COVID-19 Delta Wave Caused Early Overburden of Hospital Capacity in the Bulgarian Healthcare System in 2021

We develop and apply our methodology to estimate the overburdening of hospitals in Bulgaria during the upcoming delta surge. We base our estimations on an exponential risk model from the UK. Still, the methodology is generally applicable to all risk models, depending on age. Our hypothesis is that during the delta wave in Bulgaria, the system experienced a burden from late August due to decreased capacity. This will explain most of the excess mortality during the wave. We estimate the number of people from the active cases in need of hospitalization and intensive care

COVID-19 Delta Wave Caused Early Overburden of Hospital Capacity in the Bulgarian Healthcare System in 2021

We develop and apply our methodology to estimate the overburdening of hospitals in Bulgaria during the upcoming delta surge. We base our estimations on an exponential risk model from the UK. Still, the methodology is generally applicable to all risk models, depending on age. Our hypothesis is that during the delta wave in Bulgaria, the system experienced a burden from late August due to decreased capacity. This will explain most of the excess mortality during the wave. We estimate the number of people from the active cases in need of hospitalization and intensive care

Clinical and Laboratory Manifestation of Gastrointestinal Involvement in MIS-C: A Single-Center Observational Study

Background: Digestive symptoms and gastrointestinal issues in children with coronavirus 2019 disease (COVID-19) and Multisystem Inflammatory Syndrome in Children (MIS-C) are commonly reported in pediatric studies from different countries. Our retrospective observational study aimed to summarize the main digestive symptoms and objective data on gastrointestinal involvement in children with MIS-C. Methods: We present the clinical, laboratory, and imaging data of 51 children with MIS-C hospitalized in a single center from 25 November 2020 to 24 April 2021, focusing on gastrointestinal involvement. Results: A total of 46/51 children (90.2%) reported at least one abdominal symptom (abdominal pain (86%, N = 44), vomiting, nausea, diarrhea), predominantly at presentation. Most children were older than 5 years (N = 40, 78%), predominated by the male sex (N = 37, 72.5%), and with a mean age of 8.82 ± 4.16 years. We found a tendency for lymphopenia, neutrophilia, and higher levels of CRP, d-dimer, and ferritin in MIS-C patients with abdominal pain (R-squared 0.188, F-statistic vs. constant model: 11.9, p-value = 0.00122, 20% explanation of variation with p = 0.001). We found a statistically significant linear relationship (regression) between neutrophile percentage (NEU%) and hospital stay and a tendency for elevated transaminases to be more frequent in older children (27.3% under 5 years and 65% over 5 years; p = 0.0583). We found no significant associations between digestive symptoms and age or the predominant SARS-CoV-2 variant. Conclusions: Most of our MIS-C patients presented with abdominal pain, usually along with other GI symptoms, which could be applied in clinical practice to MIS-C in children visiting the emergency room with abdominal pain and evidence of recent COVID-19 contact or infection. Further information from larger cohorts of MIS-C patients is needed to better understand the epidemiology of gastrointestinal involvement in these patients

Endothelial Dysfunction and Pregnant COVID-19 Patients with Thrombophilia: A Narrative Review

Pregnancy with SARS-CoV-2 infection can raise the risk of many complications, including severe COVID-19 and maternal–fetal adverse outcomes. Additionally, endothelial damage occurs as a result of direct SARS-CoV-2 infection, as well as immune system, cardiovascular, and thrombo-inflammatory reactions. In this narrative review, we focus on endothelial dysfunction (ED) in pregnancy, associated with obstetric complications, such as preeclampsia, fetal growth retardation, gestational diabetes, etc., and SARS-CoV-2 infection in pregnant women that can cause ED itself and overlap with other pregnancy complications. We also discuss some shared mechanisms of SARS-CoV-2 pathophysiology and ED