ABSTRACT
[Purpose] The purpose of this study was to clarify the characteristics of patients who were hospitalized for severe COVID-19 pneumonia and discharged from hospital after they could walk independently. [Participants and Methods] We compared 112 patients who underwent ventilator management and rehabilitation in an intensive care unit, and divided them into two groups: the independent group (76 patients) and non-independent group (36 patients) according to whether they could walk at the time of discharge. [Results] The independent and non-independent groups differed significantly in age (55.8 ± 12.3 vs. 66.7 ± 13.0), delirium (12 vs. 12 patients), Sequential Organ Failure Assessment score (SOFA) score (7 vs. 8), ferritin (1813 vs. 1168 ng/mL) and duration of intubation (6.1 days vs. 11.1 days). [Conclusion] Age, presence of delirium, SOFA score, ferritin, and duration of intubation were associated with the ability of patients with severe COVID-19 pneumonia to walk independently at discharge. © 2022, Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai). All rights reserved.
ABSTRACT
The coronavirus disease 2019 (COVID-19) vaccination campaign has progressed worldwide. Rare but severe adverse events of COVID-19 vaccination such as anaphylaxis and myocarditis have begun to be noticed. Of note, several cases of new-onset antineutrophil cytoplasmic antibody-associated vasculitis (AAV) after COVID-19 mRNA vaccination have been reported. In contrast, relapse of AAV in remission has not been recognized enough as an adverse outcome of COVID-19 vaccination. We report, to the best of our knowledge, a first case of renal-limited AAV in remission using every 6-month rituximab administration that relapsed with pulmonary hemorrhage, but not glomerulonephritis, following the first dose of the COVID-19 vaccine. Notably, the patient received the COVID-19 vaccine more than 6 months after the last dose of rituximab according to the recommendations. Ironically, his CD19 positive B cell counts were found to be increased after admission, indicating that our case might have been prone to relapse after COVID-19 vaccination. Although our case cannot establish causality between AAV relapse and COVID-19 mRNA vaccination, a clinical vigilance for relapse of AAV especially in patients undergoing rituximab maintenance therapy following COVID-19 vaccination should be maintained. Furthermore, the elapsed time between rituximab administration and COVID-19 mRNA vaccination should be carefully adjusted based on AAV disease-activity (Nishioka et al. Front Med 2022. in press).
ABSTRACT
[Purpose] The purpose of this study was to elucidate the effect of prone positioning on the respiratory function of patients with the severe coronavirus disease (COVID-19) which emerged in 2019. [Participants and Methods] We examined 24 COVID-19 patients who underwent mechanical ventilation at the Japanese Red Cross Medical Center from March 2020 to November 2021. The respiratory function of these patients before and after prone positioning was compared. The indices of respiratory function were the P/F ratio obtained from the blood data and peak pressure (Ppeak), positive end expiratory pressure (PEEP), delta P (⊿P), and static compliance (Cstat) displayed on the graphic monitor of the ventilator. [Results] After prone positioning, significant increases in the P/F ratio and Cstat were observed. Although Ppeak, PEEP and ⊿P decreased, their differences were not significant. [Conclusion] The results of this study demonstrate that prone positioning was effective at contributing to improvement of the respiratory status of patients with severe COVID-19. © 2022, Society of Physical Therapy Science (Rigaku Ryoho Kagakugakkai). All rights reserved.