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Analiza wpływu szczepienia BCG na częstość występowania oraz przebieg zakażeń SARS-CoV-2 wśród pracowników ochrony zdrowia w Polsce
(Uniwersytet Rzeszowski, 2024-03-13) Zapolnik, Paweł
Szczepionka przeciwko gruźlicy (Bacillus Calmette-Guérin, BCG) została wprowadzona 100 lat temu i jest nadal zalecana przez Światową Organizację Zdrowia w celu zapobiegania tej chorobie. Badania wykazały że szczepienie BCG może stymulować nieswoistą odpowiedź immunologiczną i zmniejszać częstość występowania niektórych chorób. Na początku pandemii choroby koronawirusowej postawiono hipotezę, że zachorowalność na COVID-19 może być mniejsza w krajach stosujących profilaktykę BCG. Próbując zweryfikować tą tezę, przeprowadzono wieloośrodkowe, randomizowane, podwójnie zaślepione, kontrolowane placebo badanie na grupie 695 pracowników służby zdrowia w Polsce. Wszyscy uczestnicy badania mieli wykonaną próbę tuberkulinową, po której osoby z ujemnym wynikiem były randomizowane (w stosunku 1:1) i otrzymywały szczepionkę BCG lub placebo. Od tego momentu osoby te były poddawane trzymiesięcznej obserwacji pod kątem występowania objawów COVID-19 oraz analizie serologicznej. Wyniki przeprowadzonych badań nie wykazały zależności między rewakcynacją szczepionką BCG a zachorowalnością na COVID-19. Nie odnotowano również znamienności statystycznej między wynikami testu tuberkulinowego a ilością zachorowań na COVID-19. Jednocześnie wykazano znamiennie częstsze zachorowania na COVID-19 wśród pielęgniarek w porównaniu do osób wykonujących inne zawody medyczne. U 150 uczestników badania wykryto obecność przeciwciał anty-SARS-CoV-2 w klasie IgG, natomiast stężenia przeciwciał nie różniły się znacząco między trzema badanymi grupami i nie wykazano istotności statystycznej.
Case of multisystem inflammatory syndrome in adults
(Publishing Office of the University of Rzeszow, 2023-03) Dominik, Hanna; Dominik, Barbara
Introduction and aim. Multisystem inflammatory syndrome in adults (MIS-A) is a rare severe illness which is related to prior SARS-CoV2 infection in individuals>=21 years old. The condition was described few months after recognition of similar entity in children known as MIS-C (United Kingdom, April, 2020). The diagnosis of MIS-A is based on clinical symptoms andevidence of inflammation in laboratory markers. It is characterized by extrapulmonary organ dysfunction (cardiovascular, gastrointestinal), general symptoms such as fever, malaise, rash and deviations in blood tests (elevated level of ferritin, procalcitonin, CRP, IL-6, D-Dimer) with a previous or current SARS-CoV-2 infection. The purpose of this study is to present the syndrome on the basis of a clinical case example, to show the course of the disease, its symptoms and the result of applied treatment. Description of the case. The following case describes the clinical history, diagnostic process and applied treatment of 37-year old female patient who was admitted urgently to the hospital with a suspicion of sepsis originating from pharynx. The final diagnosis – MIS-A was settled after performing a broad panel of tests. Clinical picture was non- characteristic. The patient was successfully treated with steroids. Conclusion. MIS-A is a rare clinical entity linked with SARS-CoV-2 infection. The symptoms manifest from multiple organ systems and the diagnostic process may be challenging. The illness can be successfully treated with steroids.
Clinico-epidemiological and vaccination profile of patients attending flu clinic of a tertiary health care institution in Eastern India during the third wave of COVID-19 pandemic
(Publishing Office of the University of Rzeszow, 2022-12) Singh, CM; Chaudhary, Neha; Naik, Bijaya Nanda; Rao, Rajath; Pandey, Sanjay; Kumar Nirala, Santosh ; Ranjan, Alok; Prasad, Santosh
Introduction and aim. With the third wave of COVID-19 hitting the country, there is an urgent need to systematically document the clinical-epidemiological and vaccination details of the patients to formulate evidence-based decisions. So, this study was planned to describe the profile of patients attending the flu clinic of a tertiary care hospital in eastern India. Material and methods. This hospital-based cross-sectional study was done for 6 weeks (Jan-Feb 2022) among 623 patients using a pre-tested, structured questionnaire related to COVID-19. An unadjusted odds ratio was calculated and statistical significance was attributed to a p-value <0.05. Results. Out of 623 patients, almost 90% of the patients were vaccinated against COVID-19 with at least one dose of any vaccine. Cough (57.8%) was the most common complaint. Patients aged > 60 years and those having one or more than one comorbidity suffered from moderate-severe COVID-19 infection when compared to their counterparts (p<0.001). Also, 2.1% of fully vaccinated, 3.8% of one dose vaccinated and 10.9% of unvaccinated patients suffered from moderate-severe COVID-19. Conclusion. During the third wave of the COVID-19 pandemic, a smaller number of elderlies compared to the previous two waves were affected indicating age shifting. The severity of COVID-19 was less among vaccinated individuals compared to unvaccinated highlighting the importance of COVID-19 vaccination.
