The Influence of SARS-CoV-2 on Minimally Invasive Therapeutic Approach for Benign Prostatic Hyperplasia.

Introduction: The COVID-19 pandemic definitely changed the management of patients with benign prostatic hyperplasia (BPH). This study followed the modalities of treatments in patients with BPH associated with SARS-CoV-2 attending the Urology Clinic of "Sf. Ioan" Emergency Clinical Hospital, Bucharest, Romania. Material and methods:The present study included 81 patients (mean age 63.2 years, age range 55-87 years) with SARS-CoV-2 and BPH who were admitted to our Urology Department between January 2021 and January 2022. The diagnosis of SARS-CoV-2 was based on the PCR test and that of BPH by using the diagnostic triad consisting of digital rectal examination, PSA, free PSA and ultrasound examination. It should be noted that some of the hospitalized patients were following treatment with alpha blockers and/or 5-alpha-reductase inhibitors at the time of admission. Results:Out of the 81 hospitalized cases, 13 required emergency endoscopic intervention under spinal anaesthesia (TURP or TURisP) for haemostasis because those patients presented with persistent haematuria which did not respond to conservative treatment. A number of 17 cases showed acute urinary retention during hospitalization and a urethrovesical catheter was fitted and will be re-evaluated urologically after the COVID episode. Of the remaining 51 subjects with BPH, 17 already had chronic urinary retention on admission, with urethrovesical probe present, 13 cases began during hospitalization with alpha-blocker treatment associated with 5-alpha-reductase inhibitors; meanwhile, there were no urological interventions to modify the treatment regimen in the remaining 21 patients, who were strictly managed on the side of COVID-19 infection. Conclusion:There was no clear influence of the evolution of patients with BPH due to SARS-CoV-2 pathology, and the general management trend was to delay chronic cases until the time of viral infection remission.

COVID-19 in a child with multiple comorbidities

A female child, 1 year-old and 2 months, diagnosed with multiple neurological conditions, including myelomeningocele and operated hydrocephalus, was diagnosed with SARS-CoV-2 in October 2020 and hospitalized in our clinic. At the time of the onset of the disease, the patient had a febrile episode, laboratory blood tests showed a slightly increased biologi-cal inflammatory syndrome, and mixed pneumonia was described radiologically. Thus, antibiotic treatment was initiated, with laboratory tests and control imaging within normal limits after several days of admission. Being an institutionalized child, according to the epidemiological recommendations of that time, she was hospitalized in our clinic during the 14 days of the illness. Thus, on the 15th day of the disease she was discharged, with negative SARS-CoV-2 control RT-PCR, with good general condition, afebrile over 10 days. © 2021, Amaltea Medical Publishing House. All rights reserved.

SARS-CoV-2 infection in a child with Fanconi anemia and determined immunosuppressed status

Introduction. SARS-CoV-2 virus infection affects all age groups. In children, the infection mainly causes asympto-matic or mildly symptomatic forms of the disease, regardless of their immune status. Case presentation. We describe the case of a 7-year-old male child, known to have Fanconi anemia, scheduled for bone marrow transplantation. The patient comes from a family outbreak of COVID-19, which is why he was tested for SARS-CoV-2 infection. He is asymptomatic at the time of admission to our clinic. The clinical examination performed at the time of admission shows a patient in good general condition, afebrile, with pale skin and mucous membranes, without respiratory changes. Paraclinically, severe neutropenia, severe normochromic normocytic anemia and severe thrombocytopenia are detected, for which transfusions of erythrocyte mass and platelet mass are performed. Due to the immunocompromised status, antibiotic therapy is instituted. If necessary, symptomatic treatment is administered. The evolution is favorable, and the SARS-CoV-2 RT-PCR control test is negative on the eighth day of hospitalization. Conclusions. Immunocompromised status is not a major risk factor for severe COVID-19 in children. © 2021, Amaltea Medical Publishing House. All rights reserved.

A particular case of SARS-CoV-2 infection in twins

Introduction. Although SARS-CoV-2 infection is more common in adults, many cases have been reported in the pediatric population. Case presentation. An 8-month-old infant from twin pregnancy, confirmed with COVID-19, is hospitalized with nasal obstruction, serous rhinorrhea, rare cough and watery stools. The epidemiological link is known, both the parents and the maternal grandparents of the infant being confirmed with COVID-19. Biologically, he presented with thrombocytosis and discrete inflammatory syndrome, and the lung radiograph did not show any lesions. At the same time, the twin sister was hospitalized, who presented a similar symptomatol-ogy, with a negative SARS-CoV-2 PCR test, but the lung radiograph showed specific lesions of COVID-19. During hospitalization, 2 more SARS-CoV-2 PCR tests were performed, but with negative results. The evolution of the twins was favorable under symptomatic treatment, respectively antibiotic and symptomatic treatment. Conclusion. SARS-CoV-2 infection may be asymptomatic, especially in infants and newborns, and has a lower prevalence. © 2021, Amaltea Medical Publishing House. All rights reserved.

Influence of SARS-CoV-2 Infection on the Renin Angiotensin System

The advent of coronavirus-2019 (COVID-19) as a global pandemic has prompted scientists to address an urgent need to clarify the disease's pathogenic mechanisms and treatment. Severe acute respiratory syndrome is the severe complication of coronavirus 2 (SARS-CoV-2). This novel coronavirus uses the angiotensin 2 converting enzyme (ACE2) as a key target for cell surface attachment as well as a possible entry point into the host cell. Thus, for clinical intervention, a correct understanding of the elements that can influence the expression and function of ACE2 in the healthy and diseased body is critical. Over 60% of all persons in Europe have comorbidities, necessitating the usage of a prescription drug. While prior research has focused on the use of reninangiotensin inhibitors (RAS) to regulate ACE2 expression, new evidence in the literature suggests that a number of commonly used medicines for hypertension, heart failure, diabetes, and hyperlipidemia may interfere with COVID-19 infection. The involvement of the renin-angiotensinaldosterone system in the pathology of various complications such as hypertension and chronic kidney disease, through its aldosterone-releasing effects, stimulates coronary vasoconstriction, especially in the already ischemic heart. We offer a brief discussion of the methods through which medications that interfere with the renin-angiotensin system may influence the viral entrance of SARS-CoV-2 into cells, in addition to their known therapeutic effects.