COVID-19 ve İnfluenza Pnömonileri
Özet
Hasta ve/veya cerrahi prosedürle ilişkili risklere bağlı olarak perioperatif dönemde kardiyovasküler komplikasyonlar sık görülmektedir. Perioperatif kardiyovasküler komplikasyonlarla ilişkili mortalite ve morbiditeyi azaltmak, hasta ve cerrahi işlemle ilgili riskleri belirlemek ve hasta bakımını iyileştirmeye yönelik optimum koşulları sağlamak amacıyla uygun preoperatif değerlendirme planlanmalıdır. Ayrıca preoperatif değerlendirme ile yüksek riskli hastaların ameliyat öncesi belirlenmesiyle ameliyat gününde gecikmelerin ve vaka iptallerin önüne geçmek amaçlanmaktadır. Bu bölümde kardiyak dışı cerrahilerde preoperatif kardiyovasküler değerlendirme yönelik bilgiler sunulmaktadır. Preoperatif değerlendirmenin temelini ayrıntılı bir anamnez ve fizik muayene oluşturmaktadır.
Referanslar
Demirhan R, Cimenoglu B, Yilmaz E. The Effects of Hospital Organization on Treatment During COVID-19 Pandemic. South. Clin. Ist. Euras. 2020;31(2):89-95. DOI: 10.14744/scie.2020.32154
T.C. Sağlık Bakanlığı COVID-19 Bilgilendirme platformu [Online] https://covid19.saglik.gov.tr/ [Accessed:1th March 2023]
WHO Coronavirus(COVID-19) Dashboard, [Online] https://covid19.who.int/[Accessed:1th March 2023]
Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019; 17(3):181–92. doi: 10.1038/s41579-018-0118-9
Ruch TR, Machamer CE. The coronavirus E protein: assembly and beyond. Viruses 2012;4(3):363–82. doi: 10.3390/v4030363
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62
Sharma A, Ahmad Farouk I, Lal S.K. COVID-19: A Review on the Novel Coronavirus Disease. Evolution, Transmission, Detection, Control and Prevention. Viruses. 2021;13,202. doi.org/10.3390/v13020202
Bulfamante G, Bocci T, Falleni M, et al. Brainstem neuropathology in two cases of COVID-19: SARS-CoV-2 trafficking between brain and lung. J Neurol. 2021 Dec;268(12):4486-4491. doi: 10.1007/s00415-021-10604-8
Gattinoni L, Gattarello S, Steinberg I, et al. COVID-19 pneumonia: pathophysiology and management. Eur Respir Rev. 2021;20;30(162):210138. doi: 10.1183/16000617.0138-2021.
Parums DV. Editorial: COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C). Med Sci Monit. 2021 May 31;27:e933369. doi: 10.12659/MSM.933369
Morris SB, Schwartz NG, Patel P, et al. Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection – United Kingdom and United States, March-August 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1450-56
Tuan J, Spichler-Moffarah A, Ogbuagu O. A new positive SARS-CoV-2 test months after severe COVID19 illness: reinfection or intermittent viral shedding? BMJ Case Rep 2021; 14: 240531. doi: 10.1136/bcr2020-240531.
Mansourabadi AH, Sadeghalvad M, Mohammadi-Motlagh HR, et al. Serological and Molecular Tests for COVID-19: a recent update. Iran J Immunol. 2021 Mar;18(1):13-33. doi: 10.22034/iji.2021.88660.1894.
Amato MK, Hennessy C, Shah K, et al. Multisystem Inflammatory Syndrome in an Adult. J Emerg Med. 2021 Jul;61(1):e1-e3. doi: 10.1016/j.jemermed.2021.02.007
Kang Z, Li X, Zhou S. Recommendation of low-dose CT in the detection and management of COVID-2019. Eur Radiol. 2020 Aug;30(8):4356-4357. doi: 10.1007/s00330-020-06809-6
Xie X, Zhong Z, Zhao W, et al. Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020 Aug;296(2):E41-E45. doi: 10.1148/radiol.2020200343
Ye Z, Zhang Y, Wang Y, et al. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020 Aug;30(8):4381-4389. doi: 10.1007/s00330-020-06801-0.
