ABSTRACT
Introduction: Health care workers (HCWs) with SARS-CoV-2 seropositivity are an important source of COVID-19 spread. The present study aimed to assess the level of exposure of HCWs to COVID-19. Methods: The COVID KAVACH IgG Microlisa IgG antibodies kit was used to determine the antibody prevalence in all HCWs at ESIC Hospital and Medical College. Results: A total of 1200 HCWs were included in the study. Of the HCWs with positive rRT-PCR for COVID-19 at the time of participation, 40 of 97 (41.2%) were asymptomatic at the time of COVID-19 diagnosis, 46 of 97 (47.4%) had only mild disease, 9 of 97 (9.3%) had moderate disease, 2 of 97 (2.1%) had were severely ill. Of these, 24.9% were positive for IgG antibodies to Covid-19. Conclusion: HCWs are at increased risk of infection when they work in hospitals. Infected HCWs are a potential risk to their families, patients, and colleagues;the seroprevalence of COVID-19 in HCWs is an indicator of susceptibility and should be monitored regularly as a best practice in hospitals.
ABSTRACT
Background: In the setting of septic shock, an increase in sympathetic tone results in increased heart rate and contractility as well as decreased left ventricular (LV) end diastolic volume;these compensatory mechanisms can result in LV obstruction. Separately, following an MI, varying degrees of hypokinesis may result from infarcted myocardium. Case: A 75-year-old woman with COVID-19, acute respiratory distress syndrome, and septic shock was found to have a dynamic LV mid-cavitary obstruction on transthoracic echocardiogram (TTE). Three days later, the patient suffered a proximal left anterior descending STEMI and underwent percutaneous coronary intervention with drug-eluting stents. Follow-up TTE revealed mid-anterior and apical hypokinesis, with compensatory basal hyperkinesis and new systolic anterior motion of the mitral valve, resulting in an LV outflow tract (LVOT) obstruction, further exacerbated by underlying basal septal hypertrophy. A dynamic shift of the level of LV obstruction, from mid-cavitary to the outflow tract, was identified. Decision-making: Hemodynamic optimization in the setting of LVOT obstruction complicated by ischemic cardiomyopathy and distributive shock focused on supporting preload and afterload, while avoiding inotropic therapy. Conclusion: Prior case reports have demonstrated dynamic LV obstruction as a compensatory response to septic shock or as a sequelae of MI. However, this case highlights a rare presentation of shifting levels of obstruction. [Formula presented]
ABSTRACT
A 35-year-old female was admitted to the hospital for menorrhagia and fatigue. Initial labs revealed that the patient had severe thrombocytopenia and also tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main objective in this case is to describe the investigation that eventually led to a diagnosis of idiopathic thrombocytopenic purpura (ITP) in the setting of a SARS-CoV-2 coronavirus disease 2019 (COVID-19) infection and co-infection with Epstein-Barr virus (EBV). The majority of ITP cases are idiopathic and most are diagnosed and managed without hospital admission. Admission and careful management were warranted in this particular case. Interestingly, however, the patient did not have any respiratory complications associated with COVID-19. She was given 1 unit of platelets and subsequently received intravenous corticosteroids. Platelet counts improved and the patient was discharged with a course of oral prednisone. This case highlights the importance of understanding the differences between primary and secondary ITP.