Kawasaki disease (KD) is a medium-vessel vasculitis that is typically presented during childhood; fewer than 100 cases of KD have been reported worldwide in adult patients who met the criteria according to the American College of Rheumatology. This study presents the case of an 18-year-old patient with no previous history of any disease, who presented atypical KD with liver and kidney dysfunction, with a good response to intravenous immunoglobulin therapy. The symptoms began 22 days after the application of the COVID-19 vaccine (nonreplicating viral vector Vaxzevria), and other conditions were ruled out. The term Adverse Events Following Immunization (AEFI)encompasses all the reactions that follow the application of any vaccine with no necessary causal relationship and can be due to the vaccine product, quality of the vaccine, immunization errors, or anxiety or just happen to be coincident events. These reactions should be reported so that clinicians can identify compatible cases and consider that the presentation of this disease, despite being atypical, can be manifested in adult patients. Likewise, case reports are an important basis for the pharmacovigilance of vaccines.

La salud mental es parte integral de la salud. Tener algún padecimiento psiquiátrico sin tratamiento predispone a una mala calidad de vida. Estas alteraciones se han encontrado con una prevalencia de hasta 50% en la población general. En México hay muy pocos estudios acerca de la incidencia de dichos padecimientos en los trabajadores de la salud durante la pandemia por COVID-19. determinar la presencia de estrés, ansiedad y depresión durante la pandemia de COVID-19 en los trabajadores de la salud de un hospital de tercer nivel. se realizó un estudio observacional transversal, descriptivo en los trabajadores de la salud de un hospital de tercer nivel, mediante la aplicación de encuestas aleatorizadas y autocomplementadas, en búsqueda de grado de estrés, ansiedad y depresión, durante la pandemia por COVID-19. el 44.7% de los encuestados presentó depresión, 83.1% ansiedad y 66.3% estrés. Los principales grupos afectados fueron el personal femenino, solteros y médicos residentes. Aquellos con diabetes mellitus tipo 2 tuvieron mayor incidencia de ansiedad y depresión. la presencia de estrés, ansiedad y depresión en los trabajadores de la salud es similar a la de la población general en nuestro estudio. La depresión fue la alteración más encontrada. Es de suma importancia el escrutinio de alteraciones en la salud mental en los trabajadores de la salud, con mayor énfasis en el contexto de la pandemia mencionada.

Lupus anticoagulant-hypoprothrombinemia syndrome is a rare cause of hemorrhage. In this syndrome, antiphospholipid antibodies bind to the FII epitope in its carboxy-terminal portion and form antigen-antibody complexes that are rapidly cleared by the reticuloendothelial system, conditioning hypoprothrombinemia and thus a bleeding tendency. Lupus anticoagulant-hypoprothrombinemia syndrome is associated with autoimmune diseases, mainly systemic lupus erythematosus, and less frequently with primary antiphospholipid syndrome, discoid lupus, drugs, celiac disease, and haemato-oncological diseases. Immunosuppressants, mainly steroids, are the mainstay treatment, nevertheless, there is still a concern about the right treatment for this entity since there have been described less than 200 cases around the world. We describe the case of a male patient with a history of primary antiphospholipid syndrome that comes to our hospital with a severe headache due to intracranial hemorrhage, secondary to Lupus anticoagulant-hypoprothrombinemia.

The vertiginous advance for identifying the genomic sequence of SARS-CoV-2 allowed the development of a vaccine including mRNA-based vaccines, inactivated viruses, protein subunits, and adenoviral vaccines such as Sputnik. This study aims to report on autoimmune disease manifestations that occurred following COVID-19 Sputnik vaccination. Patients and Methods: A retrospective study was conducted on patients with new-onset autoimmune diseases induced by a post-COVID-19 vaccine between March 2021 and December 2022, in two referral hospitals in Mexico City and Argentina. The study evaluated patients who received the Sputnik vaccine and developed recent-onset autoimmune diseases. Results: Twenty-eight patients developed recent-onset autoimmune diseases after Sputnik vaccine. The median age was 56.9 ± 21.7 years, with 14 females and 14 males. The autoimmune diseases observed were neurological in 13 patients (46%), hematological autoimmune manifestations occurred in 12 patients (42%), with thrombotic disease observed in 10 patients (28%), and autoimmune hemolytic anemia in two patients (7.1%). Rheumatological disorders were present in two patients (7.1%), and endocrine disorders in one patient (3.5%). Principio del formulario Conclusion: Although the COVID-19 Sputnik vaccine is generally safe, it can lead to adverse effects. Thrombosis and Guillain-Barre were the most frequent manifestations observed in our group of patients.

Type 2 diabetes mellitus (T2DM) has been one of the main risk factors associated with mortality from the coronavirus disease 2019 (COVID-19). Insulin resistance (IR) is a preceding and underlying condition of T2DM, which has been thought that it could increase mortality from COVID-19 since it favors the entry of severe acute respiratory syndrome coronavirus type 2 in the host cell. This article reports a biochemical study that estimated the prevalence of IR in COVID-19 patients and non-diabetic patients without COVID-19 history. It also assesses the prognostic role of IR in the evolution of patients with COVID-19. In this single-center, retrospective and cross-sectional design, we included patients with severe and critical COVID-19 and non-diabetic patients without COVID-19 history. We calculated the Homeostatic Model Assessment Insulin Resistance (HOMA-IR) and defined IR with a HOMA-IR >2.6. We estimated the prevalence of IR in both groups and used x² to assess the association between IR and mortality from severe and critical COVID-19. One hundred and twenty-three COVID-19 patients were included with a mean age of 53±15 years: 77 (62.6%) were men and 46 (37.4%) were women. Eighty (65%) patients were critical while the rest were severe. Forty-three (35%) patients died. Seventy-one (57.7%) patients had IR; there was no evidence of an association between IR and mortality from severe or critical COVID-19. Fifty-five non-diabetic patients without COVID-19 history were included with a median age of 40 (26-60) years; 35 (63.6%) were men and 20 (36.4%) were women. Nineteen (34.5%) people had IR. IR was more prevalent in patients with severe and critical COVID-19 than in non-diabetic patients without COVID-19 history. Our results showed no evidence of the association between IR and mortality from severe and critical COVID-19.