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Duong-Quy S, Huynh-Truong-Anh D, Nguyen-Quang T, Nguyen-Thi-Kim T, Tran-Ngoc-Anh T, Nguyen-Van-Hoai N, Do-Thi-Thu M, Nguyen-Van T, Tang-Thi-Thao T, Nguyen-Tuan A, Nguyen-Van T, Tran-Xuan Q, Vu-Tran-Thien Q, Trinh-Du T, Tran-Thai T, Nguyen-Duy T, Tran-Van H, Vo-Thi-Kim A. Guillain-Barré Syndrome due to COVID-19 Vero Cell Vaccination Associated with Concomitant COVID-19 Infection-induced ARDS and Treated Successfully by Therapeutic Plasma Exchange: A First Case Report from Vietnam. Pulm Ther 2023; 9:271-280. [PMID: 36991236 PMCID: PMC10057680 DOI: 10.1007/s41030-023-00219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/27/2023] [Indexed: 03/31/2023] Open
Abstract
Post-vaccination adverse reactions have been reported with varying symptoms and severity owing to research and production time pressures during the coronavirus disease 2019 (COVID-19) pandemic. In this article, we report a rare case of Guillain-Barré syndrome (GBS) in a patient with COVID-19 with acute respiratory distress syndrome (ARDS) after receiving Sinopharm's Vero Cell vaccine (China). The patient who was initially negative for COVID-19 was diagnosed with GBS based on paralysis that developed from the lower extremities to the upper extremities, as confirmed by cytoalbuminologic dissociation in the cerebrospinal fluid. The patient's condition worsened with ARDS caused by COVID-19 infection during the hospital stay, and SpO2 decreased to 83% while receiving oxygen through a non-rebreather mask (15 l/min) on day 6. The patient was treated with standard therapy for severe COVID-19, invasive mechanical ventilation, and five cycles of therapeutic plasma exchange (TPE) with 5% albumin replacement on day 11 due to severe progression. The patient was weaned off the ventilator on day 28, discharged on day 42, and was completely healthy after 6 months without any neurological sequelae until now. Our report showed the potential of TPE for GBS treatment in critically ill patients with COVID-19 after COVID-19 vaccination.
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Affiliation(s)
- Sy Duong-Quy
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam.
- Immuno-Allergology Division, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA.
- Outpatient Department, Pham Ngoc Thach Medical University, Ho Chi Minh, Vietnam.
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam.
| | - Duc Huynh-Truong-Anh
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tien Nguyen-Quang
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Thanh Nguyen-Thi-Kim
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Thuy Tran-Ngoc-Anh
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Nam Nguyen-Van-Hoai
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Mai Do-Thi-Thu
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tinh Nguyen-Van
- Department of Emergency and ICU, Binh Duong General Hospital, Thuan An, Binh Duong, Vietnam
| | - Tram Tang-Thi-Thao
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Anh Nguyen-Tuan
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Toi Nguyen-Van
- Clinical Research Unit, Lam Dong Medical College and Bio-Medical Research Centre, Dalat, Vietnam
| | - Quynh Tran-Xuan
- Department of Internal Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
| | - Quan Vu-Tran-Thien
- Department of Respiratory Functional Exploration, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam
| | - The Trinh-Du
- Department of Intensive Care Unit, Ninh Thuan General Hospital, Phan Rang, Ninh Thuan, Vietnam
| | - Tuan Tran-Thai
- Department of Intensive Care Unit, Ninh Thuan General Hospital, Phan Rang, Ninh Thuan, Vietnam
| | - Thai Nguyen-Duy
- National Institute for Control of Vaccines and Biologicals, Ministry of Health, Hanoi, Vietnam
| | - Huong Tran-Van
- Department of Medicine, Nam Anh General Hospital, Di An, Binh Duong, Vietnam
- Department of Public Health, Thang Long University, Hanoi, Vietnam
| | - Anh Vo-Thi-Kim
- Department of Medicine, Nam Anh General Hospital, Di An, Binh Duong, Vietnam.
- Department of Public Health, Thang Long University, Hanoi, Vietnam.
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Truong-Thanh T, Vo-Thi-Kim A, Vu-Minh T, Truong-Viet D, Tran-Van H, Duong-Quy S. The beneficial role of FeNO in association with GINA guidelines for titration of inhaled corticosteroids in adult asthma: A randomized study. Adv Med Sci 2020; 65:244-251. [PMID: 32276003 DOI: 10.1016/j.advms.2020.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/16/2019] [Accepted: 03/19/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed to demonstrate the role of fractional concentration of exhaled nitric oxide (FeNO) in association with Global Initiative for Asthma (GINA) guidelines for treatment of adult patients with asthma. METHODS It was a prospective and randomized study. The symptomatic asthmatic patients were randomly divided into two groups: GINA group (followed GINA guidelines; N = 86) or GINA + FeNO group (followed GINA guidelines + FeNO for titration of inhaled corticosteroids - ICS; N = 90). They were followed-up for 9 months. RESULTS In GINA group, 37.2% patients had no treatment and 62.8% patients discontinued treatment vs. 40.0% and 60.0% in GINA + FeNO, respectively. After 3, 6 and 9 months of treatment, the percentage of mild, moderate and severe asthma showed no significant difference between the two groups. At 9th month, Δ moderate asthma (reduction) in GINA + FeNO group was significantly higher than in the GINA group (-22.0% vs. -11.6%; P = 0.018). The improvement of asthma control test (ACT) score was not different between the groups at 9th month (12 ± 6 vs. 10 ± 5; P > 0.05); the level of FeNO reduction in GINA + FeNO group was significantly higher than that in GINA group (-42 ± 11 vs. -35 ± 9; P = 0.022). The daily dose of ICS in GINA + FeNO group was significantly lower than that in GINA group (397 ± 171 vs. 482 ± 240 mcg and 375 ± 203 vs. 424 ± 221 mcg; respectively) at the end of 6 and 9 months. CONCLUSION The use of FeNO in association with GINA guidelines has a beneficial role for accurate daily dose of ICS in adult patients with asthma.
