ACUTE GVHD TRIGGERED BY COVID-19 IN A BONE MARROW RECIPIENT (preprint)

Introduction: There are few reports regarding risk of COVID-19-associated complications in bone marrow recipients. We report a patient who had graft-versus-host disease triggered by COVID-19. Results The patient was a 17-year-old boy who underwent HSCT from matched sibling donor for CML. He had complete donor chimerism at day +30. Cyclosporine was tapered and stopped at day +65. Until day +93, he had no complaints. The patient started to suffer from cutaneus and gastro-intestinal grade III GVHD after the diagnossis of CIVID-19. Discussion In the absence of any other condition to explain this clinical picture and the good response to GVHD treatment indicate that the triggering factor in the development of GVHD may be COVID-19 in the era of TLR, which plays a common role in the pathogenesis of both GVHD and COVID-19.

Evaluation of proximal tubule functions at the children with COVID-19 infections: a prospective analytical study (preprint)

Purpose: There are limited numbers of studies focusing on renal effects of COVID-19 infection and proximal tubular dysfunction in children with COVID-19 infections. In this study, we aimed to evaluate the functions of the proximal tubule in hospitalized children with confirmed acute COVID-19.  Methods: This prospective descriptive study included the children who were hospitalized for confirmed COVID-19 were included. The diagnosis of proximal tubule injury was based on the presence of at least two of the following four abnormalities including abnormal tubular reabsorption of phosphate, normoglycemic glycosuria, hyperuricosuria, and proteinuria. Results: A total of 115 patients were included in the study.  Approximately one-third of the patients had higher serum creatinine levels or proteinuria. Additionally, abnormal renal tubular phosphate loss measured by TMP/eGFR was present in 10 patients (8.7%) and hyperuricosuria was present in 28.6%. Consequently, overall PTD was present in 24 patients (20.8%), and PTD associated with COVID-19 was significantly detected in younger children.Conclusions: Our findings suggested that one in five children with acute COVID-19 infections had proximal tubular dysfunction. The rate of proximal tubular dysfunctions was not so high as in adults but should be kept in mind. The children with COVID-19 infections should be monitored for recovery of proximal tubular functions. 

An UV disinfection robot combined cleaning and housekeeping strategy for the hospital during COVID-19 pandemic: How we protect the hospital cleaning staff? (preprint)

BackgroundThe Coronavirus Disease 2019 (COVID-19) pandemic presents important infection control challenges for the health care facilities. Proper cleaning of the patient's room after the discharge of the patients is important to protect the housekeeping staff as well as other patientsMethodsIn this study, we reviewed our experience with a novel multipurpose hybrid UV disinfecting and air disinfecting robot and the impact of it for preventing hospital cleaners getting occupational COVID-19 infection.ResultsBetween 11, March 2020 and 11 December 2020, a total of 301 children with COVID-19 were hospitalized at the COVID-19 ward. The mean hospital stay was 3.77 ± 2.71 days (range from1 to 20 days) and total COVID-19 related-care. The mean working time was 9.4 ± 1.6 months (range 5 to 10 months). The total working hours for a month for one hospital cleaner was 196 to 204 hours per month. The total duration of the UVC-robot was 491 hours 33 minutes for fans and 473 hours 20 minutes for UV lamps. During the follow-up period, two of the hospital cleaners had definitively community-acquired COVID-19 infection, but none of them had symptomatic COVID-19 infection during the study period.ConclusionsDuring the COVID-19 pandemic, none of the hospital cleaners got hospital-associated COVID-19 infection. The combination of personal protective equipment in addition to UVC-robot integrated environmental disinfection is an important strategy to protect health-care workers.