Kanne JP, Little BP, Chung JH, et al. Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel. Radiology. 2020 Aug;296(2):E113-E114. doi: 10.1148/radiol.2020200527
Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020 Jul;215(1):87-93. doi: 10.2214/AJR.20.23034.
Song F, Shi N, Shan F, et al. Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020 Dec;297(3):E346. doi: 10.1148/radiol.2020209021
Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008 Mar;246(3):697-722. doi: 10.1148/radiol.2462070712
Ufuk F, Savaş R. Chest CT features of the novel coronavirus disease (COVID-19). Turk J Med Sci. 2020 Jun 23;50(4):664-678. doi: 10.3906/sag-2004-331.
Akçay Ş, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turk J Med Sci. 2020 Apr 21;50(SI-1):604-610. doi: 10.3906/sag-2004-160
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020 Mar;30(3):269-271. doi: 10.1038/s41422-020-0282-0.
Chen J, Liu D, Liu L, et al. [A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19]. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):215-219. Chinese. doi: 10.3785/j.issn.1008-9292.2020.03.03.
Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clin Infect Dis. 2020 Apr 27:ciaa478. doi: 10.1093/cid/ciaa478.
Administration D. remdesivir EUA Letter of Authorization. 2020. https://www.fda.gov/media/137564/ download. [Accessed: 10th February 2023]
Chu CM, Cheng VC, Hung IF, et al. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax. 2004 Mar;59(3):252-6. doi: 10.1136/thorax.2003.012658
Cao B, Wang Y, Wen D, et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020 May 7;382(19):1787-1799. doi: 10.1056/NEJMoa2001282
WHO Blood Regulators Network (BRN), “Interimposition Paper on blood regulatory reponse to the evolving out-break of the 2019 novelcoronavirus SARS-CoV-2.[ Accessed: 15th March 2023]
TC Sağlık Bakanlığı COVID-19 immün (konvelesan) plazma tedarik ve klinik kullanım rehberi, Nisan 2020 [ Accessed: 15thMarch 2023]
Uciechowski P, Dempke WCM. Interleukin-6: A Masterplayer in the Cytokine Network. Oncology. 2020;98(3):131-137. doi: 10.1159/000505099
Chen IY, Moriyama M, Chang MF, et al. Severe Acute Respiratory Syndrome Coronavirus Viroporin 3a Activates the NLRP3 Inflammasome. Front Microbiol. 2019;10:50. doi: 10.3389/fmicb.2019.00050
Conti P, Gallenga CE, Tetè G, et al. How to reduce the likelihood of coronavirus-19 (CoV-19 or SARS-CoV-2) infection and lung inflammation mediated by IL-1. J Biol Regul Homeost Agents. 2020;34(2):333-338. doi: 10.23812/Editorial-Conti-2
Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med. 2009 Aug 13;361(7):680-9. doi: 10.1056/NEJMoa0904252
Crosby AW. Epidemic and Peace, 1918. Part IV. Westport, CT: Greenwood Press; 1976.
Treanor JJ. Influenza (Including Avian Influenza and Swine). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Churchill Livingstone Elsevier, 2015: 2000-24.
