ABSTRACT
INTRODUCCIÓN: COVID-19 cobró millones de vidas especialmente en la era pre-vacunas. Estudios preliminares mostraban eficacia promisoria del plasma de personas convalecientes anti SARS-CoV-2 (PPC). Objetivo: evaluar la eficacia del PPC en hospitalizados por COVID-19 de moderada gravedad. MATERIAL Y MÉTODOS: Estudio retrospectivo, bicéntrico, en adultos hospitalizados por COVID-19 moderado (no crítico) que requirieron oxigenoterapia. Al plasma donado por sobrevivientes de cuadros leves (600 cc) se les realizó búsqueda de IgG anti SARS-CoV-2. Se evaluó su impacto en mortalidad, estadía hospitalaria (días) y necesidad de ventilación mecánica (VMI). RESULTADOS: De los 119 pacientes incluidos, 58% eran hombres (edad mediana 60 años), 88% poseía comorbilidad y 43% tenía "CALL score" de alto riesgo. 43 pacientes (36%) recibieron PPC, sólo 15 (12,6%) precozmente (< 7 días). 22 pacientes debieron trasladarse a unidad intensiva, 18 recibieron VMI y 15 fallecieron (12,6%). El uso de PPC no se asoció a cambios en la mortalidad (p = 0,16), necesidad de VMI (p = 0,79) ni en la estadía hospitalaria (p = 0,24). Su administración en forma precoz (< 7 días de síntomas) tampoco demostró asociación significativa. La presencia de cardiopatía y el requerir posteriormente VMI fueron factores independientes asociados a mortalidad. CONCLUSIONES: El uso de PPC en pacientes hospitalizados por COVID-19 de moderada gravedad no se asoció a menor mortalidad, estadía hospitalaria ni necesidad de VMI.
INTRODUCTION: COVID-19 claimed millions of lives, mainly in the pre-vaccine era. Preliminary studies showed promising efficacy of convalescent plasma against SARS-CoV-2 (CP). Objective: To evaluate the efficacy of CP in patients hospitalized for COVID-19 with moderate severity. METHODS: Retrospective, bicentric study including adults hospitalized for moderate (non-critical) COVID-19 who required oxygen therapy. CP donated by survivors of mild cases (600 cc) were searched for IgG anti-SARS-CoV-2. Its impact on mortality, hospital stay (days), and need for mechanical ventilation (IMV) was evaluated. RESULTS: Of the 119 patients included, 58% were men (median age 60 years), 88% had comorbidity, and 43% had a high-risk CALL score. Forty-three patients (36%) received CP, only 15 (12.6%) early (< 7 days). Twenty-two patients had to be transferred to the intensive care unit; 18 received IMV, and 15 died (12.6%). The use of CP was not associated with changes in mortality (p = 0.16), need for IMV (p = 0.79), or hospital stay (p = 0.24). Its early administration (< 7 days of symptoms) did not show a significant association either. The presence of heart disease and subsequently requiring IMV were independent factors of mortality. CONCLUSIONS: The use of CP in patients hospitalized for moderately severe COVID-19 was not associated with lower mortality, hospital stay, or the need for IMV.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Severity of Illness Index , Immunization, Passive , SARS-CoV-2 , COVID-19/mortality , COVID-19/therapy , COVID-19 Serotherapy , Hospitalization/statistics & numerical data , Length of Stay/statistics & numerical data , Respiration, Artificial/statistics & numerical data , Retrospective Studies , Treatment OutcomeABSTRACT
Se han descrito cambios en la composición corporal en pacientes VIH mediante el análisis de la bioimpedancia eléctrica (ABE). Hay pocos estudios que describan estos cambios en la composición corporal en pacientes VIH en Venezuela. Objetivo: Conocer cuáles son las características de la composición corporal de los pacientes VIH (Hospitalizados y Ambulatorios), período enero - agosto 2015. Materiales y Métodos: Estudio descriptivo - transversal. Tres grupos: Hospitalizados: pacVIH-h (n=22), Ambulatorio: pacVIH-a (n=47) y No VIH: Control (n=28). Se registraron género, peso, talla y LCD4+. Mediante ABE se obtuvo: Masa grasa (MG), Tejido adiposo abdominal (TAA), Agua corporal total (ACT), Agua intracelular (AIC), Agua extracelular (AEC), Masa celular corporal (MCC), Masa libre de grasa (MLG), Potasio corporal total (KCT), Ángulo de Fase (AF). Resultados: Peso, IMC, LCD4+ fue menor en pacVIH-h. La MG y TAA fue menor en grupos de pacientes VIH con respecto al Control. No hubo diferencias en Agua Corporal. MMC fue menor en pacVIH-a. AF fue menor en pacVIH. Una correlación significativa entre MG y TAA, y LCD4+. Conclusión: Este estudio ha permitido exponer y reconocer los aspectos relacionados con los cambios en la composición corporal que ocurren en el paciente VIH adulto. La relación entre el compartimento graso y CD4+ permitiría explorar el papel del tejido adiposo en la reconstitución inmune.
Body composition in HIV patients have been assessed previously using bioelectrical impedance analysis (BIA). Lack of studies that describes changes in body composition in Venezuelan HIV patients. Objective: To assess body composition characteristic of HIV patients (hospitalized, ambulatory) , period January-August 2015. Methods: Descriptive-transversal study. Three groups: hospitalized: HIV-h (n=22), ambulatory: HIV-a (n=47) and Control (n=28). Gender, weight, height, CD4+ were measured. By BIA: Fat Mass (FM), Abdominal Adipose Tissue (AAT), Total body water (TBW), Intracellular water (ICW), Extracellular water (ECW), Body cell mass (BCM),Free Fat Mass (FFM), Total body potassium (TBK), Phase angle (PA). Results: Weight, BMI, CD4+ were lower in HIV-h. FM and AAT were lower in HIV patients. Water compartment showed no differences. BCM were lower in HIV-a. PA was lower in HIV patients. Significant relationship between FM, ATT and CD4+ was found. Conclusions: This study let us expose and recognize body composition changes that occur in HIV patients. Relationship between FAT, AAT and CD4+ can let us explore the possible role of adipose tissue in immune reconstitution.
ABSTRACT
In this study, water sanitation laws and methods (both Mexican and international) are compared, and the feasibility of incorporating recommendations issued by international organizations into Mexican legislation is assessed. When climate, demographic, or industry changes occur, there is an apparent need to broaden the range of substances and organisms being measured and regulated in the water. This comparative analysis identifies the following challenges: improving equipment sensitivity and specificity; removing contaminants that interfere with the process; increasing pathogen concentration of the sample; reducing manpower, equipment, and infrastructure requirements; identifying priority pathogens; adopting a flexible evaluation system; comparing and evaluating similar efforts carried out by other countries; and lastly, collating local regulations with international ones.