Mortality of hospitalized patients with COVID-19: Effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) assessed by propensity score matching, retrospective analysis

Introduction. SARS-CoV-2 respiratory infection is associated with significant morbidity and mortality, especially in hospitalized high-risk patients. We aimed to evaluate the effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) on hospital mortality in non-vaccinated patients during the 2021 spring wave in the Czech Republic. Methods. Initially, 991 patients hospitalized in the period January 1, 2021, to March 31, 2021, with PCR-confirmed SARS-CoV-2 acute respiratory infection in two university and five rural hospitals were included in the study. After exclusion of patients with an unknown outcome, a total of 790 patients entered the final analysis. The effects of different treatments were assessed in this cohort by means of propensity score matching. Results. Of the 790 patients, 282 patients died in the hospital; 37.7% were male and 33.3% were female. Age, sex, state of the disease, pneumonia, therapy, and several comorbidities were matched to simulate a case-control study. For anticoagulation treatment, 233 cases (full-dose) vs. 233 controls (prophylactic dose) were matched. The difference in mortality was significant in 16 of the 50 runs. For the treatment with isoprinosine, ivermectin, and vitamin D, none of the 50 runs led to a significant difference in hospital mortality. Conclusion. Prophylactic-dose anticoagulation treatment in our study was found to be beneficial in comparison with the full dose. Supplementation with vitamin D did not show any meaningful benefit in terms of lowering the hospital mortality. Neither ivermectin nor, isoprinosine was found to significantly decrease hospital mortality

Vysoce kvalitní a snadno regenerovatelný osobní filtr

Proper respiratory tract protection is the key factor to limiting the rate of COVID-19 spread and providing a safe environment for health care workers. Traditional N95 (FFP2) respirators are not easy to regenerate and thus create certain financial and ecological burdens; moreover, their quality may vary significantly. A solution that would overcome these disadvantages is desirable. In this study a commercially available knit polyester fleece fabric was selected as the filter material, and a total of 25 filters of different areas and thicknesses were prepared. Then, the size-resolved filtration efficiency (40-400 nm) and pressure drop were evaluated at a volumetric flow rate of 95 L/min. We showed the excellent synergistic effect of expanding the filtration area and increasing the number of filtering layers on the filtration efficiency; a filter cartridge with 8 layers of knit polyester fabric with a surface area of 900 cm(2) and sized 25 x 14 x 8 cm achieved filtration efficiencies of 98% at 95 L/min and 99.5% at 30 L/min. The assembled filter kit consists of a filter cartridge (14 Pa) carried in a small backpack connected to a half mask with a total pressure drop of 84 Pa at 95 L/min. In addition, it is reusable, and the filter material can be regenerated at least ten times by simple methods, such as boiling. We have demonstrated a novel approach for creating high-quality and easy-to-breathe-through respiratory protective equipment that reduces operating costs and is a green solution because it is easy to regenerate.Správná ochrana dýchacích cest je klíčovým faktorem pro omezení rychlosti šíření COVID-19 a zajištění bezpečného prostředí pro zdravotnické pracovníky. Tradiční respirátory N95 (FFP2) se nedají snadno regenerovat a vytvářejí tak určitou finanční a ekologickou zátěž; navíc se jejich kvalita může výrazně lišit. Žádoucí je řešení, které by tyto nevýhody překonalo. V této studii byla jako filtrační materiál vybrána komerčně dostupná pletená polyesterová fleecová tkanina a bylo připraveno celkem 25 filtrů různých ploch a tlouštěk. Poté byla vyhodnocena účinnost filtrace s rozlišením velikosti (40-400 nm) a pokles tlaku při objemovém průtoku 95 l/min. Prokázali jsme vynikající synergický efekt rozšíření filtrační plochy a zvýšení počtu filtračních vrstev na účinnost filtrace; filtrační patrona s 8 vrstvami pletené polyesterové tkaniny o ploše 900 cm(2) a rozměrech 25 x 14 x 8 cm dosáhla účinnosti filtrace 98 % při 95 l/min a 99,5 % při 30 l/min. Sestavená filtrační sada se skládá z filtrační patrony (14 Pa) nesené v malém batohu spojeném s polomaskou s celkovým tlakovým spádem 84 Pa při 95 l/min. Navíc je opakovaně použitelný a filtrační materiál lze jednoduchými metodami, jako je vaření, nejméně desetkrát regenerovat. Prokázali jsme nový přístup k vytvoření vysoce kvalitních a snadno dýchatelných dýchacích ochranných prostředků, které snižují provozní náklady a jsou ekologickým řešením, protože se snadno regenerují