Kamali A, Holodniy M. Influenza treatment and prophylaxis with neuraminidase inhibitors: a review. Infect Drug Resist. 2013 Nov 19;6:187-98. doi: 10.2147/IDR.S36601
Moscona A. Neuraminidase inhibitors for influenza. N Engl J Med. 2005 Sep 29;353(13):1363-73. doi: 10.1056/NEJMra050740
Bhat N, Wright JG, Broder KR, et al. Influenza Special Investigations Team. Influenza-associated deaths among children in the United States, 2003-2004. N Engl J Med. 2005 Dec 15;353(24):2559-67. doi: 10.1056/NEJMoa051721
Blachere FM, Lindsley WG, Pearce TA, et al. Measurement of airborne influenza virus in a hospital emergency department. Clin Infect Dis. 2009 Feb 15;48(4):438-40. doi: 10.1086/596478
Centers for Disease Control and Prevention (CDC). Severe methicillin-resistant Staphylococcus aureus community-acquired pneumonia associated with influenza--Louisiana and Georgia, December 2006-January 2007. MMWR Morb Mortal Wkly Rep. 2007 Apr 13;56(14):325-9
Newton DW, Mellen CF, Baxter BD, et al. Practical and sensitive screening strategy for detection of influenza virus. J Clin Microbiol. 2002 Nov;40(11):4353-6. doi: 10.1128/JCM.40.11.4353-4356.2002
Harper SA, Bradley JS, Englund JA, et al. Expert Panel of the Infectious Diseases Society of America. Seasonal influenza in adults and children--diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2009 Apr 15;48(8):1003-32. doi: 10.1086/598513
Aviram G, Bar-Shai A, Sosna J, et al. H1N1 influenza: initial chest radiographic findings in helping predict patient outcome. Radiology. 2010 Apr;255(1):252-9. doi: 10.1148/radiol.10092240
Cavallazzi R, Ramirez JA. Influenza and Viral Pneumonia. Clin Chest Med. 2018 Dec;39(4):703-721. doi: 10.1016/j.ccm.2018.07.005
Wang C, Takeuchi K, Pinto LH, et al. Ion channel activity of influenza A virus M2 protein: characterization of the amantadine block. J Virol. 1993 Sep;67(9):5585-94. doi: 10.1128/JVI.67.9.5585-5594.1993
Louie JK, Yang S, Acosta M, et al. Treatment with neuraminidase inhibitors for critically ill patients with influenza A (H1N1)pdm09. Clin Infect Dis. 2012 Nov;55(9):1198-204. doi: 10.1093/cid/cis636
CDC 2011-2012 Influenza Antiviral Medications: A summary for Clinicians. http://www.cdc.gov/flu/pdf/professionals/antivirals/antiviral-summary-clinicians.pdf. [ Accessed: 15thMarch 2023]
Yee C, Suarthana E, Dendukuri N, et al. Evaluating the impact of the multiplex respiratory virus panel polymerase chain reaction test on the clinical management of suspected respiratory viral infections in adult patients in a hospital setting. Am J Infect Control. 2016 Nov 1;44(11):1396-1398. doi: 10.1016/j.ajic.2016.04.221
Rodrigo C, Leonardi-Bee J, Nguyen-Van-Tam JS, Lim WS. Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis. J Infect Dis. 2015 Jul 15;212(2):183-94. doi: 10.1093/infdis/jiu645
For Clinicians: Vaccine Safety http://www.cdc.gov/flu/professionals /vaccination/vaccine_ safety.htm [ Accessed: 15thMarch 2023]
Referanslar
Demirhan R, Cimenoglu B, Yilmaz E. The Effects of Hospital Organization on Treatment During COVID-19 Pandemic. South. Clin. Ist. Euras. 2020;31(2):89-95. DOI: 10.14744/scie.2020.32154
T.C. Sağlık Bakanlığı COVID-19 Bilgilendirme platformu [Online] https://covid19.saglik.gov.tr/ [Accessed:1th March 2023]
WHO Coronavirus(COVID-19) Dashboard, [Online] https://covid19.who.int/[Accessed:1th March 2023]
Cui J, Li F, Shi ZL. Origin and evolution of pathogenic coronaviruses. Nat Rev Microbiol. 2019; 17(3):181–92. doi: 10.1038/s41579-018-0118-9
Ruch TR, Machamer CE. The coronavirus E protein: assembly and beyond. Viruses 2012;4(3):363–82. doi: 10.3390/v4030363
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62
Sharma A, Ahmad Farouk I, Lal S.K. COVID-19: A Review on the Novel Coronavirus Disease. Evolution, Transmission, Detection, Control and Prevention. Viruses. 2021;13,202. doi.org/10.3390/v13020202
Bulfamante G, Bocci T, Falleni M, et al. Brainstem neuropathology in two cases of COVID-19: SARS-CoV-2 trafficking between brain and lung. J Neurol. 2021 Dec;268(12):4486-4491. doi: 10.1007/s00415-021-10604-8
Gattinoni L, Gattarello S, Steinberg I, et al. COVID-19 pneumonia: pathophysiology and management. Eur Respir Rev. 2021;20;30(162):210138. doi: 10.1183/16000617.0138-2021.
