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Objective To explore the clinical effect and safety of Suhexiang Pills () in the treatment of patients with tachycardia after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Methods A total of 138 patients with tachycardia after SARS-CoV-2 infection admitted to eight hospitals such as 971st Hospital of the PLA Navy, Changzhou Second People's Hospital, Xuzhou First People's Hospital, Henan Provincial People's Hospital, Henan Chest Hospital from February 2023 to March 2023 were randomly divided into control group and treatment group, with 87 patients in the treatment group and 51 in the control group. Patients in the control group were po administered with betaloc, once a day, and the initial dose was 23.75 mg, adjusted in time according to the patient's heart rate. Patients in the treatment group were po administered with Suhexiang Pills, 1 pill/time, twice daily. Patients in two groups were treated for 7 d. The clinical efficacy of the two groups was observed, and the heart rate and cardiac function indexes, RR interval, blood oxygen saturation and adverse reactions were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 98.85%, and the total effective rate of the control group was 90.20%, and the difference between the two groups was statistically significant (P < 0.05). After treatment, heart rates were significantly decreased in both groups (P < 0.05), and the heart rates of the treatment group were significantly better than those of the control group (P < 0.05) on the 7th day of treatment. After treatment, the level of left ventricular ejection fraction (LVEF) in both groups was significantly higher than that before treatment (P < 0.05), and there was statistical difference between the treatment group and the control group (P < 0.05). The levels of left ventricular end diastolic dimension (LVEDD) and left ventricular end-systolic diameter (LVESD) in the treatment group significantly decreased than that before treatment (P < 0.05), and there was no statistical difference compared with the control group (P > 0.05). After treatment, the maximum RR interval in both groups reached the normal range on the third day, and the treatment group was significantly better than the control group (P < 0.05). Blood oxygen saturation of the treatment group was significantly increased on the 7th day of treatment compared with before treatment (P < 0.05), but there was no statistical significance between the two groups (P > 0.05). There was no significant difference in the total incidence of adverse events between the two groups (P > 0.05). Conclusion Suhexiang Pills decrease heart rates in patients with tachycardia after SARS-CoV-2 infection, which was equivalent to the effect of western medicine, and can protect heart, improve heart function to a certain extent.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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Objective To explore the clinical effect and safety of Suhexiang Pills () in the treatment of patients infected with SARS-CoV-2. Methods A total of 192 patients infected with SARS-CoV-2 admitted to 17 hospitals including Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from December 2022 to January 2023 were randomly divided into control group and treatment group, with 89 patients in the treatment group and 103 in the control group. The patients in control group received basic treatment according to the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 10). The patients in treatment group were oral administered with Suhexiang Pills on the basis of the control group, one pill each time, twice day. The patients in two groups were treated for 5 d. The clinical efficacy of the two groups after treatment was compared. The differences in scores of headache, chest pain, limb pain and inflammatory indexes before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 95.51%, which was significantly higher than that of the control group (81.55%, P < 0.05). After treatment, headache, chest pain and limb pain scores were significantly decreased in both groups (P < 0.05), the headache score of the treatment group was significantly lower than that of the control group from the first day of treatment (P < 0.05), the chest pain score of the treatment group was significantly lower than that of the control group on the fifth day of treatment (P < 0.05), the limb pain score of the treatment group was significantly lower than that of the control group from the third day of treatment (P < 0.05). After treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6) in the two groups were decreased significantly (P < 0.05) and the levels of CRP and IL-6 in the treatment group were significantly lower than those of the control group (P < 0.05). There was no significant difference in the incidence of adverse events between the two groups. Conclusion Suhexiang Pills have a certain effect on headache, chest pain and limb pain, inhibiting the inflammatory response in patients infected with SARS-CoV-2, with good safety.