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1.
Annals of the Rheumatic Diseases ; 81:1691, 2022.
Article in English | EMBASE | ID: covidwho-2009075

ABSTRACT

Background: Recent data suggests that SARS-Cov-2 can alter self-tolerance and trigger autoimmune responses through cross-reactivity with host cells;therefore it can lead to late autoimmune and infammatory manifestations. With regard to rheumatic and musculoskeletal diseases (RMDs), medical literature displays sporadic case reports describing a variety of conditions diagnosed after COVID-19, but it remains still unclear what are the most common problems in patients presenting to rheumatology clinic following COVID-19 disease. Objectives: To describe the pattern of post-COVID-19 RMDs in a consecutive group of patients from rheumatology outpatient clinic. Methods: We have performed an observational descriptive study of a group of adult patients who received a new diagnosis of RMD within a timeframe of 12 weeks after the confirmation of COVID-19. Data was collected based on clinical presentation, paraclinical pattern and radiological examinations. Results: The study included 23 patients who were consulted in rheumatology outpatient clinic and had post COVID-19 new onset joint, periarticular, bone or infammatory syndrome manifestations. The general characteristics of the study group were as follows: mean age 45.5±11.3 (range 21-63) years and female to male ratio of 1.8:1. The majority of subjects consulted for joint symptoms (91.4%), in other cases reason for consultation was persistent low grade fever and fatigue (4.3%) and skin rash with dyspnea (4.3%). The mean duration of symptoms was 9.8±10.5 (range 1-42) weeks, and the time of onset after COVID-19 diagnosis was 4.9±4.1 (range 0-12) weeks. Concerning COVID-19 severity, it was established that in 60.9% it was mild, 17.4 %-moderate and 21.7%-severe. After clinical and paraclinical examination, the following diseases were diagnosed: ReA, lupus like syndromes, avascular necrosis, new onset RA and new onset PsA. In 69.7% of patients were diagnosed with ReA, the clinical pattern being joint or periarticular involvement of the hand, knee and feet. In 13.0% cases patients had multisystemic involvement (myocarditis, pericarditis, skin rash, infammatory arthritis and/or low grade fever) and positive ANA and or dsDNA Ab, these cases were diagnosed as lupus like syndromes and followed a severe form of COVID-19. In 8.7% of patients who presented with non-infammatory hip pain, avascular necrosis was diagnosed, in both cases femoral head being the affected part. No be noted that patients with avascular necrosis had a severe form of COVID-19 disease and joint pain started later after COVID-19 diagnosis (10-12 weeks). In 4.3% of cases each, new onset RA and PsA were identifed. Conclusion: In the present study we have found that COVID-19 can be followed by a variety of RMDs. The most common symptom of patients presenting with RMD was joint pain. The most common disease was post-COVID ReA (69.7%). Avascular necrosis (8.7%) and lupus like syndromes (13.0%) were found in patients who experienced a severe form of COVID-19. More rarely, patients had new onset of rheumatoid arthritis (4.3%) or psoriatic arthritis (4.3%). Our findings suggest that during the COVID-19 recovery period patients might experience onset of RDMs;therefore, in the presence of joint symptoms or other manifestations suggesting an autoimmune disease, patients should be referred to a rheumatologist for careful clinical examination.

2.
Annals of the Rheumatic Diseases ; 81:1688, 2022.
Article in English | EMBASE | ID: covidwho-2009058

ABSTRACT

Background: According to the recent medical literature, COVID-19 disease can lead to a constellation of clinical syndromes lasting well beyond the frst 30 days of infection. The most common post COVID sequalae includes pulmonary, nervous system and neurocognitive, mental, metabolic, cardiovascular, gastrointestinal and several other clinical manifestations. Regarding joint involvement and particularly reactive arthritis (ReA), literature data is limited and describes case reports or series of cases of patients diagnosed with this condition following COVID-19 disease. Objectives: To describe the pattern and the management of post-COVID reactive arthritis. Methods: We have conducted a descriptive study of consecutive adult patients who presented to rheumatology outpatient clinic for joint or peri-articular pain/swelling/stiffness and received a diagnosis of post-COVID 19 reactive arthritis, by excluding other types of rheumatological conditions. The assessed clinical variables were: visual analogue scale (VAS) pain, swollen joint count (SJC), tender joint count (TJC), duration of morning stiffness, presence of enthesitis/tendinitis and axial involvement. Biochemistry and serology was performed: rheumatoid factor, ACPA, ANA, HLA B27, antiChlamydia Trachomatis, Ureaplasma Urealyticum and Mycoplasma Hominis Ab, anti HBs and HBc Ab, and anti HCV. COVID-19 disease prior to diagnosis of ReA was confrmed by PCR test. Results: In the study were included 16 patients with confrmed post COVID-19 ReA. The mean age of the study group was 43.5±10.8 (range 21-60), the female: male ratio was 4:1 and the duration of joint symptoms was 10.4±11.8 (range 1-42) weeks. The severity of COVID-19 disease was mild in 68.7% cases, moderate in 18.7% and severe in only 6.2% of the cases. The duration between COVID-19 diagnosis and ReA varied between cases, with a mean value of 4.3±4.2 (range 1-12) weeks. In 43.7% of the cases patients had peripheral joint involvement (synovitis), in 37.5%-periarticular involvement (enthesitis), 6.25%-isolate axial involvement (sacroiliac joints), 6.25% enthesitis and axial involvement (cervical spine) and 6.25% synovitis and enthesitis. In patients with peripheral joint pattern, the distribution of pain was symmetric (71.4%). The pattern of synovitis was determined by a TJC of 6.25±5.2 (range 1-16) joints and SJC 1.6±2.4 (range 0-7) joints. Both TJC and SJC correlated positively with the duration of morning stiffness (r=0.9 and r=0.6), but did not correlate with the VAS pain scale. In most of the cases synovitis affected the hand (wrist, MCP and PIP) 62.5% and the knee, feet and ankles-50%. Two patients presented with monoarthritis, 1 with oligoarthritis and 5 with polyarthritis, in the majority of cases, involvement being symmetric (75%). Periarticular pattern was determined by enthesi-tis, affecting the elbow and shoulder (50%), costo-sternal enthesitis (25%) and trochanteritis (25%). From the entire study group, 31.2% had elevated serum infammatory markers (ESR and/or CRP). Patients responded well to NSAIDs alone in 68.7% cases, local (intra-articular or peri-articular infltrations) or and systemic corticoids (5 mg Prednisolone equivalent) were administered in 5.3% and 12.5% cases respectively, in 12.5% cases (two patients) Methotrexate was administered. Conclusion: Reactive arthritis represents a post COVID-19 sequelae. The time of onset of ReA varied between 1 and 12 weeks after COVID-19 diagnosis. The clinical pattern of the disease was expressed by joint or periarticular involvement, mainly affecting the hand, feet and knee symmetrically. Cases of axial manifestations were less common. Most of the patients responded well to NSAIDs, only in a few particular cases, low doses of corticoids and/or Methotrexate were recommended.

