Background COVID-19 is a multisystem disease that presents acute and persistent symptoms, the postacute sequelae (PASC). Long-term symptoms may be due to consequences from organ or tissue injury caused by SARS-CoV-2, associated clotting or inflammatory processes during acute COVID-19. Various strategies are being chosen by clinicians to prevent severe cases of COVID-19; however, a single treatment would not be efficient in treating such a complex disease. Mesenchymal stromal cells (MSCs) are known for their immunomodulatory properties and regeneration ability; therefore, they are a promising tool for treating disorders involving immune dysregulation and extensive tissue damage, as is the case with COVID-19. This study aimed to assess the safety and explore the long-term efficacy of three intravenous doses of UC-MSCs (umbilical cord MSCs) as an adjunctive therapy in the recovery and postacute sequelae reduction caused by COVID-19. To our knowledge, this is one of the few reports that presents the longest follow-up after MSC treatment in COVID-19 patients. Methods This was a phase I/II, prospective, single-center, randomized, double-blind, placebo-controlled clinical trial. Seventeen patients diagnosed with COVID-19 who require intensive care surveillance and invasive mechanical ventilation—critically ill patients—were included. The patient infusion was three doses of 5 × 105 cells/kg UC-MSCs, with a dosing interval of 48 h (n = 11) or placebo (n = 6). The evaluations consisted of a clinical assessment, viral load, laboratory testing, including blood count, serologic, biochemical, cell subpopulation, cytokines and CT scan. Results The results revealed that in the UC-MSC group, there was a reduction in the levels of ferritin, IL-6 and MCP1-CCL2 on the fourteen day. In the second month, a decrease in the levels of reactive C-protein, D-dimer and neutrophils and an increase in the numbers of TCD3, TCD4 and NK lymphocytes were observed. A decrease in extension of lung damage was observed at the fourth month. The improvement in all these parameters was maintained until the end of patient follow-up. Conclusions UC-MSCs infusion is safe and can play an important role as an adjunctive therapy, both in the early stages, preventing severe complications and in the chronic phase with postacute sequelae reduction in critically ill COVID-19 patients. Trial registration Brazilian Registry of Clinical Trials (ReBEC), UTN code-U1111-1254-9819. Registered 31 October 2020—Retrospectively registered, https://ensaiosclinicos.gov.br/rg/RBR-3fz9yr

ObjectivesWe assessed the efficiency of BCN Checkpoint in detecting new cases of HIV infection and efficiently linking newly diagnosed individuals to care. MethodsThis study analysed during 2007-2012 the number of tests performed and the number of persons tested in BCN Checkpoint, the HIV prevalence, global and in first visits, the capacity of HIV detection compared to the reported cases in MSM in Catalonia, and the linkage to care rate. ResultsDuring the six years a total of 17.319 tests were performed and 618 HIV-positive cases were detected. Median prevalence of clients who visited the centre for the first time was 5.4% (4.1-5.8). BCN Checkpoint detected 36. 3% (35.0-40.4) of all reported cases in MSM during [2009][2010][2011]. Linkage to care was achieved directly in 90.5% of the cases and only 2.4% of cases were lost to follow-up. ConclusionsA community-based centre, addressed to a key population at risk, can be less effort consuming (time and funding) and show high efficiency in HIV detection and linkage to care. . These factors discourage persons from sexual minorities from seeking and receiving essential HIV prevention, testing, care and treatment services, condemning them to remain at disproportionately high risk of HIV acquisition [6]. Greater access to testing and availability of prevention and care services for persons infected with HIV can reduce new infections and lead to reductions in HIV-associated morbidity and mortality [7]. To overcome some of these barriers to the early diagnosis and linkage to care of infected persons, the patient-based organization Projecte dels NOMS-Hispanosida created in 2006 BCN Checkpoint, a community-based centre (CBC) for MSM in the gay area of Barcelona. This centre offers HIV testing free of prejudice, peer counselling and support, and linkage to medical care for people diagnosed with HIV infection. The centre is staffed by a part-time physician, a nurse, 12 counsellors, a receptionist and two administrative assistants. All members of the team are gay, some are HIV positive and six counsellors are part-time volunteers. Peer support is fundamental in helping HIV-infected persons to deal with the emotional impact of receiving such a diagnosis, as well as in helping them to seek medical care and adhere to treatment. This CBC is dedicated to MSM because Barcelona has a significant MSM community with a high prevalence of HIV infection (17%) [8]. Awareness of serostatus also results in a reduction in the risk of transmission of HIV to sex partners, as a substantial proportion of PLWHIV reduce sexual behaviours likely to transmit HIV after discovering that they have HIV infection [9]. Thus, HIV testing represents secondary prevention for people who know their HIV status (reduction of prevalence and severity of the disease) and primary prevention for the community (reduction of HIV incidence). KeywordsProjecte dels NOMS-Hispanosida, in addition to setting up BCN Checkpoint, started promoting regular testing for MSM and implemented for the first time in Spain the rapid HIV t...

The implementation of the Check-Ear Project in a MSM community centre allowed for the identification of early HIV infections and asymptomatic STI among MSM. The high incidence of HIV infections and the high prevalence of STI strongly support the recommendation of periodic screenings among sexually active MSM.

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Fusarium é um fungo amplamente distribuído no ambiente, pode causar infecções superficiais como onicomicose ou ceratite, até infecção fúngica invasiva como infecção pulmonar, osteoarticular ou disseminada. As formas invasivas da doença são quase exclusivamente em pacientes altamente imunossuprimidos. M.A.S, masculino, 45 anos, previamente hígido, sem histórico de exposição a tabagismo ou drogas, internou com quadro de pneumonia viral causada pelo vírus SARS-Cov2, necessitando de intubação orotraqueal, apresentou quadro de síndrome hemofagocítica secundário a infecção viral associado a hipogamaglobulinemia. Optado realizar pulsoterapia além de reposição de imunoglobulina. Evoluiu com piora do quadro de hipoxemia, febre, aumento de secreção pulmonar, sem resposta a antimicrobianos, associado então, pela primeira vez, o uso de antifúngico azólico (voriconazol) devido alta suspeição de aspergilose pulmonar associado ao COVID19 (CAPA). No décimo terceiro dia de uso de voriconazol, evoluiu com alterações de enzimas hepáticas, visto culturas, por ora negativas, optado pela suspensão do uso de voriconazol. Com três dias sem o uso do antifúngico, paciente apresentou novo quadro de febre, piora de parâmetros ventilatórios e laboratoriais associado a opacificação pulmonar em radiografia. Optado realizar lavado broncoalveolar. Na broncoscopia, diagnóstico de traqueobronquite mucopurulenta, enviado amostra de lavado broncoalveolar para cultura que apresentou crescimento de Fusarium spp. Optado, então, retorno do uso de voriconazol visto paciente ter apresentado piora clínica após suspensão do mesmo. Fez uso por 14 dias do antifúngico, cultura traqueal de controle negativa (clareamento microbiológico) associado a melhora clínica e laboratorial. Ao longo dos dias, evoluiu com sangramento intracraniano e morte encefálica. O envolvimento pulmonar pela doença é comum na forma invasiva, ocorre geralmente em paciente neutropênicos prolongados pós transplante de medula óssea ou em pacientes com uso crônico de altas doses de corticoides como aqueles com doença do enxerto contra o hospedeiro. Na revisão da literatura, até a presente data, encontramos apenas um caso relatado de fusariose pulmonar pós COVID19 (Clinical Microbiology and Infection 26 (2020): 1582-1584), sendo nosso caso, o segundo em relato.