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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Aim of the study was to evaluate the impact of anti-epidemic measures (CAM) complex on the dynamics of the epidemic process of COVID-19 in a controlled cohort of patients. Material and methods. Patients from 30 social long-term care institutions of the city were included in the study, including neuropsychiatric boarding schools, boarding houses for labor veterans, gerontological centers, and houses for stage veterans. A total of 8303 patients participated in the study, of which 4237 were men (mean age 53.6 years) and 4066 were women (mean age 62.0 years). Vaccination was carried out with Gam-Covid-Vac. Results and discussion. For the entire observation period from March 2020 to August 2021, 1619, cases of COVID-19 or 19.5% of the total number of patients were registered among patients. At the initial epidemic stage (spring-summer 2020), the incidence of COVID-19 among patients was explosive. At the same time, in the autumn-winter period of 2020, an increase in the incidence of COVID-19 was also observed. However, much less pronounced than in April 2020. Despite the progress, it was decided to strengthen the sanitary and anti-epidemic regime in institutions with the introduction of additional preventive measures. One of the most effective long-term algorithms for reducing the infectious disease incidence was vaccination. In this regard, the Moscow Department of Healthcare suggested the need for voluntary vaccination of 100% of patients in all institutions at the beginning of 2021. In the spring of 2021, the number of cases began to increase in the city. The increase in the incidence of COVID-19 was insignificant among the patients of institutions: the maximum number of cases detected in one month during this period was 13 people (in April), or 60.5 times less than in April 2020, and 2.5 times less than in October 2020. The incidence of COVID-19 has become sporadic rather than epidemic. Conclusion. The introduction of CAM in long-term care social institutions in the early stages of the epidemic contributed to a decrease in the incidence of COVID 19. 100% vaccination of patients in combination with other prevention measures reduced the incidence of COVID-19 by more than 28 times. At the same time, it was found that there is a trend of increasing incidence depending on the increase in the level of independent activity of patients.Copyright © 2023 The authors.
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Objective. Evaluation of clinical observation, the course, the risk factors, and treatment options for SARS-CoV-2 infection in hemodialysis patients with end-stage chronic kidney disease. Material and methods. The retrospective, single-center, uncontrolled study involved 231 patients (132 M/99 W) aged 61.7+/-14.7 years with COVID-19 diagnosed. The SPSS software package was used for statistical analysis. Results. 72 (31.2%) of patients died, 68 (94.4%) of them had ARDS as the main cause of death. Comparative analysis in groups with favorable and unfavorable outcomes of the disease showed that age (68.1+/- 13.2 years vs 58.7+/-14.5 years, p<0.0001) and the comorbidity index (8.8+/-2.2 vs 6.2+/-2.6, p<0.0001) were significantly higher in those who have died compared to survivors. According to CT data, they were more likely to have 3rd or 4th-degree lung damage (72.2 vs 36.5%, p<0.0001), and the minimum oxygen saturation index: 67.6+/-12.8 and 87.8+/-10.9%, respectively (p<0.0001). Somorbidity index and the need for invasive ventilation were independent predictors of the fatal outcome of COVID-19. Early administration of monoclonal antibodies to IL-6 (in the first 3 days after hospitalization) in patients with a low prevalence of the pulmonary process (CT stage 1-2) was associated with a significantly lower frequency of fatal outcome. Conclusions. SARS-CoV-2 infection in HD patients is characterized by a high rate of mortality. Predictors of severe disease in this population are comorbidity index and the need for invasive ventilation.Copyright © Infectious Diseases: News, Opinions, Training.
