Más difícil todavía: tratar una glomerulonefritis rápidamente progresiva grave en el seno de una neumonía por COVID-19

We present the case of a male patient with severe SARS-CoV-2 pneumonia, with simultaneous onset of p-ANCA positive rapidly progressive glomerulonephritis. We discuss the different therapeutic possibilities, emphasising the appropriateness of their administration according to the time in the course of the infection.     

无锡市不同人群SARS血清抗体流行病学分析

[目的]通过对不同人群的血清流行病学调查,探索无锡地区不同人群SARS-CoV感染状况,为防控措施提供依据。[方法]选择无锡地区不同人群1180例,采用ELISA法检测血清SARS-CoV抗体。[结果]所有人群的血清标本SARS-CoV抗体均为阴性。[结论]我国SARS流行前后,无锡地区的人群未受SARS-CoV的感染;支持SARS-CoV很少存在隐性感染的观点;在SARS的诊疗过程中,需严格掌握诊断标准,以防诊断过度。     

Impact of COVID-19 epidemic on maxillofacial surgery in Italy

Maxillofacial departments in 23 surgical units in Italy have been increasingly involved in facing the COVID-19 emergency. Elective surgeries have been progressively postponed to free up beds and offer human and material resources to those infected. We compiled an inventory of 32 questions to evaluate the impact of the SARS-COV2 epidemic on maxillofacial surgery in 23 selected Italian maxillofacial departments. The questionnaire focused on three different aspects: the variation of the workload, showing both a reduction of the number of team members (-16% among specialists, -11% among residents) due to reallocation or contamination and a consistent reduction of elective activities (the number of outpatient visits cancelled during the first month of the COVID-19 epidemic was about 10 000 all over Italy), while only tumour surgery and trauma surgery has been widely guaranteed; the screening procedures on patients and physicians (22% of maxillofacial units found infected surgeons, which is 4% of all maxillofacial surgeons); and the availability of Personal Protective Equipment, is only considered to be partial in 48% of Maxillofacial departments.This emergency has forced those of us in the Italian health system to change the way we work, but only time will prove if these changes have been effective.     

Prevalência e Fatores Associados à SRAG por COVID-19 em Adultos e Idosos com Doença Cardiovascular Crônica

BackgroundThe presence of Cardiovascular Disease (CVD) in individuals infected with COVID-19 may imply a worse prognosis.ObjectiveTo describe the prevalence of Severe Acute Respiratory Syndrome (SARS) by COVID-19 and to analyze the factors associated with this condition in adults and the elderly with cardiovascular disease in Brazil until the 30th Epidemiological Week of 2020.MethodsCross-sectional study conducted with data from the Influenza Epidemiological Surveillance Information System (Sistema de Informação de Vigilância Epidemiológica da Gripe – SIVEP-Gripe), referring to the SARS notification forms of hospitalized individuals in Brazil, between the 1st and 30th Epidemiological Week of 2020. Adults and the aged (≥ 18 years old) with CVD. The dependent variable was SRAG confirmation by COVID-19 and factors related to sociodemographic characteristics, signs and symptoms, and clinical factors were analyzed. Poisson regression with robust variance was applied. The level of significance adopted was 5%.ResultsNotifications from 116,343 individuals were analyzed. Of these, 61.9% were diagnosed with SARS by COVID-19. The prevalence of the outcome was 4% lower in women (95%CI: 0.94–0.99) and 18% lower in rural areas (95%CI: 0.77–0.87). There was a higher prevalence in the 50 to 59 age group (95%CI: 1.09–1.48) and in the northeast region (95%CI: 1.72–1.91). Fever, cough, admission to the ICU, use of ventilatory support, and nosocomial cases were also significantly associated with a higher probability of SRAS by COVID-19 in these individuals.ConclusionThere is a high prevalence of SARS by COVID-19 in adults and aged people with CVD in Brazil. Factors associated with sociodemographic and clinical characteristics, signs, and symptoms were associated.     

