Health Science Reports

ImportanceThe outbreak of highly contagious COVID-19 has posed a serious threat to human health, especially for those with underlying diseases. However, Impacts of COVID-19 epidemic on HD center and HD patients have not been reported. ObjectiveTo summery an outbreak of COVID-19 epidemic in HD center. Design, Setting, and ParticipantsWe reviewed the epidemic course from the first laboratory-confirmed case of COVID-19 infection on January 14 to the control of the epidemic on March 12 in the HD center of Renmin Hospital of Wuhan University. Total 230 HD patients and 33 medical staff were included in this study ExposuresCOVID-19. Main Outcomes and MeasuresEpidemiological, clinical, laboratory, and radiological characteristics and outcomes data were collected and analyzed. 19 COVID-19 HD patients, 19 non-COVID-19 HD patients and 19 healthy volunteers were enrolled for further study about the effect of SARS-CoV-2 infection on host immune responses. Results42 out of 230 HD patients (18.26%) and 4 out of 33 medical staffs (12.12%) were diagnosed with COVID-19 from the outbreak to March 12, 2020. 13 HD patients (5.65%), including 10 COVID-19 diagnosed, died during the epidemic. Only 2 deaths of the COVID-19 HD patients were associated with pneumonia/lung failure. Except 3 patients were admitted to ICU for severe condition (8.11%), including 2 dead, most COVID-19 diagnosed patients presented mild or none-respiratory symptoms. Multiple lymphocyte populations in HD patients were significantly decreased. HD patients with COVID-19 even displayed more remarkable reduction of serum inflammatory cytokines than other COVID-19 patients. Conclusions and RelevanceHD patients are the highly susceptible population and HD centers are high risk area during the outbreak of COVID-19 epidemic. HD Patients with COVID-19 are mostly clinical mild and unlikely progress to severe pneumonia due to the impaired cellular immune function and incapability of mounting cytokines storm. More attention should be paid to prevent cardiovascular events, which may be the collateral impacts of COVID-19 epidemic on HD patients.

BackgroundAt present, there is a global pandemic of coronavirus disease 2019 (COVID-19) pneumonia. For COVID-19 patients, cancer is a coexisting disease that should not be Here, we conducted a multicenter retrospective study to show the clinical information and outcomes of cancer patients infected with COVID-19. MeasurementsMedical records of COVID-19 patients with cancer admitted to hospitals from Jan 5, 2020 to Feb 18, 2020 were collected. ResultsOf the 67 patients (median age: 66 years), the median age of patients with severe illness was older than that of patients with mild symptoms (P<0.001). The proportion of severe patients had co-morbidities was higher than patients with mild disease (P=0.004). During the treatment of COVID-19 pneumonia, tumor progression and recurrence was not observed for those patients still at the anticancer treatment phase. Lymphocytopenia was the main laboratory finding accompanying increased C-reactive protein and procalcitonin in cancer patients, especially in severe cases. By Mar 10, 2020, 18 (26.9%) patients died from COVID-19. The median age of survivors was younger than that of deaths (P=0.014). Lung cancer (n=15, 22.4%) was the most common cancer type and accounted for the highest proportion COVID-19 resulted deaths (33.3%, 5/15). We observed a tendency that patients at the follow-up phase had a better prognosis than that at anticancer treatment phase (P=0.095). ConclusionThis study showed COVID-19 patients with cancer seem to have a higher proportion of severe cases and poorer prognosis. We should pay more intensive attentions to cancer patients infected with COVID-19.

