HOCl as a Promising Candidate for Effective Containment of Covid 19 From Biological and Non-Biological Surfaces

Covid 19 is a pandemic disease spread almost in the whole world. To date, no medical advancement to curb the virus. Coronavirus is an enveloped virus transmitted from the biological and non-biological surface by direct or indirect contact. Limited literature revealed that the enveloped virus can be killed by disinfectants. There are many biocidal agents used for decontamination of the virus, yet they have many issues like toxicity, killing time, activation requirement, etc. Some are specific to the inanimate surface but not used by a human being. This current situation showed an urgent need for a biocidal agent which can act on biological as well as non-biological surfaces without any potential toxicity. Moreover, it should be easy to handle, inexpensive, and safe for the environment. Hypochlorous acid is a weak acid that acts as a powerful disinfectant and shows biocidal efficacy against a wide range of microorganisms. Hypochlorous acid is simple to use, inexpensive, eco-friendly, non-toxic, and stable. The properties of HOCl can be regulated at the site of preparation and therefore, its compliance is high. Hypochlorous acid seems to be a promising agent in disinfection and sterilization in healthcare facilities. Due to its diverse biocidal actions, it may be used as a potent disinfectant against novel coronavirus.Copyright © 2022 Bentham Science Publishers.

Blepharoconjunctivitis and Otolaryngological Disease Trends in the Context of Mask Wearing during the COVID-19 Pandemic.

(1) Purpose: In 2020, wearing of face masks was mandated in the United States in an effort to lessen transmission of the novel 2019 coronavirus disease (COVID-19) pandemic; however, long-term mask wearing may present with unintended side-effects in both ophthalmic and otolaryngologic clinical practice. This study aims to examine if mask wearing increased the incidence of primarily chalazion, blepharoconjunctivitis, and rhinitis occurrence during the mask-mandated COVID-19 pandemic period. (2) Methods: Medical records from tertiary academic center clinics were analyzed for incidence of ophthalmic and otolaryngologic diagnoses of interest (blepharoconjunctivitis- and rhinitis-related disorders). Data were collected from a pre-pandemic (March 2019-February 2020) and a mid-pandemic window (March 2020-February 2021) during which widespread mask mandates were implemented in Texas. Comparison was performed using a t-test analysis between incidence of chosen diagnoses during the described time periods. (3) Results: Incidence of ophthalmic disorders (primarily blepharoconjunctivitis and chalazion) in the pre-pandemic versus mid-pandemic windows did show a significant difference (p-value of 0.048). Similarly, comparison of otolaryngologic diagnoses (primarily rhinitis and related conditions) between the two time periods showed a significant difference (p-value of 0.044) as well. (4) Conclusion: Incidence of the chosen ophthalmic and otolaryngologic disorders did increase during periods of mask mandates. While these findings are preliminary, further studies are warranted to understand other factors that may have played a role in eye and nose pathology.

