ABSTRACT
OBJECTIVE: Hip arthroplasty is one of the most performed surgeries in orthopedics. Rehabilitation process after surgery allows rapid recovery of joint functions in absence of pain in most patients. During COVID-19 pandemic, rehabilitation clinics have reduced the number of beds available. Thus, an increasing number of patients were forced to home rehabilitation programs. Our study aimed at determining any significant differences in clinical and functional outcomes between those patients who underwent a home rehabilitation program and those others who were granted a place in a Rehabilitation clinic during COVID-19 pandemic, at mid-term follow-up. PATIENTS AND METHODS: An observational retrospective single-center study was designed. The patients included were 63, divided into two groups: Group A (29 patients) for home rehabilitation, and Group B (34 patients) for clinic rehabilitation. Follow-up was performed at 1, 6 and 12 months after surgery. Clinical evaluation was assessed through Oxford Hip Score for hip function, Visual Analogue Scale (VAS) for pain and hip range of motion (ROM) to evaluate joint recovery. RESULTS: ROM was compared at follow-up with significant differences 12 months after surgery (107.93° group A vs. 104.7° group B; p=0.0168). Pain felt by patients according to the VAS scale showed no significant differences at follow-up (1 month 3.27 vs. 3.65 p=0.1489; 6 months 1.89 vs. 2.18 p=0.105; 12 months 0.58 vs. 0.68 p=0.6263). Regarding the Oxford Hip score, significant differences emerged at 1-month follow-up (38.75 group A vs. 37.94 group B; p=0.0498). CONCLUSIONS: At mid-term follow-up, little differences were found between patients who went through home rehabilitation and those who went to a rehabilitation clinic. Therefore, decreasing the number of beds available in rehab clinics during COVID-19 pandemic was not an obstacle for elective surgery for orthopedic surgeons.
Subject(s)
Arthroplasty, Replacement, Hip , COVID-19 , Humans , Retrospective Studies , Communicable Disease Control , PainABSTRACT
Purpose of Review: SARS-CoV-2 generates an atypical pneumonia with high morbidity and mortality. In many cases, the torpid evolution was related to bacterial or fungal co-infections. Non-specific manifestations of COVID-19 infection can make the differential diagnosis with other systemic diseases even more difficult. A review of systemic endemic mycoses associated with COVID-19 was carried out. We will describe epidemiological data, clinical characteristics of the endemic mycosis, and different diagnostic resources. Recent Findings: Database search process in PubMed, Latindex, and other online web was performed. From 78 published cases, coccidioidomycosis was the most frequent association followed in second place by histoplasmosis. Highly variable diagnostic methodologies were used, but all were useful. Summary: Mortality caused by these endemic mycoses does not seem to have been modified by COVID-19.
ABSTRACT
COVID-19 pandemic changed quickly world's clinical picture. Symptoms often are sneaky, hiding dramatic clinical scenarios. A 52-year-old man was sent to the Emergency Department with persistent chest pain, dyspnea and hypoxia. He also complained of cough and fever (38 degrees C) since four days without clinical improvements by paracetamol. Nasopharyngeal swab was positive for SARS-CoV-2. High resolution computer tomography (HRCT) showed typical CT pattern of bilateral COVID-19 pneumonia. During hospital stay clinical worsening occurred and a CT pulmonary angiography revealed a bilateral massive acute pulmonary embolism. The patient was treated with unfractionated heparin.