The incidence of acute kidney injury (AKI) in hospitalized patients with coronavirus disease 2019 (COVID-19) is variable, being associated with worse outcomes. The objectives of the study were to evaluate the incidence, risk factors and impact of AKI in subjects hospitalized for COVID-19 in two third- level hospitals in Cordoba, Argentina. A retrospective cohort study was conducted. 448 adults who were consecutively hospitalized for COVID-19 between March and the end of October 2020 at Hospital Privado Universitario de Cordoba and Hospital Raul Angel Ferreyra were included. The incidence of AKI was 19% (n = 85). 50.6% presented AKI stage 1 (n=43), 20% stage 2 (n=17) and 29.4% stage 3 (n=25, of which 18 required renal replacement therapy). In the multivariate analysis, the variables that were independently associated with AKI were: age (adjusted Odd ratio -aOR- =1.30, 95%CI=1.04-1.63, p=0.022), history of chronic kidney disease (aOR=9.92, 95%CI=4.52-21.77, p<0.001), blood neutrophil count at admission (aOR=1.09, 95%CI=1.01-1.18, p=0.037) and requirement for mechanical ventilation (MV) (aOR=6.69, 95%CI=2.24-19.9, p=0.001). AKI was associated with longer hospitalization, greater admission and length of stay in the intensive care unit, a positive association with bacterial superinfection, sepsis, respiratory distress syndrome, MV requirement and mortality (mortality with AKI=47.1% vs without AKI=12.4%, p<0.001). AKI was independently associated with higher mortality (aOR=3.32, 95%CI=1.6-6.9, p=0.001). In conclusion, the incidence of AKI in adults hospitalized for COVID-19 was 19% and had a clear impact on morbidity and mortality. Local predisposing factors for AKI were identified.

Malignant pleural effusion (MPE) frequently complicates advanced cancer and impairs quality of life. Chemical pleurodesis with agents such as bleomycin or povidone iodine is widely used, but comparative efficacy and safety remain uncertain. Bleomycin is an established agent but is costly and less available, whereas povidone iodine is affordable and easily accessible. This study aimed to systematically compare the efficacy and safety of bleomycin versus povidone iodine for pleurodesis in patients with malignant pleural effusions. We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, Semantic Scholar, and the Google Scholar were searched through May 20th 2025. Studies included randomized controlled trials and cohort studies comparing bleomycin and povidone iodine for pleurodesis in patients with MPE. Seven studies with 392 patients (174 in the povidone iodine group, 218 in the bleomycin group) were included. Success rates for pleurodesis ranged from 71.1% to 100% for povidone iodine and 66.7% to 95.2% for bleomycin. Meta-analysis showed no significant difference in efficacy (RR = 1.04, 95% CI: 0.94-1.15, p = 0.50; I2 = 43%). Both agents were well tolerated, with similar rates of mild adverse events. This study showed no significant bias. Povidone iodine and bleomycin are equally effective and safe for pleurodesis in MPE. Given its lower cost and greater accessibility, povidone iodine may be preferred, especially in resource-limited settings.

The COVID-19 pandemic has caused an evolving public health crisis and challenged the medical system globally, especially in the rural-stricken regions. There is concern about the spread of coronavirus in regions with lower education level, weaker health systems and underdeveloped economy. The risk of viral transmission in HD center is elevated because of the densely-populated and high mobility in an enclosed environment.This paper demonstrated the main experiences and strategies of preventing secondary COVID-19 transmission in a HD center from a poverty-stricken rural region in China. Data of subjects including 17 medical workers and 249 patients were collected from the HD center in Huangchuan County Peoples Hospital from February to April 2020. It is the first paper to provide the experiences and strategies about preventing COVID-19 secondary transmission in HD center for poverty-stricken rural region.

IntroductionRecent events highlight how emerging and re-emerging pathogens are becoming global challenges for public health. In December 2019, a novel coronavirus has emerged. This has suddenly turned out into global health concern. ObjectivesAim of this research is to focus on the bibliometric aspects in order to measure what is published in the first 30-days of a global epidemic outbreak MethodsWe searched PubMed database in order to find all relevant studies in the first 30-days from the first publication. ResultsFrom the initial 442 identified articles, 234 were read in-extenso. The majority of papers come from China, UK and USA. 63.7% of the papers were commentaries, editorials and reported data and only 17.5% of the sources used data directly collected on the field. Topics mainly addressed were "epidemiology", "preparedness" and "generic discussion". NNR showed a reduction for both the objectives assessed from January to February. Conclusions"Diagnosis" and effective preventive and therapeutic measures were the fields in which more research is still needed. The vast majority of scientific literature in the first 30-days of an epidemic outbreak is based on reported data rather than primary data. Nevertheless, the scientific statements and public health decisions rely on these data. Strengths of our studyThis is the first bibliometric research in Pubmed Database on the first 30 days of publications regarding the novel Coronavirus (SARS-nCoV-2) outbreak of 2019. The vast majority of publication in the first 30-days of an epidemic outbreak are reported data or comments, and only a small fraction of the papers have directly collected data. Limitations of our studyOur research is only PubMed based. It ill be auspicable to consult more than one relevant database in future papers. In addition, we excluded non-English publications leading to a potential bias due to the fact that the outbreak started in China.

