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1.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617062

ABSTRACT

Background: COVID-19 has changed the perspective through which medical staff look at dyspnea and hypoxemia cases. Epidemiological links are frequently missing, and clinical and imagological findings are often unspecific, overlapping substantially with other respiratory infections. Case summary: We report the case of an 11-year-old girl with a known history of asthma who had recently moved from Guinea-Bissau with her mother. Although the mother reported being Ag HBs positive, no serologic studies had ever been performed on the child. The patient was admitted to the Emergency Room after 4 days of cough and the feeling of thoracic oppression, without fever. No contact with suspected or confirmed individuals infected with SARS-CoV-2 or other respiratory viruses was reported. She presented with peripheral oxygen saturation of 90%, costal retractions and a prolonged expiratory phase. After an unsuccessful course of bronchodilators and prednisolone, she was admitted to the Pediatric Intermediate Care Unit because of a sustained need for oxygen therapy. Polymerase chain reaction analysis for SARS CoV-2 came back negative. A chest radiograph displayed a bilateral reticular infiltrate, and therapy with azithromycin was started. Due to a deterioration of the dyspnea, a chest tomography was eventually performed, revealing an exuberant and bilateral ground glass-like densification suggestive of alveolar injury. Echocardiogram and e electrocardiogram were both normal. After a positive serologic result for HIV, the patient was transferred to a Level III hospital, and Pneumocystis jirovecii was identified in bronchoalveolar lavage. T cell count was 12/mm3. Highly active antiretroviral therapy and cotrimoxazole were started, prompting clinical and analytical recovery. Discussion: Pneumocystis jirovecii can cause fatal pneumonia in immunocompromised children. Even though an asthma exacerbation and atypical bacterial or viral infections, namely COVID-19, present as more usual causes of dyspnea, a low suspicion index is warranted in children coming from HIV-endemic countries, particularly those who are unresponsive to conventional bronchodilator and antibiotic therapy.

2.
Revista Unisci ; - (56):95-115, 2021.
Article in Spanish | Web of Science | ID: covidwho-1513441

ABSTRACT

The purpose of the following article is to present the main dynamics of criminal activities and violence produced by the armed conflict in Colombia during the pandemic caused by COVID-19. After a review of the most relevant literature produced in 2020, this study presents trends in criminal violence, lato sensu, and those associated with the internal armed conflict. The situation of paralysis that the confinement produced has not translated into a mitigation of the phenomenon of violence. Thus, the massacres and murders of social leaders, activists, human rights defenders or ex-guerrillas of the FARC-EP has remained constant if not increasing during this time. This must also be related to a context of difficulty added to a Peace Agreement signed with the FARC-EP in November 2016. This must also be related to a context of added difficulty to a Peace Agreement signed with the FARC-EP in November 2016, which, in addition to governmental resistance and non-compliance, is overcome by an increasingly intense violence, which hinders the prospects of a peace-building scenario in the country.

3.
Journal of Thoracic Oncology ; 16(10):S1068-S1069, 2021.
Article in English | EMBASE | ID: covidwho-1474825

ABSTRACT

Introduction: Thymic epithelial tumors (TET) are the most common neoplasms of the anterior mediastinum. The incidence of this disease is extremely low, and there is little data on the Brazilian context. This study aims to describe the experience from PUCRS's Sao Lucas Hospital Thoracic Surgery team on mediastinal tumor resections (MTR) during the investigation of TET. Methods: The Thoracic Surgery team from PUCRS's Sao Lucas Hospital maintains a prospective database with the Brazilian Thoracic Surgery Society. Data from patients who underwent investigation for TET within 2016 and 2020 were collected from medical records in March 2021. Descriptive analyses were performed on this data. We used the classification proposed by the World Health Organization (2004) to classify all cases found. Results: There were 90 MTR performed on a total of 87 patients between 2016 and 2020. Of these, 56 (64.36%) were female, and the average age was 54.28. Among performed MTR, 11 (12.22%) were due to TET, being 10 (11.11%) by thymoma and 1 (1.11%) by thymic carcinoma. From the 10 cases of thymoma, 7 (70%) were female, and the only patient diagnosed with thymic carcinoma was male. Of the 11 patients diagnosed with TET, the average age was 56. According to the TET classification used, 1 (9.09%) was type A, 5 (45.45%) was AB, 1 (9.09%) was B2, 1 (9.09%) was B3, 1 (9.09%) was C (thymic carcinoma was classified as type C), 1 (9.09%) classified as types B1 and B2, and another (9.09%) as types AB and B3. Among 10 cases of thymoma, 2 (20%) had myasthenia gravis (MG). Immediate postoperative mortality was zero. During yearly follow-up, only 1 (9.09%) patient had a recurrence of disease, and 1 (9.09%) died. It is important to highlight that from all 90 MTR performed, 80 (88.88%) occurred between 2016 to 2019 (18 in 2016, 16 in 2017, 21 in 2018, 25 in 2019), resulting in an average of 20 RTM per year. However, in 2020, only 10 (11.11%) RTM were performed, showing a significant reduction during the first year of the COVID-19 pandemic in Brazil. Conclusion: Our data converge to what is shown in the literature since a small portion of patients who underwent MTR had a thymoma diagnosis and only one had a diagnosis of thymic carcinoma. The most frequent type was AB. Studies demonstrate that 30-65% of patients with thymoma also have MG. On the other hand, our sample shows 20%. It is essential to emphasize the reduction in the number of procedures during the Sars-CoV-2 pandemic in 2020. Keywords: thymic carcinoma, thymoma, thoracic malignancies