Parums DV. Editorial: COVID-19 and Multisystem Inflammatory Syndrome in Children (MIS-C). Med Sci Monit. 2021 May 31;27:e933369. doi: 10.12659/MSM.933369
Morris SB, Schwartz NG, Patel P, et al. Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection – United Kingdom and United States, March-August 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1450-56
Tuan J, Spichler-Moffarah A, Ogbuagu O. A new positive SARS-CoV-2 test months after severe COVID19 illness: reinfection or intermittent viral shedding? BMJ Case Rep 2021; 14: 240531. doi: 10.1136/bcr2020-240531.
Mansourabadi AH, Sadeghalvad M, Mohammadi-Motlagh HR, et al. Serological and Molecular Tests for COVID-19: a recent update. Iran J Immunol. 2021 Mar;18(1):13-33. doi: 10.22034/iji.2021.88660.1894.
Amato MK, Hennessy C, Shah K, et al. Multisystem Inflammatory Syndrome in an Adult. J Emerg Med. 2021 Jul;61(1):e1-e3. doi: 10.1016/j.jemermed.2021.02.007
Kang Z, Li X, Zhou S. Recommendation of low-dose CT in the detection and management of COVID-2019. Eur Radiol. 2020 Aug;30(8):4356-4357. doi: 10.1007/s00330-020-06809-6
Xie X, Zhong Z, Zhao W, et al. Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing. Radiology. 2020 Aug;296(2):E41-E45. doi: 10.1148/radiol.2020200343
Ye Z, Zhang Y, Wang Y, et al. Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review. Eur Radiol. 2020 Aug;30(8):4381-4389. doi: 10.1007/s00330-020-06801-0.
Kanne JP, Little BP, Chung JH, et al. Essentials for Radiologists on COVID-19: An Update-Radiology Scientific Expert Panel. Radiology. 2020 Aug;296(2):E113-E114. doi: 10.1148/radiol.2020200527
Salehi S, Abedi A, Balakrishnan S, et al. Coronavirus Disease 2019 (COVID-19): A Systematic Review of Imaging Findings in 919 Patients. AJR Am J Roentgenol. 2020 Jul;215(1):87-93. doi: 10.2214/AJR.20.23034.
Song F, Shi N, Shan F, et al. Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia. Radiology. 2020 Dec;297(3):E346. doi: 10.1148/radiol.2020209021
Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008 Mar;246(3):697-722. doi: 10.1148/radiol.2462070712
Ufuk F, Savaş R. Chest CT features of the novel coronavirus disease (COVID-19). Turk J Med Sci. 2020 Jun 23;50(4):664-678. doi: 10.3906/sag-2004-331.
Akçay Ş, Özlü T, Yılmaz A. Radiological approaches to COVID-19 pneumonia. Turk J Med Sci. 2020 Apr 21;50(SI-1):604-610. doi: 10.3906/sag-2004-160
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020 Mar;30(3):269-271. doi: 10.1038/s41422-020-0282-0.
Chen J, Liu D, Liu L, et al. [A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19]. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):215-219. Chinese. doi: 10.3785/j.issn.1008-9292.2020.03.03.
Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19. Clin Infect Dis. 2020 Apr 27:ciaa478. doi: 10.1093/cid/ciaa478.
Administration D. remdesivir EUA Letter of Authorization. 2020. https://www.fda.gov/media/137564/ download. [Accessed: 10th February 2023]
Chu CM, Cheng VC, Hung IF, et al. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax. 2004 Mar;59(3):252-6. doi: 10.1136/thorax.2003.012658
Cao B, Wang Y, Wen D, et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020 May 7;382(19):1787-1799. doi: 10.1056/NEJMoa2001282
WHO Blood Regulators Network (BRN), “Interimposition Paper on blood regulatory reponse to the evolving out-break of the 2019 novelcoronavirus SARS-CoV-2.[ Accessed: 15th March 2023]
TC Sağlık Bakanlığı COVID-19 immün (konvelesan) plazma tedarik ve klinik kullanım rehberi, Nisan 2020 [ Accessed: 15thMarch 2023]
Uciechowski P, Dempke WCM. Interleukin-6: A Masterplayer in the Cytokine Network. Oncology. 2020;98(3):131-137. doi: 10.1159/000505099
Chen IY, Moriyama M, Chang MF, et al. Severe Acute Respiratory Syndrome Coronavirus Viroporin 3a Activates the NLRP3 Inflammasome. Front Microbiol. 2019;10:50. doi: 10.3389/fmicb.2019.00050
Conti P, Gallenga CE, Tetè G, et al. How to reduce the likelihood of coronavirus-19 (CoV-19 or SARS-CoV-2) infection and lung inflammation mediated by IL-1. J Biol Regul Homeost Agents. 2020;34(2):333-338. doi: 10.23812/Editorial-Conti-2
Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med. 2009 Aug 13;361(7):680-9. doi: 10.1056/NEJMoa0904252
Crosby AW. Epidemic and Peace, 1918. Part IV. Westport, CT: Greenwood Press; 1976.
