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Hematologic malignancies are risk factors for severe COVID-19 infection. Identification of risk factors correlated with mortality in these groups of patients is important in the assessment strategy. We studied the characteristics of patients with hematologic malignancies and COVID-19 and then analyzed the predictors of mortality.Eligible for the analysis were hospitalized patients with hematologic malignancies and confirmed COVID-19 infection observed between January 2020 and March 2021. Patients were categorized based on the type of malignancy and phase of the treatment.A total of 194 COVID-19 infected patients with hematologic malignancies were included. The median age was 44 (15-81) years; 135 of them were males and 59 were females. Acute myeloid leukemia was the most frequent cancer type (43.8%). A total of 119 patients had severe COVID-19 and 61 patients were admitted to the intensive care unit. A total of 92 deaths occurred in all cases for an overall case-fatality rate of 47%. Male gender, preinduction and induction phase of the treatment, intensive care admission, low levels of oxygen saturation, Rhesus (RH) factor positivity, and higher fibrinogen level correlated with mortality.This study focuses on the epidemiology, risk factors, outcomes, and predictors of mortality of COVID-19 among patients with hematologic malignancies. Patients with hematologic malignancies are at high risk of mortality.

Endothelial injury by toxins, drugs, immune complexes leads to activation of coagulation cascade and thrombosis, which result in platelet consumption and red blood cell injury These thrombotic microangiopathies can potentially injure numerous organs and result in organ dysfunction In this case, we present the fourth reported patient with thrombotic thrombocytopenic purpura associated with COVID-19 © 2021, Tehran University of Medical Sciences All rights reserved

Coronavirus disease 2019 (COVID-19) pandemic has affected more than 40 million people worldwide. Some patients had episodes of symptom recurrence after the first episode of infection with variable intervals. There are multiple issues and hypotheses about re-infection or re-activation of the virus, especially in immunocompromised patients. In this paper, we present details of an individual with a recent history of COVID-19 who proceeded to acute myeloid leukaemia M3 and immunosuppression by chemotherapy, then we review some recently published articles about possible re-infection or re-activation.

Introduction: The main pathogenesis of COVID-19, especially in patients with moderate to severe COVID-19 pneumonia, is through cytokine release syndrome. This cytokine release causes tissue edema, chemotaxis of immune cells, and also vascular endothelial disruption. Thalidomide is an old drug with several effects on inflammation and also on immune cells physiology. Materials and Methods: 50 patients with moderate COVID-19 pneumonia, were included in this study in the Thalidomide group and control group. We administered Thalidomide 100 mg daily for 14 days + Dexamethasone + Remdesivir in the Thalidomide group and Dexamethasone + Remdesivir as the standard of care in our center in the control group. We evaluated oxygen saturation improvement to more than 94% and also the duration of hospital admission and mortality in our study. Results: We did not find any difference between these two groups in terms of duration of hospital stay (8.9 days in the Thalidomide group versus 9.6 in the control group), improvement of oxygen saturation at the first week and second week (Pvalue: 0.70 and 0.826 respectively). There was no mortality in both groups. At the end of second week of treatment, the levels of inflammatory markers were not statistically different between these two groups (ESR, CRP, ferritin, LDH, fibrinogen with Pvalue: 0.509, 0.440, 0.121, 0.005, 0.114 respectively). Only LDH in the Thalidomide group was significantly lower at the end of the second week than the control group. Conclusion: In our study, we did not find any relation between Thalidomide administration and effects on oxygen saturation improvement and also the duration of hospital admission and mortality.

Highlights • COVID-19 associated microangiopathies. • TTP as an unusual microangiopathy and its complication. • Standard of treatment in COVID-19 and TTP., Introduction Thrombotic microangiopathies are a group of disorders that are mainly related to endothelial dysfunction. This category of endothelial dysfunction results of several imbalances between platelets, endothelium and immune system, also cytokine production. Aim of this study To report cases with thrombotic thrombocytopenic purpura (TTP) and COVID-19 and review COVID-19 endothelial dysfunction literature. Methods Primary laboratory data, peripheral blood smear, ADAMTS13 antigen activity level, and antibody ordered for each of these four patients. Treatments for COVID-19 administered for all patients. Traditional treatments for TTP also were administered. Results There were numerous schistocytes (more than 5%) in peripheral blood smears for each patient. ADAMTS13 antigen activity level was below 10%, and ADAMTS13 antibody was elevated for each patient. COVID-19 PCR was positive for all patients, and CT-Scans were indicative of the involvement of COVID-19. Conclusion In this case series, we reported four COVID-19 patients who presented with signs and symptoms of anemia and thrombocytopenia, resulting in thrombotic thrombocytopenic purpura.

Introduction: Deferasirox is a new oral iron chelating agent which has been administered in β-thalassemia major patients in last few years. There is some reports regarding nephrotoxicity of this agent; however, no comparative study has been conducted yet. Objectives: The aim of this study was to compare the prevalence of kidney dysfunction in β-thalassemia major patients receiving either desferal or deferasirox as iron chelating agents. Patients and Methods: In this cross-sectional study, adult patients with β-thalassemia major who received 25 mg/kg/d of desferal or 25 mg/kg/d of deferasirox were studied. We compared them for serum calcium (Ca), creatinine (Cr) levels and 24 hours urine collection for proportion of Ca and protein. Estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault formula. Results: Twenty-seven patients receiving desferal and 23 patients receiving deferasirox were evaluated. There was no significant difference of calciuria (P=0.19), glycosuria (P=0.508), mean 24-hour urine proteinuria (P=0.44), mean serum Cr (P=0.47), serum Ca level (P = 0.067) and mean eGFR (P=0.42) between two groups. Conclusion: There is no significant difference of hypercalciuria, glycosuria, mean eGFR, proteinuria, and also serum Cr between β-thalassemia major patients who received desferal or deferasirox.

Return to work (RTW) is an important outcome following disc herniation surgery. The present study aimed at determining factors that may affect early RTW after disc herniation surgery. Data were collected from 603 patients who underwent disc herniation surgery in an educational hospital via phone interviews during a 4-year period (2005-2009). Delayed RTW and failed RTW were associated with female gender, lower educational levels, longer hospitalization periods, greater BMI, biological age exceeding 40 years, employment in manual labor, lack of encouragement by the physician to RTW, being in pain at the time of the phone interview, having negative expectations about the outcome of surgery preoperatively, and low job satisfaction ( P < .05). Psychological and occupational factors have direct effects on RTW. Important factors include positive expectations about the outcome of surgery, encouragement by the physician to RTW, job characteristics, and job satisfaction. RTW can be accelerated by appropriate strategies and team work.