5.
Hematology, Transfusion and Cell Therapy ; 42:536-536, 2020.
Article in Spanish | PMC | ID: covidwho-1385640

ABSTRACT

Objetivo: O presente estudo buscou analisar a suscetibilidade pela infecção por SARS-CoV-2 entre a tipagem sanguínea com base em estudos publicados. Introdução: O SARS-CoV-2 é um vírus pertencente à família dos Coronaviridae, tendo o RNA como seu material genético, que leva ao desenvolvimento da doença COVID-19. O novo coronavírus foi detectado pela primeira vez em dezembro de 2019 na cidade de Wuhan, China, tornando-se uma pandemia acometendo até agosto de 2020, 215 países. Neste sentido, a busca por entender os mecanismos e/ou suscetibilidade frente a infecção por este vírus, se tornou prioridade entre os pesquisadores do mundo, sugerindo então uma correlação entre o sistema ABO frente a infecção por SARS-CoV-2. Metodologia: Foi realizada uma revisão da literatura com base em artigos indexados nas plataformas: Pubmed e medRxiv, no ano de 2020. Ao final da aplicação dos critérios de exclusão para seleção dos artigos, foram selecionados 17 estudos. Resultados e discussões: Mesmo com a escassez de estudos, o que é justificável por se tratar de um novo vírus, as pesquisas apontam que o tipo A é o mais susceptível e o grupo O menos susceptível, todavia, a gravidade quanto ao risco de óbito está associado ao tipo AB. Até o presente momento não se sabe ao certo o porquê o SARS-CoV-2 é menos susceptível ao grupo O. Hipotetiza-se que o anti-A desse grupo é capaz de interferir na ligação entre a proteína Spike com o receptor da enzima conversora angiotensina 2 (ACE2), mecanismo este visto na infecção por SARS-CoV-1. Outro fato que pode ser considerado é em relação a neutralização que os anticorpos anti-A e/ou anti-B podem exercer em infecções virais semelhantemente visto nas infecções por HIV, que poderia neutralizar também o SARS-CoV-2. Conclusão: Em suma, nota-se que o tipo sanguíneo O apresenta uma menor suscetibilidade diante a infecção pelo novo coronavírus, porém, não há nenhum estudo que elucide de qual forma o SARS-CoV-2 se porta diante o grupo ABO, fazendo então a necessidade de pesquisas para esclarecer este processo.

