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1. Interstitial lung disease in a patient with premature aging: Suspected Werner syndrome

Author

Carlos D Garcia, Radames Sierra-Zorita, Modesto Gonzalez-Del Rosario, Ricardo Fernandez-Gonzalez, and Greisha M Gonzalez-Santiago

Abstract

Werner syndrome (WS) is a rare inherited autosomal recessive disease that can be diagnosed with cardinal signs without the genetic testing. Some features that are consistent with WS include premature aging, loss, and graying hair, scleroderma-like skin changes. We report a 42-year-old man with cardinal signs of WS who also developed interstitial lung disease (ILD). The patient had past medical history (PMHx) of atypical left femur fracture in his early 30s from unknown causes. Also, he had loss and graying hair, salt-on-pepper skin changes, associated with squeaky voice, muscle wasting, and osteoporosis. He had worsening symptoms of dyspnea on exertion and was found with bilateral diffuse subpleural reticular opacities with slight mid- to lower-lung predominance and mild bronchiectasis without honeycombing or ground-glass airspace opacities on chest computed tomography (CT) scan. Other causes of ILD were excluded as patient routine laboratories and rheumatologic workup was negative. Werner syndrome presents similar features with other telomerase-associated diseases such as mutations of telomerase complexes [telomerase RNA component (TERC) and telomerase reverse transcriptase (TERT)]. Werner syndrome can be difficult to diagnose because it is a rare genetic disease that begins to show symptoms and signs after 10 or 20-year-olds, but the diagnosis is recognized after 30s. Few cases have been reported about the association of WS and ILD, but both diseases are aging diseases. This case might be the first case reported in Puerto Rico of Werner syndrome associated with ILD. Early referral and treatment is important to improve patients’ quality of life and life expectancy by slowing the progression of the disease.

Published
2022
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2. COVAD survey 2 long-term outcomes: unmet need and protocol