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Dinh-Thi-Dieu H, Vo-Thi-Kim A, Tran-Van H, Tang-Thi-Thao T, Duong-Quy S. Study of the beneficial role of exhaled nitric oxide in combination with GINA guidelines for titration of inhaled corticosteroids in children with asthma. J Breath Res 2020; 14:026014. [PMID: 31905348 DOI: 10.1088/1752-7163/ab6809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The use of FENO in association with current guidelines in the treatment of asthma has not been studied thoroughly. This study aimed to evaluate the beneficial role of FENO in combination with GINA (Global Initiative for Asthma) guidelines for titration of inhaled corticosteroids (ICS) in asthmatic children. METHODS It was a prospective and descriptive study. Uncontrolled asthmatic children were randomized to two groups: group 1 (followed GINA guidelines) or group 2 (followed GINA guidelines + FENO modification for ICS titration). The two groups were followed-up for 12 months. RESULTS The mean age of the patients in the study was 10 ± 4 years for group 1 (n = 116) and 11 ± 5 years for group 2 (n = 108). There were 87.9% patients in group 1 and 82.4% in group 2 that had a familial allergic history. There were 58.6% of moderate asthma and 41.4% of severe asthma in group 1, versus 56.4% and 43.6% in group 2, respectively. The percentage of moderate and severe asthma was also significantly modified after 6th and 12th month versus at inclusion (43.1% and 35.3% versus 58.6%, P < 0.01 and P < 0.005; 23.2% and 12.9% versus 41.4%, P < 0.005 and P < 0.001, respectively). The total daily dose of ICS in group 2 at 12th months was significantly lower than that in group 1 (3515 ± 1175 versus 4785 ± 1235 mcg; P < 0.005). The daily cost of ICS treatment in group 2 was also lower than that of group 1 (18 ± 4 versus 27 ± 3 USD; P < 0.05). CONCLUSION The use of FENO in combination with GINA guidelines for ICS titration is useful in reducing the daily ICS dose and treatment cost.
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Dinh-Thi-Dieu H, Vo-Thi-Kim A, Tran-Van H, Duong-Quy S. Efficacy and adherence of auto-CPAP therapy in patients with obstructive sleep apnea: a prospective study. Multidiscip Respir Med 2020; 15:468. [PMID: 32153777 PMCID: PMC7037646 DOI: 10.4081/mrm.2020.468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 01/26/2023] Open
Abstract
Introduction The use of auto-continuous positive airway pressure (auto-CPAP) therapy has been recommended for subjects with moderate-to-severe obstructive sleep apnea (OSA) without significant comorbidities. This study is aimed at evaluating the efficacy and adherence of auto-CPAP therapy in subjects with OSA. Methods It was a perspective and descriptive study. All study subjects who had apnea-hypopnea index (AHI) > 30/h, measured by polysomnography, were included. They were treated with auto-CPAP and followed-up for 6 months for evaluating the effect of CPAP-therapy on clinical and biological features and treatment adherence. Results One hundred and thirty-nine subjects with severe OSA were accepted for auto-CPAP therapy at inclusion. BMI was 28.4±3.8 kg/m2; neck and abdomen circumferences were 38.2±6.4 and 85.7±11.6. Epworth and Pichot scores were 18.4±6.3 and 28.3±4.5, respectively; AHI was 39±7/h and arousal index was 39±13/h. At 6th month, 96.4% of study subjects continued to use auto-CPAP-therapy within 6.5±2.4 h/night. There was a significant correlation between the modification (Δ) of Epworth scores and (Δ) AHI after 3 and 6 months of auto-CPAP-therapy (R=0.568 and p=0.003; R=0.745 and p=0.002; respectively). At 6th month follow up, the main side effects of auto-CPAP were difficult sleeping, dry mouth or nose, skin marks or rashes, discomfort when breathing, and nasal congestion (36.1%, 32.0%, 20.8%, 16.0%, and 11.9%, respectively). Conclusion Auto-CPAP is effective in treatment of Vietnamese patients with severe OSA in short term follow up.
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Affiliation(s)
| | - Anh Vo-Thi-Kim
- Department of Public Health, Thang Long University, Hanoi, Vietnam
| | - Huong Tran-Van
- Department of Public Health, Thang Long University, Hanoi, Vietnam
| | - Sy Duong-Quy
- Clinical Research and Sleep Lab Centers. Lam Dong Medical College, Da Lat city, Vietnam.,Hershey Medical Center, Penn State Medical College, Hershey, PA, USA
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