Follow-up of severe asthmatic children during COVID-19 pandemic: A comparative analysis

Different health care strategies have been implemented worldwide due to the pandemic. We explore a new approach to guarantee the follow-up of severe asthmatic (SA) children. Method(s): A retrospective/prospective cohort study. All children (GINA guidelines) from the SA clinic at Garrahan Hospital were included. Clinic attendance (virtual [V] or face-to-face [FF]), asthma control (ACT), asthma exacerbations (AE) and hospitalizations (H) were evaluated in the same group during two periods: March 2019- March 2020 (FFP) and April 2020-April 2021 (VP). During VP children performed a validated electronic ACT that was sent monthly through an electronic APP, 48 hours after they were contacted via a phone call. Student's/Wilcoxon paired tests. P <0.05 Results: All SA patients (n 74) were seen every two months during FFP;47% male;median age 13 years (IQR 10- 15) and 68 (92%) of them during VP. In FFP, 393 visits were registered (5.3 visit/pat/year);246 ACT were performed (3.3 ACT/pat/year), 22% (n 54) were uncontrolled (ACT<20). During VP, 816 ACT were sent with 642 replies (79%), 9.4 ACT/pat/year;19% (n 120) <20. There were 46 (67%) patients with AE during FFP vs 31 (46%) in VP (p 0.0004);AE in FFP 135 vs 79 in VP (p 0.0031), (2 vs 1.1 AE/pat/year) with AE decrease of 41%;91 prescribed steroid courses in FFP (1.3 courses/pat/year) vs 49 in VP (0.72 courses/pat/year) (p 0.006), with a reduction of 46%. There were no differences in H (FFP 10, VP 6;p 0.39). In FFP 19% of patients were under biologics while 12% during VP. Conclusion(s): Virtual team clinics and electronic ACT at home were introduced easily and effectively during pandemic to manage SA children. Follow-up of almost all patients could be ensured.

Nitazoxanide as an early treatment to reduce the intensity of COVID-19 outbreaks among health personnel

The use of nitazoxanide has previously yielded successful results in vitro against the coronavirus. The aim of the present study was to examine the efficacy of the use of nitazoxanide at an early stage among healthcare workers exhibiting symptoms of COVID-19. This was a prospective study carried out in 2020. Healthcare personnel who presented with COVID-19 symptoms, in different 3 hospitals were invited to take Paramix (nitazoxanide), 500 mg orally, every 6 h for 2 days and then 500 mg twice a day for 4 days. To compare the hospitalization percentage, a group of healthcare workers with a respiratory viral infection without COVID-19 criteria were also followed-up. Over a period of 3 months, 150 healthcare workers (111 women and 39 men) presented respiratory symp- toms with COVID-19 criteria (mean age, 36±10.6 years;range, 18-68 years). Only one female medical doctor, one nurse and one male from the auxiliary services had to be hospitalized and one death was registered It was thus concluded that nitazoxanide yielded successful results in vitro against previous coronavirus and may prove to be useful against SARS-CoV-2 as an early intervention to avoid complications, decreasing the expected number of hospitalizations among infected healthcare workers. © 2021 World Academy of Sciences Journal. All rights reserved.