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Purpose. To demonstrate possibilities of multispiral computed tomography in the detection of fungal osteomyelitis in two patients with second type of diabetes mellitus two and six months after COVID-19 associated pneumonia. Material and methods. We present two clinical observations of patients with second type of diabetes mellitus who complained about pain in the upper jaw, nasal purulent discharge, difficulty in nasal breathing which appeared two and six months after COVID-19 associated pneumonia. To identify pathological changes, patients were directed to the department of radiology for the purpose of performing MSCT of the skull. Results. In the presented clinical cases, using MSCT, the features of the radiological semiotics of skull bone changes were studied in patients with fungal infection on the background of type 2 diabetes mellitus, the use of corticosteroids and after the viral COVID-19 associated pneumonia. The diagnosis was verified by histological and cytological studies of biopsy (surgical) material. Discussion. Recently, there has been an increase in the number of cases of fungal osteomyelitis of the jaws and paranasal sinuses in patients after viral pneumonia caused by SARS-CoV-2. The most common fungal infection is mucormycosis, caused by fungi belonging to the order Mucorales. The rhinocerebral form of mucormycosis is common in patients with diabetes mellitus after treatment with corticosteroids with the background of immunosuppression. This form of mucormycosis contributes to the appearance of extensive bone-destructive changes in the middle and upper zones of the maxillofacial region, requiring further surgical treatment. Conclusion. The 2019 coronavirus infection (COVID-19) caused by SARS-CoV-2 and type 2 diabetes remain urgent healthcare problems worldwide. This combination in a patient after treatment of COVID-19 associated pneumonia with corticosteroids leads to immunosuppression and the development of concomitant infections, including fungal ones. Fungal osteomyelitis in such patients, as a rule, affects the skull and is characterized by an aggressive course and requires surgical treatment. The use of modern and high-tech methods of radiation imaging, such as MSCT, allows to obtain complete diagnostic information about the localization and prevalence of the lesion, which, in the future, determines the management tactics and surgical treatment of patients of this category.Copyright © 2022 Chinese Journal of Pediatric Surgery. All rights reserved.
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Circular economy is a model of economic, social and environmental production and consumption, aimed to build a sustainable society in tune with the available resources. In the Brundtland Report, (1987, United Nations) sustainability it is defined as an approach focused on "meeting the needs of the present without compromising the ability of future generations to meet their own needs." The European Medical Association (EMA), that has currently more than 50 000 members, is involved in the advancement of health, pursuing educational and professional goals addressed to the quality of environment, lifestyle and civil society through a circular medicine approach. This is a comprehensive strategy, integrating best medical practice, bioinformatics and molecular biology with economy, artificial intelligence and machine learning. Circular Medicine is the resilient framework linking all these topics with circular economy methods. Innovative possibilities of circular medicine are many: it is a comprehensive paradigm shift, countering a non-medicine based on simplistic algorithms with guidelines of insufficient effectiveness, reliability and generalizability, often passed off as innovative Artificial-Intelligence approaches. We launched in 2020 a still ongoing survey aimed at the dissemination of information and at a greater sensitivity of all our members and followers on these topics, striving to build circular medicine in the real-world. This position document is based on its preliminary results: 1. Studying and investigating the links among health, climate change, biodiversity, circular economy, robust Artificial Intelligence and Machine learning support are goals and needed practice suitable to be pursued by EMA and other medical and scientific associations. Circular economy will be fruitfully used in health facilities, including hospitals, with health professionals and life science researchers acting also in the role of influencers and opinion leaders. 2. The interventions based on epidemiology, environmental sciences, best practice in medicine, sustainable technologies and molecular biology, the pillars of a potential framework of circular medicine, need a robust bioinformatics and Artificial Intelligence support. 3. Academic curricula and health professionals CME courses should provide stronger digital knowledge, reliable procedures trainings and expertise along these lines. Daily routine of clinical observation and participatory dialogue are key elements for the progress toward a culture, practice and accomplishments of circular economy and medicine. 4. Molecular biology, still the most innovative field of medical and life science, has a role for strengthening the pathways of the circular economy, as a reliable and resilient basis of "circular medicine." 5. The lessons of COVID19, the ongoing battles for healthier lifestyles dealing with nutrition, exercise and against alcohol and cigarette smoking, and the concept of smart cities are some of the cornerstones of the proposed strategy for a real-world circular medicine. Debunking interventions against the misuse of scientific and medical are means for the development of circular economy and medicine. Effective roadmaps, guidelines and grids for recognizing and counteracting the overlap of bullying, imposter's fear, insufficient expertise and knowledge, fake assertions and evaluations are actively developed by EMA's ad-hoc workshops. AI knowledge and skills should be implemented within innovative molecular biology and medical best-practice academic-CME curricula.Copyright © 2023 The American Society for Biochemistry and Molecular Biology, Inc.
