ABSTRACT
Introduction. In addition to the vaccination, other options for treating COVID-19 have been made available;such options include the monoclonal antibody (MAbs) combinations Casirivimab/Imdevimab and Bamlanivamab/Etesevimab, which have shown to reduce the chances of hospitalisation in patients at risk of severe forms of disease. The aim of this work is to define data on the use of monoclonal therapy at the hospital where our U.O.C. Pharmacy is located and also to provide a first analysis on the efficacy and safety of the treatments. Methods and materials. The period under consideration runs from March 20th to August 15th 2021. Clinical data were extracted from AIFA web records and processed using Microsoft Excel. For patients whose treatment was closed, it has been calculated: follow-up period, degree of healing, rates of negativization, average overall negativization time and for subgroups of patients identified according to specific clinical parameters. Finally, a total percentage by type of adverse reaction was established. Results. 91 treatments with one of the two MAbs combinations have been activated. The average age of patients was between 59 and 72 years. The most common symptom was fever (83,52% of patients), while the most frequently encountered risk factor was Cardio-cerebrovascular disease (59,34%). Patient files have been closed for 86 patients, 84 of which recovered and 2 deceased. Negativization rates at 7, 14, 21, 28 and 35 days were 2.60%, 27.27%, 44.16%, 74.03% and 77.92% respectively. The average time of negativization was 22.33 days;in patients treated within 3 days of onset symptom, the average time was of 18,09 days, while in those treated after 3 days it was 26.00. Only 9.09% of patients involved in the treatment experienced one or more adverse reactions to the infusion. Conclusions. The results of this work show that correctly used anti-Covid-19 MAbs are an important therapeutic resource against the new infectious agent. As observed during the experimental phase, monoclonal antibodies prove their beneficial effect when used in the early stages of infection.
ABSTRACT
INTRODUCTION: Coronavirus disease-19 (COVID-19) has been increasingly associated with thromboembolic complications. COVID-19 infection has a thrombogenic potential for stents. Herein, we report a case of stent thrombosis in diabetic obese patient COVID-19 positive where was previously released a Multilayer Flow Modulator stent (MFM) for large popliteal aneurysm. CASE REPORT: A 78-year-old male was referred to our hospital for fever and acute pain in the left leg. At history, the same patient had endovascular procedure for a large symptomatic popliteal aneurysm, treated through release of three MFM. The pulmonary CT scan showed COVID-19 infection with confirm of rhino-laryngeal swab. Duplex ultrasound and CT-angiography showed complete thrombosis of stents. The treatment consisted of mechanical thrombectomy using an 8Fr catheter Rotarex plus release of Vibahn stent-graft. DISCUSSION: COVID-19 patients can present arterial occlusion. In literature are not reported cases about thrombosis peripheral stent. Minimally invasive approaches in redo-procedure reduce risk of infection. Rotarex device was used in revascularization of acute and subacute iliac and femoropopliteal arteries. The goal is to have a debulking, to avoid an incomplete deployment of stent-graft. In our precedent experience, MFM and stent-graft to treatment of popliteal aneurism were safe. It is important to monitor these patients for early identification of failure and rapprochement. In this case, the COVID-19 infection was determinant in promoting thrombosis. CONCLUSIONS: COVID-19 increases risk of thrombosis stent. In our experience debulking through Rotarex and stenting, were decisive factors for revascularization and limb salvage.