ABSTRACT
PURPOSE: Determine the anatomical consequences of delaying intravitreal injection (IVI) therapy with anti-vascular endothelial growth factor (anti-VEGF) in patients using treat-and-extend (T&E) protocol. METHODS: Retrospective medical record review of consecutive patients receiving intravitreal anti-VEGF therapy using T&E protocol prior to and during the COVID-19 pandemic. RESULTS: The study included 923 eyes of 691patients; 58.8% (543 eyes), 25% (231 eyes), and 16.2% (149 eyes) had nvAMD, DME, and RVO, respectively. Mean (± SD) patient age was 74.5 ± 11.7 years. Overall, 56.3% of cases had a delay in therapy of ≥ 7 days; specifically, 56.2%, 61.5%, and 49.0% of nvAMD, DME, and RVO cases, respectively, had a delay. The median delay in days, among cases ≥ 7 days late was 21 (IQR 7 to 42) days, with 21(IQR 7 to 45), 22.5(IQR 8 to 42), and 14(IQR 7 to 33.5) days of delay among patients with nvAMD, DME, and RVO, respectively. Delaying therapy by ≥ 7 days resulted in increased CST in 47.5%, 58.5%, and 58.9% of nvAMD, DME, and RVO cases, respectively, with a significant correlation between the length of treatment delay and the increase in CST (Spearman's rho: 0.196; p < 0.001). CONCLUSIONS: Delayed IVI treatment in eyes treated with T&E protocol was associated with increased macular thickness with potential consequences with respect to visual outcome.
Subject(s)
Macular Edema , Retinal Vein Occlusion , Aged , Aged, 80 and over , Angiogenesis Inhibitors , COVID-19 , Humans , Intravitreal Injections , Macular Edema/drug therapy , Middle Aged , Pandemics , Ranibizumab , Retinal Vein Occlusion/drug therapy , Retrospective Studies , Tomography, Optical Coherence/methods , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors , Visual AcuityABSTRACT
The SARS-CoV-2 virus from Europe has reached Peru on March 5 and since March 16 a state of national emergency has been declared, leading to the confinement of the entire population. The objective of this study is to characterize the epidemic evolution of coronavirus disease (COVID-19) applying the SIR model (Susceptible-Infectious-recovered or deceased) during a period of 200 days. The time series data of COVID-19 from March 06 to May 14, 2020 of the Peruvian Ministry of Health was used, presenting estimated cases by varying the basic reproduction number R0. According to the SIR model, the peak of those infected occurs shortly after May 30 from the beginning of the epidemic (day 86) where the total number of infected cases decreases to R0 = 1.5. The results suggest that Peru's current stringent measures can effectively prevent the spread of COVID-19 and should be maintained even with efficient results.
El virus SARS-CoV-2 procedente de Europa ha llegado a Perú el 5 Marzo y desde el 16 de marzo se ha declarado el estado de emergencia nacional llevando al confinamiento a toda la población. El objetivo de este estudio es caracterizar la evolución epidémica de la enfermedad de coronavirus (COVID-19) aplicando el modelo SIR (Susceptibles-Infecciosos-recuperados o fallecidos) durante un periodo de 200 días. Se utilizó los datos de series temporales de COVID-19 del 06 de marzo al 14 de mayo de 2020 del ministerio de salud peruano planteando casos estimados variando el número básico de reproducción R0. Según el modelo SIR, el pico de infectados se produce poco después del 30 de Mayo desde el inicio de la epidemia (día 86) donde disminuye el número total de casos infectados a R0=1,5. Los resultados sugieren que las estrictas medidas actuales de Perú pueden prevenir eficazmente la propagación de COVID-19 y deben mantenerse aun obteniendo resultados eficientes.
Subject(s)
COVID-19 , Pandemics , Humans , Peru , SARS-CoV-2ABSTRACT
Introduction: The NAD+dependent proteins deacetylases are called Sirtuins (SIRT). Objectives: Objectives: this review is to study the sirtuins involved in cancer, as well as SIRT1 inhibition studies in patients with coronavirus disease COVID-19. Data source and selection: For this, a search was made in Medline, Scopus and WOS, where descriptive studies of each of the functions of sirtuins were included, adjusted to recent scientific research. SIRT1 inhibition reduces CD8 T cell cytotoxicity in patients with systemic erythematosus lupus, being susceptible to SARS Cov-2 infections. SIRT2 is regulated by the secretion of IL-4 by eosinophils and the increase in SIRT2 increases hyperplasia, in contrast, SIRT3 promotes angiogenesis, inducing cardiac remodeling. SIRT4 is a tumor suppressor, in contrastto SIRT5 that promotes cell proliferation causing colorectal cancer; SIRT6 attenuates herpes virus associated with Kaposi's Sarcoma (KSHV) in immune compromised patients. Suppression of SIRT7 inhibits the growth of endometrial cancer cells. Conclusions: It is concluded that SIRT1, SIRT2 and SIRT4 are involved in the development of cancer, the suppression of SIRT5 and SIRT7 promotes the apoptosis of cancer cells and SIRT6 attenuates the replication of KSHV, in addition to the molecular pathology pathway of COVID-19 is associated with the inhibition of SIRT1 activity that may be related to inflammatory processes.
Introducción: Las proteínas desacetilasas dependientes del NAD+, se denominan Sirtuinas (SIRT). Objetivos: estudiar las sirtuinas involucradas en el cáncer, así como los estudios de inhibición de SIRT1 en pacientes con la enfermedad del coronavirus COVID-19. Fuente y selección de datos: Para ello se realizó una búsqueda en Medline, Scopus y WOS, donde se incluyeron estudios descriptivos de cada una de las funciones de las sirtuinas ajustado a las recientes investigaciones científicas. La inhibición de SIRT1 disminuye la citotoxicidad de las células T CD8 en pacientes con lupus eritematoso sistémico, siendo susceptibles a infecciones por SARS CoV-2. La SIRT2 se regula por la secreción de IL-4 por los eosinófilos y el aumento de SIRT2 incrementa la hiperplasia, en contraste la SIRT3 promueve la angiogénesis, induciendo la remodelación cardiaca. La SIRT4 es un supresor de tumores, en contraste con la SIRT5 que promueve la proliferación celular provocando el cáncer colorrectal; la SIRT6 atenúa al herpes virus asociado al Sarcoma de Kaposi (KSHV) en pacientes inmuno comprometidos. La supresión de SIRT7 inhibe el crecimiento de las células cancerígenas endometriales. Conclusiones: Se concluye que las SIRT1, SIRT2 y SIRT4 están involucradas en el desarrollo del cáncer, la supresión de SIRT5 y SIRT7 promueve la apoptosis de células cancerígenas y la SIRT6 atenúa la replicación de KSHV, además la vía de patología molecular de la COVID-19 está asociada a la inhibición de la actividad de SIRT1 que puede estar relacionada a procesos inflamatorios.