BackgroundCatheter-related bloodstream infection (CRBSI) is a major cause of morbidity and mortality among patients undergoing hemodialysis (HD), particularly in low- and middle-income settings where non-tunneled hemodialysis catheters (NTHC) are widely used. Local epidemiological data are essential to guide preventive and therapeutic strategies. ObjectivesTo determine the prevalence, microbiological profile, antimicrobial resistance patterns, and clinical outcomes of CRBSI in patients undergoing HD via internal jugular NTHC at a tertiary care center in South India. MethodsThis retrospective observational study included adults initiated on HD using internal jugular NTHC between January 2017 and December 2023. Patients with pre-existing infections or catheters inserted elsewhere were excluded. CRBSI was defined using KDOQI criteria. Demographic, clinical, laboratory, microbiological, and outcome data were analyzed. Logistic regression identified risk factors, and receiver operating characteristic (ROC) analysis evaluated predictors of adverse outcomes. ResultsAmong 396 patients (mean age 56.3 {+/-} 14 years; 70.4% male), 65 (16.4%) developed CRBSI, with an incidence of 4.7 per 1000 catheter days. Emergency HD initiation (OR 14.86, p < 0.001) and access failure (OR 2.71, p = 0.004) significantly increased CRBSI risk, while planned initiation for uremic symptoms was protective. Patients with CRBSI had lower serum albumin and higher leukocyte counts. Gram-negative organisms predominated (53.8%), with Klebsiella pneumoniae being the most common isolate. High resistance was observed to {beta}-lactam/{beta}-lactamase inhibitor combinations and carbapenems. Gram-negative CRBSI was associated with significantly higher odds of hospitalization, ICU admission, inotropic support, and mortality. ROC analysis showed good predictive ability for adverse outcomes (AUC 0.73-0.77). ConclusionsCRBSI remains a significant complication of NTHC-based HD. Predominant Gram-negative infections with high antimicrobial resistance are associated with worse clinical outcomes, underscoring the need for early permanent access creation, strict catheter care, and robust antibiotic stewardship.

Given the vulnerability of people with chronic kidney disease to COVID-19, nephrology societies have issued statements calling for prioritization of these patients for vaccination. It is not yet known whether COVID-19 vaccines confer the same high level of protection in patients with kidney disease. The aims of this study were to evaluate the safety measured by the events supposedly attributed to vaccines and the effectiveness evaluated by the presence of antibodies in dialysis patients immunized with the COVID-19 Sputnik V vaccine. Methodsmulticenter, observational and analytical study of a prospective cohort of hemodialysis patients in the Autonomous City of Buenos Aires with a vaccination plan. Patients older than 18 years on dialysis who received both components of the COVID-19 vaccine were included. Results491 patients included in the safety analysis. ESAVI with either the first or second component was detected in 186 (37.9% 95% CI 33.6%-42.34%). The effectiveness analysis measures of antibodies against SARS-Cov-2 were performed in 102 patients, 98% had positive IgG against SARS-Cov-2 antibodies 21 days after the second component .In patients with COVID-19 prior to vaccination, antibodies at day 21 after the first component reached almost the highest levels compared to those patients who did not have COVID-19, and the rise between the last measures was lower than patients without COVID-19. ConclusionDialysis patients constitute a vulnerable population for SARS-Cov-2 infection, beyond the recommendations that were implemented by dialysis units, full vaccination is a priority and necessary. The Sputnik V vaccine has been shown to be safe and effective in this patient population.