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The proceedings contain 369 papers. The topics discussed include: effective FiO2 delivered by a new frugal CPAP system with low oxygen needs: from bench to clinical observations;effect of non invasive respiratory support on interstitial lung disease with acute respiratory failure: a systematic review and meta analysis;causes of mortality of severe COVID 19 patients receiving high flow oxygen therapy;patient ventilator interaction during noninvasive ventilation with helmet: a comparison between pressure support ventilation and the new neural pressure support (NPS) software;tidal volume measurement during non invasive respiratory support by helmet continuous flow CPAP is feasible and accurate in a bench model;delayed intubation with high flow nasal cannula in COVID: a comparison between a first and second pandemic wave;outcomes following application of high flow nasal cannula and non invasive ventilation during the second COVID 19 wave in Singapore;ventilator avoidance among critically ill COVID 19 patients with acute respiratory distress syndrome;and mortality rate, intensive care unit length of stay and time to orotracheal intubation of COVID 19 patients under different non invasive ventilatory therapies: retrospective cohort study.
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Introduction (contexte de la recherche): Erythema nodosum (EN) is a type IV delayed hypersensitivity reaction to a variety of antigens stimuli. In fact, EN is commonly caused by a range of conditions, including infections and vaccines. EN induced by COVID-19 vaccines is rarely reported. Objectif: Herein, we report an original clinical observation of EN occurring after the first dose of AstraZeneca COVID-19 vaccine (vaxzevria), a viral vector vaccine, without recurrence after the second dose. Methodes: This case was notified on August 2021 to Tunisian National Centre of Pharmacovigilance and was analyzed according to the French updated method for the causality assessment of adverse drug reactions. Resultats: A 46-year-old woman with no medical history, presented with diffuse erythematous painful and nodular lesions, located symmetrically over her legs. Eleven days before, she had received the first dose of vaxzevria which was followed by a sudden asthenia, and oedema over her lower limbs. The patient reported no recent infectious episodes. She had no known drug allergy. Skin examination showed multiple, tender, erythematous nodules, which ranged from 3 to 4 cm in diameter located over the tibial area. Some were regressive according to biligenesis shades. Laboratory tests including a complete blood count, renal and hepatic tests and antistreptolysin O titer were carried out and were negative except an elevated c-reactive protein of 45 mg/dL. The dermatological examination found lesions on both legs to be consistent with EN and started therapy with prednisone 40 mg daily for one week, subsequently gradually tapered and suspended, with complete regression of lower limb skin lesions within 10 days. No skin biopsy was performed due to the typical clinical presentation, color evolution and a complete response to steroid therapy. The patient subsequently received the second dose after two months without the reappearance of EN. Conclusion(s): In this case the role of vaccine was suspected in front of a temporal association between the first dose of vaccine and the onset of EN and the absence of another etiology. However, the good evolution of this skin manifestation will help reassure patients in the safety of vaccine administration.Copyright © 2023
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The reason for the publication of this article was the increase in the number of children with long-standing organic foreign bodies in the respiratory tract, the late diagnosis of which causes severe complications. The article presents the three most significant cases from the general series, when the diagnosis and treatment tactics at the stages of treatment were associated with errors both at the prehospital stage and in the hospital. In the first clinical case, as it turned out, the child had aspired multiple foreign bodies. The first bronchoscopy revealed one solid foreign body. Due to severe fibrinous-purulent endobronchitis and contact bleeding, the bronchoscopy procedure was aborted. However, after 10 days, the child independently coughed up the second seed, which was a surprise to us. Control bronchoscopy after 3 weeks revealed no foreign bodies. In the second clinical observation, a child developed bronchiectasis due to a long stay of a foreign body in the respiratory tract. The third case demonstrates the diagnosis and treatment tactics in a child with a foreign body against the background of a coronavirus infection. In the first and third cases, the results of treatment were satisfactory. In the second case, a long stay of peanuts in the respiratory tract led to bronchiectasis in the lower lobe of the left lung, which required its removal. In the follow-up, there are no complaints, the child grows and develops according to age. The study analyzes the mistakes made at the stages of diagnosis and treatment of children with foreign bodies in the respiratory tract. Conclusion. Young children with long-term and atypically current respiratory diseases, dubious and even normal radiological picture with the absence of comprehensive information on the anamnesis of diseases should alert the doctor to the possibility of aspiration of a foreign body in the respiratory tract and serve as the basis for performing bronchoscopy.Copyright © 2023 National Academy of Pediatric Science and Innovation. All rights reserved.
