Clinical Case of the Occurrence of Stroke Followed by Death After Vaccine Against SARS-CoV-2

2021-10-22T18:02:35+00:00

Introduction: The current COVID-19 pandemic has involved developing vaccines to control the virulence of SARS-CoV-2. More than 4.1 million people have died from COVID-19.1 In response to this public health emergency, several vaccines against COVID-19 have been developed, with more than 3.7 billion doses administered worldwide. After the introduction of the adenovirus vector vaccine ChAdOx1, several cases of severe venous thrombosis with thrombocytopenia were reported worldwide. Objective: It was to present a case report of a 25-year-old female patient who presented extensive left intraparenchymal hematoma and rapid progression to brain death followed by death. Case report: A 25-year-old woman, CSS, was vaccinated against COVID-19 with the adenovirus ChAdOx1, 14 days after admission, evolved with a fever that started about 13 days ago, associated with holocranial, tight, moderate-intensity headache. On the day of admission, she was found by the torporous, unresponsive, and vomiting family, referred to the hospital emergency room. The patient was admitted to Glasgow 4 with evidence of anisocoria, with the left pupils larger than the right, rapidly progressing to mydriasis. Cranial computed tomography (CT) showed extensive left intraparenchymal hematoma, performing urgent decompressive craniectomy and placement of an intracranial pressure monitoring catheter. The cerebrospinal fluid exam did not show bacteria or fungi. CT angiography showed extensive thrombosis of the anterior portions of the superior sagittal sinus and probable thrombosis of the superficial drainage veins of the frontal regions. Skull CT revealed diffuse and bilateral ischemia. Laboratory tests showed mild thrombocytopenia and no change in the coagulogram. After one day, the patient evolved with worsening neurological status. Sedation was turned off to start the brain death protocol, which was confirmed twice. Finally, an electroencephalogram was performed with evidence of a straight-line tracing, without evidence of electrical brain activity. Final considerations: Several studies have been published regarding cerebral thrombosis, stroke, and thrombotic thrombocytopenic events. Thus, safe and effective vaccines against COVID-19 are an urgent need, as they can leave pathophysiological responses of hypercoagulability and thrombo inflammation associated with acute infection.

The Importance of Religiosity / Spirituality in the Prognosis of Heart Patients: An Approach to the Covid-19 Pandemic

2021-10-22T18:19:47+00:00

Introduction: Religious and spiritual beliefs have long been held to deal with difficult situations. Studies have shown that psychiatric disorders in the short and long term can be reduced by the practice of religiosity and spirituality (R/S). R/S can influence cardiovascular and pro-inflammatory markers, hypertension, obesity, and diabetes. Studies have shown an 18-25% reduction in mortality rates with R/S practices. Objective: This chapter sought to bring together the main results published on the influence of religiosity and spirituality on the cardiac health of patients at risk during the COVID-19 pandemic. Development: R/S practices may be associated with clinical outcomes with less progression of CVD, being a protective predictor. However, R/S is in most medical services neglected in cardiac rehabilitation programs. The results showed that increases in religiosity were associated with increases in weight and QoL in patients who underwent cardiac procedures. The findings suggested that higher levels of R/S might be related to improved QoL among patients with CVD. Conclusion: The studies covered in this chapter revealed that religiosity and spirituality can act positively on several fronts in the COVID-19 pandemic, influencing the mental and physical health of patients with heart and cardiovascular diseases, in addition to helping to develop preventive and therapeutic measures. Health professionals and managers must be able to address these beliefs, seeking to understand them in each of their patients, offering comprehensive care.

Bulletin of Medical and Clinical Research

Clinical Case of the Occurrence of Stroke Followed by Death After Vaccine Against SARS-CoV-2

The Importance of Religiosity / Spirituality in the Prognosis of Heart Patients: An Approach to the Covid-19 Pandemic