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Background: Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs annually. Although most infections are self-limiting, symptoms can be distressing. Many treatments are used to control symptoms and shorten illness duration. Most treatments have minimal benefit and may lead to adverse events. Oral homeopathic medicinal products could play a role in childhood ARTI management if evidence for their effectiveness is established. This is an update of a review first published in 2018. Objectives: To assess the effectiveness and safety of oral homeopathic medicinal products compared with placebo or conventional therapy to prevent and treat ARTIs in children. Search methods: We searched CENTRAL (2022, Issue 3), including the Cochrane Acute Respiratory Infections Specialised Register, MEDLINE (1946 to 16 March 2022), Embase (2010 to 16 March 2022), CINAHL (1981 to 16 March 2022), AMED (1985 to 16 March 2022), CAMbase (searched 16 March 2022), and British Homeopathic Library (searched 26 June 2013- no longer operating). We also searched the WHO ICTRP and ClinicalTrials.gov (16 March 2022), checked references, and contacted study authors to identify additional studies. Selection criteria: We included double-blind randomised controlled trials (RCTs) or double-blind cluster-RCTs comparing oral homeopathy medicinal products with identical placebo or self-selected conventional treatments to prevent or treat ARTIs in children aged 0 to 16 years. Data collection and analysis: We used standard methodological procedures expected by Cochrane. Main results: In this 2022 update, we identified three new RCTs involving 251 children, for a total of 11 included RCTs with 1813 children receiving oral homeopathic medicinal products or a control treatment (placebo or conventional treatment) for ARTIs. All studies focused on upper respiratory tract infections (URTIs), with only one study including some lower respiratory tract infections (LRTIs). Six treatment studies examined the effect on URTI recovery, and five studies investigated the effect on preventing URTIs after one to four months of treatment. Two treatment and three prevention studies involved homeopaths individualising treatment. The other studies used predetermined, non-individualised treatments. All studies involved highly diluted homeopathic medicinal products, with dilutions ranging from 1 x 10-4 to 1 x 10-200. We identified several limitations to the included studies, in particular methodological inconsistencies and high attrition rates, failure to conduct intention-to-treat analysis, selective reporting, and apparent protocol deviations. We assessed three studies as at high risk of bias in at least one domain, and many studies had additional domains with unclear risk of bias. Four studies received funding from homeopathy manufacturers;one study support from a non-government organisation;two studies government support;one study was co-sponsored by a university;and three studies did not report funding support. Methodological inconsistencies and significant clinical and statistical heterogeneity precluded robust quantitative meta-analysis. Only four outcomes were common to more than one study and could be combined for analysis. Odds ratios (OR) were generally small with wide confidence intervals (CI), and the contributing studies found conflicting effects, so there was little certainty that the efficacy of the intervention could be ascertained. All studies assessed as at low risk of bias showed no benefit from oral homeopathic medicinal products, whilst trials at unclear or high risk of bias reported beneficial effects. For the comparison of individualised homeopathy versus placebo or usual care for the prevention of ARTIs, two trials reported on disease severity;due to heterogeneity the data were not combined, but neither study demonstrated a clinically significant difference. We combined data from two trials for the outcome need for antibiotics (OR 0.79, 95% CI 0.35 to 1.76;low-certainty evi
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Background: COVID-19 develops severe inflammatory responses that can lead to death. It is essential in a pandemic to have accessible instruments to estimate the prognosis of the disease. The lymphocyte-to-C-reactive protein ratio (LCR) is a predictive biomarker studied in oncology, which could have some advantages in COVID-19 patients in the early stages of the disease. Our objective was to estimate the risk of LCR < 100 and mortality in hospitalized patients with COVID-19. Methods: hospitalized patients with COVID-19 seen between March to October 2020 were included. The patients were grouped according to LCR < 100 and LCR > 100. A Cox regression model was performed to estimate the association between LCR < 100 and mortality. Results: we included 730 patients with COVID-19. The mean age at diagnosis was 49.9 years (SD 16.8) and 401 (55%) were men. Cox regression model showed an association between LCR < 100 and mortality (HR 6.2;95% CI 1.6 to 23.5;p 0.008), adjusting by age. severe pneumonia, intensive care requirements, and comorbidities. Conclusion: LPCR < 100 in the initial assessment of hospitalized patients with COVID-19 suggests a higher risk of mortality.