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Background. SARS-CoV-2 infection can be accompanied by neuromuscular disorders. Rhabdomyolysis and Guillain-Barre syndrome have been described repeatedly. There are case reports of inflammatory myopathies manifesting during COVID-19, presenting as dermatomyositis, polymyositis or immune-mediated necrotizing myopathy, with dermatomyositis-like presentations most commonly reported. Larger cases series are from postmortem examinations of COVID-19 patients, where variable inflammatory pathology of the skeletal muscle has been found frequently but without local detection of the actual virus. Thus, autoimmune mechanisms or the systemic interferon response are discussed as causes. We report a case of focal inflammatory myopathy with perimysial pathology of the temporalis muscle occurring with acute, but mild COVID-19. Methods. Case report of clinical observations, cranial MRI, histopathological, and laboratory findings. 3T cranial MRI was performed with gadolinium contrast. Open temporalis muscle biopsy was performed. The sample underwent standard cryohistological studies as well as immunohistochemistry with antibodies against MHC-I and II, CD3, CD4, CD19, CD68, anti-MAC, p62 and MxA. Testing for auto-antibodies was based on immunoblots or ELISA. RT-PCR for SARS-CoV-2 was run with RNA extracted from cryopreserved muscle. Results. A Caucasian woman in her 60s with no history of autoimmune or muscle complaints developed swelling and pain of the right jaw musculature five days after testing positive for SARS-CoV-2 due to respiratory tract symptoms. In addition, she experienced trismus, but no further neuromuscular complaints. The course of respiratory tract symptoms stayed mild. She had been vaccinated previously with single shot SARS-CoV-2 vector vaccine. Due to persistent swelling and complaints, giant cells arteritis was excluded by unresponsiveness to five days oral steroids and sonography of the temporal artery. Cranial MRI was performed nearly four weeks after the SARS-CoV-2 infection and showed marked swelling and oedema of the temporalis muscle. Its biopsy showed numerous CD68 and acid phosphatase positive cells infiltrating from perimysial perivascular foci towards the endomysium with perimysial damage but little damage of adjacent, perifascicular muscle fibres. Muscle fibres did not react with anti-MHC-II, anti-MAC or -MxA. Capillaries did not react with anti-MAC or -MxA. SARS-CoV-2 RNA was not detected in muscle tissue. Serum creatine kinase was not elevated in the subacute phase. Slightly elevated ANA titre led to detection of autoantibodies against proliferating cell nuclear antigen (PCNA). No pathological results for other autoantibodies, including myositis-specific antibodies and anti-ds-DNA, were found in blood. Neither were antibodies against hepatitis C and B viruses. Retesting 15 weeks after infection, anti-PCNA immunoblot was still positive, but ELISA did not indicate a pathologic titre. The swelling, myalgia and trismus regressed spontaneously a month after onset, yet the latter still persists at the time of reporting. Conclusion. Our case diverges from the majority of COVID-19 associated my-ositis reports in the unusual location of the focal myositis and the histopathological pattern of predominantly perimysial damage and histiocytic infiltration. It concurs with the literature as no SARS-CoV2 RNA could be detected in the muscle. Anti-PCNA is associated very rarely with myositis. Other associated disorder (systemic lupus erythematosus, chronic viral hepatitis B or C) were not found. Increased levels of autoantibodies are reported in COVID-19 and mostly attributed to loss of self-tolerance during the acute disease phase. Interestingly, the structural protein M of SARS-CoV-2 appears to interact notably with PCNA in infected cells. Still, the causal connection between the myositis and COVID-19 in this case is based on the close temporal association in the absence of alternative, competing explanations from the medical history and findings.
