ABSTRACT
INTRODUCTION: Covid-19 infection usually manifests with respiratory symptoms, but neurological signs might be the mean symptom revealing this infection such as Guillain Barre syndrome (GBS).COVID-19 associated GBS seems to be more severe than non-COVID-19 GBS. CASE MANAGEMENT: We reported a 49 old-man admitted in the intensive care unit for bilateral ascending symmetrical paresthesia associated with lower limb numbness and sphincter disorders two weeks after an upper respiratory infection. The diagnosis of post-Covid-19 GBS was maintained, and the evolution was favorable after Intravenous Immunoglobulin (IVIg) and plasma exchange (PLEX) as a second therapy. CONCLUSION: This case report suggest the probable causal link between COVID 19 and GBS. This severe association prompts us to do further research that may help professionals in an early diagnosis and early treatment thus improving morbidity and mortality.
ABSTRACT
BACKGROUNDS: Corona virus disease 19 (Covid-19) affects especially the respiratory tract, and induces lung injury which may progress to the acute respiratory distress syndrome (ARDS). Various treatment options were tried all over the world, corticosteroids had showed beneficial effects.The Objective of this study, is to compare the safety and efficiency of two corticosteroids: dexamethasone and prednisolone in the treatment of Covid-19 infection. METHODS: This retrospective and comparative study included 513 patients diagnosed with Covid-19 infection and were admitted to intensive care unit of our university hospital center of MOHAMMED VI Oujda from March 1, 2020, to December 31st, 2020. RESULTS: In this study, 513 cases were included, 230 patients were received methylprednisolone, and 283 were treated with dexamethasone. The median age in methylprednisolone group was 64 years, and 63 years in the second group treated with dexamethasone. Patients treated with dexamethasone had more critically lesions compared to patients treated with methylprednisolone (67.6%), these patients had a good evolution with a significant reduction of oxygen supplementation, lower use of invasive ventilation and a significant improvement in biological parameters. The difference in outcome between the two groups in terms of mortality was significantly reduced in the second group. CONCLUSION: Both steroids are efficient in the management of mild, moderate and severe Covid-19 pneumonia with a clear superiority of dexamethasone especially in severe forms.
ABSTRACT
INTRODUCTION: Covid-19 is a severe emerging infection with high rate of mortality. Patients with Covid-19 and Down syndrome represent a high rate of morbidity and mortality. CASE PRESENTATION: Case 1: A 27-year-old white male with Down's syndrome admitted to the ICU for Covid-19 infection with lung damage of 30-50%. The patient improved and referred to the pulmonology department.Case 2: A 49-year-old man admitted to the ICU for Covid-19 infection with a lung damage of 50%. The evolution was lethal and he passed away after 12 days of his admission. CONCLUSION: People suffering from Down syndrome should be given priority in the management of acute respiratory distress following infection with SARS COV2, or even candidates for early immunosuppressive treatment and possible vaccination once started.