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Health jurisdictions have seen a near-disappearance of Respiratory Syncytial Virus (RSV) during the first year of the COVID-19 pandemic. Over a corresponding period, we report a reduction in RSV antibody levels and neutralization in women and infants one year into the COVID-19 pandemic (February - June 2021) compared to earlier in the pandemic (May - June 2020), in British Columbia (BC), Canada. This supports that humoral immunity against RSV is relatively short-lived and its establishment in infants requires repeated viral exposure. Waned immunity in young children may explain the inter-seasonal resurgence of RSV cases in BC as seen also in other countries.
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The coronaviruses belong to the family Coronaviridae in the order Nidovirales. CoVs are found globally and infect a variety of animals, causing illnesses that range from gastrointestinal tract infections, encephalitis and demyelination;and can be fatal. Humans coronaviruses (hCoVs) have traditionally been associated with self-limiting upper respiratory tract infections and gastrointestinal tract infections. In recent years, however, it has become increasingly evident that the hCoVs can cause more severe lower respiratory tract infections such as bronchitis, pneumonia and even acute respiratory distress syndrome (ARDS), and can lead to death. Seven CoVs are known to infect humans, with the four "common cold” CoVs circulating globally on a yearly basis. The remaining three are more pathogenic and have resulted in outbreaks with high mortality rates. This review focussed on the three pathogenic CoVs. © 2022 Elsevier Inc. All rights reserved.
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Objective. To review a literature published over the past 5 years and our own data on the etiology of lower respiratory tract infections (LRTI), antimicrobial resistance and its relationships between sepsis and choice of appropriate antibiotic therapy. Materials and methods. National Nosocomial Infections Surveillance (NNIS) criteria were used to diagnose LRTI. A review of the articles regarding LRTI from the Russian and international English language journals published over 6 years was performed. Identification of microorganisms was performed by culture over the period of 2003-2013;since 2014, MALDI-TOF MS method was used for this purpose. Results. Despite the ongoing policy to limit the use of antimicrobial therapy in the ICUs, there is an increase in carbapenemase-producing isolates in the ICUs from 2.2% (2018) to 11.7% (2020, 9 months). Along with the trend to increase in carbapenemase-producing pathogens causing LRTI, their variability is also increasing. In particular, it applies to strains producing carbapenemases OXA-48 or combination of OXA- 48 with KPC;with the trend to combined production of carbapenemase beginning at 2019. Conclusions. Carbapenemase producers are becoming more widespread in the ICU settings, including the lower respiratory tract in mechanically ventilated patients. Practitioners didn't get used to associate VAP with the Sepsis-3 criteria. The changes in etiology include the increased rate of carbapenem-resistant Enterobacterales and non-fermenting Gram-negative bacteria, primarily Acinetobacter spp., in Russia. It's due to improved quality of respiratory support and increased consumption of carbapenems, tigecycline and polymyxins. Significant increase of OXA-48-producing pathogens is likely to be associated with a poor compliance with temporary guidelines on COVID-19 with regard to antibiotic therapy.Copyright © 2021, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.
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Human mobility triggers how fast and where infectious diseases spread and modelling community flows helps assess the impact of social distancing policies and advance our understanding of community behaviour in such circumstances. This study investigated the relationship between human mobility and the surging incidence of COVID-19 in India. We performed a generalised estimating equation with a Poisson log-linear model to analyse the daily mobility rate and new cases of COVID-19 between 14 March and 11 September 2020. We found that mobility to grocery and retail locations was significantly associated (p < 0.01) with the incidence of COVID-19, these being crowded and unorganised in most parts of India. In contrast, visits to parks, workplaces, and transit stations did not considerably affect the changing COVID-19 cases over time. In particular, workplaces equipped with social distancing protocols or low-density open spaces are much less susceptible to the spread of the virus. These findings suggest that human mobility data, geographic information, and health geography modelling have significant potential to inform strategic decision-making during pandemics because they provide actionable knowledge of when and where communities might be exposed to the disease.