Deep Airway Inflammation and Respiratory Disorders in Nanocomposite Workers

Thousands of researchers and workers worldwide are employed in nanocomposites manufacturing, yet little is known about their respiratory health. Aerosol exposures were characterized using real time and integrated instruments. Aerosol mass concentration ranged from 0.120 mg/m3 to 1.840 mg/m3 during nanocomposite machining processes; median particle number concentration ranged from 4.8 × 104 to 5.4 × 105 particles/cm3. The proportion of nanoparticles varied by process from 40 to 95%. Twenty employees, working in nanocomposite materials research were examined pre-shift and post-shift using spirometry and fractional exhaled nitric oxide (FeNO) in parallel with 21 controls. Pro-inflammatory leukotrienes (LT) type B4, C4, D4, and E4; tumor necrosis factor (TNF); interleukins; and anti-inflammatory lipoxins (LXA4 and LXB4) were analyzed in their exhaled breath condensate (EBC). Chronic bronchitis was present in 20% of researchers, but not in controls. A significant decrease in forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) was found in researchers post-shift (p ˂ 0.05). Post-shift EBC samples were higher for TNF (p ˂ 0.001), LTB4 (p ˂ 0.001), and LTE4 (p ˂ 0.01) compared with controls. Nanocomposites production was associated with LTB4 (p ˂ 0.001), LTE4 (p ˂ 0.05), and TNF (p ˂ 0.001), in addition to pre-shift LTD4 and LXB4 (both p ˂ 0.05). Spirometry documented minor, but significant, post-shift lung impairment. TNF and LTB4 were the most robust markers of biological effects. Proper ventilation and respiratory protection are required during nanocomposites processing

Manikin-based size-resolved penetrations of CE-marked filtering facepiece respirators

Summarization: The purpose of this manikin-based study was to determine the percentage penetrations of nine CE-marked filtering facepiece respirator models (two samples from each) from filtering classes FFP1, FFP2, and FFP3 and to demonstrate by an independent measurement method the disadvantages and shortcomings of the currently valid European Norm (EN 149: 2001) for filtering facepieces. All of the filtering facepieces were evaluated size-selectively in an experimental chamber using charge-neutralized monodisperse ammonium sulfate in 9 sizes ranging from 20-400 nm of count median diameter (CMD) under flowrate of 95 L/min. The results were then compared to the previous study concerning penetrations of 47-mm diameter filters cut from the filtering material of identical filtering facepieces. Although these two experimental methods for measuring penetrations of filtering materials from filtering facepieces are in good agreement (R-2 = 0.91), the results show within-respirator variations in all three filtering classes (5.5-19.3% for all FFRs in FFP1, 2.8-8.5% in FFP2, and 0.1-2.8% in FFP3). The most penetrating particle size (MPPS) in this study was found to be in the range of 25-65 nm (CMD), which is in agreement with the range of 30-60 nm found in the previous study. Moreover, 7 out of 9 FFR models reached higher penetrations from manikin-based respirator measurements than during measurements of filters from the respective respirators. Furthermore, penetration levels increased up to similar to 50% when the respirator was not sealed around the face of the manikin, indicating that the real protection level provided by these filtering facepieces may be even lower if the respirator does not fit perfectly. Considering that poor filtration efficiency and poor fit may increase under real work conditions, the particle penetration is even higher than was found in this study. Therefore, the CE-marked respirators examined in this study may not be efficient in providing the expected level of protection for workers exposed to nanoparticlesPresented on: Journal of Occupational and Environmental Hygien

Markers of Oxidative Stress in the Exhaled Breath Condensate of Workers Handling Nanocomposites

Researchers in nanocomposite processing may inhale a variety of chemical agents, including nanoparticles. This study investigated airway oxidative stress status in the exhaled breath condensate (EBC). Nineteen employees (42.4 ± 11.4 y/o), working in nanocomposites research for 18.0 ± 10.3 years were examined pre-shift and post-shift on a random workday, together with nineteen controls (45.5 ± 11.7 y/o). Panels of oxidative stress biomarkers derived from lipids, nucleic acids, and proteins were analyzed in the EBC. Aerosol exposures were monitored during three major nanoparticle generation operations: smelting and welding (workshop 1) and nanocomposite machining (workshop 2) using a suite of real-time and integrated instruments. Mass concentrations during these operations were 0.120, 1.840, and 0.804 mg/m3, respectively. Median particle number concentrations were 4.8 × 104, 1.3 × 105, and 5.4 × 105 particles/cm3, respectively. Nanoparticles accounted for 95, 40, and 61%, respectively, with prevailing Fe and Mn. All markers of nucleic acid and protein oxidation, malondialdehyde, and aldehydes C6–C13 were elevated, already in the pre-shift samples relative to controls in both workshops. Significant post-shift elevations were documented in lipid oxidation markers. Significant associations were found between working in nanocomposite synthesis and EBC biomarkers. More research is needed to understand the contribution of nanoparticles from nanocomposite processing in inducing oxidative stress, relative to other co-exposures generated during welding, smelting, and secondary oxidation processes, in these workshops