ABSTRACT
Introduction: Vanishing lung syndrome , a primary bullous disease of the lung is defined as a large bulla occupying at least one third of a hemithorax. Usually it associated with riskfactors of smoking, marijuana abuse, alpha 1 antitrypsin deficiency. Here we present a rare case of vanishing lung syndrome developed in a post covid patient without any comorbidities making it a rare presentation. History: A 35year,male with no significant cigaratte smoking presented with acute onset dyspnoea along with dry cough and right sided chest pain for 1 week duration .no history of any recent trauma Past history of COVID 19 one month back, he was hospitilized was put on NIV and HFNC and was discharged on domicillary oxygen and other medications. Clinical Findings: On examination there was hyperresont note in right side along with diminished air entry in all areas in right side along with left side mammary, infraaxillary, infrascapular areas. Diagnosis and Management: Diagnosis was made with the help of contrast enchanced computed tomography aided by other serological and microbilogical workup. Patient was managed conservatively antibiotics ,analgesics and other supportive measures. Learning Points: We are well aware of lung fibrosis post covid , our intention was to throw light into the new entity of bullous lung disease Bullous lung disease (with or without pneumothorax) should be part of differential diagnosis in a patient returning with chest pain and dyspnoea after SARS-Cov-2 infection.CT imaging essential to differentiate radiographically presumed complex pneumothoraces from large bullae to prevent erroneous chest drain insertion into a bulla.
ABSTRACT
Introduction: After the aftermath of covid 19 we are left to learn and understand the multiple respiratory manifestations of post covid 19 sequele The presence of bullous lung disease in post covid patients is one such a rare entity ,has been infrequently reported, studied Eventhough the exact mechanism of formation of bullae in post covid 19 are unknown, an emerging association has been observed.A bulla is an air containing space within the lung parenchyma that arises from destruction dilatation and confluence of airspaces distal to terminal bronchioles and is larger than 1 cm in diameter .Its wall are composed of attenuated and compressed parenchyma. Here in this case series we describe this unique presentation of bullous lung diseases in post covid 19 patients. Case Series: Here wepresent a case series of 7 patients without any known comorbidities who were diagnosed with post covid bullous lung disease Diagnosis was made with the help of contrast enchanced computed tomography aided by other serological and microbilogical workup. Patient was managed conservatively antibiotics, analgesics and other supportive measures. Learning Points: We are well aware of lung fibrosis post covid, our intention was to throw light into the new entity of bullous lung disease in post covid period. Bullous lung disease (with or without pneumothorax) should be part of differential diagnosis in a patient returning with chest pain and dyspnoea after SARSCov- 2 infection. CT imaging essential to differentiate radiographically presumed complex pneumothoraces from large bullae to prevent erroneous chest drain insertion into a bulla.
ABSTRACT
Introduction: COVID-19 is a respiratory and systemic disorder caused by the SARS-CoV-2 virus with a range of severity from mild respiratory symptoms to severe lung injury, multiorgan failure, and death. The main risk factors of the disease are increased age and underlying comorbidity. Newer reports show that younger patients can also suffer from severe COVID pneumonia of which the data are limited. This study intends to uncover the factors that resulted in severe COVID-19 infection in young adults. Objectives: To study the clinicodemographic profile and outcomes of severe COVID-19 infection in young adults. Materials and methods: This single-center retrospective study included 163 hospitalized patients in the age group 18 to 35 years diagnosed with severe COVID-19 infection at a tertiary care hospital in Uttar Pradesh from July 2020 to November 2020. Details about patient's demographics, clinical features, previous comorbidities, laboratory and radiological investigations, and hospital outcomes were obtained from patient records and analyzed. Results: Out of 163 patients, 60.1% (98) were males and 39.8% (65) were females. The most common comorbidity was diabetes 68.7%, hyperlipidemia 33.1% and obesity 32%. 30.6.% (51) of patients were smokers. Patients presented with shortness of breath (66.9%), cough (65.6%) and fever (60.7%) respectively. Multilobe infiltrates were found in chest xray of (75.4%) patients,. Mean length for ICU stay was 15.5 days (range 3-46). Mechanical ventilation was required in 26.9% of patients .In patients requiring mechanical ventilation, 17 (38%) were discharged and 27(62.8%) died. Of the mechanically ventilated patients 44 had abnormal BMI. Overall mortality was 27% (37patients). Discussions: There was a male sex predominance with diabetes. Obesity, smoking, and hyperlipidemia were the major risk factors. The major presenting symptoms in these patients were shortness of breath, cough, and fever. Only a quarter of patients required mechanical ventilation, and in those obesity was found to be a major risk factor. Conclusion: Our study provides insight into presenting characteristics, demographics, and overall outcomes of severe COVID-19 infection in young adults. The preconceived notion of COVID-19 being a disease of the elderly should be changed. In medical emergencies like the COVID pandemic, it is very important to analyze patient demographics to identify the population at risk. Such knowledge not only allows us to produce strategies to help control the spread of disease but also helps us to risk stratify to prevent mortality. It is crucial to learn from an epidemic like this so we can be better prepared for the future.