ABSTRACT
Emerging infectious diseases (EIDs) and their determinants are attracting increasing attention from scientists, with approximately 75% of EIDs being zoonotic. Among these pathogens are viruses belonging to the Coronaviridae family. Until 2002, CoVs were primarily studied for scientific or veterinary purposes. However, the world's view on the virulence of CoVs changed in 2002 when a zoonotic betacoronavirus named SARS-CoV appeared in southern China and caused a global epidemic with over 8,000 cases. Ten years later, in the Middle East, another zoonotic betacoronavirus, MERS-CoV, emerged and caused 2,521 cases. A new highly contagious CoV named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) emerged in 2019, causing the largest pandemic of the modern era known as coronavirus disease 2019 (COVID-19). Vaccination is one of the most effective methods to reduce the risk of severe illness, hospitalization, and death. The main objective of the study was to evaluate the acceptability of the COVID-19 vaccine among healthcare workers, describe the main adverse reactions, and identify the need for medication administration based on the severity of the adverse reactions manifested.Copyright © 2023, Romanian Society for Pharmaceutical Sciences. All rights reserved.
ABSTRACT
Since WHO declared COVID-19 a pandemic, globally more than 212 milion people were infected and approximately 4.4 milion died (25 August 2021). As the pandemic evolved, it became clear that there are many more things to research and discover about the SARS-CoV-2 infection. Besides the fact that SARS-CoV-2 primarily affects the respiratory system, more and more articles indicate a systemic involvement which could be responsible for long term consequences. The aim of this review was to evaluate the long-term signs and symptoms of COVID-19 infection. We looked for information regarding the prevalence and persistence of symptoms associated with COVID-19 infection and the persistence of organ dysfunction beyond the acute phase. We also searched data regarding the impact of the infection on the quality of life, physical, mental and psychosocial function. Recent studies have shown that some symptoms can persist a long time after the acute episode of COVID-19. Fur-thermore, organ sequalae can be present after the acute episode. The most common symptoms of “long COVID” are: fatigue and shortness of breath, lack of taste/smell, cough, myalgia and arthralgia, headache. Also, cardiac abnormalities, cognitive impairment, insomnia, anxiety and concentration issues can be present. © 2021, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
COVID-19 treatment includes both antiviral agents and immunosuppressive and immunomodulatory medication for moderate and severe disease, which decrease systemic inflammation. Our objective was to evaluate tocilizumab, anakinra and corticosteroid effectiveness in a cohort of COVID-19 patients hospitalized in a tertiary care unit from Bucharest, Romania, during the second and third SARS-CoV-2 pandemic waves, by assessing the prediction variables for the length of hospital stay (LHS). We enrolled 330 consecutive patients, with a mean age of 58.2 +/- 14.8 years, 119 females (mean age 61.4 +/- 14.1 years) and 211 males (mean age 56.4 +/- 15 years). The prediction parameters for LHS were the treatment approach, older age and the presence of COPD, but were not associated with other significant comorbidities for COVID-19, such as obesity, diabetes, chronic renal failure or active malignancy. We found a significant difference in the mean LHS between patients who received tocilizumab and standard of care and patients treated with anakinra plus standard of care. Still, this difference was only seen in patients who required high concentration oxygen therapy (more than 5 L O-2/min). We suggest that, especially in non-critically-ill patients with a high oxygen therapy requirement, the administration of tocilizumab and standard of care is associated with a reduced length of hospital stay compared to the anakinra standard of care regimen.