3.
3rd International Conference on Inventive Research in Computing Applications, ICIRCA 2021 ; : 1600-1605, 2021.
Article in English | Scopus | ID: covidwho-1476054

ABSTRACT

Global impact of COVID-19 disrupted normal life, during the pandemic enormous amount of unreliable information about COVID-19 is creating and disseminating every minute, which leads to information flooding. So people cannot extract reliable information from these unreliable sources. Machine Reading Comprehension can alleviate this problem. Machine Reading Comprehension (MRC) is a core process in question answering systems and that efficiently extracts the answer from relevant resources automatically for the questions posed by humans. Machine reading comprehension brings attention to a textual understanding with answering questions. This article introduces a new dataset, COVIDATA for the span extraction task of MRC in the domain of COVID-19 and exploits the advancements of the Transformer-BERT fine-tuned model. COVIDATA dataset generated from the COVID-19 news and information from the World Health Organization. Fine-tuned BERT, SciBERT, BioBERT, ClinicalBERT, and Bio+Clinical BERT models are used for the experiment and evaluation of the COVIDATA dataset. © 2021 IEEE.

4.
European Journal of Public Health ; 30:2, 2020.
Article in English | Web of Science | ID: covidwho-1046990
6.
European Journal of Public Health ; 30, 2020.
Article in English | ProQuest Central | ID: covidwho-1015331

ABSTRACT

To understand the public sentiment toward the measures used by policymakers for COVID-19 containment, a survey among representative samples of the population in seven European countries was carried out in the first two weeks of April 2020. The study addressed people's support for containment policies, worries about COVID-19 consequences, and trust in sources of information. Citizens were overall satisfied with their government's response to the pandemic;however, the extent of approval differed across countries and policy measures. A north-south divide in public opinion was noticeable across the European states. It was particularly pronounced for intrusive policy measures, such as mobile data use for movement tracking, economic concerns, and trust in the information from the national government. Considerable differences in people's attitudes were noticed within countries, especially across individual regions and age groups. The findings suggest that the epidemic acts as a stressor, causing health and economic anxieties even in households that were not directly affected by the virus. At the same time, the burden of stress was unequally distributed across regions and age groups. Based on the data collected, we draw lessons from the containment stage and identify several insights that can facilitate the design of lockdown exit strategies and future containment policies so that a high level of compliance can be expected. Key messages Citizens were overall satisfied with their government's response to the COVID-19 outbreak. A north-south pattern in public opinion was observed across the European states.

7.
European Journal of Public Health ; 30, 2020.
Article in English | ProQuest Central | ID: covidwho-1015314

ABSTRACT

The coronavirus disease (COVID-19) outbreak in many parts of the world has posed serious concerns to the public health. During this period of crisis, the World Health Organization (WHO) reminds all countries and communities that the spread of this virus can be significantly slowed or even reversed through the implementation of robust containment and control measures. The WHO has also asked the public to be careful while reading and spreading health recommendations from untrustworthy online sources of information. Myths and misbeliefs about the prevention and spread of COVID-19 not only create global panic but also pose risks to people's lives and public health in general. Rampant misinformation on the disease slows down the efforts of public health bodies to contain the outbreak. Therefore, the role of public health bodies in communicating the right message and in the right form to the public is crucial. In our study, we aim to assess the effectiveness of communication strategies used by international and national public health authorities to inform the public on COVID-19 risks and prevention. In particular, we conduct a survey experiment on a large sample (N = 4000) of adults from seven European countries to test the efficacy of public health messages in a form of prevention and corrective information provision. The study seeks to investigate how people's risk perceptions and behaviors change subject to the preventive information provision or treatment with the information countering widely spread misperceptions about the COVID-19 as compared to the control group. The findings of this research will be relevant for policymakers and public health professionals in the development of effective communication strategies during disease outbreaks. Key messages Risk perceptions towards COVID-19 and their determinants across European countries are unknown. Unclear effectiveness of public health messages in a form of prevention and corrective information provision.

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