ABSTRACT
As our knowledge and experience of COVID-19 increases, our treatment approaches may change. For patients with respiratory failure due to COVID-19 disease, the disease table can be better controlled with systemic glucocorticoids, and mortality rates and hospitalization periods can also be reduced. Steroid therapy can be applied for the long-term, especially in cases with organized pneumonia, and patients can be discharged from hospital with maintenance treatment. Complications have been noted in patients in the post-COVID period resulting from the use of glucocorticoids. While mostly bacterial and fungal lung infections are seen, another side-effect of glucocorticoids is their negative effect on bone metabolism. We present here a case in which avascular bone necrosis developed as a result of long-term steroid use for the treatment of COVID-19.
ABSTRACT
The new type of coronavirus (SARS-CoV2) reported to have originated in China in December 2019 has spread rapidly all over the world and has become a global problem. COVID-19 is more common and more severe in people with such comorbidities as cardiovascular disease, hypertension and diabetes. There is a lack of consensus on whether rheumato-logical diseases and drugs used in their treatment increase the risk of developing COVID-19. There is also lack of data in literature regarding the develop-ment of COVID-19, especially in patients with Anky-losing Spondylitis. This case presentation relates to two patients with Ankylosing Spondylitis using anti-TNF agents who were affected by COVID-19. The younger of the two, who had no comorbidities, healed quickly with antiviral and supportive therapy, while the older patient, who had cardiovascular and chronic kidney comorbidities, experienced an aggres-sive disease course and did not survive. The course of COVID-19 infection and mortality is strongly con-nected with underlying comorbidities. Our focus here is on rheumatological diseases, their immunosup-pressive treatments and their impact on the course of the novel type Coronavirus infection, based on two cases of Ankylosing Spondylitis, in light of literature.
ABSTRACT
SARS-CoV2 infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) may result in thrombosis development in both venous and arterial systems under the effects of inflammation increase, thrombocyte activation, endothelial dysfunction and stasis in blood flow. Accordingly, although many guidelines recommend thrombosis prophylaxis for hospitalized patients, it is not recommended for outpatients. Pulmonary embolisms were detected on computed tomography examinations performed in the emergency department in the two patients in the present study, who were being treated for coronavirus disease-19 (COVID-19) infection, but who did not require hospitalization, and who presented with complaints of shortness of breath and chest pain after treatment. We deemed it appropriate to present these cases in non-hospitalized patients to emphasize the need for thrombosis prophylaxis, considering the balance of bleeding and thrombosis.