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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.

Multiple Sclerosis Journal ; 27(1 SUPPL):40, 2021.
Article in English | EMBASE | ID: covidwho-1334701


Background: The reception and rehabilitation services for Multiple Sclerosis (MS) have been partially interrupted in most countries since the beginning of the COVID-19 pandemic. Objectives: To present the health care in neurorehabilitation promoted by the Brazilian Association of Multiple Sclerosis (ABEM) during a pandemic period by COVID-19. Methods: A Social Therapeutic Action Plan was developed to identify the needs of people with MS. Social Service call centers were made available via landline, cell phone, WhatsApp and e-mail at the beginning of the pandemic. Results: 2,975 telephone calls were made between March 23 to September 30, 2020, referrals were made and distributed as follows: art therapy = 29 (1%), physiotherapy = 2,185 (73.4%), neurology = 29 (1%), psychology = 638 (21.4%), psychiatry = 8 (0.3%), shiatsu = 86 (2.9%). Conclusions: In addition to raising awareness and encouraging people with MS not to abandon physical and mental health monitoring during the pandemic, it is extremely important to offer and provide essential services such as social and health care. The findings of this study showed the importance of the organization aimed at people with MS in the optimization and continuity of health care and access to effective interventions to promote quality of life. Diagnostic Criteria and Differential Diagnosis.