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Background: Robust data of IL-6 is available in bacterial infection, and now it can be utilized in currently ongoing COVID-19 (corona virus disease-19) pneumonia pandemic to guide treatment strategy as marker of inflammation. Methods: Prospective, observational study included 1,000 COVID-19 cases confirmed with RT PCR (reverse transcription polymerase chain reaction). All cases were undergone categorized after clinical details, HRCT (high resolution computerized tomography) thorax, oxygen saturation, IL-6 (interleukin 6) at entry point and follow up. Age, gender, comorbidity and use BIPAP/NIV (bilevel positive airway pressure/non-invasive ventilation), and outcome as with or without lung fibrosis as per HRCT severity were key observations. Statistical analysis is done by using Chi-square test. Results: In study of 1,000 COVID-19 pneumonia cases, age (<50 and >50 years) and gender has significant association with IL-6. HRCT severity score at entry point has significant correlation with IL-6 level (p < 0.00001). IL-6 level has significant association with duration of illness (p < 0.00001). Comorbidities has significant association with IL-6 level (p < 0.00001). IL-6 level has significant association with oxygen saturation (p < 0.00001). BIPAP/NIV requirement has significant association with IL-6 level (p < 0.00001). Timing of BIPAP/NIV requirement during course of hospitalization has significant association with IL-6 level (p < 0.00001). Follow-up IL-6 titer during hospitalization as compared to entry point normal and abnormal IL-6 has significant association with post-COVID-19 lung fibrosis, respectively (p < 0.00001). Conclusion: IL-6 has very crucialrole in COVID-19 pneumonia in predicting severity of illness, progression of illness including 'cytokine storm' and assessing response to treatment during hospitalization and follow-up titers in analyzing post-COVID-19 lung fibrosis.
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Objective: To investigate the quality of life (QOL) of coronavirus disease 2019(COVID-19) patients in the recovery stage of six months after discharge and to analyze the influence factors. Methods: Based on the COVID-19 case registration system whose establishment was led by Beijing University of Chinese Medicine Third Affiliated Hospital, 117 COVID-19 patients in the recovery stage hospitalized in designated hospitals of COVID-19 in Wuhan, Hubei Province from January 17th to March 17th, 2020 were taken as the research objects and were followed up for six months after discharge. The QOL of patients was investigated with the World Health Organization Quality of Life-BREF (WHOQOL-BREF) face to face. The score of the QOL of patients with different clinical characteristics was analyzed and compared. The relationship between different clinical characteristics and the total score of the QOL of patients was analyzed by Pearson correlation analysis. Statistically significant factors were included in the linear regression analysis and the linear correlation equation of the total score of the QOL was obtained. Results: The total score of the QOL of patients in the WHOQOL-BREF scale was 75.79 +or- 13.80 points, the self-evaluation of the QOL was 3.20 +or- 0.78 points, and the self-evaluation of health condition was 2.60 +or- 0.79 points. The total score of the QOL of female patients, patients with high sequelae grade, and patients with history of smoking was lower than that of male patients, patients with low sequelae grade, and patients without history of smoking. The Pearson correlation analysis showed that the typing of the acute stage of COVID-19, sequelae grade, gender, and history of smoking were related to the total score of the QOL of patients at six months after discharge. The linear regression analysis showed that sequelae grade was linearly correlated with the total score of the QOL of patients at six months after discharge. Linear correlation equation was Y=94.179-9.153X. Conclusions: At six months after discharge, COVID-19 patients in the recovery stage were generally dissatisfied with their QOL and health condition. Their overall QOL was relatively low. It was affected by factors such as gender, BMI, underlying diseases, and history of smoking. And the sequelae symptoms had the most significant impact.
