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1.
Pediatric Infectious Disease Journal ; 42(1):E39, 2023.
Article in English | EMBASE | ID: covidwho-2190917
2.
Annals of the Rheumatic Diseases ; 81:1639, 2022.
Article in English | EMBASE | ID: covidwho-2009111

ABSTRACT

Background: Glucocorticoid (GC) use is well established in the treatment of rheumatics diseases, particularly rheumatoid arthritis (RA). The use of low dose GC has been endorsed by EULAR recommendations for the management of rheumatic and musculoskeletal diseases even if in the context of SARS-CoV-2, but long-term use is generally discouraged. Objectives: To estimate the prevalence of glucocorticosteroids induced osteoporosis (GIOP) on bone mineral density (BMD) in African adult patients with infammatory rheumatic diseases. Methods: For this systematic review and meta-analysis, PubMed, Google Scholar, Scopus and African index medicus were systematically searched up to December 2020 without language restrictions. We included studies as follows: population-based or hospital-based study, study with sufficient information to estimate the prevalence of GIOP and osteoporotic fractures in African patients with rheumatic disease. Searches were limited to peer-reviewed full text articles. A standardized data extraction form was used to collect information from eligible studies. A random-effects meta-analysis was conducted to obtain the pooled prevalence of GIOP in these studies. The meta-analysis was strati-fed by geographical region. The study is registered with PROSPERO, number CRD42021256252. Results: Our search identifed 8571 studies, of which 8 studies were included in the systematic review from only four African countries and 7 studies in the meta-analysis. The pooled prevalence of osteoporotic fractures in our study was 47.7% (95% CI 32.9-62.8) with 52.2% (95% CI 36.5-67.6) in North Africa and 15.4% (95% 1.9-45.4%) in South Africa (SA). There was no evidence of publication bias, although heterogeneity was high (p=0.018). There was no data from sub-Saharan Africa apart from the two studies from SA. Conclusion: The overall prevalence of GIOP in African adult patients with infam-matory rheumatic diseases was high at 47.7% (95% CI 32.9-62.8). Meta-analysis calculation revealed patient geographic origin as possible confounding factors of the proportion outcomes and further studies are required.

3.
Fertility and Sterility ; 116(3 SUPPL):e90, 2021.
Article in English | EMBASE | ID: covidwho-1880434

ABSTRACT

OBJECTIVE: COVID-19 has influenced family building, delayed fertility care, and affected people's decisions about where to live.We sought to understand differences in movement of cryopreserved reproductive tissue before and during the pandemic. MATERIALS AND METHODS: This was a retrospective cohort study of patients who transported tissue into or out of a single academic fertility center in New York City (NYC). Tissue transport was compared the year before (PRE, 4/1/2019-3/31/2020) and after (DUR, 4/1/2020-3/31/2021) the height of the COVID-19 pandemic in NYC, an epicenter. The primary outcome was the number of patients transporting tissue DUR compared to PRE. Secondary outcomes were the number of geographic changes, type of tissue, geographic origin/destination, and type of movement (in or out). Statistical analyses were performed using Kolmogorov-Smirnov, Wilcoxon Signed Rank Sum, Chi-Square, and Fisher's Exact tests with p<0.05 considered significant. RESULTS: A total of 367 tissue transports were included, with similar rates between cohorts (PRE 46.3% (170/367) vs DUR 53.7% (197/367), p=0.16). The median age at transport was the same (PRE 41 (range 29-54) vs DUR 41 (range 28-54) years, p=0.54). A similar amount of tissue was transported in (PRE 30.0% (51/170) vs DUR 35.0% (69/197)) and out (PRE 70.0% (119/170) vs DUR 65.0% (128/197), p=0.32). Patients were more likely to transport embryos pre-pandemic (37.6% (64/170) oocytes vs 61.8% (105/170) embryos, PRE) and oocytes during COVID-19 (51.8% (102/197) oocytes vs 44.2% (87/197) embryos, DUR) (p<0.01). A subgroup analysis excluding tissue moved for a gestational carrier or donor gametes found a similar number of transports were due to patient geographic relocation (PRE 50.0% (61/122) vs DUR 40.5% (60/148), p=0.12). Examination of geographic origin and destination of tissue PRE vs DUR produced no identifiable trends (p=0.38). Timing of tissue transport varied. The monthly transport rates were relatively even PRE (average 8% per month). However, during the pandemic, there were few transports in the beginning (April-May 2020, 0-1% per month) followed by a peak of transports in June-August 2020 (10-11% per month) and February-March 2021 (11-16% per month) (p<0.01). Transport activities were impacted by closure of clinics and courier service availability. CONCLUSIONS: The rate of cryopreserved tissue movement did not differ in the year before versus during the pandemic at our center, despite being in a COVID-19 epicenter, although transport activities were concentrated into fewer days. There was peak movement of tissue three months after the pandemic onset and roughly one year from the start of the pandemic. The type of tissue transported shifted to favor oocytes during the pandemic, warranting more investigation in how COVID-19 impacted family building activities. IMPACT STATEMENT: Despite the impact of COVID-19 on reproductive and place of living choices, the pandemic did not affect the amount of cryopreserved tissue that was relocated. However, insight into the increased movement of oocytes and potential impacts on warming outcomes or timelines is necessary.

