ABSTRACT
Introduction. Today, two years after the first outbreak of the novel coronavirus infection (NCI) COVID-19, there is still insufficient data to fully assess risks and pattern of the course of this infectious disease in pregnant women. Aim(s): to conduct a comparative analysis of perinatal pregnancy outcomes as well as clinical and laboratory data in COVID-19 patients at the time of delivery and those suffering from the disease during pregnancy. Materials and Methods. A retrospective comparative study was carried out after analyzing pregnancy and childbirth histories in 191 women admitted for delivery in three obstetric medical organizations of Saint Petersburg in the years 2020-2021. Perinatal outcomes of pregnancy as well as clinical and laboratory data in patients suffering from COVID-19 during pregnancy were analyzed: Group 1-57 patients with asymptomatic and mild form of verified COVID-19;Group 2-50 patients with COVID-19 of moderate and severe course;Group 3-52 patients who underwent COVID-19 in the third trimester of pregnancy. Group 4 (control) consisted of 32 women lacking COVID-19. Results. Comparing delivery outcomes in Group 1 vs. Group 2 revealed a significantly higher rate of urgent deliveries - 54 (94.7 %) and 38 (76.0 %) (chi2 = 7.76) respectively, as well as a significantly lower number of premature births - 3 (5.3 %) and 12 (24.0 %) (chi2 = 7.76) respectively. Comparison of Group 1 vs. Group 3 showed significantly fewer natural births - 33 (57.8 %) and 42 (80.8 %) (chi2 = 6.63) respectively, but a greater rate of caesarean section - 24 (42.0 %) and 10 (19.2 %) (chi2 = 6.63). Comparison of Group 1 vs. Group 4 revealed a significantly higher number of women with acute and progressive fetal hypoxia (fetal distress) - 16 (28.1 %) and 2 (6.3 %) (chi2 = 6.05) respectively. These data allow us to state about an impact of the severity of infectious process SARS-CoV-2-caused disease and its timeframe during pregnancy on the timing and method of delivery. No significant data were obtained that might allow to state that the infectious process directly caused increased rate of premature birth in pregnant women with moderate and severe COVID-19. At hospital admission and discharge, patients with mild and asymptomatic COVID-19 were significantly less likely to have neutrophilia - 5 (8.8%) and 42 (84.0%) (chi2 = 61.2;p < 0.001) respectively, increased aspartate aminotransferase - 4 (7.0 %) and 38 (76.0 %) (chi2 = 53.15;p < 0.001), lactate dehydrogenase (LDH) - 0 (0.0 %) and 12 (24.0 %) (chi2 = 15.41;p < 0.001), C-reactive protein (CRP) - 6 (10.5 %) and 49 (98.0 %) (chi2 = 81.58;p < 0.001), creatinine reduction - 0 (0.0 %) and 11 (22.0 %) (chi2 = 13.98;p < 0.001) respectively. In groups with severe, mild and asymptomatic COVID-19, a strong direct correlation was established the CRP level and leukocyte count, between level of serum CRP and alanine aminotransferase;a less noticeable relationship was observed between serum CRP and LDH concentrations, CRP and total protein level. Conclusion. It was shown that no specific effect of SARS-CoV-2 infection was exerted on majority of parameters related to normal course of labor, as well as on condition of neonates born to patients with COVID-19 of varying severity. In patients with COVID-19 at the time of delivery, changes in clinical and laboratory parameters corresponded to the disease severity. Copyright © 2022 Rostovskii Gosudarstvennyi Meditsinskii Universitet. All rights reserved.
ABSTRACT
The COVID-19 pandemic has exposed the vulnerability of global manufacturing companies to their supply chains and operating activities as one of the significant disruption events of the past two decades. It has demonstrated that major companies underestimate the need for sustainable and resilient operations. The pandemic has resulted in significant disruptions especially in the automotive industry. The goal of the study is to determine impact of the COVID-19 on supply chain operations in a Turkish automotive manufacturer and to develop a framework for improving operational activities to survive in the VUCA (volatility, uncertainty, complexity, and ambiguity) environment. The study identifies how the case study company has been affected by the COVID-19 outbreak and what challenges the company faced during the pandemic. A diagnostic survey and semi-structured interviews were used as data sources with qualitative and quantitative analysis. The results showed that the pandemic led to significant disruptions through various factors explained by shortage of raw materials/spare parts, availability of transportation, availability of labors, demand fluctuations, increase in sick leaves, new health and safety regulations. Findings also show the necessity to re-design resilience supply chain management by providing recovery plans (forecasting, supplier selection, simulation, monitoring) which consider different measures in different stages. In addition, the best practices were recommended for the case study by considering internal, external, and technological challenges during the COVID-19 pandemic. Some of the given targeted guidelines and improvement for the automotive company might be applicable in the industrial practices for other organizations. The article concludes with future research directions and managerial implications for successful applications.
ABSTRACT
Introduction: The COVID-19 pandemic caused by the new coronavirus has led to enormous pressure on health systems around the world, with an increase in the number of hospitalizations for pneumonia with a higher incidence of healthcare-associated infections (1). Material(s) and Method(s): We performed a retrospective analysis of 40 cases hospitalized in the first pandemic wave between March 2020-May 2020, addmited in the Intensive Care Unit of the Clinical Hospital for Infectious Diseases Constanta, including patients with a diagnosis of SARS-CoV-2 infection and Bacterial superinfection. Multiple parameters were analysed: Clinical, biological, bacterial culture results, resistance profile of isolated strains, as well as patient's evolution. Results and Conclusion(s): In terms of patient profile, the average age was 62.3 years, with the male sex being the majority represented by a number of 30 cases (75%). All patients had associated comorbidities. The clinical picture presented by the patients was characteristic of severe forms of infection, with respiratory failure. The observed bio-humoral changes characteristic of bacterial superinfections were found in all patients, leukocytosis with marked neutrophilia, significant biological inflammatory syndrome and positive procalcitonin. During the period analysed we observed a significant increase in carbapenem-resistant strains. The resistant strains were represented by Klebsiella Pneumoniae found in 35 samples (54%), Acinetobacter Buamanni was isolated in 15 culture samples (23%). The antibiotic regimen used consisted of a combination of 2 or 3 classes of antibiotics depending on the resistance profile, monotherapy is not recommended in infections with multi-resistant germs. All patients required oxygen therapy, the average length of hospital stay was 28 days. Death was recorded in 10 cases (25%). Copyright © 2022 Mihai Raluca et al., published by Sciendo.
ABSTRACT
The review presents the results of a combined analysis of literature data and own clinical observations regarding the safety and feasibility of using monoclonal anti-CD20 antibodies in the treatment of B-cell lymphoproliferative diseases during the COVID-19 pandemic. The main points of the pathogenesis of the influence of monoclonal anti-CD20 antibodies on the course of COVID-19 are described. The current trends in the modification of the accepted algorithms of lymphoproliferative diseases therapy with the inclusion of monoclonal anti-CD20 antibodies are summarized, and the possibilities of specific prevention by vaccination against COVID-19 are also considered. Copyright © 2022 ABV-Press Publishing House. All rights reserved.