ABSTRACT
Background and Aim of the study: As of 17 June 2020, Italy had237.828 cases of SARS-CoV-2 infections, with about 35.000deaths;median age of cases 61 years, median age of deceased81 years. A single-center observational cohort study was conducted to evaluate clinical features, laboratory characteristicscomparing two groups of subjects by age (>75 and <75 years)admitted in the sub-intensive therapy of the COVID Unit HospitalF. Miulli (Acquaviva delle Fonti, Bari, Italy) from 17 march to 17may 2020.Materials and Methods: The data contained in the medicalrecords were studied.Results: A total of 174 patients hospitalized (60.4% males),mean age 68 yrs, with diagnosis of SARS-CoV2, were analyzed;they were divided into two groups >75 years and <75 years (110pts and 64 pts respectively). The group of older subjects had ahigher prevalence of comorbility (heart, kidney failure, COPD);mortality was more significant in subjects >75 years (37.3% vs 0.9%)compared to young people. No difference was observed in thelength of stay (21 days on average), while the younger subjectswere treated with hydroxychloroquine more than the elderly(83.6% vs 40.6% respectively) as well as with lopinavir / ritonavir(39.4% vs 14.5%).Conclusions: Our data, although referring to a small sample ofsubjects, show that patients over 75 years of age are more fragile(die more), have better comorbidities and have been under treatedcompared to younger subjects.
ABSTRACT
Background and Aim of the study: Partial or complete ageusiaand anosmia have been observed as initial and sometimes uniquesymptoms of COVID-19 infection, especially in paucisymptomaticpatients. A single-center observational cohort study was conductedto evaluate taste and smell in a group of subjects admitted in thesub-intensive therapy of the COVID UNIT Hospital F. Miulli (Acquaviva delle Fonti, Bari, Italy) from 8 april to 11 may 2020.Materials e Methods: A questionnaire was administered to agroup of patients, with normal cognitive system. The laboratoryand clinical data contained in the medical records were studied.Results: 53 patients, 35 male and 18 female aged between 23and 82 replied to the questionnaire. 19 patients reported no loss,3 reported only loss of smell and 31 loss of taste;of these, 23also reported an associated loss of smell (9 partial loss and 14total loss). Patients with olfactory deficits complained of nasalcongestion and the need to breathe through the mouth in 23% ofcases and rhinorrhea in 15%. The loss of taste was rarely associated with a decrease in appetite (3%) and in 65% this deficit wastotal. The division of patients into 4 phenotype groups (based onthe severity of the clinical presentation) did not reveal significantdifferences between the groups.Conclusions: The data of our study, although referring to a reducedsample, show that olfactory and gustatory deficits are associatedwith SARS-CoV2 infection in a high percentage of patients. The phenotype did not show a role in the development of these symptoms.
ABSTRACT
Description of the case: A 83-year-old man has been hospitalized for fever, cough and dyspnea in our UOC pneumology Covid fornasopharyngeal swab positive for SARS COV2. In anamnesis itpresented hypertension, COPD and atherosclerotic vasculopathy.At the entrance it has dyspnoea, BP 130/80 mmHg, CF 72 bpm,no heart failure symptoms, Ps 02 89% in ambient air. Pulmonaryauscultation demonstrated the presence of ronchi spreads tochest with hypomobile bases. At ECG sinus rhythm was 65 bpmwith repolarization anomalies QTc470 ms. Echocardiography wascompatible for hypertensive heart disease. Bilateral thickeningswith an emery glass appearance in the bilateral basal middle fieldat the chest CT scan. Laboratory showed the signs of inflammation.He begins antibiotic and antiviral therapy with lopinavir, LMWH,dexametazone and O2 therapy with integral mask with fi02 50%peep 10 mmHg. The respiratory symptoms have improved but itshowed up steep edema, asthenia, bradycardia with difficultyspeaking. Ecg presents complete atrioventricular block with junctional escapement at 35 bpm. Bilateral thickenings with an emeryglass appearance in the bilateral basal middle field at the chestCT scan. Laboratory showed the signs of inflammation. He beginsantibiotic and antiviral therapy with lopinavir, LMWH, dexametasone and O2 therapy with integral mask with fi02 50% peep 10mmHg. The respiratory symptoms have improved but it showed upsteep edema, asthenia, bradycardia with difficulty speaking. ECGpresents complete atrioventricular block with junctional escapement at 35 bpm. Ps O2 94% in O2 at 4 l / m. The patient waspromptly taken to the electrophysiology room for the definitive single-chamber pacemaker implant. Clinical and hemodynamic conditions have improved as well as lung and ventilator conditions.Conclusions: In our experience we have observed the presenceof numerous cases of heart rhythm disturbances both in the bradycardic and tachycardic sense not only iatrogenic but also suggestive of a direct action of the SARS-CoV2 virus on the cardiacconduction system.
ABSTRACT
Background and Aim of the study: The SARS-CoV2 associatedinterstitial pneumonia characterized by acute respiratory failureand other symptoms affecting different organs and systems.Among these also the cardiovascular system.Materials e Methods: More than 250 patients were hospitalizedin our Covid Unit to 15 March from 15 May 2020, divided betweenCovid pulmonology, Covid infectious diseases and Covid intensivecare unit.Results: Of the patients discharged, more than 200 from the various units, between the end of May and June 15, 10 patients werereadmitted to the covid unit for the re-positivity of the nasopharyngeal swab. Among them, 4 patients (40%) 3 males (54, 24and 42 years) and 1 female (50 years) had clinical, instrumentaland laboratory signs indicative of acute pericarditis, absent previously and at discharge. They were treated with anti- inflammatoryand colchicine therapy with clinical and instrumental improvementand re-discharged to subsequent negativity with clinical follow-upprogramming.Conclusions: It is suggestive that the long-term persistence ofpositivity to SARS-CoV2, perhaps because it is linked to a greaterpersistence over time of the inflammatory state linked to the viralinfection, triggers a local inflammatory reaction to the pericardialsheets, especially in subjects of a younger age.