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Background: Serological studies can demonstrate pathogen circulation in regional populations and reflect public health mea-sures' effectiveness during different pandemic phases. By late November 2021, coinciding with the third pandemic wave, the sero-prevalence of SARS-CoV-2 spike IgG antibodies among the Iranian population was 32.63%. Objective(s): This study aimed to assess the Iranian population's seroprevalence during the fifth pandemic wave by analyzing donated blood samples. Method(s): This population-based cross-sectional study was conducted on Iranian blood donors referred to all 31 main provincial capitals between August 2021 and September 2021. The participants selected through quota sampling were asked to complete a questionnaire on socio-demographics and coronavirus disease 2019 (COVID-19)-related information. Also, SARS-CoV-2 spike IgG antibodies were measured in serum samples using SARS-CoV-2 enzyme-linked immunosorbent assay (ELISA) kits. The seroprevalence was weighted based on the gender and age groups of the population and then adjusted for test performance. Result(s): Totally 3,339 blood donors participated in this study. The overall population-weighted seroprevalence adjusted for test performance was 52.67% (95% confidence interval (CI): 50.14-55.21). Seroprevalence was higher among participants with a high school diploma (55.45%, 95% CI 50.61-60.29), a positive history of close contact with COVID-19 patients (65.23%, 95% CI 60.83-69.63), and previous positive COVID-19 PCR tests (86.51%, 95% CI 82.32-90.7). Conclusion(s): More than half of the study population was exposed to SARS-CoV-2, indicating a 1.7-fold increase in the seroprevalence between late November 2020 and mid-September 2021. Our finding illuminated the pattern of Iran's fifth wave of the pandemic.Copyright © 2023, Author(s).
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Introduction: Joint bleeding is the main cause of joint pain in hemophilia patients and can lead to chronic joint disease which also happens to be one of the significant causes of disability and joint pain in these patients. Furthermore, ComplexRegional Pain Syndrome (CRPS), despite being a very rare complication, should be considered in cases of persistent intractable pain, especially in the pediatric group. Clinical symptoms in CRPS include severe chronic pain, edema, and decreased range of motion. CRPS management is critical to allowing the function and ability of the joint to restore. Method(s): This study aims to report a hemophilia case with intractable pain and his underlying diagnosis. A 14-year-old severe hemophilia A patient with high titer/responder inhibitor was on on-demand treatment by Bypassing Agents (BPAs). Result(s): During the disease course, his right knee became a target joint due to recurrent bleedings. Consequently, he underwent Radiosynoviorthesis (RSO) and treatment with BPAs. After three days of improving, he got an increasing fever and severe right knee pain. The COVID-19 test result was negative, but Staph. Aureus was found in the synovial fluid, and treatment began with Vancomycin and Rifampin. After several days, his condition and laboratory markers were improved, However, intractable disabling pain remained constant regardless of augmented combination therapy with FEIBA and rFVIIa. Parallelly, morphine was prescribed due to the Pain Management counseling. However, the pain began to rise as the morphine dosage declined. As a result, CRPS proposed to be the leading cause of pain, and after several prolonged special physiotherapy sessions, pain reduced significantly, only one BPA was continued and he was ambulated again. Discussion/Conclusion: The current case indicates that CRPS is a rare complication in patients with bleeding disorders which has been reported rarely till now. Nonetheless, it should be considered a diagnosis in complicated patients with recurrent hemarthrosis due to its debilitating and destructive nature.
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Background: The patients with COVID-19 disease are at high risk for thrombosis. More aggressive thromboprophylaxis anticoagulation are considered in these patients. Several reports indicates a higher HIT incidence in the patients with COVID-19 than other medical patients, Aims: We conducted this study to evaluate the frequency of HIT among patients with COVID-19 in comparison with non-COVID- 19 patients. Method(s): The study population included patients who referred to the Iranian blood transfusion organization (IBTO) reference coagulation laboratory for anti-PF4/ H Ab testing (LFIA method, STic EXPERT, STAGO) during a 30 months period before and after the COVID-19 pandemic in Iran. On 19 February 2020, Iran reported its first confirmed cases of infections in Qom. The patients have been divided into three groups: Group1, Sep 2019-Feb 2020 (before COVID-19 pandemic in Iran), group 2: March 2020-Aug 2020 (the first and second peaks), group 3: Sep2020-Feb 2021 (the third and fourth peaks). The demographic data;4Ts score, Anti PF4-Ab (LIFA), and HIPA test results were evaluated. The HIPA test was checked in cases with the positive result of LFIA test. Result(s): A total number of 110 patients have been referred for anti- PF4 Ab testing to our laboratory center during a 30 months period with the detail in table 1and 2. The rate of positive LFIA was 10 % and 33% in the non-Covid- 19 and Covid-19 patients respectively (OR = 4.1%, 95% CI, P-value: 0.022). HIPA test was assessed in 4 cases of Covid-19 and all were positive (definitive HIT). Conclusion(s): Among 110 referral cases in 30 months period who were referred for Anti PF4/H Ab testing to our lab, 94 ( 85%) of cases were referred during the first year of the Covid-19 pandemic in Iran. Regarding the rate of definite HIT (>=16%) among Covid-19 patients, our data confirm the high rate of HIT in this group of patients. (Table Presented).