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The coronavirus disease 2019 (COVID-19) pandemic in Iran is part of the worldwide pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The present study aimed to demonstrate the clinical characteristics of patients affected by COVID-19, in our tertiary teaching hospital. Medical records and compiled data of 668 patients with suspected COVID-19 were obtained retrospectively between January to April 2020. The present study outcomes included demographic features of infected patients, underlying diseases and conditions, the relationship between the results of reverse transcription-polymerase chain reaction (RT-PCR) or CT-scan with the manifestations of the disease, mortality rate, and age distribution of fatalities among men and women. The median age of hospitalized patients was 63 years old (from 18 to 94). The patients' chief complaints in the admission time were cough, dyspnea, fever, and gastrointestinal problems, respectively. Hospitalized patients' common comorbidities were hypertension (HTN), and cardiovascular disease (CVD) (24%), diabetes mellitus (DM) (21.5%), asthma, or chronic obstructive pulmonary disease (COPD) (6%), or other underlying diseases (15.5%). One-third of patients had no comorbidity according to the data of medical records. In hospitalized patients, 169 (84.5%) had positive RT-PCR, and 156 (78%) had positive chest CT findings. The mortality rate of males was higher than females (66.3% vs. 33.3%) and in patients with positive RT-PCR compared to patients with positive chest CT-scan findings. The majority of deaths had a history of DM or HTN/CVD in their medical records. The chief complaint of patients was cough. DM and HTN or CVD were the common underlying disease related to death in hospitalized cases. Besides, the hospitalization and mortality rate in males was higher than in females. About 87% of dead hospitalized cases had positive RT-PCR results, and this rate was 82% for chest CT results.
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Introduction : The Coronavirus disease 2019 (COVID-19) primarily involves respiratory system but may also affect the Cardiovascular System leading to abnormal ECGs. Its early recognition is crucial as it may be associated with increased mortality. Hence we aimed to find out various Electrocardiographic (ECG) manifestations of COVID- 19 patients admitted in a Tertiary Care Hospital and its relation to disease severity. Methods : We performed a hospital-based retrospective observational study between April, 2021 to November 2021 and analyzed the ECG changes at admission by three Cardiologists according to standard definitions and diagnostic criteria. Results : Out of 579 patients, ECG of 473 was available for analysis. ECG was normal in 227 (48%) and abnormal in 246 (52%) patients. Most common abnormal ECG finding in COVID19 patients was Sinus Tachycardia(19.5%) and less common findings were Sinus Bradycardia (5.3%), Incomplete Right Bundle Branch Block (RBBB) (3.2%), atrial fibrillation (2.5%), complete RBBB (2.3%), atrial premature complexes (2.3%), S1Q1T3 pattern (2.1%), first degree AV block (1.5%), ST-T wave changes (1.3%), Atrial flutter (1.1%). In mechanically ventilated patients, incidence of acute Right Ventricular Pressure Overload (RVPO) related ECG findings were more frequent. Conclusion : There is a wide spectrum of ECG manifestations in COVID-19 patients which varies depending upon the severity of COVID as well as prior Cardiovascular status, associated comorbidities and need for ventilatory support. Knowledge of ECG changes might help in risk stratification and triaging of COVID-19 patients.
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Background: Severe acute respiratory illness due to SARS-CoV-2 represents great global public health concern. The spectrum of disease ranges from mild to life-threatening. Surveillance of hospitalized patients with severe acute respiratory infections (SARI) is an important public health tool used to identify etiologies to understand the disease, track changes in circulating viruses and as an alert mechanism for potential pandemic viruses. We aim to find out the rate of SARS-CoV-2 positivity in SARI cases and further study the epidemiological and clinical characteristics of patients. Material & Methods: A Prospective study was conducted on 200 Severe Acute Respiratory Illness patients admitted at tertiary care hospital. The clinical, demographic, epidemiological, risk factors / co-morbidities of all the patients were recorded. Oropharyngeal and nasopharyngeal samples were collected and tested for SARS-CoV-2 by real time reverse transcriptase (RT-PCR) test. Results: Out of 200 SARI patients, 51 (25.5%) were tested positive for SARS-CoV-2. Maximum cases (54.90%) were in the age group of 41-60 years;males were infected predominantly (52.94%). The most common symptoms of presentation were fever (100%), cough (86.27%), dyspnoea (82.35%) and sore throat (56.86%). Comorbidities associated with COVID-19 were Hypertension (56.86%), Diabetes Mellitus (33.33%), Chronic Obstructive Pulmonary Disease (13.72%) and Coronary Artery disease (9.8%). More than 30% of the patients were admitted in ICU and 9.80% received mechanical ventilation. Conclusions: Evaluation of clinical and epidemiological profiles of SARI patients can help in understanding and managing the outbreak more efficiently. Close monitoring and quarantine will be required to prevent extensive transmission within the community.
