ABSTRACT
Background: Coronavirus disease 2019 (COVID), a respiratory illness (RI) caused by SARS-CoV-2 (CoV2) was first reported in Wuhan, China in December 2019. It spread rapidly and the US confirmed its first case in January 2020. Due to the novelty of CoV2 and COVID, little was known about the epidemiology, clinical course, and diagnostic methods. Since then, studies have shown that CoV2 originated from bats and COVID may have pre-existed undiagnosed outside China before the cases were first reported. Our aim was to evaluate the prevalence of CoV2 in autopsy cases at our institution, where autopsy was not performed on known COVID cases. Design: We searched our pathology database for adult autopsies performed on the lungs and heart in our institution from 6/1/19 - 6/30/20. Cases were divided into groups by cause of death (COD) possibly related to COVID, presence of a clinical RI, and autopsy findings of pneumonia (Pnx). CODs possibly related to COVID (COVID-possible) included bronchopneumonia and multisystem organ failure and CODs unlikely related to COVID (COVID-unlikely) included conditions such as acute myocardial infarction. Total RNA was extracted from archived formalin-fixed-paraffin-embedded (FFPE) lung tissue of all COVID-possible cases and COVID-unlikely cases with Pnx using a commercial kit and following the instructions in the kit. CoV2 RNA was tested for using CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel, testing the N1 region of the CoV2 genome and an RNA integrity control during amplification. An extracted CoV2 sample from our State Department of Health was used as positive control. Results: 88 cases were included;44 males and 44 females with an average age of 66 years. 42/88 (48%) cases were considered COVID-possible with 24/42 (57%) showing RI and/or Pnx. COVID as COD was considered unlikely in 46/88 (52%) with 34/46 (74%) showing no RI or Pnx. See Table 1. CoV2 PCR was performed on a total of 49 cases: 42 COVID-possible and 7 COVID unlikely with Pnx. CoV2 PCR was negative in all 49 cases with appropriate positive control and RNA integrity in all cases. Conclusions: In our single-institution autopsy cohort, CoV2 was not detected in FFPE lung tissue from any cases without a clinical diagnosis of COVID. Our data suggest that patients in our community who died between 6/1/2019 and 06/30/2020 without known COVID were unlikely to have had sub clinical and/or undiagnosed COVID. Therefore, clinical examination and accurate laboratory testing likely identify the majority of cases of COVID.
ABSTRACT
The ABLE.family project deploys disability and crip approaches and universal design, to create a platform that engages diverse older adults with dementia (OAD) and their carers in social engagement and play. Our prototyped gaming platform, created with OAD stakeholders and carers aims to decrease loneliness and despair experienced by OAD and carers during the COVID-19 pandemic, by increasing opportunities for intergenerational family engagement. Pleasurable interactions are encouraged through real-time collaborative play (e.g. art and turn based games) and real-time video-calling embedded in the platform. Our human-centered design approach works with OAD and their carer networks to design the platform interface with features that can be used to effectively collaborate, interact and produce sustainable platforms for OAD and their carer community. This project is supported generously by funding from CABHI (Centre for Aging and Brain Health Innovation), the Alzheimer Society of Hamilton and Halton, and MIRA (the McMaster Institute for Research on Aging);resources and spaces supporting this work are provided by Pulse Lab (funded by the Asper Foundation) and McMaster University. © 2021, Springer Nature Switzerland AG.
ABSTRACT
Peripartum cardiomyopathy is a relatively rare condition, that usually presents with features of heart failure in the peripartum period. The ongoing pandemic caused by coronavirus disease 2019 (COVID-19) has been reported to be associated with myocarditis, with progression to dilated cardiomyopathy and heart failure. Dilated cardiomyopathy in a peripartum patient with COVID-19 infection may present a diagnostic dilemma. We report a case of dilated cardiomyopathy in a peripartum patient with COVID-19 infection. She presented with shortness of breath in the peripartum period. Chest X-ray showed a grossly enlarged heart with bilateral pulmonary infiltrates consistent with congestive heart failure or viral pneumonia. Echocardiography revealed dilated chambers with 22% left ventricular ejection fraction (LVEF) and global hypokinesis. Despite completing 5 days of remdesivir and dexamethasone, she had worsening dyspnea on postpartum day 10, a repeat echocardiogram showed further reduction in LVEF to 10-15% and was discharged with a life-vest after acute management. She had multiple hospital admissions for decompensated heart failure. Myocardial core biopsy showed marked acute inflammation and necrosis. She had an intra-aortic balloon pump, left ventricular and right ventricular assist devices placed on account of persistent hemodynamic instability, and is now scheduled to have a cardiac transplant.
ABSTRACT
Patients with diabetes coexisting with COVID-19 show a high mortality risk and severe complications for the reason that the COVID-19 disease and the diabetes mellitus health condition combine to induce a lower immune system and consequent organ failure fatalities. While a cure has not yet been found for COVID-19, studies have shown that diets that low glycemic index, fiber-rich diet exhibit beneficial effects on improving health conditions in diabetes patients. In this paper, therefore, the nutritional prospects of Musa paradisiacal (M. paradisiacal: plantain) flour-meal for immune system improvement that could be against COVID-19 complications in diabetes patients have been studied. For this, the study elucidates how the essential nutrients in M. paradisiacal could help boost the immune system in diabetes patients that may be living with and without the COVID-19 virus infection. The detailed prospects of nutritional benefits that could be accrued from Musa paradisiacal, therefore, and the attendant health condition improvements, that could essentially reduce risks of COVID-19 complications support the use of the flour-meal for patients living with diabetes.