Objectives: The BNT162b2 mRNA COVID-19 vaccine has been found to be highly effective in preventing COVID-19 but is associated with increased reactogenicity. We aimed to examine the correlation between immunogenicity and reactogenicity of the BNT162b2 vaccine. Methods: Subjects without prior SARS-CoV-2 infection that participated in active surveillance after being vaccinated with the BNT162b2 vaccine were included. Study participants reported adverse drug reactions (ADRs) through questionnaires administered by text message after receiving each dose of the vaccine. A reactogenicity score was developed based on the type and duration of ADRs. In addition, anti-receptor binding domain (RBD) levels and neutralization assays were performed 7–21 and 7–38 days after the first and second vaccine doses, respectively. Associations between ADRs and antibody levels were assessed by Spearman correlations. Multivariable logistic regression analyses were used to identify factors associated with ADRs. Results: A total of 831 health care workers were included. The mean age was 46.5 years (SD = 11.8) and 75.5% were females. 83.4% and 83.3% had at least one local ADR after the first and second doses, respectively. 33% and 83.2% had at least one systemic ADR after the first and second doses, respectively. Multivariate logistic regression analysis found a significant correlation between ADR score and anti-RBD-IgG titers (r = 0.366; p < 0.0001) after adjustment for age, gender, and days after the second vaccination. High anti-RBD-IgG levels, being younger than 55 and being female, were all correlated with increased rates of ADRs. Conclusion: BNT162b2 mRNA COVID-19 vaccine reactogenicity appears to be correlated with higher post-vaccination antibody levels and is independently associated with younger age and female gender.

Objectives: To assess valve surgery outcomes in antiphospholipid syndrome (APS). Methods: A retrospective study assessing complications and mortality rate and possible factors associated with adverse outcomes of APS patients undergoing valve surgery in two tertiary medical centers. Results: Twenty-six APS patients (median age at surgery 47.5 years) who underwent valve surgery were detected, of whom 11 (42.3%) had secondary APS. The mitral valve was most commonly involved (n = 15, 57.7%). A valve replacement was performed in 24 operations (92.3%), 16 of which (66.7%) were mechanical valves. Fourteen (53.8%) patients sustained severe complications, and four of them died. The presence of mitral regurgitation (MR) was associated with severe complications and mortality (odds ratio (95% confidence interval) 12.5 (1.85–84.442), p = 0.008, for complications. All deceased patients had MR (p = 0.033). The presence of Libman-Sacks endocarditis (LSE) (7.333 (1.272–42.294), p = 0.045), low C3 (6.667 (1.047–42.431), p = 0.05) and higher perioperative prednisone doses (15 ± 21.89 vs. 1.36 ± 3.23 mg/day, p = 0.046) were also associated with complications. A lower glomerular filtration rate (GFR) was associated with mortality (30.75 ± 19.47 vs. 70.68 ± 34.44 mL/min, p = 0.038). Conclusions: Significant morbidity and mortality were observed among APS patients undergoing valve surgery. MR was associated with mortality and complications. LSE, low complement and higher doses of corticosteroids were associated with complications, while a low GFR was associated with mortality.

Background: Eosinophilia, defined as peripheral blood eosinophil counts > 0.5 K/μL, is associated with various clinical conditions, including allergic, infectious, and malignant diseases. Emerging evidence suggests that eosinophils may contribute to thrombo-inflammatory processes, but their association with thromboembolic events and mortality remains insufficiently characterized. This study aimed to evaluate whether eosinophilia is independently associated with increased risk of thromboembolic events and mortality in hospitalized patients. Methods: We conducted a retrospective cohort study using electronic medical records from Sheba Medical Center (2011–2020). Eosinophilia was classified as mild (0.5–1.5 K/μL) or hypereosinophilia (HE, >1.5 K/μL). Patients with eosinophilia were matched 1:1 to controls with normal eosinophil counts based on age, sex, and follow-up duration. Results: Among 93,320 patients (46,660 with eosinophilia and 46,660 controls), thromboembolic events occurred in 20.9% of eosinophilic patients vs. 9.8% of controls. Eosinophilia was independently associated with thrombosis (OR = 1.33; 95% CI, 1.28–1.38; p < 0.0001), with increased risk from counts ≥ 0.7 K/μL. Mortality was also higher among eosinophilic patients (HR = 1.17; 95% CI, 1.13–1.20; p < 0.0001). Conclusions: Eosinophilia is associated with increased thromboembolic and mortality risk, highlighting the importance of eosinophil monitoring in clinical practice.