ABSTRACT
Background: Influenza is an acute infection affecting all age groups;however, elderly patients are at an increased risk. We aim to describe the clinical characteristics and the circulation of influenza virus types in elderly patients admitted for severe acute respiratory infection (SARI) to a tertiary care hospital in Bucharest, Romania, part of the I-MOVE+ hospital network. Methods: We conducted an active surveillance study at the National Institute for Infectious Diseases “Prof. Dr Matei Balș,” Bucharest, Romania, during three consecutive influenza seasons: 2015/16, 2016/17, and 2017/18. All patients aged 65 and older admitted to our hospital for SARI were tested for influenza by PCR. Results: A total of 349 eligible patients were tested during the study period, and 149 (42.7%) were confirmed with influenza. Most patients, 321 (92.5%) presented at least one underlying condition at the time of hospital admission, the most frequent being cardiovascular disease, 270 (78.3%). The main influenza viral subtype circulating in 2015/16 was A(H1N1)pdm09, followed by A(H3N2) in 2016/17 and B influenza in 2017/18. Case fatality was highest in the 2015/16 season (3.7%), 0% in 2016/17, and 1.0% in 2017/18. Vaccination coverage in elderly patients with SARI from our study population was 22 (6.3%) over the three seasons. Conclusions: Our study has highlighted a high burden of comorbidities in elderly patients presenting with SARI during winter season in Romania. The influenza vaccine coverage rate needs to be substantially increased in the elderly population, through targeted interventions. © 2020 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.
ABSTRACT
Background: The severe manifestations of the coronavirus disease 2019 (COVID-19) are linked to viral hyper-inflammation, cytokine release syndrome and subsequent coagulation disturbances. The most common coagulation abnormality observed in COM-19 patients is the elevation of the plasma levels of D-dimers. The aim of this study was to evaluate the characteristics of COVID-19-associated inflammatory syndrome and coagulopathy, in correlation with disease severity. Methods: We performed a cross-sectional study, enrolling all consecutive COVID-19 patients treated in the Adulti 3 Department of the Prof Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania, between 1st march and 30th September 2020. We recorded clinical and epidemiological characteristics, inflammatory markers, coagulation abnormalities and lymphocyte count. The severity of lung involvement was assessed using native Computed Tomography examination. Results: We included 106 patients with SARS-COV2 infection, 50 males (47.2%) and 56 females (52.8%), age range 14-91 years. All markers of inflammation were increased in our study in patients with severe disease, as were lactate dehydrogenase, monocyte distribution width, and neutrophil-to-lymphocyte ratio. An elevated level of serum D-dimers was observed in approximately half of our subjects and was associated with disease severity. Our best linear regression model for predicting COVID-19 coagulopathy (manifested as abnormal D-dimer levels) included age, fibrinogen, and lymphocyte count. Conclusion: Our findings emphasize the association between COVID-19 coagulopathy and the presence of systemic inflammation. A significant proportion of patients with moderate and severe disease had coagulation abnormalities and these were linked with the presence of inflammation and older age..
ABSTRACT
Cytokine storm seems to be one of the main culprits for developing a severe form of COVID-19, IL-6 being one of its basic components. Therefore, currently, tocilizumab is widely studied as a powerful treatment in patients with severe forms of COVID-19. Our aim was to determine whether it could potentiate a favourable outcome in such patients. We conducted a retrospective observational study including all consecutive admitted patients with confirmed SARS-CoV-2 infection that received treatment with tocilizumab in the period between 01.05-23.08.2020 in Matei Bals National Institute for Infectious Diseases and Neurology Department of the Colentina Clinical Hospital in Bucharest, Romania. 22 patients were enrolled with a severe form of COVID-19, predominantly women, with an average age of of 61.72 ± 14.5 years. The fatality rate was 31.81%. It was observed that following tocilizumab administration, patients presented improvement in the majority of the studied parameters, statistically significant in the case of fibrinogen, C reactive protein and blood oxygen level (p < 0.05). Tocilizumab might be regarded as a valuable drug in the management of severe SARS-CoV-2 infection. © 2020, Romanian Society for Pharmaceutical Sciences. All rights reserved.
ABSTRACT
The novel coronavirus has generated the Coronavirus Disease 2019 (COVID-19) pandemic, which has become the new challenge for the healthcare systems, since there is no etiological treatment and the infectiousness of SARS-CoV2 is exceeding the expectations. Therefore, various treatments have been tried in an attempt to stop the spread of the virus and to enhance the early recovery of the patients. Hydroxychloroquine, an antimalarial drug used for decades, has been one of the first drugs tried to reduce the infectivity of the virus. First data were promising, but afterwards, adverse events and long-term evolution of patients outweighed the potential benefits, and its utility was questioned. In this article we are reviewing literature regarding the use of Hydroxychloroquine during the COVID-19 pandemic and we present the experience of its use in the Neurology Department in Colentina Clinical Hospital, Bucharest, Romania.