Background: Transverse myelitis (TM) is most often triggered by an autoimmune reaction due to infections and perhaps vaccines. During the current coronavirus disease 2019 (COVID-19) pandemic, some case reports have shown a temporal association between TM and COVID-19 vaccine. We aimed to report a case of TM with a temporal association with ChAdOx1 nCoV-19 (AZD1222, Oxford/AstraZeneca) vaccine in a Brazilian public hospital. Case Presentation: A 27-year-old woman experienced fever, low back pain and urinary retention 3 weeks after the first dose of the ChAdOx1 nCoV-19 vaccine. Two days later, she experienced decreased strength of the lower limbs associated with paresthesia of the distal extremities. At the hospital, there was progression of weakness associated with anesthesia in T4-L1. Magnetic resonance imaging findings were suggestive of demyelination and acute inflammation. Cerebrospinal fluid analysis showed monomorphonuclear pleocytosis, increased protein and decreased glucose.Gram stain, oligoclonal bands, anti-aquaporin-4 antibody, and screening for infectious agents and connective tissue disease were all negative. During treatment, the patient received 5-day pulse therapy with methylprednisolone, acyclovir and 7-day plasmapheresis. Despite all treatments, she persisted with lower limb plegia, areflexia and anesthesia at the level of T4. She was discharged with a monthly cyclophosphamide plan and outpatient follow up. Conclusions:In the absence of other causes, the diagnosis of TM was made with evidence of a possible temporal association with ChAdOx1 nCoV-19 vaccine. It is important to emphasize that it is a temporal association only and the benefits of vaccination continue to outweigh the risk of TM.

Objective: Evaluate the influence of isolated and associated prepregnancy obesity and gestational diabetes mellitus (GDM) on adverse perinatal outcomes. Materials and methods: Cross-sectional observational study with women who delivered at a Brazilian Maternity Hospital, between August and December 2020. Data were collected by interview with application form, and medical records. Sample was stratified by body mass index (BMI) and GDM screening in four groups: no obesity (BMI < 30 kg/m 2 ) no GDM -reference; isolated GDM; isolated obesity (BMI ≥ 30 kg/m 2 ); and obesity with GDM. Preeclampsia (PE), cesarean section (CS), large-for-gestational-age (LGA) newborn and admission to neonatal intensive care unit (NICU) were analyzed by odds ratio (OR) adjusted for confounding factors, adopting 95% confidence interval (CI) and P ˂ 0.05 statistically significant.

Introdução A mielite transversa (MT) geralmente é desencadeada por uma reação autoimune, devido a infecções e, possivelmente, vacinas. Na pandemia atual, há alguns relatos de casos que demonstram uma associação temporal entre a MT e a vacina COVID-19. Em seguida, pretendemos relatar um caso de MT com associação temporal com a vacina ChAdOx1 nCoV-19 (AZD1222, Oxford / AstraZeneca) em um hospital público brasileiro. Descrição do caso Uma mulher de 27 anos começou com febre, dor lombar e retenção urinária três semanas após a primeira dose da vacina ChAdOx1 nCoV-19. Dois dias depois, teve diminuição da força de membros inferiores associada a parestesias de extremidades distais. No hospital, houve progressão da fraqueza associada à anestesia em T4-L1. Na ressonância magnética, houve achados sugestivos de desmielinização e inflamação aguda. A análise do LCR mostrou pleocitose monomorfonuclear, aumento da proteína e diminuição da glicose. A coloração de Gram, a pesquisa de bandas oligoclonais, aquaporina-4 e triagem para agentes infecciosos e doença do tecido conjuntivo foram todas negativas. Durante o tratamento, ela recebeu 5 dias de pulsoterapia com metilprednisolona, aciclovir e sete sessões de plasmaférese. Apesar de todos os tratamentos, ela persistiu com plegia de membros inferiores, arreflexia e anestesia ao nível de T4. Recebeu alta com plano mensal de ciclofosfamida e acompanhamento ambulatorial. Comentários Na ausência de outras causas, o diagnóstico de MT foi feito com evidências de uma possível associação temporal com a vacina ChAdOx1 nCoV-19. É importante enfatizar que é apenas uma associação temporal e os benefícios da vacinação continuam a superar o risco da MT.