Isolated severe rhabdomyolisis revealing COVID-19: case report

Covid-19 remains a multisystem viral-related disease surprising the healthcare teams. We report the case of a patient presenting with rhabdomyolysis in the context of COVID-19 disease.

Paralytic ileus as a delayed gastro-intestinal manifestation of severe COVID-19: cases report

Introduction: A short time ago, COVID-19 disease spread worldwide, causing pneumonia and other extra pulmonary complications. Furthermore, gastrointestinal symptoms are progressively being identified as one of the virus's extrapulmonary manifestations. Here we describe a 68 year old patient identified with SARS-COV-2 infection complicated by paralytic ileus at day 15 of symptoms, confirmed by imaging as distended large bowel with no intestinal obstruction associated with normal liver function, lipase and kalemia. Therapeutic components included were administration of prokinetics with no surgical procedure. Conclusion: In cases of severe paralytic ileus, understanding if its mechanism is a complication of COVID-19 is crucial since underdiagnosing this complication can lead to abdominal distention that will prevent the mobility of the diaphragm and thus the risk of mechanical ventilation if not treated and a possible bowel perforation.

Severe hypercalcemia requiring acute hemodialysis: A retrospective cohort study with increased incidence during the Covid-19 pandemic.

BACKGROUND: The Covid-19 pandemic has had dramatic consequences on the progression of numerous pathologies, especially neoplastic ones. The orientation of hospital activities toward the care of patients with SARS-Cov2 infection has caused significant delays in the diagnosis and therapy of many other pathologies. What about severe hypercalcemia? The aim of this work was to determine the clinical and biological presentation, etiologies, mortality, and the impact of the Covid-19 pandemic on severe hypercalcemia. MATERIAL AND METHODS: we conducted a retrospective study for 84 months (September 2014 to September 2021) at the Nephrology Unit in University Hospital Mohammed VI, Oujda, Morocco. Included were all adult patients diagnosed with severe hypercalcemia (defined as corrected total serum calcium of >3.5 mmol/l or > 14.0 mg/dl) and who had benefited from one or more hemodialysis sessions. RESULTS: 66 episodes of severe hypercalcemia occurred in 64 patients. The mean age was 57 ± 15 years and 57.6% were female. The mean corrected serum calcium at admission was 16.9 ± 2.1 mg/dl and 33.3% had more than 18.0 mg/dl. Malignancies represented 80.4% of all etiologies. Acute kidney injury was observed in 69.7%. The delta drop in serum calcium 48 h after initiation of medical treatment was 4.64 ± 1.63 mg /dl. Mortality was noted in 14% of all cases. Electrocardiographic abnormalities were observed in 58.3%, 87.5% and 85.7%, respectively, in group 1 (14.0-16.0 mg/dl), group 2 (16.1-18.0 mg/dl), and group 3 (> 18.0 mg/dl) (p = 0.04). The mean serum potassium value was 5.1 ± 1.3, 4.0 ± 1.0, and 3.7 ± 0.7 respectively, in group 1 (14.0-16.0 mg/dl), group 2 (16.1-18.0 mg/dl), and group 3 (> 18.0 mg/dl) (p < 0.001). Newly diagnosed neoplasia, severe hypercalcemia (> 16.0 mg/dl), and mortality have been observed in 15.4% vs. 23.7% (p = 0.31), 25% vs. 50% (p = 0.03), and 35.7% vs. 52.6% (p = 0.13) respectively, in patients before and during the Covid-19 pandemic. CONCLUSIONS: The Covid-19 pandemic caused an increase in both the incidence and severity of hypercalcemia and the hemodialysis practiced in this context remains efficient and safe.

Severe case of covid-19 infection in children: Case report.

INTRODUCTION: Although covid-19 infection manifest with mild symptoms in children, it might be serious or even fatal forms of this disease. CASE REPORT: In this paper, we report three cases of severe forms of pulmonary covid-19 infection in children with several studies have shown that the mortality rate is higher in adults, mainly the elderly and the immune compromised, on the other hand a severe form in children with hospitalization in intensive care is often lethal. CONCLUSION: Mortality in the pediatric population with covid-19 is linked to both the severity of the pulmonary involvement and the heavy impact of intensive care.

