Background
:
Knowledge about COVID-19 in pregnancy is limited, and evidence on the impact of the infection during pregnancy and postpartum is still emerging.
Aim
:
To analyze maternal morbidity and mortality due to severe acute respiratory infections (SARI), including COVID-19, in Brazil.
Methods
:
National surveillance data from the SIVEP-Gripe
(Sistema de Informação de Vigilância Epidemiológica da Gripe)
was used to describe currently and recently pregnant women aged 10-49 years hospitalized for SARI from January through November, 2020. SARI cases were grouped into: COVID-19; influenza or other detected agent SARI; and SARI of unknown etiology. Characteristics, symptoms and outcomes were presented by SARI type and region. Binomial proportion and 95% confidence intervals (95% CI) for outcomes were obtained using the Clopper-Pearson method.
Results
:
Of 945,460 SARI cases in the SIVEP-Gripe, we selected 11,074 women aged 10-49 who were pregnant (7,964) or recently pregnant (3,110). COVID-19 was confirmed in 49.4% cases; 1.7% had influenza or another etiological agent; and 48.9% had SARI of unknown etiology. The
pardo
race/ethnic group accounted for 50% of SARI cases. Hypertension/Other cardiovascular diseases, chronic respiratory diseases, diabetes, and obesity were the most common comorbidities. A total of 362 women with COVID-19 (6.6%; 95%CI 6.0-7.3) died. Mortality was 4.7% (2.2-8.8) among influenza patients, and 3.3% (2.9-3.8) among those with SARI of unknown etiology. The South-East, Northeast and North regions recorded the highest frequencies of mortality among COVID-19 patients.
Conclusion
:
Mortality among pregnant and recently pregnant women with SARIs was elevated among those with COVID-19, particularly in regions where maternal mortality is already high.
Dizziness is a prevalent symptom in the general population, accounting for a
considerable share of physician office visits, and most causes are clinically
treatable. It is also a common indication for neuroimaging studies, in order to
identify a specific etiology and exclude surgical causes. Here, we illustrate
the main peripheral and central causes of dizziness, discussing their possible
differential diagnoses, as well as their most important image aspects.
Hearing disorders are usually unilateral and are more common in women. They can
be congenital or acquired, and hearing loss is categorized as sensorineural,
conductive, or mixed. The onset of hearing loss can be progressive or sudden,
and it is a common reason for seeking medical attention. In this context,
computed tomography and magnetic resonance imaging have assumed critical roles
in the search for an etiological diagnosis and in guiding the therapeutic
approach. In this pictorial essay, we illustrate the common causes of hearing
loss, discussing the possible differential diagnoses and highlighting the most
relevant imaging findings.
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