Severe Covid-19 in pregnant and postpartum women admitted to an intensive care unit: A retrospective cohort study.

BACKGROUND: SARS-CoV-2 infection is associated with worse maternal and fetal outcomes. This study aims to describe the characteristics of pregnant and postpartum women with severe Covid-19 admitted to ICU. METHODS AND FINDINGS: It's a retrospective cohort study evaluating pregnant and postpartum women referenced to a specialized ICU between May 2020 and June 2022. Covid-19 was confirmed with RT-PCR or rapid antigen test on a nasopharyngeal swab. Variables were described by median and IQR when numerical, and by frequency and percentage when categorical. OR with 95% CI were calculated for the evaluation of factors related to death. P-values were calculated using Pearson's ꭓ2-test, Fisher's exact test, Wilcoxon rank sum test, and Kruskall-Wallis test, and statistical significance was established as < 0·05. Missing data were excluded. All statistical analysis were performed using R software version 4.2.2. Of the 101 admissions, 85 (84·2%) were of pregnant women. Obesity (23·0%) and systemic arterial hypertension (13·0%) were the most prevalent medical conditions. Sixty-six (65·3%) were admitted using some type of oxygen support. Forty-seven (46·5%) evolved to mechanical ventilation. There were 61 events considered obstetric complications, with 8 stillbirths/fetal losses. The overall lethality was 15·8%. Pregnancy interruption, need for non-invasive mechanical ventilation, level of oxygen support at admission, prone maneuver, hemodialysis, and healthcare-related infections were factors associated with death. Evaluating the WHO 7-category ordinary scale, there was a trend of increase in the risk of death with higher punctuation, with a statistically significant difference of women with 5 (OR = 7·27; 95% IC = 1·17-194; p = 0·031) or 6 points (OR = 12·0; 95% IC = 1·15-391; p = 0·038) when compared to the ones with 3 points, i.e., of women admitted with a high-flow non-rebreathing mask or invasive mechanical ventilation, compared with the ones admitted at room air, respectively. The main limitations of this study are the relatively small number of participants, and the use of data derived of medical records-which are susceptible to misclassification and variable amounts of missing data. CONCLUSIONS: Pregnant and postpartum women with severe Covid-19 have high lethality and a high incidence of clinical and obstetric complications. These findings support that this population should be prioritized in public health strategies that address Covid-19.

Intravenous Ceftriaxone on an Outpatient Basis in the Treatment of Ocular Syphilis.

PURPOSE: The goal of this study is to describe the clinical and laboratory outcomes of patients with syphilitic uveitis treated with 2 g intravenous Ceftriaxone daily on an outpatient treatment basis for 14 days, in the setting of the COVID pandemic and lack of hospitalization availability. METHODS: This study included a review of the clinical records from patients from January 2020 to December 2021 and who were then followed for 6 months at the Research Laboratory of Infectious Diseases in Ophthalmology of the National Institute of Infectious Diseases Evandro Chagas (INI) FIOCRUZ, Rio de Janeiro, Brazil. CONCLUSION: This study showed that almost all of the 15 patients were well treated for ocular syphilis with Ceftriaxone without any signs of therapeutic failure with documented clinical improvement and satisfactory decreasing VDRL titers.