ABSTRACT
Background: Predictions have been made that Africa would be the most vulnerable continent to the novel Coronavirus disease 2019 (COVID-19). Interestingly, the spread of the disease in Africa seems to have been delayed and initially slower than in many parts of the world. Here we report on two cases which make us suspect that COVID-19 might have been present in our region before the official declaration of the disease in December 2019. Case presentation: These two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress secondary to atypical pneumonia were seen in Bukavu, in Eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts with travellers from China in the 2 weeks prior to the onset of symptoms. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough and fever) and laboratory changes (procalcitonin within the normal range, slight inflammation, and lymphopenia) compatible with a viral infection. The chest X-Rays series of the first patient showed lesions (reticulations, ground glass, and nodules ≤ 6 mm) similar to those found in COVID-19. In addition, unlike the 25-year-old female patient who had no comorbidity, the 55-year-old male patient who had hypertension as comorbidity, developed a more severe acute respiratory distress which progressed to death.Conclusion: These cases bring to the attention a number of facts which make us suspect that COVID-19 may have already been present in the region months before the official beginning of the pandemic. This is important, as prior presence of the disease or infections with related virus may account for the delayed and less extensive development of the epidemic in the region.
Subject(s)
Dyspnea , Fever , Pneumonia , Cough , Virus Diseases , Hypertension , COVID-19 , Inflammation , LymphopeniaABSTRACT
Introduction: Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus. Case presentation: We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-Cov-2 during the last term of her pregnancy. She gave birth by caesarean after 34 weeks of gestation to a new-born baby also infected with SARS-Cov-2. The per-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels. Conclusion: This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.
Subject(s)
COVID-19 , Thrombotic MicroangiopathiesABSTRACT
Introduction: Vertical transmission of covid-19 is possible; its risk factors are worth researching. The placental changes found in pregnant women have a definite impact on the foetus.Case presentation: We report a case of a 25-year-old woman, gravida 3, para 2 (2 alive children), with a history of two caesarean deliveries, who was infected by the SARS-Cov-2 during the last term of her pregnancy. She gave birth by caesarean after 34 weeks of gestation to a new-born baby also infected with SARS-Cov-2. The per-operative observations noted several eruptive lesions in the pelvis, bleeding on contact. Microscopic examination of the foetal appendages revealed thrombotic vasculopathy in the placenta and in the umbilical cord vessels.Conclusion: This case is one of the first documented cases of COVID-19 in pregnancy in sub-Saharan Africa. We strongly suggest obstetricians to carefully examine the aspect of the peritoneum, viscera and foetal appendages in affected pregnant women.
Subject(s)
COVID-19 , Drug Eruptions , ThrombosisABSTRACT
Background: COVID-19 has heterogeneous manifestations, though one of the most common symptoms is a sudden loss of smell (anosmia or hyposmia). We investigated whether olfactory loss is a reliable predictor of COVID-19. Methods: This preregistered, cross-sectional study used a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified singular and cumulative predictors of COVID-19 status and post-COVID-19 olfactory recovery. Results: Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean{+/-}SD, C19+: -82.5{+/-}27.2 points; C19-: -59.8{+/-}37.7). Smell loss during illness was the best predictor of COVID-19 in both single and cumulative feature models (ROC AUC=0.72), with additional features providing no significant model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms, such as fever or cough. Olfactory recovery within 40 days was reported for ~50% of participants and was best predicted by time since illness onset. Conclusions: As smell loss is the best predictor of COVID-19, we developed the ODoR-19 tool, a 0-10 scale to screen for recent olfactory loss. Numeric ratings [≤]2 indicate high odds of symptomatic COVID-19 (10
Subject(s)
COVID-19 , Fever , Olfaction Disorders , CoughABSTRACT
BackgroundPredictions have been made that Africa would be the most vulnerable continent to the novel coronavirus disease 2019 (COVID-19). Interestingly, the spread of the disease in Africa seems to have been delayed and initially slower than in many parts of the World. Here we report on two cases which make us suspect that COVID-19 might have been present in our region before the official declaration of the disease in December 2019.Case presentationThese two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress secondary to atypical pneumonia were seen in Bukavu, in eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts with travellers from China in the 2 weeks prior to the onset of symptoms. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough and fever) and laboratory changes (procalcitonin within the normal range, slight inflammation, and lymphopenia) compatible with a viral infection. The chest X-Rays series of the first patient showed lesions (reticulations, ground glass, and nodules ≤ 6 mm) similar to those found in COVID-19. In addition, unlike the 25-year-old female patient who had no comorbidity, the 55-year-old male patient who had hypertension as comorbidity, developed a more severe acute respiratory distress which progressed to death.ConclusionThese cases bring to the attention a number of facts which make us suspect that the COVID-19 epidemic may have already been present in the region months before the official beginning of the pandemic.
Subject(s)
Dyspnea , Fever , Pneumonia , Cough , Virus Diseases , Hypertension , COVID-19 , Inflammation , LymphopeniaABSTRACT
Background: Predictions have been made that Africa would be the most vulnerable continent to the novel coronavirus disease 2019 (COVID-19). Interestingly, the spread of the disease in Africa seems to be slower than in many parts of the World. Among possible hypotheses, some parts of Africa may have undergone a “silent” COVID-19 epidemic and acquired a herd immunity before the official declaration of the disease in December 2019.Case presentation: We report two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress secondary to atypical pneumonia in Bukavu, in eastern Democratic Republic of the Congo (DRC) which occurred between September and December 2019, before the official beginning of the COVID-19 pandemic. One patient had returned from China and the other had close contacts with travellers from China in the 2 weeks prior to the onset of symptoms. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough and fever) and laboratory changes (procalcitonin within the normal range, slight inflammation, and lymphopenia) compatible with a viral infection. The chest X-Rays series of the first patient showed lesions (reticulations, ground glass, and nodules ≤ 6 mm) similar to those found in COVID-19. In addition, unlike the 25-year-old female patient who had no comorbidity, the 55-year-old male patient who had hypertension as comorbidity, developed a more severe acute respiratory distress which progressed to death.Conclusion: These cases bring to the attention a number of facts which make us suspect that the COVID-19 epidemic may have already been present in the region months before the official beginning of the pandemic.