ABSTRACT
Various methods used by different countries' governments to control the spread of coronavirus disease 2019 (COVID-19), the cause of pandemic in 2020, affected air quality. The aim of this study was to evaluate the effects of lockdown in Armenia on the content of the main air pollutants-dust, SO2 and NO2. This was a cross-sectional study. We analyzed data on the concentrations of SO2, NO2 and dust from March to June, 2019 and the same period in 2020 as well as data on positive COVID-19 cases from Yerevan, Vanadzor and Hrazdan. In 2020, dust was found to be lower in Yerevan and in Hrazdan and higher in Vanadzor than in the same period in 2019. The same pattern was present for SO2 concentrations: in Yerevan and Hrazdan there was a decrease, and there was an increase in Vanadzor. The concentrations of NO2 increased in Yerevan and Hrazdan, with a slight decrease in Vanadzor. New cases of COVID-19 had a negative correlation with dust and a positive correlation with SO2. The strict quarantine measures were effective in containing the spread of COVID-19.
ABSTRACT
Background: As considerable evidence indicates viruses play an important role in the pathogenesis of infammatory rheumatic diseases as environmental factors. The most prominent pathogenic viruses which have been proposed in the triggering and initiation of autoimmune diseases include Parvovirus B19, Epstein-Barr-virus (EBV), Cytomegalovirus (CMV), Herpes virus-6, HTLV-1, Hepatitis A and C virus, and Rubella virus1. It is possible that COVID-19 infection is also a trigger. Because SARS-CoV-2 infection can break immune tolerance and trigger autoimmune responses, it is also likely to induce clinical autoimmunity2. Objectives: Find out a possible association between Covid-19 infection and development of IMDs. Methods: We analyzed data of 21 patients (Male 4/19 %/, female 17/81%/, mean age 45.5 ± 13,9 years), who were admitted to Rheumatology department of 'Mikayelyan' University Hospital after Covid-19 infection with newly diagnosed IMDs from June till December 2021. All of included had never had such kind of disorder before. EULAR/ACR criteria were used for diagnosis and assessment of disease activity. Results: After SARS-CoV-2 infection some patients presented with preserved fever, high levels of CRP and ESR, had rash and arthritis. Particularly, 3 (14.3%) developed systemic lupus erythematosus, 3(14.3%)-antiphospholipid syndrome, 4 (19%)-rheumatoid arthritis, 2(9.5%)-spondyloarthritis, 3 (14.3%)-sarcoidosis, 4 (19%)-erythema nodosum, 1 (4.8%)-small-vessel vasculitis, 1 (4.8%)-undifferentiated arthritis, and 1(4.8%)-Tietze syndrome. 11 (52.4%) experienced severe course of Covid-19 with pneumonia and respiratory failure, in 10 (47.6%) patients the course of disease was mild. We've found a signifcant association between severe course of Covid-19 and development of erythema nodosum. (p< 0.05). Also an association between female gender and severe course of Covid-19 was determined (p<0,05). Conclusion: In acute progression of the COVID-19 along with development of antiviral immunity, a dysregulated response of immune system may occur, represented by the marked cytokine release syndrome, macrophage activation, and systemic hyperinfammation.3 We analyzed the data of patients who didn't have any typical symptom of rheumatic diseases before coronavirus infection, therefor, on our opinion, virus played an important role to induce clinical autoimmun-ity and autoinfammation and subsequently-IMDs. Possibly, Covid-19 infection may be included in the group of trigger viruses for.
ABSTRACT
Patient 60 years old, a teacher working from home, got infected from her husband. The husband was an asymptomatic. Symptoms were loss of taste and smell, fever, weakness, nausea, vomiting, diarrhea, blurred vision. Hemodynamic parameters-BP 90/60 mm Hg, HR-99 bpm. Her regular HR was 55-60 bpm. Due to the overloading of hospitals, there was a queue for hospitalization at home. She was receiving the treatment of a family doctor. On the 9th day, her condition became worst. CT-scan picture showed 20% of lung lesions. Hemodynamic parameters were-BP 80/50 mm Hg, HR-115 beats. Due to of progressive dehydration, the high temperature lasted for 12 days. In anamnesis she has a drug allergy, chronic hypertension with left anterior bundle branch block because of suffering with rheumatic heart disease from the childhood. Any kind of liquid per oral caused immediate nausea and vomiting. Saturation was 74. We had to start i/v therapy at home in order to stop severe dehydration and high fever. Mobile oxygen delivery devices were used to monitor saturation. With that treatment during the day, the saturation indicator was 92. But at night, when the saturation went down below 86, the device, by means of an audible alert, gave a signal to connect oxygen. BP dropped to 70/50 mm Hg, HR-120 bpm. The patient also received factor XA inhibitor, antibiotic therapy, antiviral therapy, vitamins C and D. After these measures, she felt better, but could not take liquid on her own, as it still caused nausea. On the 14th day, a place was vacated in one of the hospitals and she was hospitalized. In the hospital, she spent another 10 days, the hemodynamics returned to normal and the second CT-scan showed 5% of the lungs damage. She was discharged of her own free will. For 1.5 months after that, she still felt severe weakness and was unable to work.
ABSTRACT
Background: Nowadays, the data on Coronavirus Disease 2019 (COVID-19) among cancer patients is controversial. It is debatable whether cancer patients are at a significantly higher risk of severe COVID-19. The current study aims to assess the risk of severe and critical COVID-19 cases among patients receiving systemic anticancer treatment (SACT). Methods: This was a retrospective cohort study utilizing census sampling. The data was obtained through medical records. Inclusion criteria: COVID-19 diagnosis through RT-PCR/chest CT among those who received SACT in the Chemotherapy Departments of Hematology Center after prof. Yeolyan and Institute of Surgery after Mikaelyan Yerevan, Armenia between March 1, 2020, and February 1, 2021. Descriptive analysis was done to characterize the cohort. We run logistic regression to evaluate the risk of COVID-19 severity (mild, severe/critical) among those receiving SACT (high, intermediate, and low-risk protocols of febrile neutropenia (FN), age, gender, smoking status, comorbidities). Results: In total 75 cancer patients were diagnosed with COVID-19 in both centers. Data of only 72 patients were analyzed, as the outcome variable of the excluded patients was unknown. The male-to-female ratio was 1:1.5, age range was 31-80 years (median age: 61). The patients received SACT with high (13.9 %), intermediate (63.9 %), and low (8.3 %) risk for FN. The others did not receive SACT at the moment of COVID-19 diagnosis. Infection-associated pneumonia was developed in 63% of cases. Mild COVID-19 was diagnosed in 76.4% and severe/critical in 23.6% of cases. Infected patients’ hospitalization rate was 28%. The case fatality rate was 8%. Only patients who underwent SACT at the time of COVID-19 infection were included in logistic regression analysis (n=62). Significant association between COVID-19 severity and the risk of SACT-induced FN, gender, smoking status, comorbidities was not found. Contrary, COVID-19 severity was significantly associated with age when adjusted to other predictors (p=0.017, 95% CI = 1.021-1.230). Conclusions: Thus, we demonstrate the lack of rationale to reschedule SACT during the pandemic as it does not affect the COVID-19 severity and may bring unnecessary treatment delays. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.