AN UNCOMMON CAUSE OF A COMMON DISEASE: AUTOIMMUNE SMALL-FIBER POLYNEUROPATHY AFTER COVID-19 VACCINATION

CASE: JW is a previously healthy 27-year-old woman who presented with several months of progressive weakness, neuropathy, and tachycardia that began shortly after her second dose of the Pfizer COVID-19 vaccine. Initially, she noticed fatigue followed by occipital neuralgia and paresthesia. Weeks later, she was febrile with extremity tremors and neuralgia. She went to the ED where she was lymphopenic, group A strep positive (GAS+), and had unremarkable imaging;she was given antibiotics and gabapentin. Her fever resolved, but her pain/tremor continued. Occipital nerve blocks provided temporary relief;acyclovir and duloxetine had no effect. On two subsequent ED visits, she was again GAS+ and was given additional antibiotics. Later, she developed non-pruritic rash, dermatographia, and blepharitis;skin biopsy showed non-vasculitic progressive pigmented purpura. An extensive rheumatologic, post-infectious, and paraneoplastic workup was unrevealing. Notably, she had high anti-COVID-19 spike antibody on qualitative assay. During workup, her symptoms rapidly worsened, leading to admission. On exam, she had intact sensation, profound gait imbalance, and HR to 150s with standing. LP was negative;EMG ruled out large fiber polyneuropathy (LFPN). She was diagnosed with autoimmune small fiber polyneuropathy (SFPN) and POTS. She improved rapidly with IVIG and steroids. Given her negative workup, the COVID-19 vaccine was identified as the likely trigger. IMPACT/DISCUSSION: Despite being common, SFPN is undiagnosed in many patients, likely due to its non-specific symptoms and low awareness among physicians. Furthermore, SFPN and LFPN often coexist, complicating the diagnosis of SFPN which typically requires confirmatory skin biopsy. Postvaccine SFPN has been described, including a milder case following the Pfizer COVID-19 vaccine. Symptoms typically progress chronically, follow a Guillain-Barré-like presentation, and may include dysautonomia. SFPN is thought to be mediated via humoral autoimmunity and autoreactive B-cells. Treatment is immunoglobulins and steroids. That JW's case progressed through the healthcare system for several months prior to diagnosis demonstrates two key points: 1) despite the ubiquity of SFPN, scant diagnostic tools and the subjective and chronic nature of symptoms may result in underdiagnosis;2) given the public discourse around vaccination and the rarity of adverse effects, there may be a tendency to dismiss complaints related to vaccines. Despite JW's early suggestion that the COVID19 vaccine caused her symptoms, post-vaccine syndromes were not considered until late in the course. CONCLUSION: SFPN should be considered in any patient with neuropathy. Clearer diagnostic criteria for SFPN are needed and may improve patient outcomes and enable more clinical trials. COVID-19 vaccination can trigger polyneuropathy. Vaccine-related adverse outcomes should remain on the differential when symptoms begin shortly after vaccination, despite the rarity of such outcomes.

Infections in the structure of comorbid pathology in patients with inflammatory diseases of the joints

Objective: To evaluate the significance of infections in the structure of comorbid pathology in patients with inflammatory diseases of the joint (IDJ) during a single-stage retrospective study. Methods: The study included 437 patients with IDJ (259 women, 178 men, mean age 45 y): 172 -rheumatoid arthritis, 169 -ankylosing spondylitis, 74 -psoriatic arthritis, 22 -undifferentiated spondylarthritis. The majority of patients (n=343) received immunosuppressive therapy (glucocorticoids, methotrexate, leflunomide, biological drugs). The patients were interviewed by a research doctor with the completion of a unified questionnaire. Additional information was obtained from medical records. Results: The following comorbid pathology was documented in patients with IDJ: cardiovascular diseases -30.1%, gastrointestinal diseases -27.2%, respiratory diseases -12.5%, endocrine system diseases -10.9%, urogenital diseases -9.1%, skin diseases, except for psoriasis -4.2%. 653 cases of respiratory tract infections (RTI) and ENT organs and 537 cases of infections of other localization were diagnosed. RTI and ENT organs included acute nasopharyngitis (n=273), tonsillitis (n=110), pneumonia (n=69, including 29 caused by the SARS-CoV2 virus), acute bronchitis (n=54), sinusitis (n=52), influenza (n=47), otitis (n=41), tuberculosis (n=7). Infections of other localizations were represented by herpes-viral infections (n=184), mycoses (n=121), urinary tract infections (n=84), conjunctivitis and blepharitis (n=63), skin infections (n=26), intestinal infections (n=25), genital infections (n=22), osteomyelitis, purulent arthritis, nervous system infections (2 cases each), chronic hepatitis A, B and C, rubella, measles, HIV infection (1 case each). After the debut of IDJ, an increase in the frequency of acute nasopharyngitis, acute bronchitis, sinusitis, herpes-viral infections, and mycoses was noted. Serious infections requiring hospitalization and/or intravenous administration of antibiotics were diagnosed in 78 patients. of these, 64%of cases were caused by RTJ and ENT organs (pneumonia, including those caused by the SARS-CoV2 virus, acute bronchitis, sinusitis, purulent otitis), 36% -by other infections (intestinal infections, purulent paraproctitis, acute salpingitis, purulent endometritis). Conclusion: The problem of infections in patients with IDJ still remains relevant. Further studies are needed on large samples of patients with the aim of studying the prevalence of infections depending on the therapy (primarily, biological drugs), as well as the search for significant risk factors.

