ABSTRACT
Background: COVID-19 brought with it unknowns related to systemic sclerosis. Objective: To know the clinical evolution and prognosis of COVID-19 in a cohort of patients with systemic sclerosis. Methods: During the pandemic, we had digital contact with a cohort of 197 patients with SSc. If they had any condition that met the suspected definition of COVID-19, they underwent polymerase chain reaction testing for SARS-CoV-2;they were treated on an outpatient or hospital basis without interfering with their treatment. They followed their evolution every 24 hours until they became asymptomatic or died. Results: Thirteen patients (6.6%), nine diffuse cutaneous (dcSSc), and four limited cutaneous (lcSSc) developed COVID-19 during nine months of follow-up. The immunosuppressants used at the time of the disease were: mycophenolate mofetil, methotrexate, and prednisone, in low doses. Seven patients had interstitial lung disease (ILD). The main symptoms were chest pain, cough, dyspnea, dysgeusia, and anosmia, 1 with mild symptoms without pneumonia, 11 with mild pneumonia, and one with severe pneumonia that required hospital management. Only one (7.7%) presented severe pneumonia, was hospitalized, and died. Conclusions: COVID-19 disease in patients with SSc can be overcome in most cases, even when they are ILD and were using immunosuppressants at the time of infection with the SARS-CoV-2 virus. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
Background: Adequate glycemic control improves the prognosis of patients hospitalized for pneumonia associated with severe COVID-19. Objective: To evaluate the impact of hyperglycemia (HG) on the prognosis of patients hospitalized for severe pneumonia associated with COVID-19 in unvaccinated patients. Material and methods: Prospective cohort study. We included patients hospitalized from August 2020 to February 2021, with severe COVID-19 pneumonia, not vaccinated against SARS-CoV-2. Data was collected from admission to discharge. We used descriptive and analytical statistics according to the data distribution. ROC curves were used to determine the cut-off points with the highest predictive performance for HG and mortality, with the IBM SPSS program, version 25. Results: We included 103 patients, 32% women, 68% men, age 57 +/- 13 years;58% were admitted with HG (191, IQR 152-300 mg/dL) and 42% with normoglycemia (NG < 126 mg/dL). Mortality was higher in HG at admission 34 (56.7%) than in NG 13 (30.2%) (p = 0.008). HG was associated with diabetes mellitus 2 and neutrophilia (p < 0.05). The risk of death increases 1.558 times (95% CI 1.118-2.172) if HG is at admission and 1.43 times (95% CI 1.14-1.79) during hospitalization. Maintaining NG throughout the hospitalization contributed independently to survival (RR = 0.083 [95% CI 0.012-0.571], p = 0.011). Conclusion: HG significantly impacts prognosis by increasing mortality more than 50% during hospitalization for COVID-19. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.
ABSTRACT
BACKGROUND: The possibility that the blood group (BG) predisposes to SARS-CoV-2 infection is controversial. OBJECTIVE: To compare the prevalence of BG, anti-IgG SARS-CoV-2, and more frequent symptoms in convalescent health personnel vs controls prior to vaccination. MATERIAL AND METHODS: Analytical cross-sectional design of cases and controls, which included health personnel, from March to June 2020, confirmed with (polymerase chain reaction) PCR-SARS-CoV-2 and negative controls with PCR and anti-IgG-SARS-CoV-2. Participants were questioned concerning symptoms and BG was determined. It was used descriptive statistics and comparative analysis with chi squared, Fisher's exact test, Student's t, and Mann Whitney's U tests. RESULTS: Of 218 workers, 102 (46.8%) were confirmed cases for SARS-CoV-2 (convalescent) and 116 controls. The distribution of BG was similar between cases and controls, being BG-O + the most frequent (52.9%). The risk of becoming infected by SARS-CoV-2 for BG-O compared to BGNo-O showed a lower trend (odds ratio [OR] 0.725, 95% confidence interval [95% CI] 0.416-1.261, p = ns). The BG-A (28.4%) compared with BG-No-A (71.6%) showed a trend of increased risk in BG-A (OR 1.523, 95% CI 0.818-2.837, p = ns). The presence of SARS-CoV-2 IgG antibodies was 85% in the convalescent group. CONCLUSIONS: The prevalence of infected was proportionally higher for BG-A and lower for BG-O. About 15% did not develop SARS-CoV-2 antibodies after overcoming COVID-19 disease.