IntroductionTuberculosis (TB) remains as an important concern of public health worldwide because the high prevalence and severe sequelae. Tuberculous meningitis (TBM) is the most lethal and disabling form. AimTo describe the clinical, laboratory, and neuroimaging characteristics of TBM on admission at neurological center in Mexico City. MethodsRetrospective cohort study at the third level neurological center from 2010 to 2016. Clinical follow-up was evaluated at hospital discharge, three months, and one-year either due to lack of follow-up or mortality, during the follow-up the adverse events were registered. ResultsOne-hundred and six patients were included, 74 (69.8%) males and 32 (30.2%) females. From these 31 (29.2%) were HIV-positive. The median age was 35.5 (IQR:28-51). Pulmonary TB was found in 25% of the population. Alcoholism was observed in a half of the patients while diabetes in 15%, the latter being significant (p=0.04). Abnormalities in neuroimaging were significant among our population (p=0.003). Only one-third of the population had a positive Lowenstein-Jensen culture. There were no differences in clinical outcomes between HIV positive and non-HIV patients. ConclusionOur study shows data to those described in the literature. The initiation of empirical treatment in all patients with a high clinical suspicion of tuberculosis mandatory to try to avoid severe neurological sequels.

After the outbreak of the middle east respiratory syndrome (MERS) worldwide in 2012. Currently, a novel human coronavirus has caused a major disease outbreak, and named corona virus disease 2019 (COVID-19). The emergency of MRES-COV and COVID-19 has caused global panic and threatened health security. Unfortunately, the similarities and differences between the two coronavirus diseases remain to be unknown. The aim of this study, therefore, is to perform a systematic review to compare epidemiological, clinical and laboratory features of COVID-19 and MERS-COV population. We searched PubMed, EMBASE and Cochrane Register of Controlled Trials database to identify potential studies reported COVID-19 or MERS-COV. Epidemiological, clinical and laboratory outcomes, the admission rate of intensive cure unit (ICU), discharge rate and fatality rate were evaluated using GraphPad Prism software. Thirty-two studies involving 3770 patients (COVID-19 = 1062, MERS-COV = 2708) were included in this study. The present study revealed that compared with COVID-19 population, MERS-COV population had a higher rate of ICU admission, discharge and fatality and longer incubation time. It pointed out that fever, cough and generalised weakness and myalgia were main clinical manifestations of both COVID-19 and MERS-COV, whereas ARDS was main complication. The most effective drug for MERS-COV is ribavirin and interferon.

BackgroundA novel coronavirus (SARS-CoV-2) causing coronavirus disease (COVID-19) was detected at the end of 2019 in China. There are many COVID-19 studies in progress however, little is known about the course of COVID-19 in people living with HIV (PLWH). The aim of our study was to describe epidemiology and clinical characteristics of PLWH diagnosed with COVID-19 reported form Central and Eastern European Countries. MethodsOn-line survey was sent to Euroguidelines in Central and Eastern Europe (ECEE) Network Group. Analysis included all confirmed COVID-19 cases between March 11 and June 26 2020 among PLWH in 12 countries: Albania, Belarus, Bosnia and Herzegovina, Bulgaria, Czech Republic, Estonia, Hungary, Lithuania, Poland, Romania, Russia, and Serbia. ResultsIn total 34 cases were reported. The mean age of those patients was 42.7 years (IQR = 35.8-48.5) and most of the patients were male (70.6% vs 29.4%). The mean CD4+ T-cell count prior COVID-19 diagnosis was 558 cells/mm3 (IQR = 312-719) and HIV RNA viral load (VL) was undetectable in 18 of 34 (53%) cases, the data about most recent HIV RNA VL was not available in three cases (8,8%). Comorbidities were observed in 19 (55.9%) patients, mostly cardiovascular disease (27,8%), and in 10 (29.4%) patients had coinfection, mostly chronic hepatitis C (87.5%). The clinical course of COVID-19 was asymptomatic in 4 (12%) cases, mild disease without hospitalization was reported in 11 (32%) cases. Stable patients with respiratory and/or systemic symptoms have been documented in 14 (41%) cases; 5 (15%) patients were clinically unstable with respiratory failure. Full recovery was reported in 31 (91%) cases, two patients died. In one case the data was not available. ConclusionThis study from 12 countries in Central and Eastern Europe region indicates no alarming signals of increased morbidity or mortality from COVID-19 among HIV-positive persons there is a need for further research.