6.
Journal of Clinical Rheumatology ; 27(SUPPL 1):S7, 2021.
Article in English | EMBASE | ID: covidwho-1368326

ABSTRACT

Objectives: To describe risk perception and its relationship with sources of information consulted, actions, and the impact of the pandemic on the physical and mental health as well as social aspects of a group of patients from the rheumatology consultation. Methods: A survey was conducted from August 10 to November 29, 2020 in rheumatic diseases (RD) patients who returned to an outpatient clinic in Mexico following the Stay at home program implemented from March 23 to July 31. An online questionnaire was administered on mobile devices. Measurements: Assessment of the patient's health status by rheumatologist (visual analog scale ranging 0-10) and some sections of the UNIV-COVID-19 questionnaire. A descriptive analysis was performed. Measures of central tendency and dispersion for continuous variables and frequency measures for categorical variables. Normality was checked with the Shapiro-Wilk test. Inferential statistical tests were performed to determine differences between the COVID-19 + vs -groups with Chi-square and Student's t test for nominal and continuous sociodemographic variables, respectively. Logistic regressions were performed. Results: A total of 471 patients with RD were included, 84.5% women, aged 46.9 (SD 14.5) years old;rheumatoid arthritis (RA) was the most prevalent diagnosis 42.4%. 4.8%had SARS-CoV-2 infection, 21.74% required hospitalization. Treatment modification was reported in 36.1% (66.6% discontinued);health condition worsened in 39.1% of the patients. 52.1% of the patients who made modifications in their treatment had COVID-19 and 39.1% of those who had COVID-19 reported that their health condition worsened. The perception of risk was 85.9% (very serious/serious). The preventive action carried out was home isolation 44.3%. Television was consulted 88.7%and alert 74.5%the most prevalent feeling, while 7% said they felt discriminated. The logistic regression analysis revealed that having SpA, taking leflunomide, feeling discriminated, and greater perception of risk were associated with having COVID-19. The bimodal results for each variable are presented to indicate the change on action taken per group. Conclusion: The risk perception in RD patients was very high. 5% had COVID-19. The impact on disease activity, physical/mental health was greater in patients with COVID-19. Discrimination of RD and COVID-19 patients is an important phenomenon.

7.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):905-906, 2021.
Article in English | EMBASE | ID: covidwho-1358851

ABSTRACT

Background: COVID-19 outcomes in Mexican patients with rheumatic diseases (RDs) in comparison to general population patients are unknown. Objectives: To compare mortality and hospitalization of COVID-19 patients with RDs and those without. Methods: We included for this study all the Mexican patients with RDs and COVID-19 registered from April 17th to October 30th, 2020 in the COVID-19 Global Rheumatology Alliance registry. We compare clinical and demographic characteristics of patients with RDs and COVID-19 to patients with COVID-19 that were selected randomly from the Mexican Epidemiology database (1:3). A logistic regression analysis was performed to adjust for confusion variables. Results: We included 322 patients with COVID-19 and RDs and 969 controls without RDs. Table 1 shows the demographic characteristics and comorbidities of both groups. Bivariate analysis showed that patients with RDs had higher mortality, were older, and were more frequently hospitalized. Comorbidities, such as diabetes, hypertension, cardiovascular and renal diseases were also more frequent in patients with RDs. In the multivariate analysis, having a RD was no longer associated with mortality (Figure 1). Conclusion: Patients with RDs had higher comorbidities, hospitalizations, and mortality than the general population in the bivariate analysis. However, adjusted multivariate analysis showed that the odds for mortality were not increased because of having a RD. These findings suggest that the increased mortality of Mexican patients with RDs may be explained by the higher frequency of comorbidities in this population.

8.
Annals of the Rheumatic Diseases ; 80(SUPPL 1):904, 2021.
Article in English | EMBASE | ID: covidwho-1358845

ABSTRACT

Background: As of the 25th of January 2021, more than 150 thousand deaths as consequence of COVID-19 have been reported in Mexico [1]. Advanced age, male gender and comorbidities have been described as risk factors for severe disease and mortality in general population [2]. COVID-19 mortality in Mexican patients with rheumatic and musculoskeletal diseases (RMDs) is unknown. Objectives: To describe characteristics of Mexican patients with RMDs and COVID-19, and to analyse factors associated with mortality. Methods: The Global Rheumatology Alliance COVID-19 (GRA) physician reported registry, is an international effort to collect information on COVID19 in adult patients with RMDs. GRA is an observational registry. The first patient from Mexico was registered on April 17, 2020. All Mexican patients registered in GRA until October 30, 2020 were included in this analysis. The association of mortality with demographic and clinical variables was estimated using logistic regression analysis. Results: A total of 323 patients were registered, with a median age of 52 (IQR 41-61) years old, 166 (51.4%) patients lived in Mexico City. The most frequent RMDs were rheumatoid arthritis, 149 (46.1%) and systemic lupus erythematosus, 24 (19.8%). Over a third of patients with RMDs and COVID-19 (119 (36.8%)) were hospitalized, and 43 (13.3%) died. Table 1 shows clinical and demographic characteristics. In the univariable analysis, the absence of comorbidities was a protective factor, OR 0.3 (95% CI 0.1-0.6). Factors associated with mortality at COVID-19 diagnosis were age over 65 years old, having type 2 diabetes, chronic renal insufficiency, treatment at COVID-19 diagnosis with corticosteroids or with CD20 inhibitors. In the multivariable adjusted analysis, these factors remained independently associated with mortality. No associations with other treatments or comorbidities at COVID-19 diagnosis were found. Conclusion: Mexican patients with RMDs and COVID-19 in the GRA physician reported registry had a mortality of 13.3%. Factors associated with mortality were those described in the general population, such as older age and being on corticosteroids and CD20 inhibitors treatment at COVID-19 diagnosis.