Treanor JJ. Influenza (Including Avian Influenza and Swine). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Churchill Livingstone Elsevier, 2015: 2000-24.
Kamali A, Holodniy M. Influenza treatment and prophylaxis with neuraminidase inhibitors: a review. Infect Drug Resist. 2013 Nov 19;6:187-98. doi: 10.2147/IDR.S36601
Moscona A. Neuraminidase inhibitors for influenza. N Engl J Med. 2005 Sep 29;353(13):1363-73. doi: 10.1056/NEJMra050740
Bhat N, Wright JG, Broder KR, et al. Influenza Special Investigations Team. Influenza-associated deaths among children in the United States, 2003-2004. N Engl J Med. 2005 Dec 15;353(24):2559-67. doi: 10.1056/NEJMoa051721
Blachere FM, Lindsley WG, Pearce TA, et al. Measurement of airborne influenza virus in a hospital emergency department. Clin Infect Dis. 2009 Feb 15;48(4):438-40. doi: 10.1086/596478
Centers for Disease Control and Prevention (CDC). Severe methicillin-resistant Staphylococcus aureus community-acquired pneumonia associated with influenza--Louisiana and Georgia, December 2006-January 2007. MMWR Morb Mortal Wkly Rep. 2007 Apr 13;56(14):325-9
Newton DW, Mellen CF, Baxter BD, et al. Practical and sensitive screening strategy for detection of influenza virus. J Clin Microbiol. 2002 Nov;40(11):4353-6. doi: 10.1128/JCM.40.11.4353-4356.2002
Harper SA, Bradley JS, Englund JA, et al. Expert Panel of the Infectious Diseases Society of America. Seasonal influenza in adults and children--diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis. 2009 Apr 15;48(8):1003-32. doi: 10.1086/598513
Aviram G, Bar-Shai A, Sosna J, et al. H1N1 influenza: initial chest radiographic findings in helping predict patient outcome. Radiology. 2010 Apr;255(1):252-9. doi: 10.1148/radiol.10092240
Cavallazzi R, Ramirez JA. Influenza and Viral Pneumonia. Clin Chest Med. 2018 Dec;39(4):703-721. doi: 10.1016/j.ccm.2018.07.005
Wang C, Takeuchi K, Pinto LH, et al. Ion channel activity of influenza A virus M2 protein: characterization of the amantadine block. J Virol. 1993 Sep;67(9):5585-94. doi: 10.1128/JVI.67.9.5585-5594.1993
Louie JK, Yang S, Acosta M, et al. Treatment with neuraminidase inhibitors for critically ill patients with influenza A (H1N1)pdm09. Clin Infect Dis. 2012 Nov;55(9):1198-204. doi: 10.1093/cid/cis636
CDC 2011-2012 Influenza Antiviral Medications: A summary for Clinicians. http://www.cdc.gov/flu/pdf/professionals/antivirals/antiviral-summary-clinicians.pdf. [ Accessed: 15thMarch 2023]
Yee C, Suarthana E, Dendukuri N, et al. Evaluating the impact of the multiplex respiratory virus panel polymerase chain reaction test on the clinical management of suspected respiratory viral infections in adult patients in a hospital setting. Am J Infect Control. 2016 Nov 1;44(11):1396-1398. doi: 10.1016/j.ajic.2016.04.221
Rodrigo C, Leonardi-Bee J, Nguyen-Van-Tam JS, Lim WS. Effect of corticosteroid therapy on influenza-related mortality: a systematic review and meta-analysis. J Infect Dis. 2015 Jul 15;212(2):183-94. doi: 10.1093/infdis/jiu645
For Clinicians: Vaccine Safety http://www.cdc.gov/flu/professionals /vaccination/vaccine_ safety.htm [ Accessed: 15thMarch 2023]