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A 5-month-old, intact male, yellow Labrador retriever was presented with a 24-hour history of anorexia and vomiting. Abdominal imaging revealed the presence of a mechanical obstruction in the jejunum and peritoneal effusion. Cytologic evaluation and culture of the effusion prior to surgery identified a suppurative exudate with bacteria consistent with septic peritonitis and suspected to be related to the intestinal lesion. An exploratory laparotomy was performed, and a segment of jejunum was circumferentially severely constricted by an off-white, fibrous band of tissue. Resection and anastomosis of the strangulated segment of jejunum and excision of the constricting band provided resolution of the clinical signs. The dog made a complete recovery. Histologic evaluation revealed the band to be composed of fibrovascular and smooth muscle tissue, consistent with an idiopathic anomalous congenital band. No other gastrointestinal lesions were observed, either grossly at surgery or histologically in the resected segment of intestine. To our knowledge, a similar structure has not been reported in the veterinary literature.Copyright © 2022 Canadian Veterinary Medical Association. All rights reserved.
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Bullous pemphigoid (BP) is the most common autoimmune bullous disease characterized by autoantibodies against hemidesmosomal components: BP180 and BP230. Although a causal association between vaccine and BP has never been proved, since mass vaccination against COVID-19 started, more than 90 vaccine-associated BP were reported. Of note, a recent study comparing very large cohorts of vaccinated and not-vaccinated individuals found no increased incidence of BP in vaccinated people, concluding that COVID-19 vaccine does not directly cause BP. To bring to an agreement among real-life clinical observations on patients with new-onset BP after COVID-19 vaccine and recent epidemiologic data, a cohort study was performed. Fifty-nine BP patients visiting our institute in 2021 were clinically and immunologically characterized. Fourteen patients (23.7%), experiencing BP onset 1-34 days after the first or second dose, were considered vaccine-associated. Vaccine-associated and non-associated patients had the same M/F ratio (1.3) and similar disease severity (mean BPDAI: 41.1 vs 38.6) and mean age (76.7 vs 79.5 years). Interestingly, BP230 reactivity was higher in vaccine-associated patients (87.5% vs 41.4%, p=0.042), while no other significant differences in autoantibodies profiles and titers were found. Noteworthy, the comparison of the monthly distribution of BP onset throughout the year before and during mass vaccination showed significant differences: in 2021, BP onsets on April-May and June-July increased (p=0.009) and declined (p=0.064) compared to 2018-2020, respectively. In conclusion, our findings suggest that COVID-19 vaccine may be considered an accelerating factor rather than an inducing one: vaccination, in genetically predisposed individuals with sub-clinical autoreactivity against BP antigens, of which high BP230 reactivity at diagnosis could represent an indicator, could slightly anticipate BP onset without increasing its incidence.Copyright © 2023
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Objective To explore the clinical effect and safety of Suhexiang Pills () in the treatment of patients infected with SARS-CoV-2. Methods A total of 192 patients infected with SARS-CoV-2 admitted to 17 hospitals including Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from December 2022 to January 2023 were randomly divided into control group and treatment group, with 89 patients in the treatment group and 103 in the control group. The patients in control group received basic treatment according to the Diagnosis and Treatment Protocol for COVID-19 (Trial Version 10). The patients in treatment group were oral administered with Suhexiang Pills on the basis of the control group, one pill each time, twice day. The patients in two groups were treated for 5 d. The clinical efficacy of the two groups after treatment was compared. The differences in scores of headache, chest pain, limb pain and inflammatory indexes before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 95.51%, which was significantly higher than that of the control group (81.55%, P < 0.05). After treatment, headache, chest pain and limb pain scores were significantly decreased in both groups (P < 0.05), the headache score of the treatment group was significantly lower than that of the control group from the first day of treatment (P < 0.05), the chest pain score of the treatment group was significantly lower than that of the control group on the fifth day of treatment (P < 0.05), the limb pain score of the treatment group was significantly lower than that of the control group from the third day of treatment (P < 0.05). After treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6) in the two groups were decreased significantly (P < 0.05) and the levels of CRP and IL-6 in the treatment group were significantly lower than those of the control group (P < 0.05). There was no significant difference in the incidence of adverse events between the two groups. Conclusion Suhexiang Pills have a certain effect on headache, chest pain and limb pain, inhibiting the inflammatory response in patients infected with SARS-CoV-2, with good safety.Copyright © 2023 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.