The novel coronavirus (COVID-19) is known to be the fifth pandemic causing massive deaths worldwide. This virus has not only been deeply associated with acute respiratory distress, but also acute kidney injury (AKI). This study describes the baseline characteristics and various outcomes of AKI based on the KDIGO 2012 Clinical Practice Guidelines in patients hospitalized with COVID-19 at a Philippine tertiary hospital. A total of 195 patient records were retrospectively reviewed for the study. Of the 195 patients, 81(42%) patients developed AKI. Significant baseline characteristics included older age (56.28 + 14.12), presence of hypertension (p=0.004), diabetes mellitus (p=0.002), and cardiovascular disease (p=0.003). Also, the use of diuretics, inotropes and antibiotics were more prevalent in patients who developed AKI. Most of the patients who had AKI were categorized as stage 1 (49.38%). Mechanical ventilation was significantly (p<0.001) more prevalent in patients with AKI (20.99%) compared to patients without AKI (5.26%). There was significantly higher rates (p<0.001) of renal replacement therapy in patients with AKI (30.86%). Lastly, higher mortality rates were observed in patients with AKI (50.62%) versus patients without AKI (12.28%). Our study demonstrated that patients with COVID-19 can develop AKI and tend to have a poorer prognosis.

IntroductionSome hemodialysis patients are reluctant to COVID-19 for the development of adverse events (AEs). The aim of this study was to verify the safety of mRNA-1273 vaccine in hemodialysis patients. MethodsWe conducted a retrospective analysis of in-center hemodialysis patients who underwent mRNA-1273 vaccine from March 1st to April 30th, 2021. All AEs occurring after the first and the second doses were collected and classified as local or systemic. ResultsOverall, 126 patients on chronic maintenance dialysis without a prior COVID-19 diagnosis were vaccinated with two doses of mRNA-1273 vaccine. Mean age was 68 (IQR, 54,7-76) years and 53.6% of patients were aged [&ge;] 65 years. During the observational period of 68 (IQR, 66-70) days, AEs occurred in 57.9% and 61.9% of patients after the first dose and second dose, respectively. The most common AEs were: injection-site pain (61.9%), erythema (4.8%), itching (4.8%), swelling (16.7%), axillary swelling/tenderness (2.4%), fever (17.5%) headache (7.9%), fatigue (23.8%), myalgia (17.5%), arthralgia (12.7%), dyspnoea (2.4%), nausea/vomiting (7.1%), diarrhoea (5.6%), shivers (4%) and vertigo (1.6%). The rates of local AEs were similar after the first and second doses (P=0.8), whereas systemic AEs occurred more frequently after the second dose (P=0.001). Fever (P=0.03), fatigue (P=0.02) and nausea/vomiting (P=0.03) were significantly more frequent after the second dose of the vaccine. There were no age-related differences in the rate of AEs. Overall, vaccine-related AEs in hemodialysis patients seem to be lower than in the general population. ConclusionRNA-1273 vaccine was associated with the development of transient AEs after the first (57.9%) and second doses (61.9%) in patients on chronic maintenance hemodialysis. Systemic AEs were more common after the second dose. Overall, all AEs lasted for a few days, without any apparent sequelae.

The outbreak of COVID-19 has significant impact on health care systems. The workflow in renal care facilities and dialysis facilities is complex. The aim of his study was to explore multinational renal physician perspective about the disruption of outflow of renal service amid COVID-19 pandemic. Methodswe distributed a questionnaire electronically to renal physicians of various grades from 5 countries. The questionnaire was formulated of 9 questions with domains centered on the acute and chronic renal services Results97 physicians took part in the survey from 5 countries. 58% of the participating renal physicians agreed that there has been disruption to the acute service offered to renal patients. 38% of the physicians who took the survey report disruption to the hemodialysis facilities. ConclusionAt this challenging time of the pandemic, it is important to perform audits and quality control to explore the deficiencies of acute and chronic renal care pathways.

