ABSTRACT
Introduction: COVID19 infection has been linked to various glomerulonephropathies (GN) including collapsing focal segmental glomerulosclerosis, pauciimmune crescentic glomerulonephritis, and possibly minimal change disease and IgA nephropathy. Case Description: A 57-year-old obese man with hypertension, hyperlipidemia, prediabetes, chronic obstructive pulmonary disease, illicit drug use, status post Pfizer COVID vaccine (1st dose 4m prior, 2nd dose 3w later), and COVID19 infection 7w prior, presented with an acute onset purpuric rash that began from bilateral hands and feet and progressed to arms and legs. Patient denied joint pain or abdominal discomfort. Initial studies: Serum creatinine (Cr) 4.17 mg/dL (2.37 mg/dL 2w prior, baseline 0.93 mg/dL 4m prior). Urinalysis: > 50 red blood cells/high power field;Urine protein/Cr 4g/g, albumin/Cr >3g/g;Negative: HIV, ANCA, ANA, antiGBM, complements. Chest CT: Bilateral multifocal consolidative opacities concerning for aspiration, multifocal bacterial or viral pneumonia, or atypical presentation of COVID19 pneumonia. Skin biopsy: Leukocytoclastic vasculitis;No immunoreactants detected. Patient suffered from rapid respiratory deterioration, multiple hypotensive episodes, and acute kidney injury requiring mechanical ventilation and dialysis support. Kidney biopsy: IgA dominant immune complex mediated glomerulonephritis with focal/remote fibrous crescents;acute tubular injury. Treatment: Intravenous methylprednisolone 250 mg x 3d, followed by oral prednisone course. Patient recovered adequate function after 6w and was able to discontinue dialysis. Discussion(s): COVID19 infection-related inflammatory response may precipitate GN in susceptible individuals. Crescentic IgAN is known to be associated with acute inflammatory conditions involving lungs, gastrointestinal tract, and skin. The timeline for the development of cIgAN herein raises suspicion for COVID19 infection/pneumonia as the inciting event. (Figure Presented).
ABSTRACT
Background: Provided that COVID-19 pandemic has led to mental wellbeing disorders for city dwellers, and given that there is a significant association between outdoor activities and mental health, this paper investigated how the frequency of walking during the pandemic contributes to the immediate and subsequent ‘mood’. Methods: A longitudinal data collection method was adopted to verify the ‘mood’ of the participants before and after walking. The survey was conducted with 100 participants in a walking path in Shiraz, Iran, on Jan 2021. The quantitative analysis methods were performed in SPSS to examine the mental wellbeing outcomes of walking in the outdoor walking path when considering the psychological impacts of the pandemic and the quan-tity. Results: The result affirms the positive contribution of walking in the improvement of mental-wellbeing-mood during the pandemic;though, such a mood boost is in a direct relationship with the quantity of the activity with-in a week. Moreover, other factors can play a significant role, including the ‘mood before walking’, and the age of the participants. Conclusion: It is likely that encouraging people to consider walking as their routine activity can lead to several positive consequences on mental wellbeing since walking as a basic outdoor activity during the pandemic can contribute on the mood. . © 2021, Tehran University of Medical Sciences. All rights reserved.