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HemaSphere ; 5(SUPPL 2):379, 2021.
Article in English | EMBASE | ID: covidwho-1393457


Background: The coronavirus disease 2019 (COVID-19) pandemic has imposed several constrains in the medical practice, especially in hematologic patients (pts) where a higher mortality rate is expected. In our center strict measures were implemented earlier, with the use of personal protective equipment, hand wash at all times, internal separated circuits, frequent prophylactic tests, teleconsultation and rapid isolation of positive cases. However, data is still limited and risk factors for increased susceptibility remain unclear. Aims: Characterize our pts with COVID-19 regarding the type of hematologic disease, the respective treatment, infection severity and identification of any possible risk factors that may have impact in the outcome. Methods: Pts with a positive quantitative RT-PCR from nasopharyngeal swab between 18/03/2020 and 02/02/2021 were identified. Epidemiologic, laboratory, and clinical characteristics were retrospectively collected. Chi-square and Mann-Whitney-U tests were performed to identify statistical differences between groups and logistic binary regression to assess predictive risk factors. Severity of illness was defined by level of care [ambulatory, general inpatient wards and intensive care unit (ICU)], need for respiratory support, incidence of thrombotic events, acute kidney injury and/or death. Active hematologic treatment was defined as therapy within 6 months of COVID-19 diagnosis. Results: A total of 81 pts were identified, with a median age of 61 years (19-88), 52% were male, 63% had an ECOG PS 0 and 69% had at least one comorbidity (hypertension 36%, dyslipidemia 21%, cardiovascular disease 21%, diabetes mellitus 14% and pulmonary disease 11%). Regarding the hematologic disease, 83% had a neoplastic malignancy (non-Hodgkin lymphoma 30%, myeloproliferative neoplasms 16%, acute myeloid leukemia 11% and multiple myeloma 11%), 64% were in active treatment and 43% had active disease. Concerning the COVID-19 infection, 46% required hospital admission among which 65% needed respiratory support and 9% admitted to an ICU. Median overall survival (OS) was not reached (84% at 1 month) and the mortality rate was 17%, mainly in pts with active disease and neoplastic malignancy. Non-survival pts had a lower hemoglobin level (8,3g/dL vs 12g/dL;p-value 0,016), a higher CRP (218mg/L vs 22mg/L;p-value 0,041), acute renal failure (36% vs 6%;p-value 0,014), more need of respiratory support (71% vs 27%;p-value 0,004) and mechanical ventilation (21% vs 5%;p-value 0,022). There were no statistical differences regarding age, absolute lymphocyte count, platelet count and LDH. Regression analysis revealed hemoglobin level (p-value 0,026), CRP (p-value 0,05) and respiratory support (p-value 0,003) as predictive factors for death. In our pts there were no thrombotic events. Summary/Conclusion: Nearly half of the pts were admitted to the hospital and discharged. In our analysis low hemoglobin level, high CRP and respiratory support were associated with poorer survival, however, given our small sample, these findings need to be confirmed. Contrary to most of the published results, the number of confirmed COVID-19 positive cases was surprisingly low, with only 81 cases in 11 months, with a mortality rate similar to the general population and lower than expected. We believe that implementing early and rigorous protective measures as well as create self-awareness may be the key to improve mortality rate in this highly susceptible population.

Ocul Immunol Inflamm ; 29(6): 1200-1206, 2021 Aug 18.
Article in English | MEDLINE | ID: covidwho-1360249


PURPOSE: To describe a case of acute thyroiditis and bilateral optic neuritis associated with SARS-CoV-2 vaccination. METHODS: A single case report from a tertiary referral center. RESULTS: The patient described in the following case report developed acute thyroiditis and bilateral optic neuritis following SARS-CoV-2 vaccination. The patient underwent pulse therapy followed by oral tapering corticosteroid therapy with an improvement of the bilateral disc swelling and the visual field, and recovery of thyroid-stimulating hormone to the normal limits. CONCLUSION: Although the association between immunization and the onset of demyelinating manifestations of the central nervous system is well documented, this is the first reported case of bilateral optic neuritis and acute thyroiditis and subsequent to administration of vaccination against SARS-CoV-2.

COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Optic Neuritis/etiology , SARS-CoV-2 , Thyroiditis/etiology , Vaccination/adverse effects , Acute Disease , Adult , Female , Glucocorticoids/therapeutic use , Humans , Magnetic Resonance Imaging , Optic Neuritis/diagnosis , Optic Neuritis/drug therapy , Orbit/diagnostic imaging , Pulse Therapy, Drug , Thyroiditis/diagnosis , Thyroiditis/drug therapy , Tomography, Optical Coherence , Visual Acuity/physiology
Aerosol Science & Technology ; : 1-15, 2021.
Article in English | Academic Search Complete | ID: covidwho-1182927


The use of face masks is mandatory in public places in many countries to slow the spread of the COVID-19 pandemic. In developing countries, homemade masks with varying techniques and fabrics are used on the streets. On these fabric masks, the protection against SARS-CoV-2 varies significantly. The most common mask types are N95, surgical masks, and homemade nonwoven and cotton masks. The performance of 227 different face masks used in Brazil was evaluated to quantify their breathability and filtration efficiency (FE) for airborne particles. FE values were measured using NaCl aerosol particles sized from 60 to 300 nm and at 300 nm, minimum efficiency. The differential pressure drop over the mask and the FEmin at 300 nm was used to calculate the mask Quality Factor (QF). The N95 masks showed the highest FE60-300, around 0.98, and a QF of 13.2 KPa−1, and were considered the reference for evaluating homemade masks performance. Surgical masks have an FE60-300 of 0.89, with a good QF of 15.9 KPa−1. Nonwoven masks showed an average FE60-300 of 0.78, with an excellent QF of 24.9 KPa−1, and can be regarded as the best material for homemade masks. The most commonly used material for homemade masks, cotton fabrics, showed significant variability in FE60-300, ranging from a low 0.20 to 0.60, with a low QF of 1.4 KPa−1. Masks always reduce droplets and aerosols emitted by COVID-19 symptomatic and asymptomatic persons, reducing SARS-CoV-2 contamination. [ABSTRACT FROM AUTHOR] Copyright of Aerosol Science & Technology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)