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Objective: To analyze the endemic characteristics of SARS-CoV-2 Omicron variant in Sanya, and to provide reference for the prevention and control of the Omicron variant. Methods: The information of coronavirus disease 2019 (COVID-19) infected persons (asymptomatic infected persons and confirmed cases) in Sanya City from August 1 to September 19, 2022 was collected through the Infectious Disease Reporting Information System of the Chinese Information System for Disease Control and Prevention. SPSS 25.0 software was used to analyze and compare the epidemiological characteristics of this Omicron variant outbreak between confirmed cases and asymptomatic infected persons. Results: A total of 15 651 cases of COVID-19 infection were reported in Sanya including 9 057 asymptomatic infections (57.87%) and 6 594 confirmed cases (42.13%), there were 0 deaths. The age ranged from 0 to 107 years old in which 0 to 5 years old, 6 to 18 years old, 19 to 64 years old and above 65 years old accounted for 5.64%, 15.03%, 71.83% and 7.51% respectively. The mean age of confirmed cases was (43.26..0.27) years old, which was significantly older than (31.89..0.16) years old of asymptomatic infection (Z=-37.89, P < 0.001). Sex ratio between men and women was 1:1.12. The occupation was mainly business service (8 239, 52.64%). The districts were mainly concentrated in Gangmen Village community of Jiyang District (10.02%), Danzhou Village community of Tianya District (9.69%) and Linchun Community of Jiyang District (8.11%). Asymptomatic and confirmed cases were 57.87% and 42.13% respectively. The differences between asymptomatic infected and confirmed cases in terms of gender, occupation and detection method were statistically significant (X2=17.63,1 632.44, 179.35, P all<0.001);the length of hospitalization of asymptomatic infected and confirmed cases was statistically significant (Z=-12.467, P < 0.001). Conclusions: This novel coronavirus outbreak was caused by Omicron BA.5.1.3 variant, which was discovered for the first time in China. The epidemiological mode is an outbreak mode, and the new Omicron variant is more insidious and infectious, and fast and decisive measures are needed to prevention and control the epidemic.
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We provide a study of the Covid-19 spread in Bulgaria in the period starting December 15, 2021 until early February, 2022. In particular, we provide predictive scenarios for the peak of the pandemic. Based on these scenarios, we estimate the risks in terms of fatalities in the case no restrictive measures are imposed. The main challenge is distinguishing the influence of the Delta variant which is still dominating in December, 2021, while Omicron becomes dominant in early January, 2022.