ObjectiveTo determine the clinical and laboratory characteristics, as well as evaluating the factors associated with mortality in patients with COVID-19 infection and acute kidney injury (AKI) hospitalized in the Intensive Care Unit (ICU) of the Hospital Nacional Arzobispo Loayza. Materials and MethodsRetrospective cohort study, with convenience sampling during the period from April 2020 to March 2021, through the review of medical records data. Inclusion criteria were; patients [&ge;] 18 years old, with a diagnosis of COVID-19 infection, who were admitted to ICU with normal renal function and developed AKI during their stay in ICU. Exclusion criteria were; patients who developed AKI prior to ICU admission, patients with chronic kidney disease with and without dialysis. ResultsA total of 177 medical records that met the inclusion and exclusion criteria were evaluated. The mean age was 57.2{+/-}13.2 years, 145 (81.4%) were male; comorbidities were: obesity 112(63.3%), arterial hypertension 55 (31.1%) and diabetes mellitus 30(16.9%); the most frequent cause of AKI was hypoperfusion (93%). 83 participants (46.8%) received dialytic support in the intermittent hemodialysis modality. In-hospital mortality was 151 (85.3%) and was higher in the group with stage 3 AKI: 109 (72.2%). The increase in ferritin level (OR: 10.04 (95%CI 4.4-38.46), p<0.001) and APACHE score (OR: 1.75 (95%CI 1.4-2.12), p<0.001), as well as the decrease in PaO2/FiO2 level (OR: 0.85 (95%CI 0.59-0.92), p<0.041, were related to mortality. ConclusionsAKI in ICU patients with COVID-19 infection has a high mortality and the related factors were the increase in APACHE II score and ferritin level, as well as the decrease in PaO2/FiO2 level.

BackgroundSince December 2019, Coronavirus Disease 2019(COVID-19) occurred in wuhan, China, and outbreaked rapidly into a global pandemic. This current poses great challenges to hemodialysis (HD) patients. ObjectiveTo make a comprehensive evaluation and comparison between HD patients confirmed with COVID-19 and the general HD patients. MethodsHD patients confirmed with COVID-19 in Wuhan No.5 Hospital were admitted as confirmed group from Jan 10 to Mar 15, 2020. And HD patients not infected in our dialysis center were chosen as control group. General characteristics, laboratory indicators were retrospectively collected, analyzed and compared. ResultsA total of 142 cases were admitted, including 43 cases in confirmed group and 99 in control group. Body mass index (BMI) was slightly lower in confirmed group than that in control group (P=0.011). The proportion of one or less underlying disease in confirmed group(51.16%) was higher than that in control group(14.14%)(P< 0.001), and the proportion of three or more underlying diseases in confirmed group(11.63%) was lower than that in control group(52.53%)(P< 0.001). Patients in confirmed group exhibited significantly lower hemoglobin, lymphocyte count, and lymphocyte percentage, but higher neutrophil percentage, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein, aspartate transaminase, and alkaline phosphatase. There was no significant difference in age, gender, dialysis age, primary disease, the using of ACEI/ARB, platelet-to-lymphocyte ratio (PLR), and other indicators between the two groups. ConclusionsFaced with Severe Acute Respiratory Syndrome-CoV-2 (SARS-CoV-2), HD patients with lower BMI and hemoglobin were more susceptible to be infected, which might be related to malnutrition. Once confirmed with COVID-19, HD patients expressed obviously dis-regulated of inflammation and immune.

While the novel coronavirus continues to spread worldwide, the reported incubation period has varied between studies and is imprecise due to limited data. A literature search with certain selection criteria was conducted on May 30, 2020. In total, sixty-four articles were included, and 854 individual-level data were extracted from 30 studies for pooled analysis. Of these studies, 72% of them reported a median or mean incubation period of 4-7 days, while our estimated median was 4.9 days (95% confidence interval [CI]: 4.6-5.2). However, the inclusion of 81 asymptomatic and presymptomatic patients, as well as 31 cases with incubation periods exceeding 14 days, led to our estimation of 97.5 th percentile with 19.3 days (95% CI: 17.4-21.4), beyond the currently suggested 14-day quarantine period. Therefore, we appeal to prolong the quarantine duration, especially for areas that have insufficient testing resources, to protect susceptible populations from being infected. Article Summary LineThis article reviewed the COVID-19 studies involving incubation period and provided pooled estimation based on available data from these studies.The result showed that our estimated median incubation period is consistent with the estimates of formal studies but the 97.5 percentile is larger than ever on account of including a number of asymptomatic and presymptomatic patients.These finds suggested that we should properly prolong the isolation or quarantine period in order to identify more patients with longer incubation period and those without any symptoms.

