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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-313043

ABSTRACT

Background: SARS-CoV2 virus could be potentially myopathic. Serum creatinine phosphokinase (CPK) is frequently found elevated in severe SARS-CoV2 infection, which indicates skeletal muscle damage precipitating limb weakness or even ventilatory failure. Case presentation: We addressed such a patient in his forties presented with features of severe SARS-CoV2 pneumonia and high serum CPK. He developed severe sepsis and acute respiratory distress syndrome (ARDS) and received intravenous high dose corticosteroid and Tocilizumab to counter SARS-CoV2 associated cytokine surge. After 10 days of mechanical ventilation (MV) weaning was unsuccessful albeit apparently clear lung fields, having additionally severe and symmetric limb muscle weakness. Ancilliary investigations in addition with serum CPK, including electromyogram, muscle biopsy and muscle magnetic resonance imaging (MRI) suggested acute myopathy possibly due to skeletal myositis. Conclusion: We wish to stress that myopathogenic medication in SARS-CoV2 pneumonia should be used with caution. Additionally serum CPK could be a potential marker to predict respiratory failure in SARS-CoV2 pneumonia as skeletal myopathy affecting chest muscles may contribute ventilatory failure on top of oxygenetion failure due to SARS-CoV2 pneumonia.

2.
Skelet Muscle ; 11(1): 10, 2021 04 21.
Article in English | MEDLINE | ID: covidwho-1197351

ABSTRACT

BACKGROUND: SARS-CoV2 virus could be potentially myopathic. Serum creatinine phosphokinase (CPK) is frequently found elevated in severe SARS-CoV2 infection, which indicates skeletal muscle damage precipitating limb weakness or even ventilatory failure. CASE PRESENTATION: We addressed such a patient in his forties presented with features of severe SARS-CoV2 pneumonia and high serum CPK. He developed severe sepsis and acute respiratory distress syndrome (ARDS) and received intravenous high dose corticosteroid and tocilizumab to counter SARS-CoV2 associated cytokine surge. After 10 days of mechanical ventilation (MV), weaning was unsuccessful albeit apparently clear lung fields, having additionally severe and symmetric limb muscle weakness. Ancillary investigations in addition with serum CPK, including electromyogram, muscle biopsy, and muscle magnetic resonance imaging (MRI) suggested acute myopathy possibly due to skeletal myositis. CONCLUSION: We wish to stress that myopathogenic medication in SARS-CoV2 pneumonia should be used with caution. Additionally, serum CPK could be a potential marker to predict respiratory failure in SARS-CoV2 pneumonia as skeletal myopathy affecting chest muscles may contribute ventilatory failure on top of oxygenation failure due to SARS-CoV2 pneumonia.


Subject(s)
COVID-19/physiopathology , Creatine Kinase/blood , Muscle, Skeletal/physiopathology , Muscular Diseases/physiopathology , Quadriplegia/physiopathology , Respiratory Distress Syndrome/physiopathology , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Adult , Alanine/analogs & derivatives , