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Objective: To describe 2 cases of autoimmune neutropenia (AIN) patients infected with Sars-Cov-2. Design/Method: Two subjects case report. Result(s): Case report 1: A girl with primary AIN since 1 year and 10 months old, maintaining severe neutropenia and mild recurrent infections. Presented to the emergency department in June/2020, at 3 years and 8 months old, with flu-like symptoms, afebrile, in good general condition. Physical examination was normal. The absolute neutrophil count (ANC) was 0.279 x 109/L. At hospital admission, Sars-Cov-2 (RT-PCR) tested positive and filgrastim (G-CSF) 5 mug/kg/day was initiated. Chest X-ray was also normal and blood culture resulted negative. She remained in great general condition, afebrile, and was discharged on the 2nd day of hospitalization, with clarithromycin (15 mg/kg/day). After G-CSF, ANC: 0.494 x 109/L (1st dose), 1.431 x 109/L (2nd dose). On outpatient follow-up, she had no long-term complications from Covid-19. Case Report 2: A man with chronic immune thrombocytopenia purpura (ITP) since 2008, autoimmune hemolytic anemia since 2013, evolved with AIN on May/2020, at 42 years old, with ANC lower than 0.5 x 109/L. On 6/1/2020, he had ANC 0.170 x 109/L. On 6/25/2020, he started flu-like symptoms, had ANC of 5.118 x 109/L, and tested positive for Sars-Cov-2 (RT-PCR). He kept high fever (102,2degreeF) and was hospitalized for 10 days without use of G-CSF. After discharge, on outpatient follow-up, he had no long-term complications from Covid-19, and presented ANC 0.338 x 109/L (Aug/2020). Discussion(s): At beginning of Covid-19 pandemic, severity infection in children was unknown. Today is known that most of them have milder clinical course, regardless of chronic diseases. In adults, in contrast, the inflammatory response tends to exacerbation, with more severe clinical conditions. Furthermore, many case reports of patients infected by SARS-CoV-2 with comorbidities literature are published. However, to date there are no reports on the impact of COVID-19 in AIN patients. Increased neutrophil counts during infectious episodes are common in AIN, which appears to be related to the benign course of most infections. We reported 2 cases of AIN patients diagnosed with Covid-19, both with favorable clinical outcomes despite heterogenic clinical course. On the first case, she presented few symptoms and ANC increased only after using G-CSF. On the second reported patient, there was a spontaneous increase of ANC and greater inflammatory response than the first case. It could suggest a correlation between inflammatory response to COVID-19 and ANC in cases of autoimmune neutropenia. Conclusion(s): In the reported cases, clinical course of disease and neutrophil count were different between adult and pediatric patients. It is not possible to state whether this difference is due to age group, individual response to infection or other variables. It is important to assess other cases of AIN infected by COVID 19 to better understand correlation between severity of infection and neutrophil count response. Copyright © 2022
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This research aimed to identify the perception of parents about changes in their parenting practices and their impact on their children, aged 6 to 12 years, during the Covid-19 pandemic. This is a descriptive and qualitative study developed from the application of a Likert-type questionnaire with 26 items, which were answered by 35 participants who met the inclusion criteria. The results indicate that the most prevalent parenting practices during the pandemic context were positive monitoring and moral behavior, to the detriment of those considered negative, such as negligence, relaxed discipline, inconsistent punishment and negative monitoring. Data analysis also highlighted the predominance of the authoritative parenting style to resolve conflicting situations. It was possible to identify that, even in a challenging scenario, most parents sought dialogue and affection as a means to resolve the conflicts that arose with their children during social isolation and so many other adversities brought about by the pandemic.
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Objective: To identify the available evidence on ways of presenting psychological distress and actions to protect and promote mental health in university students during the COVID-19 pandemic. Method: Integrative literature review, performed in stages: Elaboration of the guiding question;establishment of inclusion and exclusion criteria;definition of the information to be extracted;critical analysis of studies and results;presentation of the review related to the impact of the pandemic on students and mental health protection and promotion actions. Results: Among the seven articles investigated, published in 2020, emotional reactions were observed, described by stress, anxiety, grief, anger and panic, associated with concern about the delay of academic activities and fear of falling ill. Conclusion: The pandemic and its related aspects interfere in the academic life and health of students and their families, causing negative effects on their mental health. © 2021 Universidade Federal da Bahia. All rights reserved.
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This article aims to describe the epidemiological profile and the spatial distribution of deaths and confirmed cases of COVID-19 in the health macroregion of Western Bahia. An ecological study on the inland expansion of SARS-CoV-2 was performed from March 21, 2020 to March 31, 2021 considering incidence and mortality rate, case fatality rate, case density and moving average of cases and deaths. 37,036 cases and 536 confirmed deaths were registered. Of all cases, 94.5% recovered and 4.0% remained active. The incidence rate was 3884.1/100,000 inhabitants, the mortality rate 56.2/100,000 inhabitants and the fatality rate was 1.4% A predominance of very high and high intensity of the occurrence of COVID-19 in the macroregion was identified and moving average revealed an increasing trend. Findings show a high risk of infection and death in the macroregion, in addition to a growing trend in accumulated cases, confirming the inland expansion of the disease.
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BACKGROUND: The COVID-19 pandemic has changed digestive endoscopy services around the world. OBJECTIVE: This study aimed to measure the number of urgent/emergency endoscopic procedures performed in a Brazilian hospital, comparing it to the same period in the previous year, and to identify risk factors in COVID-19 patients undergoing endoscopic procedures for upper gastrointestinal bleeding (UGIB). METHODS: This was a retrospective, cross-sectional, observational, single-center study. The study evaluated urgent/emergency endoscopic procedures performed on adult patients from March to August in 2019 and 2020. The COVID-19 patients included were diagnosed using RT-PCR, aged over 18 years with complete medical record information. The variables evaluated were age, sex, comorbidities, length of stay, D-dimer, need for intensive care unit (ICU) and mechanical ventilation. Student's t-test for independent samples or the non-parametric Mann-Whitney test was used to compare quantitative variables. Categorical variables were analyzed using Fisher's exact test. A P-value <0.05 indicated statistical significance. RESULTS: A total of 130 urgent/emergency endoscopic procedures were performed in 2020 and 97 in 2019. During the study period, 631 patients were hospitalized due to COVID-19, of whom 16 underwent urgent/emergency endoscopic procedures, 10 (1.6%) due to UGIB. Of the variables analyzed, the need for ICU and/or mechanical ventilation during hospitalization was statistically significant as a risk factor for UGIB. CONCLUSION: This study showed increased urgent/emergency endoscopic procedures during the pandemic at the study site. Among the patients hospitalized with the novel coronavirus, there is a higher risk for UGIB in those needing ICU and/or mechanical ventilation.