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Objective: To explore the safety of chloroquine phosphate treatment in patients with novel coronavirus pneumonia (COVID-19) and provide references for clinical safety medication. Method(s): Active monitoring for adverse events (AE) was carried out in the Third People's Hospital of Shenzhen from February to March 2020 during the treatment with chloroquine phosphate in patients with COVID-19. The causal relationship between AE and chloroquine phosphate was evaluated. Result(s): A total of 33 patients were entered in the study, including 16 males and 17 females, aged (43+/-13) years. The clinical types of COVID-19 in 26 patients (78.8%) were mild, in 7 patients (21.2%) were common. There were 7 patients (21.2%) with basic diseases, including 6 with hypertension and 1 with hypothyroidism. The treatment course of chloroquine phosphate was (8+/-3) days. During the treatment, a total of 28 cases of AE in 24 (72.7%) of the 33 patients which were probably or possibly related to chloroquine phosphate were detected. The clinical manifestations of AE included abnormal liver function (8/33, 24.2%), gastrointestinal reactions (8/33, 24.2%), neuropsychiatric system reactions (8/33, 24.2%), cardiovascular system reactions (5/33, 15.2%), eye and vision abnormality (2/33, 6.1%), and skin injury (1/33, 3.0%). The severity of AE was grade 1 or grade 2. After drug withdrawal or symptomatic treatments, all the patients' symptoms were improved and the laboratory tests results returned to normal. Conclusion(s): The adverse effects of chloroquine phosphate in the treatment of patients with COVID-19 are mild, but it is still necessary to strengthen the monitoring.Copyright © 2020 by the Chinese Medical Association.
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Spinal cord affection, according to various sources, is a common complication of a new coronavirus infection. The article describes various variants of spinal cord pathology in COVID-19, their potential mechanisms of development, approaches to treatment and outcomes of the disease. Three patients who were observed at the Research Center of Neurology and represent the most interesting cases of classic transverse myelitis, myelitis with predominant involvement of the lateral and posterior cords, and longitudinal widespread myelitis associated with antibodies to myelin oligodendrocyte glycoprotein (MOG) are considered in detail. These clinical observations demonstrate the importance of early diagnosis and selection of adequate therapy for a favorable outcome of the disease.Copyright © 2022 Ima-Press Publishing House. All rights reserved.