IntroductionDespite the new SARS-CoV-2 (COVID-19) be the seventh of the coronavirus family viruses known to cause human disease, little is known about potential symptoms and syndromes secondary to the compromise of the central and peripheral nervous systems. We reviewed neurological manifestations due to the new coronavirus, thus far published in the literature, as well as guidelines issued by sub-specialties in Neurology, to tackle the disease. Methodswe searched medical databases, such as PubMed, PubMed Central, LILACS and Google scholar for papers (case reports, short letters, case series, etc) describing neurological symptoms in patients with confirmed or suspect COVID-19 diagnosis and also searched webpages of associations and organizations that deal with neurological disorders. Resultswe describe briefly each article considered for this review. Forty-one papers were found associating neurological conditions and COVID-19. Cases are divided by disease groups and, within each disease group, results are listed in chronological order or publication date. We also discuss briefly recommendations for neurological patients, according to disease group. ConclusionAlthough there is evidence of neurological manifestations with previous coronaviruses, COVID-19 is assuring a volume of published papers not seen before for other coronavirus infections. Most neurological cases are not life-threatening, but 10 to 20% of cases will require hospitalization and are in risk for sequelae and death. Although a lot of data coming from these papers is amassing, researchers must bear in mind that many papers currently published are not yet peer-reviewed, and thus are prone to further corrections.

IntroductionRenal disease is asymptomatic in its early stages but on progression into advanced stage is expensive to manage requiring renal replacement therapy. Monitoring of childrens renal functionality is not routinely done but only on a doctors request. However, there is currently no published study on renal disease prevalence among children living with HIV in Uganda and the associated factors. ObjectiveTo determine the prevalence of renal disease and its associated factors among HIV positive children on ART at the Joint Clinical Research Center (JCRC) Pediatric clinic. MethodsWe conducted a cross sectional study from JCRC Pediatrics Clinic. Children attending the clinic between January and August, 2020 were recruited using consecutive sampling. Information on age, sex, z sore for age, Blood pressure, route of transmission, clinical stage of the disease, ART regimen, duration on ART, non-ART drugs, Viral load and comorbidities was obtained. Blood and urine samples were also collected from the participants and sent to the laboratory for analysis. Renal disease was diagnosed using either proteinuria on urine dipstick or reduced estimated Glomerular Filtration Rate, (eGFR). ResultsThe study participants were 261, of which 51% were female and 49% male, with a median age of 12 years. The prevalence of renal diseases was 21.5% as proteinuria and 9.6% with low eGFR. Factors associated with proteinuria were; age (p-value =0.01), clinical stage of the disease (p=0.035) and diastolic blood pressure (DBP, p = 0.001) and with low eGFR were; DBP (p < 0.001) and clinical stage of disease (p < 0.001). ConclusionThe prevalence of proteinuria was high (21.5%) and that of low eGFR was (9.1%). Early screening for renal disease when still asymptomatic as a preventive strategy for renal disease should be considered, especially using affordable yet effective methods like urinalysis. This is because all the participants were asymptomatic at the time of enrollment.

The prevalence of chronic kidney disease (CKD) has been increasing all over the world due to the high-risk factors of metabolic syndrome. But, unfortunately, the cost of dialysis and the scarcity of dialysis center and dialysate are making it more complex for the people in least developed countries. Probiotics are being studied as a potential treatment option for chronic kidney disease, especially in the dialysis patients. The aim of this review is to investigate the effects of probiotics administration in dialysis patients in end-stage kidney disease. A systemic search was conducted on MEDLINE database from 2002 to 2023 using key terms related to dialysis, end-stage kidney disease and probiotics. Fifteen studies met eligibility criteria, among which thirteen were on hemodialysis patients and others on peritoneal dialysis patients. The results of the studies revealed that probiotics have some significant effect on gut dysbiosis, gastrointestinal symptoms, uremic toxins, inflammation and overall quality of life of dialytic patients. Studies showed that administration of probiotics inhibit the growth of pathogenic bacteria as well as production of protein-bound uremic toxins (i.e. indoxyl sulfate and p-cresol sulfate) which can not be fully excreted by dialysis. The level of serum TNF-, IL-5 and IL-6 were significantly decreased in peritoneal dialysis patients. However, further investigations must be carried out with larger sample size with larger study duration and wit different probiotics or synbiotics preparations to obtained more specific explanations of the effects and mechanisms of probiotics to counteract the disease progression on dialysis patients in end-stage kidney disease.