4.
Blood ; 138:4070, 2021.
Article in English | EMBASE | ID: covidwho-1582214

ABSTRACT

Background: The COVID-19 disease has spread throughout the world in an unprecedented way. France and Brazil confirmed the first cases in the European and South American regions with high incidence rates at the peak of the first wave of contamination along the year 2020. Patients with hematological disorders, especially malignancies, may be more vulnerable to SARS-CoV-2 infection because of the underlying disease and treatment. Since COVID-19 presentation is heterogeneous, from asymptomatic up to severe life-threatening forms and the patients with malignancies and COVID-19 admitted to the hospital show a wide range of clinical manifestations and laboratory abnormalities, it is still unclear for clinicians which patients, blood tests at admission and disease factors are associated with worse outcomes. Getting further insights into patients with specific diseases is of particular interest. We aimed to identify profiles of hematologic patients hospitalized with COVID-19 that would be associated with survival, and to assess the differences between cohorts. Methods: A binational cohort including all consecutive hematological patients aged 18 years or more with moderate or severe COVID-19, requiring hospitalization until December 2020 at two tertiary centers, from Paris, France and São Paulo, Brazil, was studied. Patients with a hospital stay of less than 24 hours were excluded. All patients were followed until the end of hospitalization;then, after discharge, survival data was recovered on medical charts or outpatient consultations, if data were available. Patient profiles were based on age, comorbidities, blood tests at admission, COVID-19 symptoms, and hematological disease characteristics. A semi-supervised learning method was first used to obtain the prognostic driven profiles;then, a classifier was identified to allow the classification of patients using only admission (baseline) data. Results: A total of 263 patients (135 from Brazil and 128 from France) were enrolled. Male patients (58.2%), elderly (≥ 65 years, 46%), with high comorbidities prevalence were frequent. Non-Hodgkin Lymphoma (29.3%), multiple myeloma (19.4%) and chronic myeloid disorders (12.9%) were the most frequent underlying hematological malignancies and 13.3% of patients had benign diseases. Most of the patients (59.7%) had undergone chemotherapy in the last six months before COVID-19 admission. The clinical presentation of COVID-19 was similar in the two countries. Fever (68.4%), dyspnea (60.1%) and cough (55.9%) were the main symptoms at admission. The ICU admission (56% versus 25%) and invasive ventilation (42% versus 19%) rates were notably higher among Brazilian patients due to scarce ICU beds during the peak of transmission in France. The overall in-hospital mortality rate was 115/263 (43.7% [95%CI 37.6-49.9]) and the median follow-up after admission was 63 days (IQR 40-98). There was no evidence of survival difference between countries after adjusting on age, comorbidities, and diagnosis. Two clusters were identified, segregating young patients with few comorbidities, low CRP, D-dimers, LDH and creatinine levels, with a 30-day survival of 77.1%, versus 46.7% in remainders. The profiles (clusters) were strongly associated with survival (p<0.001), even after adjusting on age (p<0.001) (Figure 1). We identified a set of rules to classify patients into the two profiles, using only information available at hospital admission, with a high accuracy rate (97.7% on the training set and 84.9% on the validation set). The baseline predictors consecutively selected by the model were the number of comorbidities, creatinine, CRP, a continuous regimen of chemotherapy, platelets and lymphocytes counts, a symptom of ageusia, dyspnea, hematological malignancy, high blood pressure, and symptom of myalgia. Conclusions: This analysis allowed to identify two profiles of hospitalized hematological patients with COVID-19 that have a different outcome when infected with SARS-CoV-2. The results showed the importance of CRP, LHD, and creatinine in COVID-19 prese tation and prognosis, whatever the geographic origin of the patients. The identification of patterns and clinical manifestations experienced by hematological patients during moderate or severe SARS-CoV-2 infection might be helpful to medical staff in the care management and in the allocation of scarce resources. [Formula presented] Disclosures: No relevant conflicts of interest to declare.

5.
Open Bioinformatics Journal ; 14(1):13-20, 2021.
Article in English | EMBASE | ID: covidwho-1581526

ABSTRACT

Background: The ongoing COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). International travels to Australia during the early stages of the pandemic prior to border closure provided avenues for this virus to spread into Australia. Studies of SARS-CoV-2 biogeographical distribution can contribute to the understanding of the viral original sources to Australia. Objective: This study aimed to investigate the clonality and ancestral sources of Australian SARS-CoV-2 isolates using phylogenetic methods. Methods: We retrieved 1,346 complete genomes from Australia along with 153 genomes from other countries from the GISAID and NCBI nucleotide databases as of the 14th May 2020. A representative dataset of 270 Australian and international sequences were resulted from performance of nucleotide redundancy reduction by CD-HIT. We then constructed a median-joining network by Network 10.1.0.0, and phylogenies by IQ-Tree, BEAST and FastTree. The Bayesian statistical dispersal-vicariance analysis (S-DIVA) and Bayesian interference for discrete areas (BayArea) built in RASP were used to reconstruct ancestral ranges over the phylogenetic trees. Results: Two major clusters, from Europe and from Asia, were observed on the network of 183 haplotypes with distinct nucleotide variations. Analysis of ancestral area reconstruction over the phylogenies indicated most Australian SARS-CoV-2 sequences were disseminated from Europe and East Asia-Southeast Asia. Conclusion: The finding is genetic evidence for the geographic origins of the Australian SARS-CoV-2 sequences. Most Australian sequences were genetically similar to those from Europe and East Asia-Southeast Asia, which were also suggested as two main sources of introduction of SARS-CoV-2 to Australia.

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