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Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients. Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients. Methods: This study was performed on 50 consecutive COVID-19 patients with severe/critically ill disease. Severe disease was defined as having at least one of the following symptoms: shortness of breath, respiratory frequency ≥ 20/min, blood oxygen saturation ≥ 93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, lung infiltrates > 50% within the last 24-48 h. Critically ill disease was identified by intensive care unit admission, respiratory failure, septic shock, or multiple organ dysfunction or failure. Primary outcomes included the safety of CP transfusion, 14-day and 30-day survival rate, and change in lung computed tomography (CT) scan score. Several other clinical and laboratory features were evaluated as the secondary outcomes. Results: Based on the results, 21 out of 50 consecutive patients were on mechanical ventilation at the time of CP transfusion. In total, 32 patients (64%) survived 30 days after CP transfusion. The survival rates were 74% and 44% in patients who received CP < 7 and ≥ 7 days after admission, respectively. While 92% of patients without mechanical ventilation survived, the survival rate of patients on mechanical ventilation was 29%. Moreover, the CT scan score and some other clinical features were improved in the group that received CP transfusion, and no adverse effects were observed. Conclusion: The CP transfusion is a safe and effective treatment in severe/critically ill COVID-19 patients. The best outcome can be achieved in patients who are not on mechanical ventilation, especially early in the disease course.
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Background: Convalescent plasma (CP) transfusion is one of the suggested treatments for Coronavirus disease 2019 (COVID-19) especially in critically ill patients. Objectives: This study aimed to investigate the efficacy and safety of CP transfusion were investigated in severe/critically ill COVID-19 patients.
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Background: In December 2019, a new coronavirus appeared in China, as a cause of acute respiratory disease. Healthcare Workers (HCWs) in children's hospitals are one of the groups who are at a high rate of exposure to COVID-19 patients. The detection of antibodies is useful and helps diagnose late or recent SARS-CoV-2 infection. Most children may present with asymptomatic or mild SARS-CoV-2 infection and can be silent sources of infection in the community and hospitals. Objectives: This study was conducted to determine the antibodies (IgM and IgG) against SARS-CoV-2 in Mofid children's hospital staff. Methods: This cross-sectional study evaluated 475 staff from Mofid children's hospital from April 20 to May 5, 2020, in Tehran. We collected blood samples for the antibody assay with a rapid test kit. A questionnaire was used to collect demographic and clinical data. Results: Of 475 staff who participated in this study, 25 (5.3%) were diagnosed with COVID-19 by Polymerase Chain Reaction (PCR) and/or CT scan. Besides,140 (29.4%) of them were positive for IgM and/or IgG SARS-CoV-2 antibodies. Conclusions: The seropositivity of antibodies against SARS-CoV-2 among children's hospital staff was higher than expected. Approximately 5% of the participants were diagnosed as definitive positive COVID-19 cases by PCR and/or CT scan, but 29.4% of them were seropositive. The difference is a warning, as it shows seropositive people could be silent sources of transmission during asymptomatic infection.
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Background: Coronavirus disease 2019 (abbreviated as COVID-19) is a mysterious respiratory syndrome symptomatically spanning from healthy carriers to patients with life-threatening complications, in some cases, leading to a mournful death. For the time being, the contributory role of hematologists is much more recognized in the management of COVID-19, since the emergence of coagulopathy has recently been the focus of many studies in SARS-CoV-2 infection. Methods: To provide a well-conceptualized viewpoint demonstrating the prognostic value of coagulation-related laboratory tests, we planned to perform a meta-analysis of pertinent literature representing information on PT, aPTT, and D-dimer tests in patients with COVID-19. Results: Albeit the estimated pooled means of PT and aPTT were higher in severe cases, their mean values were not significantly higher as compared with patients in a non-severe condition. On the other hand, the mean value of D-dimer in severe patients was significantly higher than non-severe cases (X2=6.34, P=0.01), highlighting that the elevation of this parameter may be associated with the progression of the disease toward an unfavorable clinical outcome. Conclusion: Even though at the time of writing this article the lack of adequate and appropriate studies denotes a major limitation to the current study, planning for the future research to determine the prognostic value of laboratory tests reflecting SARS-CoV-2-induced coagulopathy, mainly D-dimer, will definitively cast a flash of light on the significance of therapeutic anticoagulation at least for those with no absolute contraindication.