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Aim. To study the impact of coronavirus disease 2019 (COVID-19) pandemic on hospitalization rates, diagnosis, and outcomes of infective endocarditis (IE) with a subanalysis of IE course in combination with COVID-19. Material and methods. This prospective cohort study included 168 patients with definite or probable IE (DUKE 2015) hospitalized in the V. V. Vinogradov City Clinical Hospital from July 2017 to July 2022. All patients underwent a conventional examination in accordance with current clinical guidelines. We studied clinical, paraclinical and etiological parameters, as well as outcomes. Two clinical observations of the combination of IE and COVID-19 are presen-ted. Results. When assessing the local registry of patients with IE, a trend towards an increase in hospitalizations rate of IE in 2021-2022 was shown, with a decrease during the period of long-term lockdowns in Moscow and a subsequent surge after their cancellation. Patients with IE during the COVID-19 pandemic had a more favorable clinical profile, a 2-fold increase in IE diagnosis (due to late hospitalization), frequent detection of Staphylococcus aureus MSSA (32,6%), and frequent surgical treatment (up to 87,6% with a combination of IE and COVID-19), as well as high in-hospital mortality, but without a tendency to increase (30,4%). Clinical observations of IE and COVID-19 combination are presented, which demonstrates the contribution of COVID-19 as the only risk factor for native tricuspid valve IE in a patient without predisposing causes, as well as a factor in the unfavorable prognosis for native aortic valve IE after the addition of COVID-19, which led to lethal outcome. Conclusion. The present study demonstrates the profile of patients with IE and COVID-19 depending on the epidemiological situation of COVID-19 and the association with SARS-CoV-2 infection. The data obtained make it possible to discuss the potential relationship between COVID-19 and IE. The "endocarditis team" determines the timely implementation of surgery and the absence of an increase in inhospital mortality, regardless of the epidemiological situation.Copyright © 2023, Silicea-Poligraf. All rights reserved.
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Clinical Infectious Diseases Hospital. S.P. Botkin has been providing assistance to pregnant women and newborns suffering from COVID-19 since the beginning of the pandemic. In the period from April 2020 to April 2022, 550 newborns born to mothers suffering from COVID-19 of varying severity were observed in the hospital, of which 52 children had a registered diagnosis of COVID-19 (the SARS-CoV-2 virus was identified in a swab from the nasopharynx of a newborn using PCR). In this paper, an analysis of the pathological changes identified in this category of newborns was carried out, the issues of the influence of the covid status of the mother and the duration of stay with her on the child's condition were studied. Analysis of the results of the work revealed a relationship between the duration of the period of stay of a newborn with a mother with an active form of COVID-19 and the severity of the disease in newborns. According to our clinical observations, the vertical route of transmission of the virus seems highly probable. Newborns who have had COVID-19 or have perinatal contact with SARS-CoV-2 are subject to dynamic observation. It is necessary to determine the order, timing and scope of dispensary observation for the timely detection of pathological changes in this category of children.Copyright © 2022 Authors. All rights reserved.
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Clinical Infectious Diseases Hospital. S.P. Botkin has been providing assistance to pregnant women and newborns suffering from COVID-19 since the beginning of the pandemic. In the period from April 2020 to April 2022, 550 newborns born to mothers suffering from COVID-19 of varying severity were observed in the hospital, of which 52 children had a registered diagnosis of COVID-19 (the SARS-CoV-2 virus was identified in a swab from the nasopharynx of a newborn using PCR). In this paper, an analysis of the pathological changes identified in this category of newborns was carried out, the issues of the influence of the covid status of the mother and the duration of stay with her on the child's condition were studied. Analysis of the results of the work revealed a relationship between the duration of the period of stay of a newborn with a mother with an active form of COVID-19 and the severity of the disease in newborns. According to our clinical observations, the vertical route of transmission of the virus seems highly probable. Newborns who have had COVID-19 or have perinatal contact with SARS-CoV-2 are subject to dynamic observation. It is necessary to determine the order, timing and scope of dispensary observation for the timely detection of pathological changes in this category of children.Copyright © 2022 Authors. All rights reserved.
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Spinal cord affection, according to various sources, is a common complication of a new coronavirus infection. The article describes various variants of spinal cord pathology in COVID-19, their potential mechanisms of development, approaches to treatment and outcomes of the disease. Three patients who were observed at the Research Center of Neurology and represent the most interesting cases of classic transverse myelitis, myelitis with predominant involvement of the lateral and posterior cords, and longitudinal widespread myelitis associated with antibodies to myelin oligodendrocyte glycoprotein (MOG) are considered in detail. These clinical observations demonstrate the importance of early diagnosis and selection of adequate therapy for a favorable outcome of the disease.Copyright © 2022 Ima-Press Publishing House. All rights reserved.