Portuguese immunoallergology clinical experience in patients with severe atopic dermatitis under dupilumab treatment

Background: Dupilumab has been recently approved for treatment in patients with severe AD in Portugal-until now there is no published data regarding Portuguese experience in Allergy centers. Method: Cross sectional clinical and laboratory assessment of 33 patients (pts) with moderate to severe AD treated with dupilumab (dupi) for at least 16 weeks (W): prospective evaluation of severity scores (SCORAD-Scoring Atopic Dermatitis, EASI-Eczema Area and Severity Index, P-VAS-Pruritus Visual Analogic Scale), report of adverse events up to 52 weeks of treatment. SCORAD and EASI were assessed in 23 pts at W52, P-VAS in 21 pts at W52. Results: Of the 33 pts, 18 were female (55%) with a mean age (SD, range) of 35.3 years (13.2, 15-60). In 16 pts the age of onset was before 2 years old, mean (SD) disease duration 28.1 years (12);94% patients had a diffuse pattern of skin lesions;97% of pts had allergic rhinitis, 82% asthma, 52% conjunctivitis and 30% food allergy. Median total IgE at baseline was of 6313 U/ml (P25-P75: 2842-12491) with a 76% reduction at W52 in 16 pts. Median eosinophil count at baseline was 520 eosinophils/mm3 (P25-P75: 270-740). Before starting dupi 29 pts had been treated with cyclosporine. At the beginning, 15 pts were under oral corticosteroids, 14 under oral systemic immunosuppressive drugs (all pts but two stopped both until W12 of dupi) and 5 switched from omalizumab. At baseline, median SCORAD and EASI were 69.3 and 24.2 points. At W16, W36 and W52, median SCORAD was 27.4, 22.3 and 21.5, and median EASI 5.3, 4.1 and 2.1. At W16, the EASI-50, EASI-75 and EASI-90 were achieved by 91%, 61% and 18% pts, and at W52, by 87%, 70% and 52% pts. The mean percentage of SCORAD reduction at W16 and W52 was 55% and 73%;and of EASI was 76% and 82%. At W16 and W52, an improvement of ≥4 points in P-VAS was achieved by 77% and 95% pts. There was a mean reduction of P-VAS at W2, W4, W16 and W52 of 2.6;3.6;4.7 and 6.3 points, respectively. Conjunctivitis was reported in 10 (30%) pts, two of them with keratoconjunctivitis and blepharitis, without needing to interrupt treatment;two pts also had facial erythema. One patient had COVID, and dupilumab scheme treatment was maintained. Conclusion: The majority of AD patients had a significant and consistent improvement in all the severity scores, after one year of treatment with dupilumab. No relevant adverse events were reported.

Increased incidence of chalazion associated with face mask wear during the COVID-19 pandemic.

PURPOSE: To determine whether the incidence of chalazion increased significantly in the San Francisco Bay Area and Los Angeles County following the widespread adoption of face mask wear in response to the COVID-19 pandemic. METHODS: This is a retrospective multicenter study of two ophthalmology institutions: a private Oculoplastics practice in San Francisco and the Oculoplastics division of the Stein Eye Institute at the University of California, Los Angeles. All patients seen during the studied time periods with a diagnosis of chalazion or hordeolum were identified through review of electronic medical records and included in the study. Incidence was determined for each month between January and August 2020, and compared to data from prior years via ANOVA to evaluate for changes after the onset of the pandemic. RESULTS: In San Francisco, the incidence of chalazion rose significantly in June through August of 2020 when compared to the same interval in 2016, 2017, 2018, and 2019. In Los Angeles, the rise in chalazion incidence in 2020 was also statistically significant when compared to data from the years 2018 and 2019. CONCLUSION: Importance: Widespread mask wear does appear to correspond to an increased incidence of chalazion. This risk may be minimized, while still maintaining the protective benefits of mask wear, by taking the proactive measures discussed to decrease mask induced eye dryness and changes in the eyelid microbiome.