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Background: Health insurance coverage is expected to protect individuals from out-of-pocket (OOP) expenditures, potentially preventing them from falling into poverty. However, to date, the effect of health insurance on OOP spending during the coronavirus disease 2019 (COVID-19) pandemic has not been fully explored. This study aimed to estimate differences in the proportion and the amount of OOP expenditures among Peruvians during the pre- and post-mandatory lockdown response to COVID-19 in 2020 according to the health insurance coverage status. Methods: This study utilized repeated cross-sectional data from the National Household Survey on Living and Poverty Conditions (ENAHO) from the first quarter of 2017 until the fourth quarter of 2020. The outcomes were (i) the proportion of individuals who incurred OOP expenditures and (ii) the monetary value of OOP expenditures. An interrupted time series analysis (ITS) and a quasi-experimental difference-in-difference (DID) analysis were performed to examine the outcomes among the control (individuals without health insurance) and treatment groups (individuals with health insurance) after the COVID-19 pandemic. Results: ITS analysis showed that the proportion of individuals reporting OOP expenditures after implementation of mandatory lockdown due to COVID-19 in Peru decreased in both groups, but no difference in the slope trend was found (P = .916). The average quarterly amount of OOP spending increased in both groups, but no difference in the slope trend was found (P = .073). Lastly, the DID analysis showed that the mandatory lockdown was associated with a higher amount of OOP, but there was no evidence to indicate that the higher amount was different between the control and treatment groups. Conclusion: The mandatory lockdown in response to the COVID-19 was associated with a higher amount of OOP expenditures and a lower likelihood of incurring OOP expenditures. However, our findings suggest that health insurance coverage does not lower OOP expenditures or reduce the likelihood of incurring OOP expenditures. [ABSTRACT FROM AUTHOR]

The objective of the research was analyze the personal finances during the COVID-19 pandemic in inhabitants of the rural area Kunurana Bajo. The research is qualitative, exploratory and developed with the phenomenological technique, the instrument applied for data collection was a structured interview with fifteen merchant mothers from the aforementioned area, once the data was collected they were analyzed in the ATLAS ti software In this way, obtaining reliable results, it was observed that there was a decrease in monthly income, difficulty in paying their financial obligations, increased expenses and use of savings. [ABSTRACT FROM AUTHOR]

We report the case of a patient diagnosed with a clinical relapse of acquired immune-mediated thrombotic thrombocytopenic purpura (TTP) who was successfully treated with low-dose rituximab plus corticosteroids without the use of plasma exchange (PEx), which was unavailable at the time due to the COVID-19 pandemic. Rituximab 100 mg weekly for 4 weeks was administered, combined with 1 mg/kg of prednisone, obtaining a complete hematological response in 6 weeks. This case suggests that PEx may be unnecessary for a subset of patients with relapsed TTP who are clinically stable without significant end-organ damage. A brief literature review regarding TTP patients treated without plasma exchange is also included. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus 2, a new and different coronavirus. Since almost every continent in the world has been affected, the global actions have been focused on prevention, detection, and patient monitoring with no specific treatment until now. Classical and historical interventions have remerged as options including convalescent plasma. The use of convalescent plasma has become more important during large-scale epidemics, such as Mid-East respiratory syndrome-CoV and influenza pneumonia, data regarding support its clinical use. Unfortunately, published clinical data on the usefulness of convalescent plasma in patients with COVID-19 are scarce, but it has shown good clinical outcomes. There are no reports of adverse events in clinical trials of patients receiving convalescent plasma treatment for COVID-19. Nevertheless, FDA has issued its recommendations for the use of convalescent plasma as an option that may provide clinical effect for treatment during the public health emergency caused by COVID-19, with recommendations to avoid adverse effects in centers developing clinical trials with coronavirus convalescent plasma. [ABSTRACT FROM AUTHOR]