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Background: The severe acute respiratory syndrome coronavirus called the novel coronavirus caused the pandemic coronavirus disease 19 (COVID-19). All over the world, SARS-CoV-2 pneumonia is causing significant short-term morbidity and mortality, but the medium-term impact on lung function and quality of life of affected patients is still unknown. Aims: To assess clinical, laboratory, and radiological parameters of COVID-19 Patients and to correlate radiological findings and disease severity among patients. Methodology: In this retrospective observational study a total of 630 patients with radiologically confirmed pneumonia and COVID-19 RT PCR positive were included from a tertiary care centre in Pune, Maharashtra, following their voluntary informed consent. Patients underwent clinical, laboratory, and radiological investigations. Results: It was observed that the majority 174 (27.6%) were in the age group of 31 to 40 years and male predominance was observed compared to female. The majority of the patients 314 (49.8%) had mild, 232 (36.8%) were moderate and 84 (13.3%) had severe illness as per CT scores (HRCT Chest score). Mean BSL levels were 181 +or- 81.44, mean pulse rate was 94.03 +or- 14.93 bpm, mean respiratory rate was 22.84 +or- 3.71cpm, systolic blood pressure was 129.09 +or- 13.18 mmHg, diastolic blood pressure was 82.80 +or- 9.67 mmHg and mean temperature was 98.56 +or- 1.67 degrees F. The mean ferritin levels were 181 +or- 81.44, the mean LDH level was 94.03 +or- 14.93, mean HbA1C was 7.45 +or- 1.68. The mean NLR was 5.51 +or- 2.41, the mean WBC count was 7238.38 +or- 4942.23 and the mean hematocrit was 39.69 +or- 4.80. The mean D dimer level was 402.29 +or- 424.70, median levels were 260 (170-450). 503 (79.8%) had CRP levels more than 5 and 127 (20.2%) had levels less than 5. The mean duration of hospital stay was 9.18 days +or- 4.34 days. Majority 570 (90.5%) had fever, 493 (78.3%) had cough, 286 (45.4%) had breathlessness, 66 (10.5%) had sore throat. Other symptoms include vomiting, and loose motion in 17 (2.7%). Among 630 subjects included in the present study, the majority 584 (92.7%) have recovered/were discharged from the hospital and 46 (7.3%) succumbed to the illness. The mean SGOT and SGPT levels were 44.86+or- 31.29 and 43.60 +or- 31.25 respectively. Mean serum creatinine and BUN levels were 0.87+or- 0.80 and 13.96 +or- 9.46 respectively. The mean values of pulse rate, systolic blood pressure, diastolic blood pressure, respiratory rate and temperature showed an increasing trend across the grades of severity. Conclusion: We concluded that age, gender, blood sugar level, blood pressure, clinical symptoms, comorbidities, inflammatory biomarkers and CT severity score were independently associated with the severity and mortality based on our findings.
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Surgeons were facing considerable ethical dilemma during this COVID-19 pandemic-whichpatient to select for surgery and which patient to be deferred for a later date. Surgeons also had a difficult taskof protecting themselves and their team and perform a safe surgery without infecting the patient. There were also ethical issues of using Oxygen or an Intensive Care Unit (ICU) bed during this time for the surgical patient when it was in short supply. A critical factorwas balancing the benefit of surgery for the patient against the risk of contacting the COVID-19 virus and the complications of the disease process.
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This article sums up the possible impact of honey in the amelioration of COVID-19 induced recognized pathogenesis. The pandemic due to the current outbreak of COVID-19 infected thousands of individuals round the globe. The indicator of COVID-19 infection suggests that increased inflammation, oxidation, and an overstressed immune reaction are key contributor of COVID-19 pathogenesis. This overstressed immune response leads to numerous cytokine production and consequently and led to the development of severe injury in lungs (ALI)/acute respiratory distress disorder and in some conditions becomes reason of death. Honey is formed when honey bees collect nectar from various, and then process it to form the honey. It is a natural remedy to reduce the incidence of various diseases, due to its potential anti-inflammatory, anti-oxidative, immune booster, antiviral, anti-diabetic, antimicrobial, anti-proliferative, cardiovascular, neurological and gastrointestinal diseases and anti-metastatic properties. Honey has been used for the curing of bronchial asthma, throat infections, tuberculosis, thirst, hiccups, fatigue, and hepatitis and also for the ALI/ARDS treatment caused by virus or any other pathogen. Doctors recommend honey as a nutritional supplement to boost the immunity of patients under critical conditions, reducing oxidative stress, inflammation, viral infections that confirm that honey may be used to combat the infection and other complications caused by COVID-19 pandemic. There are many reports which reveal that honey may be used in bacterial and viral infections such as COVID-19, however, further experimental studies are required to validate these speculations.