Impact of mental health on disease activity in mastocytosis during COVID-19 pandemic

BackgroundMast cell-related symptoms might be influenced by mental health status in mastocytosis. In this study, we aimed to investigate the influence of mental health problems developed during the COVID-19 pandemic on the course of mastocytosis.MethodsMental health status in 60 adult patients with mastocytosis was prospectively evaluated with the total Depression-Anxiety-Stress Scale (tDASS-21) and Fear of COVID-19 Scale (FCV–19S) in the lockdown period (LP) and the return to normal period (RTNP) during the pandemic. The disease course was assessed from emergency and outpatient medical reports, including Scoring Mastocytosis (SCORMA) index and serum baseline tryptase levels, by telephone interviews and clinical visits.ResultsThe mean FCV-19S and median tDASS-21 scores were significantly higher in LP than RTNP (p < 0.001) and there was a positive correlation between FCV-19S and tDASS-21 in LP (r = 0.820, p < 0.001) and in RTNP (r = 0.572 p= <0.001). Disease-related symptoms including skin lesions, flushing and anaphylaxis attacks increased in 22 patients in LP, and in this group, mean FCV-19S and median tDASS-21 were higher than those without symptom exacerbation (p < 0.001). During the study period, four (6.7%) patients who experienced COVID-19 recovered without any requirement for hospitalization and had not experienced symptom exacerbation.ConclusionsFear of COVID-19 can be a reason for mental health changes, including depression, anxiety and stress which may further increase mast cell-related symptoms. Therefore, psychological support is important to control the severity of mast cell-related symptoms in mastocytosis during a pandemic.     

[Translated article] Oral Findings in Patients With COVID-19

The aim of this study was to describe oral lesions in a group of patients with COVID-19. We recruited 55 patients, 25 women (45.5%) and 30 men (54.5%), aged between 1 and 89 years with confirmed COVID-19 at different stages of severity. After obtaining informed consent, we examined their mouths and recorded clinical findings. Forty percent of the patients had at least 1 oral lesion. The most common lesions were candidiasis and ulcers (7 patients each); 2 patients had enanthems. Geographic tongue and caviar tongue were also observed. Altered taste, dry mouth, and painful/burning mouth were noted in 60%, 27.3%, and 36.4% of patients, respectively. Oral mucosal alterations and lesions were prevalent in this series of COVID-19 patients. Altered taste and a painful/burning mouth were common symptoms.     

SARS COV-2- IgG antibodies in blood donors in pandemic – A game changer for policy makers

BackgroundA novel beta coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has been identified as the causative pathogen for the present pandemic. The objective of the study was to measure the levels of IgG antibodies targeting the SARS-CoV-2 during the peak period of the COVID-19 pandemic in Odisha State, India to know the magnitude of SARS-CoV-2 exposure, the prevalence of herd immunity in the population, the distribution of IgG-positive cases examined according to ABO blood groups and the number of blood donors with higher neutralizing IgG antibody titre who later on were converted into Plasma Donors donating Convalescent Plasma (CP).MethodThis observational prospective study was conducted for a duration of three months on 1032 number of Blood donors consisting of 1025 number of males and 07 number of females. The samples of donors were subjected to Electro- chemiluminescence immunoassay (ECLIA) to detect SARS-CoV-2 IgG antibodies.ResultOut of 1032 Donors, 370(35.9%) were SARS-COV-2 IgG positive which included 303 donors (29.36%) with neutralizing antibody titre of SARS-COV2 IgG antibodies above 1:80. SARS-COV-2 IgG positive cases consisted of 367(35.8%) male and 3(42.9%) female donors. The number of IgG positive cases were highest in 21–40 years’ age group i.e. 323 out of 869(37.2%). In terms of Blood group, 145(42.4%) out of 342 were from B RhD positive group. Out of 22 donors who were positive with COVID 19 in the past with neutralizing IgG antibody titre more than 1:80, 6(27.3%) persons came for voluntary convalescent plasma(CP) donation.ConclusionA high prevalence of SARS-CoV-2 antibodies was detected among blood donors which indicated a high level of exposure to the virus within the population and development of innate immunity against the virus. Policy makers can add the protocol of antibody testing in the screening of blood donors to enhance the number of Plasma Donation cases for the treatment of serious COVID patients.