暂无摘要。

Background: Mass coronavirus disease 2019 (COVID-19) vaccination to achieve herd immunity is an effective means to mitigate the current COVID-19 pandemic. Reports of COVID-19 vaccine-associated allergic reactions and lack of clear local guidance are contributing factors leading to a low vaccine acceptance rate in the community. A task force of experts from the Hong Kong Institute of Allergy (HKIA) has been formed to address current needs. Objective: To formulate a set of consensus statements (CS) on COVID-19 vaccine allergy safety (VAS) in Hong Kong. Methods: A nominated task force of experts managing patients with drug and vaccine allergies in Hong Kong formulated the CS by the Delphi method. An agreement was a priori defined as ≥80% consensus. Results: A total of 11 statements met the criteria for consensus with good overall agreement among task force members, including seven statements on pre-vaccination recommendations and four statements on vaccination and post-vaccination guidance. Individuals with a history of suspected allergic reaction to prior COVID-19 vaccination should not receive further COVID-19 vaccination, and other groups at risk of COVID-19 vaccine-associated allergic reactions have been identified. The importance of pre-vaccination and post-vaccination assessment by frontline healthcare workers and evaluation by allergists are highlighted. Conclusion: The CS provides pragmatic and timely guidance for local frontline healthcare providers on decisions regarding COVID-19 VAS.

暂无摘要。

The fast diffusion of the SARS-CoV-2 pandemic have called for an equally rapid evolution of the therapeutic options.The Human recombinant monoclonal antibodies (mAbs) have recently been approved by the Food and Drug Administration (FDA) and by the Italian Medicines Agency (AIFA) in subjects aged ≥12 with SARS-CoV-2 infection and specific risk factors.Currently the indications are specific for the use of two different mAbs combination: Bamlanivimab+Etesevimab (produced by Eli Lilly) and Casirivimab+Imdevimab (produced by Regeneron).These drugs have shown favorable effects in adult patients in the initial phase of infection, whereas to date few data are available on their use in children.AIFA criteria derived from the existing literature which reports an increased risk of severe COVID-19 in children with comorbidities. However, the studies analyzing the determinants for progression to severe disease are mainly monocentric, with limited numbers and reporting mostly generic risk categories.Thus, the Italian Society of Pediatrics invited its affiliated Scientific Societies to produce a Consensus document based on the revision of the criteria proposed by AIFA in light of the most recent literature and experts\' agreement.This Consensus tries to detail which patients actually have the risk to develop severe disease, analyzing the most common comorbidities in children, in order to detail the indications for mAbs administration and to guide the clinicians in identifying eligible patients.

The evolving nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has necessitated periodic revisions of COVID-19 patient treatment and discharge guidelines. Since the identification of the first COVID-19 cases in November 2019, the World Health Organization (WHO) has played a crucial role in tackling the country-level pandemic preparedness and patient management protocols. Among others, the WHO provided a guideline on the clinical management of COVID-19 patients according to which patients can be released from isolation centers on the 10th day following clinical symptom manifestation, with a minimum of 72 additional hours following the resolution of symptoms. However, emerging direct evidence indicating the possibility of viral shedding 14 days after the onset of symptoms called for evaluation of the current WHO discharge recommendations. In this review article, we carried out comprehensive literature analysis of viral shedding with specific focus on the duration of viral shedding and infectivity in asymptomatic and symptomatic (mild, moderate, and severe forms) COVID-19 patients. Our literature search indicates that even though, there are specific instances where the current protocols may not be applicable ( such as in immune-compromised patients there is no strong evidence to contradict the current WHO discharge criteria.

Disease-modifying therapies (DMT) for relapsing-remitting MS (RRMS) act on the immune system, suggesting a need for caution during the SARS-CoV2/Covid-19 pandemic. A group of experts in MS care from Saudi Arabia convened to consider the impact of Covid-19 on MS care in that country, and to develop consensus recommendations on the current application of DMT therapy. Covid-19 has led to disruption to the care of MS in Saudi Arabia as elsewhere. The Expert Panel considered a DMT\'s overall tolerability/safety profile to be the most important consideration on whether or not to prescribe at this time. Treatment can be started or continued with interferon beta, teriflunomide, dimethyl fumarate, or natalizumab, as these DMTs are not associated with increased risk of infection (there was no consensus on the initiation of other DMTs). A consensus also supported continuing treatment regimens with fingolimod (or siponimod) and cladribine tablets for a patient without active Covid-19. No DMT should be imitated in a patient with active Covid-19, and (only) interferon beta could be continued in the case of Covid-19 infection. Vaccination against Covid-19 is a therapeutic priority for people with MS. New treatment should be delayed for 2-4 weeks for vaccination. Where treatment is already ongoing, vaccination against Covid-19 should be administered immediately without disruption of treatment (first-line DMTs, natalizumab, fingolimod), when lymphocytes have recovered sufficiently (cladribine tablets, alemtuzumab) or 4 months after the last dose (ocrelizumab). These recommendations will need to be refined and updated as new clinical evidence in this area emerges.

OBJECTIVE: To assess the quality of Clinical Practice Guidelines (CPG) related to the management of paediatric dental emergencies applicable to the COVID-19 pandemic, through the use of the measuring instrument AGREE II (Appraisal of Guidelines for Research and Evaluation in Europe).
UNASSIGNED: A rigurous online search of CPG was accomplished among the main CPG compilers: National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse, Agency for Healthcare, Research and Quality (AHRQ), Andalusian Health Technology Assessment Department (AETSA), American Academy of Family Physicians, Tripdatabase. Furthermore, because of the need to identify CPG that meet the inclusion criteria, a manual search, among the main national and international dental organizations as well as recognized web sites, was also accomplished.
UNASSIGNED: All of the guides focused on paediatric dental emergencies, available in the database and \"gray\" literature, and published between 2000 and 2020 (applicable to COVID-19 pandemic) were included without any language restrictions. The CPG that did not contain the full paper or were addressed to adults or children with special needs, were excluded from the selection. The evaluation of the CPG, independently included, were achieved by four (04) experts by using AGREE II.
RESULTS: Five (05) out of twenty-three (23) selected CPG, were classified as \"acceptable\" according to AGREE II. These five guides were evaluated to determine their \"Recommendation degree\". Only one (01) CPG \"Guía Clínica AUGE de Urgencias Odontológicas Ambulatorias-Chile, 2011\" reached a score of 75%, the highest among the other guides (5 domains with a score ≥ 60%, including the domain III \"Rigour of Development\") to be considered as a \"highly recommended\" CPG.
CONCLUSIONS: According to the quality assessment and recommendation degrees criteria from AGREE II, high, middle and low quality CPG were identified. Only one CPG reached a score of 75%, to be classified as \"highly recommended\". Therefore, it is suggested that the existing CPG updates and future CPG use the available tools and methodologies during their elaboration, in order to guarantee their quality.
CONCLUSIONS: High quality CPG for the management of dental emergencies are designed to support dental health professionals in decision-making to adopt specific dental procedures in the current COVID-19 pandemic. As a matter of fact, these CPG might contribute to reduce the risk of transmission, in case of fresh outbreak of the illness. Likewise, they might help to determine which cases warrant medical attention in centres with special facilities for COVID-19.