Author

Zoha Zahid Fazal, Parikshit, Sen, Mrudula, Joshi, Naveen, Ravichandran, Lilleker, James B., Vishwesh, Agarwal, Sinan, Kardes, Minchul, Kim, Jessica, Day, Ashima, Makol, Marcin, Milchert, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Elena, Nikiphorou, Ai Lyn Tan, Tulika, Chatterjee, Lorenzo, Cavagna, Saavedra, Miguel A., Samuel Katsuyuki Shinjo, Nelly, Ziade, Albert, Selva-O’Callaghan, Arvind, Nune, Johannes, Knitza, Masataka, Kuwana, Carlos-Enrique Toro Gutiérrez, Carlo Vinicio Caballero-Uribe, Dzifa, Dey, Oliver, Distler, Hector, Chinoy, Vikas, Agarwal, Rohit, Aggarwal, Latika Gupta, COVAD Study Group: Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, Rakesh Kumar Pilania, Aman, Sharma, Manesh Manoj, M, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Arun Kumar, R Pandey, Prithvi Sanjeevkumar Gaur, Mahabaleshwar, Mamadapur, Akanksha, Ghodke, Kunal, Chandwar, Kshitij, Jagtap, Döndü Üsküdar Cansu, Reşit, Yıldırım, Aarat, Patel, John, D Pauling, Chris, Wincup, Margherita, Giannini, François, Maurier, Julien, Campagne, Alain, Meyer, Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Silvia, Grignaschi, Alessandro, Giollo, Lisa, S Traboco, Syahrul Sazliyana Shaharir, Suryo Anggoro Kusumo Wibowo, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Colunga‑pedraza, Iris J., Javier, Merayo-Chalico, Jesús, Loarce-Martos, Sergio, Prieto-González, Albert, Gil-Vila, Raquel, Aranega, Leonardo Santos Hoff, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Stylianos, Tomaras, Fabian Nikolai Proft, Marie-Therese, Holzer, Margarita Aleksandrovna Gromova, Aharonov, Or, Melinda, Nagy-Vincze, Zoltán, Griger, Ihsane, Hmamouchi, Pr Imane El bouchti, Zineb, Baba, Uyi, Ima-Edomwonyi, Ibukunoluwa, Dedeke, Emorinken, Airenakho, Nwankwo Henry Madu, Abubakar, Yerima, Hakeem, Olaosebikan, Okwara Celestine Chibuzo, Becky, A, Ouma Devi Koussougbo, Elisa, Palalane, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Océane, Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, Álvaro, Arbeláez, Javier, Cajas, José António Pereira Silva, João Eurico Fonseca, Olena, Zimba, Doskaliuk, Bohdana, Ho, So, Manuel Francisco Ugarte-Gil, Lyn, Chinchay, José Proaño Bernaola, Victorio, Pimentel, Tanveer Hasan, A. T. M., Sreoshy, Saha, Binit, Vaidya, Hanan Mohamed Fathi, Reem Hamdy, A Mohammed, Yi-Ming, Chen, Ghita, Harifi, Lina El Kibbi, Hussein Mohammed Halabi, Akawatcharangura, P, Wanruchada, Katchamart, Yurilís, Fuentes-Silva, Karoll, Cabriza, Jonathan, Losanto, Nelly, Colaman, Antonio, Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Raúl Agustín González, Lilith Stange Nunez, Cristian Vergara, M, Jossiell Then Báez, Hugo, Alonzo, Carlos Benito Santiago Pastelin, Rodrigo García Salinas, Alejandro Quiñónez Obiols, Nilmo, Chávez, Andrea Bran Ordóñez, Sandra, Argueta, Daniel, Quijivix, Gil Alberto Reyes Llerena, Radames, Sierra-Zorita, Dina, Arrieta, Eduardo Romero Hidalgo, Ricardo, Saenz, Idania Escalante, M., Roberto, Morales, Wendy, Calapaqui, Ivonne, Quezada, Gabriela, Arredondo, Institut Català de la Salut, [Fazal ZZ] Medical College, Aga Khan University Hospital, National Stadium Road, Sindh, Pakistan. [Sen P] Maulana Azad Medical College, 2-Bahadurshah Zafar Marg, New Delhi, India. [Joshi M] Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India. [Ravichandran N] Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. [Lilleker JB] Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Centre for Musculoskeletal Research, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. Neurology, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, UK. [Agarwal V] Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India. [Selva-O'Callaghan A] Unitat d’Inflamació i Autoimmunitat, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Investigative Techniques::Epidemiologic Methods::Data Collection::Surveys and Questionnaires [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Autoimmune diseases, COVID-19, Long-term adverse effects, Registries, Vaccination, COVID-19 Vaccines, COVID-19/prevention & control, Immunology, Complex Mixtures::Biological Products::Vaccines::Viral Vaccines [CHEMICALS AND DRUGS], Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores], Enquestes, Antiviral Agents, Rheumatology, Other subheadings::Other subheadings::/adverse effects [Other subheadings], virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], Immunology and Allergy, Humans, Pandemics/prevention & control, Vacunes - Efectes secundaris, Pandemics, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], técnicas de investigación::métodos epidemiológicos::recopilación de datos::encuestas y cuestionarios [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], mezclas complejas::productos biológicos::vacunas::vacunas víricas [COMPUESTOS QUÍMICOS Y DROGAS], Long term adverse effects, Covid-19, COVID-19 (Malaltia) - Vacunació, COVID-19 Vaccines/adverse effects
Abstract

COVID-19; Registries; Vaccination COVID-19; Registros; Vacunación COVID-19; Registres; Vacunació Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently approved vaccines are live-attenuated, several reports of disease flares, waning protection, and acute-onset syndromes have emerged as short-term adverse events after vaccination. Hence, scientific literature falls short when discussing potential long-term effects in vulnerable cohorts. The COVAD-2 survey follows on from the baseline COVAD-1 survey with the aim to collect patient-reported data on the long-term safety and tolerability of COVID-19 vaccines in immune modulation. The e-survey has been extensively pilot-tested and validated with translations into multiple languages. Anticipated results will help improve vaccination efforts and reduce the imminent risks of COVID-19 infection, especially in understudied vulnerable groups. HC is supported by the National Institution for Health Research Manchester Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Published
2022
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3. COVID-19 vaccine safety during the antenatal period in women with idiopathic inflammatory myopathies

