Introduction: The rate of secondary attacks of SARS-COV-2 is high among household close contacts. Social distancing, isolation and infection control measures are important for preventing exposure to infection, but insufficient. Aim: The study aimed to evaluate possible role of oral ivermectin as a chemoprophylaxis in asymptomatic family close contacts with COVID-19 patients. Materials and Methods: A prospective interventional randomised open label-controlled study was conducted (registered at clinicaltrials.gov; NCT04422561) during June and July 2020. Two arms were designed according to use of ivermectin. In ivermectin arm, contacts received ivermectin according to Body Weight (BW) on day of the diagnosis of their index case. The non-intervention group received no treatment. Both groups were followed-up for two weeks for development of symptoms suggestive of COVID-19. Results: Ivermectin group included 203 contacts (to 52 index cases) aged 39.75±14.94 years; 52.2% were males. Non-intervention group included 101 contacts (to a total of 24 index cases) aged 37.69±16.96 years, 49.5% were males. Fifteen contacts (7.4%) developed COVID-19 in the ivermectin arm compared to 59 (58.4%) in the non-intervention arm (p<0.001). The protection rate for ivermectin was more prominent in contacts aged less than 60-year-old (6.2% infected compared to 58.7% if no treatment). Ivermectin in the protection against SARS-CoV-2 infection had an OR of 12.533 and 11.445 (compared to nontreatment) in both univariate and multivariate models, respectively. Side effects of ivermectin were reported in 5.4%; they were mild. Conclusion: Ivermectin is suggested to be a promising, effective and safe chemoprophylactic drug in management of COVID-19.

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Background A few people infected by the coronavirus become seriously ill, while others show little to no signs of the symptoms, or are asymptomatic. Recent researches are pointing to the fact that the ABO blood group might play an important role in a person’s susceptibility and severity of COVID-19 infection. Aim of the study: try to understand the relationship between ABO groups and COVID-19 (susceptibility and severity). Results A total of (507) patients were included in this study. The study population was divided based on the ABO blood group into types A+, A−, B+, AB, O+, and O−. Blood group A was associated with high susceptibility of infection: group A, 381 (75.1%); and less common in group O, 97 (19.2%), group B, 18 (3.5%), and group AB, 11 (2.2%). The severity of COVID-19 infection was common in non-blood group O where (20 (7.1%), 4 (26.7%), 2 (11%), and 1 (9%) in type A+, A−, B+, and AB, respectively), while in type O 3.1%. And mechanically ventilated patients were 22 (5.9%), 2 (13.4%), 2 (11.1%), and 1 (1%). Mortality was high in blood groups A and B, 16 (4.37%) and 1 (5.5%), respectively, while in blood group O, it was 1%. Conclusion The incidence, severity, and mortality of COVID-19 were common in non-blood group O. While blood group O was protected against COVID-19.

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Background Despite advances in antimicrobial therapy and a range of drainage techniques for the infected pleural area, thoracic empyema continues to be a serious reason behind morbidity and mortality. Although chest ultrasonography has been found to be an efficient diagnostic tool for pleural effusion features, it is rarely utilized to predict the outcomes of pleural illnesses. Aim of the work To determine the impact of sonographic patterns in predicting the outcomes of thoracic empyema patients. Patients and methods In this retrospective study, patients were divided into four groups based on their sonographic patterns: (I) complex non-septated effusions (plankton sign), (II) complex fixed septated effusions, (III) complex mobile septated effusions, and (IV) homogenously echogenic effusions (hematocrit sign). These sonographic patterns were compared to the patients’ co-morbidities, length of stay in the hospital, chest tube drainage, and medicinal or surgical therapy effectiveness. Results In comparison with other sonographic pattern groups, patients in group I (70.6%) and group IV (45.5%) had effective thoracic tube drainage with a very high statistically significant difference (P value < 0.001). For patients in group II (75%) (P value < 0.001), open thoracotomy was a very highly significant effective therapy (P value 0.001). Conclusion The sonographic pattern of thoracic empyema is a useful tool for guiding treatment decisions in these patients.

Background For various types of cancer in oncologic patients, the clinical features of pulmonary embolism (PE) are unknown. The purpose of the study is to identify pulmonary embolism incidence and type among oncologic patients along with evaluating any associated clinical variables. Patients and methods A prospective cohort study was conducted on 540 patients who had various types of cancers and attended to a 1-day care unit of oncology in King Fahd Hospital, Kingdom of Saudi Arabia. Chest CT with contrast and CT pulmonary angiography was applied when indicated. Results This study was conducted on 540 patients who have different types of cancers; among them, 24 (4.44%) developed PE. Pulmonary embolism was reported in 50% of patients who had seminoma and germ cell tumor, while in cancer larynx, it was represented in 33.4% of them. Moreover, PE was less common among patients who had cancer colon, prostate, and breast (6.68%, 4.7%, and 2.54%, respectively). Seven patients with PE (1.3%) were diagnosed incidentally during cancer staging, while 17 patients (3.14%) had symptomatic PE. Eighty-four percent of the PE cases were diagnosed within the first 6 months of cancer diagnosis, while 4/24 (16%) of the PE cases were diagnosed throughout patient follow-up within the first year of diagnosis. Chest pain and dyspnea were the common presentations in confirmed PE either symptomatic or incidental group. Conclusions Low-risk PE was the most frequent degree; massive and sub-massive PE was uncommon in oncologic patients. Dyspnea and chest discomfort are concerning signs of PE in cancer. Meticulous care during the first 6 months for cancer patients to pick up pulmonary embolism is recommended.

Background: Coronavirus disease 2019 (COVID-19) is a virus that is quickly spreading and has heterogeneous clinical features. Early identification of prognostic variables is necessary to coordinate treatment plans and accurately determine patient severity. Objectives: The aim of the current work was to evaluate the possible value of exhaled carbon monoxide (CO) as a marker of inflammation in different severity categories of hospitalized COVID-19 patients. Patients and Methods: A prospective cohort study was conducted on 39 confirmed COVID-19 nonsmoker patients who admitted to isolation unit at Zagazig University isolation hospital from March 2021 to February 2022. They were divided into two groups: Moderate COVID-19 and severe COVID-19. Exhaled carbon monoxide (eCO) was measured on admission (day 1) and after seven days (day 7). Results: It was revealed that there was high statistically significant difference between the studied groups regarding eCO at day one and seven (the level was significantly higher among severe group) (p≤0.001). Also, there were high significant positive correlations between eCO and CRP level in both moderate and severe groups through day one and seven (p≤0.001). Conclusion: It could be concluded that exhaled CO analysis can be viewed as a noninvasive inflammatory marker for determining the level and severity of inflammation as well as forecasting the prognosis of COVID-19 patients.

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