9.
Environmental Science and Technology Letters ; 2021.
Article in English | Scopus | ID: covidwho-1345526

ABSTRACT

The COVID-19 pandemic increased the demand for indoor air cleaners. While some commercial electronic air cleaners can be effective in reducing primary pollutants and inactivating bioaerosol, studies on the formation of secondary products from oxidation chemistry during their use are limited. Here, we measured oxygenated volatile organic compounds (OVOCs) and the chemical composition of particles generated from a hydroxyl radical generator in an office. During operation, enhancements in OVOCs, especially low-molecular-weight organic acids, were detected. Rapid increases in particle number and mass concentrations were observed, corresponding to the formation of highly oxidized secondary organic aerosol (SOA) (O:C ∼1.3), with an enhanced signal at m/z 44 (CO2+) in the organic mass spectra. These results suggest that organic acids generated during VOC oxidation contributed to particle nucleation and SOA formation. Nitrate, sulfate, and chloride also increased during the oxidation without a corresponding increase in ammonium, suggesting organic nitrate, organic sulfate, and organic chloride formation. As secondary species are reported to have detrimental health effects, further studies should not be limited to the inactivation of bioaerosol or reduction of particular VOCs, but should also evaluate potential OVOCs and SOA formation from electronic air cleaners in different indoor environments. © 2021 American Chemical Society.

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11.
Hematology, Transfusion and Cell Therapy ; 42:525, 2020.
Article in Portuguese | ScienceDirect | ID: covidwho-893849
13.
Fertility and Sterility ; 114(3):e178-e179, 2020.
Article in English | EMBASE | ID: covidwho-880477

ABSTRACT

Objective: Currently, there is limited data regarding the implications of infection with COVID-19 on reproductive or pregnancy outcomes. Given the lack of knowledge, the American Society for Reproductive Medicine (ASRM) released recommendations on March 17th, 2020 for reproductive health providers to guide clinical practice during this global pandemic. The primary objective of this study was to determine practice preparedness, clinical changes, compliance with ASRM recommendations, and patient/reproductive health provider reactions in response to the COVID-19 pandemic. The secondary objective was to assess whether these changes will alter the practice patterns of reproductive health providers in the future. Design: Survey study distributed nationally to American reproductive health providers and practice staff between April 13th to May 19th, 2020. Materials and Methods: The survey was distributed using social media platforms and subspecialty specific list-servs utilized by reproductive health providers. To ensure survey question face validity, expert review and interim analysis of the responses was conducted. Statistical analysis was performed with Chi squared tests using R software. Results: A total of 134 responses were received of 612 surveys distributed. There was a significant difference in the method by which reproductive health practices received the ASRM recommendations, with e-mail being the most common for private practice, and word-of-mouth for academic practice (p=0.02). Once distributed, the academic providers were significantly more likely to follow guidelines compared to those in private practice (p=0.006). Most practices implemented guidelines, regardless of specialty and location, within one week of publication (March 16-20th), however academic providers implemented them earlier (March 9-13th) (p=0.002). The majority of practices completed their last embryo transfer within one to two weeks (March 16-27th). Continued unmonitored ovulation induction was more commonly offered to the Midwest population compared to the rest of America (p=0.03), regardless of practice type (p=0.07). Overall, the patients’ responses to practice changes were well received. Nonetheless, specialists at academic practices were significantly more likely to offer their patients mental health resources (p=0.001). Provision of telehealth, whether before, during, or planning for after the COVID-19 pandemic, did not yield any statistically significant results. Conclusions: The guidelines proposed by ASRM have had an obvious impact on reproductive care during the COVID-19 pandemic. Reproductive health practice changes were quickly implemented once received. Although the patient population was undoubtedly affected, patients were understanding regarding the need for delay in care.

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