Gastrointestinal symptoms as antecedent signs of severe acute respiratory syndrome coronavirus 2 infection
(Wydawnictwo Uniwersytetu Rzeszowskiego, 2020) Młodożeniec, Aleksandra; Szul, Paulina; Gala-Błądzińska, Agnieszka
Introduction. The coronavirus disease 2019 (COVID‑19) is an acute infectious disease of the respiratory system caused by severe acute respiratory syndrome coronavirus (SARS‑CoV‑2). Most patients present with typical, respiratory symptoms. Common signs include cough, fever, dyspnea and shortness of breath. In this case we provide atypical indications of COVID-19, which may occur earlier than respiratory symptoms. Aim. This case is an example of an unusual course of SARS-CoV-2 infection. Description of the case. This article describes a case of a 63-year-old man and his wife, a 60-year old woman who were admitted to the emergency department with a few days’ history of gastrointestinal symptoms. Both patients presented with the digestive symptoms of nausea, diarrhea and loss of appetite. They denied abdominal pain and the loss of smell or taste. Due to suspicion of SARS-CoV-2 infection a nasopharyngeal swabs of both patients was taken. The results of real- time reverse transcriptase-polymerase chain reaction were positive. When the final diagnosis of COVID-19 was established they were transported to another hospital. Conclusion. COVID-19 may manifest with atypical indications such a nausea and diarrhea. An atypical indications of COVID-19 may occur earlier than respiratory symptoms. It is important for clinicians to remain alert.
Lung abscess with pneumonia after SARS-CoV-2 infection – a case report
(Publishing Office of the University of Rzeszow, 2024-09) Borys, Renata; Szeliga, Ewa; Wojtuń, Kazimierz; Kużdżał, Adrian; Sawka, Karolina
Introduction and aim. Some patients after the SARS-CoV-2 infection may be at higher risk of consequent bacterial or fungal infections even if they have no risk factors (advanced age, obesity, metabolic diseases). A possible complication of SARS-CoV-2 infection is lung abscess with pneumonia what requires further examination and specialized treatment as well as the pulmonary rehabilitation. Description of the case. This report presents all stages of the diagnosis and treatment of lung abscess with pneumonia of male patient, aged 42 years in course of COVID-19. The article emphasizes the role of pulmonary rehabilitation in decreasing the number of postoperative pulmonary complications. Presented case report includes a description of a rehabilitation program conducted during the patient’s hospitalization. Conclusion. Lung abscess is a serious disease with an often unpredictable course, complications and an uncertain prognosis. However, most patients can be treated conservatively, and the priority in treatment is antibiotic therapy and physiotherapy treatments.
Serum levels of IFN-γ and IL-4 in hospitalised COVID-19 patients – evidence of reduced cytokine storm in discharged patients
(Publishing Office of the University of Rzeszow, 2023-12) Arinola, Ganiyu Olatunbosun; Onifade, Abdulfattah Adekunle; Adigun, Kehinde; Oshingbesan, Mosunmade Babatunde
Introduction and aim. Coronavirus disease 2019 is characterised by cytokine storm and it was managed with repurposed drugs, however the effect of this treatment on cytokine storm is unknown. The aim of the study was to investigate the effect of repurposed management on serum Th1 pro-inflammation cytokine (IFN-γ) and Th2 anti-inflammation cytokine (IL-4) in COVID-19 patients. Material and methods. The levels of IFN-γ and IL-4 were determined in sera from 45 COVID-19 patients at admission followed-up till discharge after repurposed treatment using ELISA. The mean levels and proportions above normal reference ranges of IFN-γ and IL-4 were compared in COVID-19 at admission and discharge. Results. The mean values of IFN-γ and IL-4 were significantly higher in COVID-19 patients at admission compared with discharged COVID-19 patients whereas IFN-γ:IL-4 ratio was significantly higher in discharged COVID-19 patients compared with admitted COVID-19 patients. Significantly higher proportion of COVID-19 patients at discharge had IFN-γ within the normal reference ranges compared with COVID-19 patients at admission whereas the proportions of COVID-19 patients at discharge and COVID-19 patients at admission having IL-4 within the normal reference ranges were the same. Conclusion. Cytokine storm was evidenced in COVID-19 patients at admission and repurposed treatment suppressed pro-inflammation cytokine (IFN-γ) in most discharged COVID-19 patients.