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Hematology, Transfusion and Cell Therapy ; 43:S514-S515, 2021.
Article in English | EMBASE | ID: covidwho-1859713

ABSTRACT

Introdução: COVID-19 é o conjunto de sintomas causados pelo SARS-CoV-2, variando de quadros leves a formas graves. Pacientes com COVID-19 grave frequentemente apresentam marcadores laboratoriais anormais que refletem resposta inflamatória sistêmica. Alguns deles, estão ligados a desfechos clínicos desfavoráveis e estão emergindo como parâmetros prognósticos confiáveis. Alterações hematológicas fazem parte destes parâmetros. Objetivo: Avaliar hemograma de pacientes internados e correlacionar com o desfecho da infecção pelo COVID-19. Material e Método: De março de 2020 a julho de 2021 ocorreram 15013 internações nas instalações do HSPE, 4638 casos tiveram RT-PCR positivo para COVID-19. Avaliamos dados preliminares dos pacientes que tiveram PCR + durante sua internação no período de 07/2020 a 04/2021 que totalizaram 828 pacientes. Foram excluídas internações por outro motivo e PCR+ durante a internação e PCR+ executados para internação eletiva e assintomáticos. Para efeito da análise os pacientes foram divididos em 2 grupos: os que evoluíram a óbito e os que receberam alta hospitalar. Resultados: O hemograma de entrada dos pacientes que receberam alta hospitalar revelou valores médios de hemoglobina (Hb) 12,84 g/dL (± 2,10);leucócitos (LCT) 8433/mm3 (± 4.363,45), variando de 990 a 45.106/mm3;Neutrófilos (NEUT) 6.457,71/mm3 (± 3.692,15) de 567 a 28240/mm3;linfócitos (LINF) 1.246,25/mm3 (± 776,79) de 200 a 7190/mm3;plaquetas (PLT) 233630/mm3 (± 91.079,10) de 36.000 a 759.000/mm3. O grupo dos óbitos apresentou Hb média 12,39 g/dL (± 2,41), variando de 6,10 a 19,10 g/dL;NEUT 7621/mm3 (± 5.444);LINF 1070/mm3 (± 955);PLT 192.000/mm3 (± 102.229) 10.600 a 684000/mm3. Quando avaliamos a relação plaquetas/linfócitos (RPL): 145 pacientes com RPL ≥ a 180 evoluíram a óbito enquanto 291 obtiveram receberam alta. Dos pacientes com RLP < 180, 98 evoluíram para óbito, enquanto 216 obtiveram desfecho favorável (p= 0,5803). A relação neutrófilo/linfócitos (RNL) à entrada demonstrou que 37 pacientes com RNL < 3,3 evoluíram para óbito enquanto 154 obtiveram desfecho favorável (p = 0,0001). Das RNL por ocasião dos desfechos < 3,3, 10 evoluíram a óbito e 237 tiveram desfecho favorável e 215 com RNL ≥ 3,3 evoluíram para óbito e 251 para alta hospitalar (p = 0,0001). Discussão: Elevada RPL (> 180) como fator prognóstico na COVID-19 foi recentemente descrita, com especificidade e sensibilidade de 0,44 e 0,77, respectivamente. Entretanto, a RPL não foi medida em um ponto específico no curso da doença. Recente metanálise evidenciou RPL elevada em doença grave comparando com não grave. Elevada RNL foi identificada como marcador para mortalidade hospitalar e COVID-19 grave. Os neutrófilos são importantes nas respostas imunes inatas, enquanto os linfócitos nas respostas inflamatórias. Assim, aumento da RNL reflete desequilíbrio da resposta inflamatória e pode ser considerado indicador de gravidade. Estudo prévio introduziu RNL como um preditor independente de desfechos clínicos na COVID-19. Conclusão: A RNL ao diagnóstico ≥ 3,3 revela-se como marcador prognóstico tanto em análise feita com dados à entrada quanto por ocasião do desfecho. Análise em curso com maior número de casos pretende verificar a estratificação de valores desta relação, no sentido de prever com maior rigor o seu impacto. A RPL não demonstrou diferença entre os grupos. Entretanto, melhor padronização quanto ao momento em que esta avaliação deva ser realizada se faz necessária.

2.
Portuguese Journal of Pediatrics ; 52(4):252-256, 2021.
Article in English | Scopus | ID: covidwho-1594525

ABSTRACT

Introduction: Since the emergence of coronavirus disease 2019, known as COVID-19, there are limited data describing the risks and specific effects of severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, in pregnant women and their neonates. To date, there is scarce evidence of in utero transmission, and the risk of perinatal transmission and consequent neonate risk of developing COVID-19 during the perinatal period are also unknown. Methods: Since April 2020, universal screening of all pregnant women presenting in labor has been implemented in our hospital. To those who are positive for SARS-CoV-2, the possibility to room-in with the neonate is given. Neonates are tested for SARS-CoV-2 within the first 24 hours and again at 48 hours of life. We made a prospective cohort analysis of all neonates born of mothers positive for SARS-CoV-2 in our hospital from April to November 2020. Demographics, neonatal and maternal symptoms at the delivery, during hospitalization and once discharged, perinatal routine care and SARS-CoV-2 reverse transcription polymerase chain reaction results were studied. Results: We analyzed 23 mothers positive for SARS-CoV-2. Only eight declared having symptoms, mainly headaches, anosmia, and ageusia/dysgeusia. The 23 neonates were negative for SARS-CoV-2 in both reverse transcription polymerase chain reaction tests performed. All of the neonates were born and remained asymptomatic during the 14 days of surveillance time and all of them were breastfed. Discussion: According to our results, rooming-in was safe for newborns of SARS-CoV-2 positive mothers since there was no evidence of perinatal infection. This practice is a well-known way to promote early breastfeeding and encourage maternal-infant bonding. © Author(s) (or their employer(s)) and Portuguese Journal of Pediatrics 2021.