Author

Andreoli, Laura, Parikshit, Sen, Lini, Daniele, Melinda Nagy Vincze, Karen, Schreiber, COVAD Study Group, Vikas, Agarwal, Rohit, Aggarwal, Latika Gupta The COVAD study group includes: Naveen, R, Mrudula, Joshi, Sreoshy, Saha, Kshitij, Jagtap, Lilleker, James B., Vishwesh, Agarwal, Sinan, Kardes, Jessica, Day, Marcin, Milchert, Tamer, Gheita, Babur, Salim, Tsvetelina, Velikova, Abraham Edgar Gracia-Ramos, Ioannis, Parodis, Elena, Nikiphorou, Tulika, Chatterjee, Ai Lyn Tan, Lorenzo, Cavagna, Saavedra, Miguel A., Samuel Katsuyuki Shinjo, Nelly, Ziade, Johannes, Knitza, Masataka, Kuwana, Arvind, Nune, Oliver, Distler, Hector, Chinoy, Ashima, Makol, Dzifa, Dey, Carlos Enrique Toro Gutie´rrez, Carlo Vinicio Caballero-Uribe, Bhupen, Barman, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Pandya, Sapan C., Rakesh Kumar Pilania, Aman, Sharma, Manesh, Manoj, Vikas, Gupta, Kavadichanda, Chengappa G., Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Pande, Arunkumar R., Kunal, Chandwar, Akanksha, Ghodke, Zoha Zahid Fazal, Do¨ndu¨ U¨ sku¨ dar Cansu, Res¸it, Yıldırım, Aarat, Patel, Pauling, John D., Chris, Wincup, Armen Yuri Gasparyan, Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Silvia, Grignaschi, Alessandro, Giollo, Alessia, Alluno, Florenzo, Ioannone, Marco, Fornaro, Lisa, S Traboco, Syahrul Sazliyana Shaharir, Suryo Anggoro Kusumo Wibowo, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio Garc ıa-De La Torre, Colunga-Pedrazza, Iris J., Javier Merayo Chalico, Jesu´, s Loarce-Martos, Sergio Prieto-Gonza´ lez, Raquel Aranega Gonzalez, Leonardo Santos Hoff, Akira, Yoshida, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Takahisa, Gono, Stylianos, Tomaras, Fabian Nikolai Proft, Marie-Therese, Holzer, Russka, Shumnalieva, Margarita Aleksandrovna Gromova, Aharonov, Or, Zolta´n, Griger, Ihsane, Hmamouchi, Imane El bouchti, Zineb, Baba, Margherita, Giannini, Franc¸ois, Maurier, Julien, Campagne, Alain, Meyer, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Oce´ane, Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, ´ lvaro Arbela´ez, A, Javier, Cajas, Jose´ Anto´nio Pereira Silva, Jo~ao Eurico Fonseca, Olena, Zimba, Doskaliuk, Bohdana, Uyi, Ima-Edomwonyi, Ibukunoluwa, Dedeke, Emorinken, Airenakho, Nwankwo Henry Madu, Abubakar, Yerima, Hakeem, Olaosebikan, Okwara Celestine Chibuzo, Becky, Adugna, Oruma Devi Koussougbo, Elisa, Palalane, Ho, So, Manuel Francisco Ugarte-Gil, Lyn, Chinchay, Jose´ Proa~no Bernaola, Victorio, Pimentel, Tanveer Hasan, A. T. M., Binit, Vaidya, Hanan Mohammed Fathi, Mohammed, Reem Hamdy A., Yi-Ming, Chen, Ghita, Harifi, Lina El Kibbi, Hussein Mohammed Halabi, Akawatcharangura, P., Wanruchada, Katchamart, Yuril ıs Fuentes-Silva, Karoll, Cabriza, Jonathan, Losanto, Nelly, Colaman, Antonio, Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Rau´, l Gonza´ lez, Lilith Stange Nunez, Cristian Vergara, M, Jossiell Then Ba´ez, Hugo, Alonzo, Carlos Benito Santiago Pastelin, Rodrigo Garc ıa Salinas, Alejandro Qui~no´nez Obiols, Nilmo, Cha´vez, Andrea Bran Ordo´ ~nez, Sandra, Argueta, Gil Alberto Reyes Llerena, Radames, Sierra-Zorita, Dina, Arrieta, Eduardo Romero Hidalgo, Ricardo, Saenz, Idania Escalante, M, Roberto, Morales, Wendy, Calapaqui, Ivonne, Quezada, and Gabriela, Arredondo

