RESUMO
The coronavirus disease 2019 (COVID-19) pandemic has a significant impact on the immune system. This is the first and largest study on pre-existing immune thrombocytopenia (ITP) patients infected with COVID-19 in China. We prospectively collected ITP patients infected with COVID-19 enrolled in the National Longitudinal Cohort of Hematological Diseases (NICHE, NCT04645199) and followed up for at least 1 month after infection. One thousand and one hundred forty-eight pre-existing ITP patients were included. Two hundred and twelve (18.5%) patients showed a decrease in the platelet (PLT) count after infection. Forty-seven (4.1%) patients were diagnosed with pneumonia. Risk factors for a decrease in the PLT count included baseline PLT count <50 × 109/L (OR, 1.76; 95% CI, 1.25-2.46; p = 0.001), maintenance therapy including thrombopoietin receptor agonists (TPO-RAs) (OR, 2.27; 95% CI, 1.60-3.21; p < 0.001) and previous splenectomy (OR, 1.98; 95% CI, 1.09-3.61; p = 0.03). Risk factors for pneumonia included age ≥40 years (OR, 2.45; 95% CI, 1.12-5.33; p = 0.02), ≥2 comorbidities (OR, 3.47; 95% CI, 1.63-7.64; p = 0.001), maintenance therapy including TPO-RAs (OR, 2.14; 95% CI, 1.17-3.91; p = 0.01) and immunosuppressants (OR, 3.05; 95% CI, 1.17-7.91; p = 0.02). In this cohort study, we described the characteristics of pre-existing ITP patients infected with COVID-19 and identified several factors associated with poor outcomes.
Assuntos
COVID-19 , Púrpura Trombocitopênica Idiopática , Trombocitopenia , Humanos , Adulto , Púrpura Trombocitopênica Idiopática/epidemiologia , Púrpura Trombocitopênica Idiopática/terapia , Estudos de Coortes , Estudos Prospectivos , Trombocitopenia/epidemiologia , Trombocitopenia/etiologia , Trombopoetina , Proteínas Recombinantes de Fusão , Receptores Fc , HidrazinasAssuntos
Face , Doenças Hematológicas , Mutação , Púrpura Trombocitopênica Idiopática , Tireoidite Autoimune , Doenças Vestibulares , Humanos , Doenças Vestibulares/genética , Doenças Vestibulares/complicações , Púrpura Trombocitopênica Idiopática/genética , Púrpura Trombocitopênica Idiopática/complicações , Doenças Hematológicas/genética , Doenças Hematológicas/complicações , Face/anormalidades , Face/patologia , Tireoidite Autoimune/complicações , Tireoidite Autoimune/genética , Feminino , Anormalidades Múltiplas/genética , MasculinoRESUMO
INTRODUCTION: Assessing the effects of non-pharmaceutical interventions (NPIs) and vaccines on controlling the coronavirus disease 2019 (COVID-19) is key for each government to optimize the anti-contagion policy according to their situation. METHODS: We proposed the Braking Force Model on Virus Transmission to evaluate the validity and efficiency of NPIs and vaccines. This model classified the NPIs and the administration of vaccines at different effectiveness levels and forecasted the duration required to control the pandemic, providing an indication of the future trends of the pandemic wave. RESULTS: This model was applied to study the effectiveness of the most commonly used NPIs according to the historic pandemic waves in different countries and regions. It was found that when facing an outbreak, only strict lockdown would give efficient control of the pandemic; the other NPIs were insufficient to promptly and effectively reduce virus transmission. Meanwhile, our results showed that NPIs would likely only slow down the pandemic's progression and maintain a low transmission level but fail to eradicate the disease. Only vaccination would likely have had a better chance of success in ending the pandemic. DISCUSSION: Based on the Braking Force Model, a pandemic control strategy framework has been devised for policymakers to determine the commencement and duration of appropriate interventions, with the aim of obtaining a balance between public health risk management and economic recovery.