ABSTRACT
The emergence of SARS-CoV-2 at the end of 2019 sparked the beginning of the COVID-19 pandemic. Even though it was a novel virus, the workup of suspected COVID-19 included standard protocols used for the investigation of similar respiratory infections and pneumonia. One of the most important diagnostic tests in this regard is computed tomography (CT). CT scans have a high sensitivity in diagnosing COVID-19, and many of the characteristic imaging findings of COVID-19 are used in its diagnosis. The role of CT in COVID-19 management is expanding as more and more hospital practices adopt regular CT use in both the initial workup and continued care of COVID-19 patients. CT has helped hospitalists diagnose complications such as pulmonary embolism, subcutaneous emphysema, pneumomediastinum, pneumothoraces, and nosocomial pneumonia. Although mainly used as a diagnostic tool, the prognostic role of CT in COVID-19 patients is developing. In this review, we explore the role of CT in the management of hospitalized patients with COVID-19, specifically elucidating its use as a diagnostic and prognostic modality, as well as its ability to guide hospital decision-making regarding complex cases. We will highlight important time points when CT scans are used: the initial encounter, the time at admission, and during hospitalization.
ABSTRACT
Multisystem inflammatory syndrome is a life-threatening condition associated with elevated inflammatory markers and multiple organ injury. A diagnosis of exclusion, it has been reported after severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) in children and adults; recently it has been described in some post-COVID-19 vaccinated individuals. The prognosis with supportive care and immunomodulatory therapy is good, although some individuals may require treatment in the intensive care unit (ICU). Here we report a case of a 58-year-old man who developed multi-organ failure after receiving the second dose of the Moderna mRNA-1273 COVID-19 vaccine. He required critical organ support in the ICU. An extensive workup was done to rule out alternative infectious and inflammatory processes. Following a period of gradual in-hospital convalescence, our patient made a full recovery. To our knowledge, this is the first comprehensively described case of multisystem inflammatory syndrome associated with Moderna mRNA-1273 COVID-19 vaccine in an adult over 50 years of age.
ABSTRACT
Introduction: COVID-19 is an emerging viral infection whose pathogenic mechanisms are not well understood. Interestingly, Vitamin D deficiency and COVID-19 share prevalence patterns for hypertension, diabetes, obesity, advanced age, and male sex. Vitamin D deficiency can contribute to our understanding of COVID-19 health disparities. Patients and methods: a cross sectional study involving 100 adult hospitalized patients with positive PCR for COVID-19 at Diwaniyah teaching Hospital / Shiffaa center, Diwaniyah, Iraq, during a period of 3 months. The serum 25 OH-D level was measured and Vitamin D deficiency, defined as a 25(OH) D level < 20 ng/mL, and insufficiency define as a 25(OH)D level 30-20 ng/mL. History of some other underlying health diseases (diabetes mellitus, hypertension, hypothyroidism and gastro esophageal reflux disease) was taken directly from the patients. The data was analyzed using SPSS version 26 and the study aimed to measure serum vitamin D level among COVID-19 patients. Result: The mean ± SD age was 38.8±13.7 years ranging between 18- 67 years. The mean±SD of 25(OH)D levels was 20.2±16 ng/mL. Vitamin D deficiency was present in 58 patients and vit D insufficiency was found in 25 patients. Those with vitamin D deficiency did not differ from those who were sufficient (vitamin D ≥ 20 ng/mL) in terms of age, gender or comorbidities. Conclusion: low 25(OH) vitamin D levels were highly prevalent among hospitalized COVID-19 patients Vitamin D supplementation should be considered an adjuvant therapy for COVID-19. © 2022 Universidad Tecnica de Manabi. All right reserved.
ABSTRACT
Multisystem inflammatory syndrome (MIS) after a primary infection with coronavirus disease 2019 (COVID-19) was first recognized in 2020 and presents with similar symptoms as Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome/secondary hemophagocytic lymphohistiocytosis. In children, it is called multisystem inflammatory syndrome in children (MIS-C); in adults, it is termed multisystem inflammatory syndrome in adults (MIS-A). This case offers a unique presentation of MIS in a 20-year-old young adult, who turned 21 years old one week after his presentation. He fits the criteria for MIS-C and MIS-A according to the Centers for Disease Control and World Health Organization, respectively. Initial symptoms in the emergency department included headache, neck stiffness, and fever with diffuse rash. Other symptoms consistent with MIS-C/A developed rapidly later during the course of the disease.
ABSTRACT
Introduction The influence of coinfections on the morbidity and mortality of the new clinical syndrome coronavirus disease 2019 is unknown (COVID-19). Fungal agent of aspergillosis, mucormycosis, and candidiasis is the main superinfection that occurs as complicated to COVID-19;it may be related to ventilator-associated pneumonia (VAP), diabetic disease, or long time exposure to a corticosteroid that cause immune-suppressive even cytokine storm. These factors act as risk factors for fungemia and fungal shock that causes severe inflammation, disturbances in blood circulation with sepsis, and damage in many organs. Therefore, This review aimed to identify the main fungal agent and explain the pathogenesis and pathological aspect as complicated to COVID-19. Conclusion The high rate of severe infection and mortality in patients with COVID-19’s is thought to be due in part to a lack of natural immunity and raped viral replication in the lower respiratory tract, as well as superinfections, secondary infections, or coinfections, the mainly fungal agent that cause severe lung injury and acute respiratory distress syndrome (ARDS) as well as cause damage and sepsis in other organs. Copyright © 2021, the Authors.