Subjects
Rheumatology, Pharmacology (medical)
Published
2022
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4. Prevalence of Rheumatoid Arthritis and Drug Dispensing Patterns Among Medicaid and Medicaid–Medicare Dually Eligible Beneficiaries in Puerto Rico

Author

Radames Sierra‐Zorita, Wenfei Wei, and José J. Hernández-Muñoz

Subjects
Adult, Male, musculoskeletal diseases, Specialty, MEDLINE, Eligibility Determination, Pharmacy, Medicaid medicare, Medicare, Drug Prescriptions, Drug Costs, Arthritis, Rheumatoid, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Health care, Prevalence, Humans, Medicine, Practice Patterns, Physicians', skin and connective tissue diseases, Aged, Aged, 80 and over, 030203 arthritis & rheumatology, Medicaid, business.industry, Insurance Benefits, Puerto Rico, Middle Aged, medicine.disease, Drug Utilization, United States, Dually eligible, Cross-Sectional Studies, Antirheumatic Agents, Rheumatoid arthritis, Female, Rheumatologists, business, Specialization, Demography
Abstract

Objective Estimate the prevalence of rheumatoid arthritis (RA) in Puerto Rico and describe disease-modifying anti-rheumatic drug (DMARD) dispensing patterns by prescriber specialty. Illustrate the impact of RA case definition on the estimated prevalence. Methods This study estimated the prevalence of RA in Puerto Rico during 2016 among Medicaid and Medicaid-Medicare dually-eligible beneficiaries of the Mi Salud Healthcare Plan (MSHP), a federally-funded health insurance program. DMARD dispensing and cost patterns were described and stratified by provider specialty. A sensitivity analysis was conducted to evaluate the effect of RA case definition on estimated prevalence. Results The prevalence of RA in 2016 was estimated to be 2 cases per 1,000 beneficiaries, with 3 per 1,000 beneficiaries among females, 4.5 times that of males. 44% of beneficiaries received conventional synthetic DMARDs (csDMARDs) only, 32% received biological or targeted synthetic DMARDs (b/tsDMARDs) only, and 24% received a combination of csDMARDs and b/tsDMARDs. Rheumatologists and combination of specialties (COS) accounted for the highest median number of dispensed DMARDs, with 14 each. Sensitivity analysis revealed that when RA cases with ≥3 medical claims were restricted to having ≥1 DMARD claim, the estimated prevalence changed from 6 to 3 cases per 1,000 beneficiaries. Conclusion The prevalence of RA in Puerto Rico in this study is lower than reported in the mainland United States, possibly due to more stringent criteria to define RA. DMARD dispensing and cost patterns are similar to those found in other studies. Claims algorithms that identify RA have higher validity when pharmacy data is included.

Published
2021
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5. Vaccine hesitancy decreases, long term concerns remain in myositis, rheumatic disease patients: A comparative analysis of the COVAD surveys