3.
27th Annual Americas Conference on Information Systems, AMCIS 2021 ; 2021.
Article in English | Scopus | ID: covidwho-1513631

ABSTRACT

Digital transformation is changing the world landscape with the rise of new technologies such as social media, IoT, blockchain, big data, etc. However, despite the multiplicity of technological novelties and recipes for their successful implementation, whether in business, public administration, or private life, these initiatives are taking much longer and facing more difficulties than has been expected. During the outbreak of the Covid-19 pandemic and with the implementation of social distancing, digital transformation has become a major issue. Nevertheless, while adopting the same was inevitable, the world has encountered several challenges to do that. Thus, this study aims to understand the role of digital transformation during the Covid-19 pandemic, by analyzing several mini-cases in Brazil. Therefore, via an integrative approach, one analyzed the positive, negative, and unforeseen outcomes accrued from digital transformation initiatives in Brazil, unveiling potential challenges and opportunities for technology in a post-Covid-19 reality. © AMCIS 2021.

4.
20th IFIP WG 8.5 International Conference on Electronic Government, EGOV 2021, held in conjunction with the IFIP WG 8.5 International Conference on Electronic Participation, ePart 2021 and the International Conference for E-Democracy and Open Government Conference, CeDEM 2021 ; 12850 LNCS:16-28, 2021.
Article in English | Scopus | ID: covidwho-1437107

ABSTRACT

The development of ICT is an important factor in boosting the economies of developing countries. Despite the multiplicity of technological novelties and recipes for their successful implementation, these initiatives are taking much longer and facing more difficulties than it has been expected. During the outbreak of the Covid-19 pandemic and with the implementation of social distancing, digital transformation has become a major issue. The world has encountered several challenges as the adoption and use of technologies became mandatory. In public administration, the development of an environment capable of keeping up with this pace of change was paramount. Hence, this study aims to understand the role of digital transformation during the Covid-19 pandemic, by analyzing several mini-cases in Brazil. Therefore, adopting a qualitative approach based on multiple longitudinal mini-case studies grounded on a critical interpretive approach, one analyzed the positive, negative, and unforeseen outcomes accrued from digital transformation initiatives in Brazil, thereby unveiling potential challenges and opportunities for technology in a post-Covid-19 reality. © 2021, IFIP International Federation for Information Processing.

5.
Annals of Oncology ; 31:S1028, 2020.
Article in English | EMBASE | ID: covidwho-806289

ABSTRACT

Background: On March 11, 2020, COVID-19 was declared a global pandemic. Caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this infection may remain asymptomatic. The European Society of Medical Oncology and the Portuguese Health Authority recommended both a symptomatic survey and laboratory testing in all cancer patients (pts) undergoing immunosuppressive treatment (IT). The impact of this measure is still unknown. We report our experience in a Portuguese center. Methods: Since March 2020, a symptomatic survey has been performed at our institution before each hospital visit. From April 6 through May 8, 2020, reverse-transcriptase polymerase chain reaction (RT-PCR) SARS-CoV-2 testing was added on cancer pts before undergoing IT. The impact of this intervention was evaluated comparing the hospitalization rate of cancer pts due to COVID-19, before and after the introduction of RT-PCR testing. Retrospective analysis of clinical data was performed. Results: 444 tests were carried out on 244 pts and laboratory SARS-CoV-2 infection was confirmed in 11 (5%);5 were male, with a median age of 65 years [34-76]. Breast and colorectal cancer were prevalent;2 pts had lung cancer;6 advanced disease. Ongoing IT in these pts was temporarily suspended: 9 pts under chemotherapy, 1 atezolizumab and 1 rituximab. Only 1 patient was symptomatic (9%) and previously hospitalized. No admission due to COVID-19 was registered in this group. Since March 7, 179 pts were admitted due to COVID-19 at our center: 12 were active cancer pts (6.7%) of which 4 were under IT. 6 of the oncological pts passed away, all of them had advanced diseases, 1 was under IT. Of the dead pts, lung and breast tumors were prevalent. Among all COVID-19 hospitalizations, the prevalence of pts under IT was similar before and after the implementation of the RT-PCR testing (2.2% vs. 2.4%). Conclusions: We found a significant percentage of active cancer pts diagnosed with asymptomatic COVID-19. Due to the small sample size of COVID-19 pts under IT, it is difficult to evaluate the impact of RT-PCR testing. However, on a long-term analysis, this intervention may reduce the risk of severe complications related to COVID-19 in cancer pts. Health education and dynamic organization are also important measures. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

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