Peripheral facial paralysis as the only symptom revealing sars cov 2 infection: Case report.

The SARS cov 2 infection was initially marked by its respiratory symptomatology. Nevertheless, other non-respiratory manifestations have been raised as atypical revealing symptoms, namely cardiac and neurological attacks. Several neurological manifestations have been described during this pandemic. We describe in this case report the clinical, biological and radiological characteristics of two patients presenting to the emergency department with facial paralysis revealing a Sars cov 2 viral infections after investigation.

Acute myocarditis related to Covid-19 infection: 2 cases report.

INTRODUCTION AND IMPORTANCE: Since COVID 19 was described for the first time in December 2019, we have not stopped discovering its different clinical manifestations. Despite the respiratory complication which is the most common symptomatology, multi-organ dysfunction and multiple cardiovascular complications were described such as acute myocarditis, heart failure and even arrhythmias. CASES PRESENTATION: Two patients aged 26 and 56 year-old, developed acute myocarditis related to Covid-19 infection but with different symptomatology. CASE 1: Presented to the emergency room with digestive symptomatology, Covid-19 infection was confirmed by a positive chest CT scan and positive COVID-19 serology testing. Clinical, biological, radiological findings allowed making the diagnosis of a Covid-19 infection with a bacterial superinfection complicated by a fulminant myocarditis. CASE 2: Presented to the emergency department with a chest pain, dyspnoea, paroxistic cough, myalgia and fever. A Covid-19 infection was confirmed. The electrocardiogram showed a diffuse ST elevation, echocardiography showed normal systolic function and the high-sensitivity cardiac troponin I level was high. Invasive coronary angiography was performed, revealing angiographically normal coronary arteries. CLINICAL DISCUSSION: Our 2 cases were treated differently, case 1 received antibiotherapy because of the bacterial superinfection and inotropic support for the septic and cardiogenic choc. Contrarily to case 2 who received inotropic support, immunoglobulin and corticosteroid. With a total recovery for both patients. CONCLUSION: This article can help in considering cardiac affection due to SARS-CoV2, even with poor respiratory symptomatology, and to insist on the importance of the cardiac evaluation for young patients with a sever Covid-19 infection.

ST elevation revealing acute myocarditis with SARS cov 2 infection: Case report.

INTRODUCTION: SARS-CoV-2 viral infection can manifested by respiratory symptoms, or other symptoms, such as the cardiovascular manifestations including acute coronary syndrome, pericardial effusion, and heart failure. CLINICAL CASE: A 51-year-old patient admitted to the emergency room for epigastric pain with no respiratory signs and with an ST-segment elevation inelectrocardiogram that ultimately revealed myocarditis and SARS CoV-2 2 infection. CONCLUSION: The clinical manifestations of SARS CoV-2 might be atypical, and the diagnosis might be considered in this pandemic area.

New-Onset Diabetes in Children during COVID-19: Clinical Case Report.

INTRODUCTION: Data of COVID-19 in newborns and children are limited, and clinical manifestations are nonspecific and might delay the diagnosis, which might lead to severe complications. In this clinical case, we will describe new-onset diabetes with consciousness impairment as an atypical revealing way of COVID-19. CASE: A 3-year-old child presented to the Emergency Department with loss of consciousness (without fever), lethargy, and stupor. Clinical assessment on admission found an unconscious child with a pediatric Glasgow Coma Scale of 10/15 with no localizing signs or meningeal syndrome, polypneic of 35 breaths/min, pulse oximetry of 90%, with signs of overall dehydration: skin folds, sunken eyes, tachycardia of 160 beats/minute, and recoloring time superior at 3 seconds. Laboratory findings showed hyperleukocytosis of 16000/mm3, lymphopenia of 450/mm3, glycemia of 5 g/L with a correct ionogram : corrected natremia of 139 mmol/L, serum potassium of 4.5 mmol/L, glycosuria of 3+, ketonuria of 2+, and HbA1c of 10%, and COVID-19 RT-PCR came back positive. CONCLUSION: COVID-19 might be revealed with atypical symptoms including new-onset diabetes and diabetic ketoacidosis; therefore, clinicians must suspect it in children with blood glucose and HbA1c at the time of admission. This will help to manage patients with hyperglycemia early.