cohort study in Hong Kong and the UK

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Our study reported highly consistent increased incidences of a diverse range long-term sequelae involving multiple organ systems and all-cause mortality during the post-acute phase of COVID-19 infection in HK and UK. Findings from this study emphasize the importance of sustained interdisciplinary follow-up for patients recovering from COVID-19 to improve their clinical outcomes and reduce morbidity of post-acute sequelae of SARS-CoV-2 (PASC).

Post-acute sequelae of COVID-19 in older persons:
multi-organ complications and mortality

Eric Yuk Fai Wan, Ran Zhang, Sukriti Mathur, Vincent Ka Chun Yan, Francisco Tsz Tsun Lai, Celine Sze Ling Chui, Xue Li, Carlos King Ho Wong, Esther Wai Yin Chan, Chak Sing Lau, Ian Chi Kei Wong

Published: 13 June 2023

DOI: https://doi.org/10.1093/jtm/taad082

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COVID-19 is associated with long-term risks of multi-organ complications in older adults (aged ≥ 60). Infected patients in this age-group may benefit from appropriate monitoring of signs/symptoms for developing these complications.

Association between BNT162b2 and CoronaVac vaccination and risk of CVD and mortality after COVID-19 infection:
A population-based cohort study

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The risk of CVD and mortality in both the acute and post-acute phase after COVID-19 infection was lower among recipients of BNT162b2 and CoronaVac. There was a positive dose-response relationship between the magnitude of overall risk reduction of CVD and the number of vaccine doses received.

Effectiveness of molnupiravir vs nirmatrelvir-ritonavir in non-hospitalised and hospitalised patients with COVID-19:
a target trial emulation study

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Our analyses suggest that nirmatrelvir-ritonavir was more effective than molnupiravir in reducing the risk of all-cause mortality in both non-hospitalised and hospitalised patients. When neither drug is contraindicated, nirmatrelvir-ritonavir may be considered the more effective option.

Long-term effects of coronavirus disease 2019 on diabetes complications and mortality in people with diabetes:
Two cohorts in the UK and Hong Kong

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COVID-19 infection is associated with long-term increased risks of diabetes complications (especially cardiovascular complications, and mortality) in people with diabetes. Monitoring for signs/symptoms of developing these long-term complications post-COVID-19 infection in the infected patient population of people with diabetes may be beneficial in minimizing their morbidity and mortality.

Elevated risk of multimorbidity post-COVID-19 infection: protective effect of vaccination

F T T Lai, W Liu, Y Hu, C Wei, R Y K Chu, D H Lum, J C N Leung, F W T Cheng, C S L Chui, X Li, E Y F Wan, C K H Wong, C L Cheung, E W Y Chan, I F N Hung, I C K Wong

Published: 12 October 2023

DOI: https://doi.org/10.1093/qjmed/hcad236

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We found a significantly elevated risk of multimorbidity following a Covid-19 episode among people with one pre-existing chronic condition. Full vaccination significantly reduced this risk increase.

Effectiveness and Respiratory Adverse Events Following Inactivated and mRNA COVID-19 Vaccines in Patients with COPD and Asthma: A Chinese Population-Based Study

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Among people with COPD and asthma, the COVID-19 vaccines CoronaVac and BNT162b2 did not increase severe exacerbations and achieved moderate-to-high effectiveness against COVID-related outcomes. COVID-19 vaccination remains essential and should be encouraged to protect this vulnerable population in future epidemic waves.

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