ABSTRACT
Cytomegalovirus (CMV) pneumonitis infections might present mild or severe illnesses and need sophisticated diagnostic tools, so it remains a diagnostic challenge. We reported five infants diagnosed with CMV pneumonitis who were initially and undiagnosed by the pediatrician in secondary private or public health hospitals with no improvement with standard and escalation of antibiotics treatment for bronchopneumonia as the initial diagnoses. As all cases occurred during the COVID-19 pandemic, they proved negative COVID-19 identified by polymerase chain reaction (PCR) SARS-CoV-2. We diagnosed acquired perinatal pneumonitis CMV in all claims based on clinical criteria, imaging studies, CMV serology, and PCR-CMV urinary tests as diagnostic tools. They showed clinical improvement after two weeks of valganciclovir therapy. Other organs' involvement was considered to be evaluated, including brain-evoked response audiometry (BERA) and eye examination. The physician should consider the possibility of CMV pneumonitis, who did not respond to standard and escalation of antibiotics treatment after initial diagnoses of bronchopneumonia.
ABSTRACT
Diabetes mellitus is a chronic hyperglycemic condition that can affect the body's immune response to SARS-CoV-2 This study aimed to determine the relationship between diabetes mellitus and lung severity in COVID-19 patients. METHODS: A cross-sectional design was conducted at Hasan Sadikin General Hospital during the January-May 2021 period. Data were based on medical records of patients aged 18 years and over with COVID-19. The chi-square test was performed to assess the relationship between diabetes mellitus and lung severity based on the BRIXIA score. RESULTS: This study included 538 subjects, mostly aged <60 years (71.9%) and female (60.2%). A total of 125 subjects had abnormal blood glucose levels with an average HbA1c of 9.00 ± 1.77% in patients with diabetes mellitus and a median HbA1c of 5.85% (4.5-6.4%) in patients with reactive hyperglycemia. Lung abnormalities were found in 357 subjects (66.4%). The results of the BRIXIA score to assess lung severity found as many as 77 subjects (14.3%) had a score of 11-18 with 14 people with diabetes mellitus, five people with reactive hyperglycemia. In the population aged ≥60 years, as many as 32 people had a score of 11-18 with three people with diabetes mellitus, two with reactive hyperglycemia and 27 with normal blood glucose. A significant relationship was found between diabetes mellitus and lung severity (p = 0.024). CONCLUSION: There is a significant relationship between diabetes mellitus and lung severity in COVID-19 patients aged ≥60 years.