13 research outputs found

    SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers

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    The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers

    COVID-19 in rheumatic diseases in Italy: first results from the Italian registry of the Italian Society for Rheumatology (CONTROL-19)

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    OBJECTIVES: Italy was one of the first countries significantly affected by the coronavirus disease 2019 (COVID-19) epidemic. The Italian Society for Rheumatology promptly launched a retrospective and anonymised data collection to monitor COVID-19 in patients with rheumatic and musculoskeletal diseases (RMDs), the CONTROL-19 surveillance database, which is part of the COVID-19 Global Rheumatology Alliance. METHODS: CONTROL-19 includes patients with RMDs and proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) updated until May 3rd 2020. In this analysis, only molecular diagnoses were included. The data collection covered demographic data, medical history (general and RMD-related), treatments and COVID-19 related features, treatments, and outcome. In this paper, we report the first descriptive data from the CONTROL-19 registry. RESULTS: The population of the first 232 patients (36% males) consisted mainly of elderly patients (mean age 62.2 years), who used corticosteroids (51.7%), and suffered from multi-morbidity (median comorbidities 2). Rheumatoid arthritis was the most frequent disease (34.1%), followed by spondyloarthritis (26.3%), connective tissue disease (21.1%) and vasculitis (11.2%). Most cases had an active disease (69.4%). Clinical presentation of COVID-19 was typical, with systemic symptoms (fever and asthenia) and respiratory symptoms. The overall outcome was severe, with high frequencies of hospitalisation (69.8%), respiratory support oxygen (55.7%), non-invasive ventilation (20.9%) or mechanical ventilation (7.5%), and 19% of deaths. Male patients typically manifested a worse prognosis. Immunomodulatory treatments were not significantly associated with an increased risk of intensive care unit admission/mechanical ventilation/death. CONCLUSIONS: Although the report mainly includes the most severe cases, its temporal and spatial trend supports the validity of the national surveillance system. More complete data are being acquired in order to both test the hypothesis that RMD patients may have a different outcome from that of the general population and determine the safety of immunomodulatory treatments

    La propuesta de Directiva europea sobre diligencia debida: reflexiones de Derecho del Trabajo y de Derecho internacional Privado

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    The European system is a particularly fertile and advanced framework on the issues of the protection of human rights - in particular of rights and fair conditions at work - in the context of business activities. The Proposal for a Directive on corporate sustainability due diligence, adopted by the European Commission on 23 February 2022, represents a decisive step towards making companies responsible along the global value chain. In this perspective, the authors intend to examine some central aspects of the Proposal, such as the object of the due diligence and the actions aimed at preventing the risk; the extension of the scope of application; the systems of sanctions, liability regimes and remedies provided for violations of the due diligence obligation and the perpetration of human rights abuses. On these premises, the paper intends to question the scope and criticalities of the Proposal, and in particular on the possibility that due diligence can now be considered the regulatory tool that brings back to the system, rationalizes and empowers companies in the complexities of the present time

    Reporte de cuatro casos COVID-19 hospitalizados en unidad de cuidados intensivos en una institución hospitalaria en Barranquilla, Colombia

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    To present a COVID-19 case series with clinical admission criteria to Intensive Care Unit. Patients information was obtained from medical records, and daily clinical evaluation whereas diagnosis was carried out through paraclinical studies in blood, urine, PCR and diagnostic images in 4 patients with different comorbidities and epidemiological link for the development of COVID-19. All four cases were managed with chloroquine 300 mg orally every 12 hours and azithromycin orally every 24 hours for 5 days without complications or associated toxicity.The case 1 developed multiple organ failure, including acute kidney injury with an ICU stay of 4 days before his death, while cases 2, 3 and 4 had a favorable evolution and were discharged fromthe ICU. Rapid multicenter studies are required to scientifically guide a better diagnostic and management approach, in the context of a disease with a clinical-epidemiological behavior that must be studied in depth and will probably take many lives. In addition, due to the absence of sufficiently rapid tests, the use of a classification based on the severity of radiological lesions called CO-RADS (Covid-19 Imaging Reporting and Data System) could be of great importance to install available pharmacological treatments early and early mechanical respiratory support. Presentar una serie de casos de COVID-19 con requerimiento de ingreso a Unidad de CuidadosIntensivos. La información fue tomada de las historias clínicas, y su evaluación y diagnóstico fue realizado mediante estudios paraclínicos en sangre, orina, PCR e imágenes diagnósticas en 4 pacientes con diferentes comorbilidades y nexo epidemiológico presente para desarrollo de la enfermedad. Los cuatro casosfueron manejados con cloroquina 300 mg vía oral, cada 12 horas, y azitromicina 1 gr vía oral, cada 24 horas, durante 5 días,sin complicaciones ni toxicidad asociada. El caso 1 desarrolló falla orgánica múltiple, incluyendo injuria renal aguda con una estancia en UCI de 4 días antes de su fallecimiento, mientraslos casos 2, 3 y 4 tuvieron una evolución favorable y fueron dados de alta de UCI. Se requieren estudios multicéntricos rápidos que orienten científicamente hacia un mejor abordaje diagnóstico y manejo, en el contexto de una enfermedad con un comportamiento clínico-epidemiológico que debe estudiarse en profundidad y que probablemente cobrará muchas vidas; además, debido a la ausencia de pruebas diagnósticas rápidas, la utilización de una clasificación basada en la severidad de lesiones radiológicas llamada CO-RADS (Covid-19 Imaging Reporting and Data System) podría ser de gran importancia para instalar de manera temprana los tratamientos farmacológicos disponibles y la asistencia respiratoria mecánica precoz
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