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With the COVID-19 outbreak hitting the world, the frequency and severity of port congestion caused by various factors are increasing, challenging the stability of international supply chains. Thus, it is necessary to conduct an in-depth study on congestion risks to reduce their adverse impacts on congestion. Although traditional criticality analysis techniques may be capable of ranking port congestion risk in common scenarios, new risk analysis methods are urgently required to tackle uncertainty along with the COVID-19 pandemic. This paper develops a methodology designed for the identification and prioritization of port congestion risk during the pandemic. First, a novel congestion risk assessment model is established by extending the risk prioritization index (RPI) suggested by failure mode and effects analysis (FMEA). Next, the combination of fuzzy Bayesian reasoning, AHP and the variation coefficient method is incorporated into the model in a complementary way to facilitate the treatment of uncertainty and quantitative analysis of the congestion under the different influence of risk factors in ports. Finally, the mode introduces a set of risk utility values for calculating the RPI for prioritization. A real case study and a sensitivity analysis were carried out to illustrate and validate the proposed model. The results proved that the applied method is feasible and functional. In the illustrative example, the top three risk factors are "Interruption of railways/barges services", "Skilled labor shortage" and "Shortage of truck-drivers/drayage truck". The findings obtained from this paper could provide useful insights for risk prevention and mitigation.
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The outbreak of a novel coronavirus in Wuhan, China, in December 2019 led to a global crisis and a critical threat to the health of millions of people worldwide. Existing research indicates that besides typical respiratory symptoms and signs of COVID-19, gastrointestinal manifestations are also caused by coronavirus disease 2019 (COVID-19) and the main intention of this article is to compare the gastrointestinal disorders seen in patients infected by the virus as well as study the possible and logical mechanisms that may lead to these situations. The high rate of contagion of the virus and the number of current patients reveal the importance of this research and all other studies related to this subject.
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Background: Psoriasis is a chronic and inflammatory skin disease. Many triggering factors can cause exacerbation of psoriasis, such as infection, trauma, and drugs. Several vaccines are known to cause new lesions or exacerbation of psoriasis, including Bacillus Calmette-Guerin (BCG), influenza, tetanus-diphtheria, and pneumococcal polysaccharide. In the COVID-19 pandemic, the COVID-19 vaccine is known to cause the appearance of new lesions or exacerbation of psoriasis. Case presentation: A woman, 31 years old, came to the clinic with itchy reddish patches with white scales on her face, chest, stomach, back, arms, and both legs, and increased since 2 weeks ago. Previously, the patient got the first COVID-19 vaccine (Sinovac), and three days later, red patches appeared with white scales on the chest, stomach, and back. The patient had been diagnosed with psoriasis 3 years ago. Dermatology examination showed reddish patches with white scales on the face, chest, stomach, back, arms, and both legs. Auspitz sign and Kaarvetsvlek phenomen were positive. PASI score was 9,2. Dermoscopy examination showed red dot distribution on light pink background and white scales. She was treated with desoximetasone cream 0,05% twice a day and cetirizine tablet 10 mg once a day. After 2 months of therapy, reddish patches were decreased, and the PASI score was 6,9. Conclusion: COVID-19 vaccine can cause exacerbations in psoriasis patients, but this vaccine can still be given to psoriasis patients. It is based on the documented efficacy of the COVID-19 vaccine in the prevention of severe COVID-19 infection and fatality. Psoriasis patients should be consulted before getting vaccinated for COVID-19, and prompt clinical visits should be available if exacerbation develops.
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This work analyses the construction of social isolation as a public problem during the first wave of COVID-19, drawing on experiences in Rio de Janeiro which, in addition to being one of the country's major cities, had among the highest mortality rates in Brazil in 2020. We consider both the legal measures enacted by government agencies to contain the contagion and media coverage on the effects of these measures at the local level. The results show that, in the absence of compulsory confinement measures, urban public spaces were deployed both by government agencies and the media in a process by which social isolation was framed as a public problem. Legal measures affected daily patterns of movement, mobility, and sociability, and intervened in the dynamics of central urban functions and in access to and use of public spaces. Media reports gave voice to levels of public agreement or disagreement with regulations and emphasised the significance of legal measures to contain the spread of the virus. Public spaces are at the core of debates about compliance with legal measures to enforce social isolation because they are privileged places where social issues become visible and problematic material expressions of relationships between citizens and the law.