ABSTRACT
The first reports of SARS-CoV-2 virus infection occurred in late 2019. Infection and the development of COVID-19 disease are directly related to the particular characteristics of the individual, such as gender, age, and comorbidities. Moreover, indi-vidualswho had some type of chronic disease expressed a higher rate of complications arising from the infection. This study aimed to verify the prevalence of comorbidities in individuals infected by COVID-19 in the city of Jaragua do Sul/SC from March 2020 to December 2021. The research presented a cross-sectional, descriptive, analytical design with a quantitative approach, carried out through secondary data using the Olostech in-formation system of the Health Department of the municipality. The results showed that 40,010 subjects were infected during the study period, of which 39,574 (98.9%) were recovered and 436 died (1.1%). It was observed a predominance of females in the recov-ered group (52.3%) and males in the deceased group (59.2%). The predominant age group in the group of recovered patients was 20-59 years (n=31,636;79.9%) and in the group of deaths it was 60 years or older (n=269;61.7%). In the year 2021 there were more cases of recovered (n=26,040;65.1%) and deaths (n=342;78.4%) when compared to the year 2020. The mean age in the recovered group was 37.5 +or- 15.8 years and in the death group was 63.2 +or- 15.7 years. The data showed the profile of infected individuals and the prev-alence of the main chronic diseases: hypertension, diabetes and obesity. We suggest ac-tions and strategies aimed at minimizing these comorbidities, aiming at a better quality of life for individuals in this city.
ABSTRACT
• This article examines the role played by social media platforms (Twitter in particular) in the fabrication and dissemination of a discourse opposing health measures in the province of Quebec during the early days of the COVID-19 pandemic in 2020. Based on a materialist and actor-network theory approach, it analyzes the narratives opposing the measures that circulated in the Quebec Twittersphere during the first two weeks of the implementation of the restrictive measures imposed by the federal and provincial authorities. In particular, we show that the fabrication and dissemination of a discourse opposed to these measures leads to an ideological syncretism with blurred contours that contributes to the trivialization of ideas traditionally associated with conspiracism that target Canadian scientific and political elites. The study, both of the discourse and of the device that promotes it, shows how this device allows individuals on the fringe of the public sphere to transform themselves into popular influencers and moral techno-entrepreneurs who become the figureheads of a movement opposed to the sanitary measures. © Criminologie 2022.
ABSTRACT
Introduction: Multisystem inflammatory syndrome in children (MISC) is a severe and recently described disease affecting pediatric patients, triggered by SARS-CoV2. Current treatment is based upon IVIG and steroids but some patients are resistant to first line therapy. In these patients some authors have used IL1 receptor antagonist (Anakinra) with benefit, but data regarding efficacy, dose and route of administration are lacking. Objectives: To analyze the outcomes of MIS-C patients treated with anakinra (ANK) in Italy since 1/4/20. Methods: We performed an anonymous retrospective multicenter study of patients diagnosed with MIS-C, according to the preliminary WHO case definition, treated with ANK from 1/4/20 to 28/2/21. SARSCoV2 infection was demonstrated either by serology or by positive molecular swab (RT-PCR) in the six weeks prior to admission. After the start of ANK we measured the following outcomes: rate of patients needing further therapeutic step-up, rate of patients achieving clinical (fever defervescence in 24 hours) and laboratory response (CRP halving in 48 hours), rate of Coronary Artery Anomalies (CAA) development during follow-up. Results: In the study period 35 MIS-C patients were treated with ANK: 13 patients (37.1%) in Intensive Care Unit (ICU, Group A) and 22 (62.9%) in non-ICU settings (Group B). Epidemiological, clinical, and laboratoristic features at ANK prescription are described below: In Group A the most common indication for ANK was cardiac function worsening (46.1%), while in Group B ANK was started mostly for persistent elevation in inflammatory markers (ferritin, CRP) unresponsive to IVIG and/or steroids (31.8%). Endovenous (ev) ANK was used in all Group A patients (mean dose 8mg/Kg), while most patients in Group B (72.7%) received subcutaneous (sc) ANK (mean dose 4mg/Kg). Overall only 2 patients (5.7%) needed a step-up treatment after ANK start (1 required IVIG, 1 methylprednisolone dose increase), most of the patients achieved clinical (85.7%) and laboratory response (74.3%). 2 patients had CAA before ANK, none developed CAA after starting ANK. Overall NT-proBNP halved in 2.5 days in Group A and 2 days in Group B, while Ejection Fraction (EF) normalized respectively in 2 and 3 days. None of the patients in Group B needed ICU admission or inotropic support after ANK. The most frequently observed side effect was ALT increase (30.8% in Group A and 9.1% in Group B), only 1 patient had injection site reaction. Conclusion: MIS-C is a severe emerging disease with a high ICU admission rate. Our retrospective data suggest that both ev and sc ANK is effective in controlling inflammation, fever and cardiac dysfunction. Side effects are transient and usually mild. Overall the reported incidence of CAA in MIS-C cohorts is 10%, interestingly in our cohort no patient has developed CAA after beginning ANK, possibly suggesting a protective role of IL1 inhibition in aneurysm formation. Further studies in bigger cohorts are needed to define the most effective timing and dose of ANK in MIS-C.
ABSTRACT
Introduction: Early preventive strict quarantine due to COVID-19 pandemic was implemented in Argentina since March 20th, 2020. Transplant societies and organ procurement organizations were challenged to face this complex scenario and sustain organ donation and transplantation activity. Objectives: We evaluated the impact of complete and preventive lockdown in organ procurement and transplantation before the COVID-19 peak onset. Materials and Methods: We analyzed prospectively collected data from the National Report Agency (INCUCAI). By constructing time series, we compared donation and transplant rates from the years 2010 to 2020, during a same monthly-period between March 3rd and July 20th. We evaluated the effect of preventive lockdown before the peak of COVID-19 curve. Donation rates per million population in these months were also registered for each year. Transplant accessibility was calculated, dividing the total number of transplants and the total number of listed patients. Results: The preventive lockdown was associated with a 34.5% relative reduction (95% CI 26.9-43.2) in organ procurement when compared to 2010-2019 and significantly reduced comparing 2019 [53.3% (CI 44.6-61.6)]. This scenario was even worse in Buenos Aires city and its surroundings, the region most affected by COVID-19. During this period, donation per million population rates decreased from 7.8 in 2019 to 3.3 in 2020. This reduction was even higher in the number of deceased and living donor transplants performed comparing 2019 vs. 2020, with a relative reduction of 62.0% (CI 30.8-89.1) and 68.8% (CI 65.7-71.7), respectively. Conclusions: During this short observation period of 120 days of preventive quarantine, not yet having reached the "peak" incidence of COVID-19, a marked reduction in procurement and transplantation rates were observed. Although waiting list mortality was not significantly modified, transplant access has been significantly reduced, showing a future negative trend on waitlist mortality.