Author

Parikshit, Sen, Naveen, R, Nazanin, Houshmand, Siamak Moghadam Kia, Mrudula, Joshi, Sreoshy, Saha, Kshitij, Jagtap, Vishwesh, Agarwal, Arvind, Nune, Elena, Nikiphorou, Ai Lyn Tan, Samuel Katsuyuki Shinjo, Nelly, Ziade, Tsvetelina, Velikova, Marcin, Milchert, Ioannis, Parodis, Abraham Edgar Gracia-Ramos, Lorenzo, Cavagna, Masataka, Kuwana, Johannes, Knitza, Ashima, Makol, Aarat, Patel, John, D Pauling, Chris, Wincup, Bhupen, Barman, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Iris, J Colunga-Pedraza, Javier, Merayo-Chalico, Okwara Celestine Chibuzo, Wanruchada, Katchamart, Phonpen Akawatcharangura Goo, Russka, Shumnalieva, Yi-Ming, Chen, Leonardo Santos Hoff, Lina El Kibbi, Hussein, Halabi, Binit, Vaidya, Syahrul Sazliyana Shaharir, A T, M Tanveer Hasan, Dzifa, Dey, Carlos Enrique Toro Gutiérrez, Carlo Vinicio Caballero-Uribe, James, B Lilleker, Babur, Salim, Tamer, Gheita, Tulika, Chatterjee, Oliver, Distler, Miguel, A Saavedra, Jessica, Day, Hector, Chinoy, COVAD study group, Vikas, Agarwal, Rohit, Aggarwal, Latika Gupta COVAD Study Group Authors: Sinan Kardes, Andreoli, Laura, Lini, Daniele, Karen, Screiber, Melinda, Nagy, Vince, Yogesh Preet Singh, Rajiv, Ranjan, Avinash, Jain, Sapan, C Pandya, Rakesh Kumar Pilania, Aman, Sharma, Manesh Manoj, M, Vikas, Gupta, Chengappa, G Kavadichanda, Pradeepta Sekhar Patro, Sajal, Ajmani, Sanat, Phatak, Rudra Prosad Goswami, Abhra Chandra Chowdhury, Ashish Jacob Mathew, Padnamabha, Shenoy, Ajay, Asranna, Keerthi Talari Bommakanti, Anuj, Shukla, Arunkumar, R Pande, Kunal, Chandwar, Akanksha, Ghodke, Hiya, Boro, Zoha Zahid Fazal, Döndü Üsküdar Cansu, Reşit, Yıldırım, Armen Yuri Gasparyan, Nicoletta Del Papa, Gianluca, Sambataro, Atzeni, Fabiola, Marcello, 4 Govoni, Simone, Parisi, Elena Bartoloni Bocci, Gian Domenico Sebastiani, Enrico, Fusaro, Marco, Sebastiani, Quartuccio, Luca, Franceschini, Franco, Pier Paolo Sainaghi, Giovanni, Orsolini, Rossella De Angelis, Maria Giovanna Danielli, Vincenzo, Venerito, Silvia, Grignaschi, Alessandro, Giollo, Alessia, Alluno, Florenzo, Ioannone, Marco, Fornaro, Lisa, S Traboco, Suryo Anggoro Kusumo Wibowo, Jesús, Loarce-Martos, Sergio, Prieto-González, Raquel Aranega Gonzalez, Akira, Yoshida, Ran, Nakashima, Shinji, Sato, Naoki, Kimura, Yuko, Kaneko, Takahisa, Gono, Stylianos, Tomaras, Fabian Nikolai Proft, Marie-Therese, Holzer, Margarita Aleksandrovna Gromova, Aharonov, Or, Zoltán, Griger, Ihsane 11 Hmamouchi, Imane El bouchti, Zineb, Baba, Margherita, Giannini, François, Maurier, Julien, Campagne, Alain, Meyer, Daman, Langguth, Vidya, Limaye, Merrilee, Needham, Nilesh, Srivastav, Marie, Hudson, Océane, Landon-Cardinal, Wilmer Gerardo Rojas Zuleta, Álvaro, Arbeláez, Javier, Cajas, José, António, Pereira, Silva, João Eurico Fonseca, Olena, Zimba, Doskaliuk, Bohdana, Uyi, Ima-Edomwonyi, Ibukunoluwa, Dedeke, Emorinken, Airenakho, Nwankwo Henry Madu, Abubakar, Yerima, Hakeem, Olaosebikan, Becky, A., Oruma Devi Koussougbo, Elisa, Palalane, Ho, So, Manuel Francisco Ugarte-Gil, Lyn, Chinchay, José Proaño Bernaola, Victorio, Pimentel, Hanan Mohammed Fathi, Reem, Hamdy, Mohammed, A, Ghita, Harifi, Yurilís, Fuentes-Silva, Karoll, Cabriza, Jonathan, Losanto, Nelly, Colaman, Antonio, Cachafeiro-Vilar, Generoso Guerra Bautista, Enrique Julio Giraldo Ho, Raúl, González, Lilith Stange Nunez, Cristian Vergara, M, Jossiell Then Báez, Hugo, Alonzo, Carlos Benito Santiago Pastelin, Rodrigo García Salinas, Alejandro Quiñónez Obiols, Nilmo, Chávez, Andrea Bran Ordóñez, Sandra, Argueta, Gil Alberto Reyes Llerena, Radames, Sierra-Zorita, Dina, Arrieta, Eduardo Romero Hidalgo, Ricardo, Saenz, Idania Escalante, M, Roberto, Morales, Wendy, Calapaqui, Ivonne, Quezada, and Gabriela, Arredondo

Subjects
COVID-19 vaccines, registries, vaccine hesitancy, autoimmune disease, Idiopathic Inflammatory Myopathies

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