ABSTRACT
Lung transplantation (LTx) had been the only survival option in selected Covid-19 infected ARDS patients. We evaluated surgical outcome in such group from multi-center ECLS study. LTx patient data (n=1488)were collected from multiple institutions through the National ECLS Registry and was stratified on presence of COVID-19 infection. LTx procedure details, patient demographics and post-operative outcomes were compared between COVID-19 and non-COVID-19 patients along with pre-op ECMO vs. no ECMO COVID-19 patients using Wilcoxon rank sum test or Chi-square testing to determine distribution. Time to 30-day post-operative survival was analyzed in combination with Kaplan-Meier survival curves with log-rank testing to assess mortality in these groups of patients. P values <0.05 were considered statistically significant. Out of 1488 LTx patients, our results included a total of 34 patients infected with COVID-19 at time of LTx. When compared between covid LTx (n=34) vs. non-covid LTx (n=1,454), demographic data revealed significant differences in tracheostomy (p=0.0001), lung allocation score (p=0.0001), type of pre-op ECMO support (p=0.0001), type of ECMO support (p=0.001), conversion (p=0.006), and ventilator support time (p=0.0001);but no significant differences in gender (p=0.30), BMI (p=0.32), EVLP (p=0.078), PGD score at T24 (p=0.13), and waitlist time (p=0.75). 30-day post-operative mortality analysis showed K-M graph with no statistical significance (p=0.41) in COVID-19 and non-COVID-19 patients. In addition, we compared pre-ECMO utilized COVID-19 patients (n=21) vs. non-ECMO utilized COVID-19 patients (n=13) who were transplanted. Covid-19 infected patients when transplanted showed no significant differences in survival. Propensity score matched study indicated similar results. Selective ARDS patients may benefit from end-stage surgical options like lung transplantation. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Complications are increasingly recognized with SARS-CoV-2, the causative pathogen for COVID-19. Various mechanisms have been proposed to justify the cause of seizures in Covid-19 patients. To our knowledge, 13 cases of status epilepticus (SE) associated with COVID-19 have been reported so far. Here, we present a single-center case series, including the clinical, laboratory, and imaging characteristics, and the EEG and the outcome of SE in 5 Iranian patients with laboratory-confirmed SARS-CoV-2 virus. SE was para-infectious in four patients and post-infectious in one other patient. In Three patients, the causes of seizure were included severe hyponatremia, acute ischemic stroke, and meningoencephalitis. However, in two other patients, no specific reason for seizure was found, but there are possibilities for lesser-known mechanisms of Covid-19 that play roles in developing SE. Two of the patients recovered, and three patients, older and with higher comorbidities, failed to recover and died.
ABSTRACT
Background: Reverse transcription-polymerase chain reaction (RT-PCR) is a standard technique for diagnosing coronavirus disease 2019 (COVID-19). The parameters for the diagnosis of COVID-19 included the his-tory of exposure to positive COVID-19 patients, clinical signs and symptoms related to the disease, inflammation factors in the blood test or positive antigen-antibody test, and chest computed tomography (CT) findings. The current study evaluated the chest CT scan findings in patients with respiratory problems following positive RT-PCR of COVID 19. Materials and methods: This cross-sectional study was performed on 120 patients referred to Ali Ibn-Abi Talib Hospital in Rafsanjan, Kerman Province, Iran, with respiratory symptoms between Dec-2019 to Dec-2020. Two radiologists reviewed the chest CT scans of these patients using the checklist that included parameters such as the types of involvement (consolidation/grand-glass/crazy paving, etc.) and the patterns of involvement (central/periph-eral), and the pleural findings. Results: The CT scan was conducted in 107 patients with a typical condition and 11 patients with an atypical form of the disease. The frequency of the typical CT image of COVID-19 in the male group was significantly higher than that in the female group (P=0.004). The frequency of reverse halo sign, septal thicken-ing, cardiomegaly, and crazy paving was significantly higher in males than in females (P≤0.05). Also, there was a significant difference between age groups based on the number of involved lobes (P=0.04). Conclusion: Chest CT scan is an important diagnostic method for COVID 19 with high sensitivity. The parameters in the CT scan are beneficial for the diagnosis of COVID 19. In addition, some characters in CT scans in the male gender are more specific.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syn-drome coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19) is chronic, inflammatory. Although the exact mechanisms of COVID-19 have not been yet discovered some drugs are found helpful for its treatment. These drugs which are divided into some lines therapies, have demonstrated to be helpful for COVID-19 patients based on immune basic and its antiviral properties of the disease. Previous studies have been indicated that deterioration of COVID-19 condition is associated with a weaker immune system. Most of these therapies impact on the immune system and immune cells. Beside many beneficial effects of these drugs, some adverse effects (AE) have been reported in many experiments and clinical trials among patients suffering from COVID-19. In this review, we conclude some AEs of vitamin-D, zinc, remdesivir, hydroxychloroquine or chloroquine, azithromycin, dexamethasone, aman-tadine, aspirin reported in different papers and we continue the rest of the drugs in second part of our review article.
ABSTRACT
The COVID-19 pandemic, caused by the virus SARS-cov-2, has been serious global health crisis. A common symptom in patients with severe cases of COVID-19 is dangerously low blood oxygen levels. Treatment of low blood oxygen requires supplementary oxygen delivery using external means, including noninvasive nasal cannulae, rebreathing masks, and non- invasive ventilators (NIV devices), and in severe cases anesthesia and invasive intubation with ventilation. Though effective, invasive intubation is dangerous due in part to the application of anesthetic, and intubated patient outcomes tend to be poor. NIV devices would thus be preferable when patients exhibit only modest symptoms. However, unknowns still exist surrounding whether or not NIV oxygen delivery methods produce potentially infectious virus-containing aerosols. Invasive ventilation involving intubation is a completely closed system and is treated as aerosol-free and less likely to spread infection. Thus, the choice of whether to prioritize the health of patients or healthcare workers has been a dilemma. Current work has explored the possibility that dangerous amounts of aerosol are produced by noninvasive oxygen delivery devices via a mannequin simulating a patient by detecting aerosol under various parameters. Preliminary data shows the efficacy of this mannequin model as well as evidence that noninvasive ventilation may produce more aerosol than nasal cannulae or a control.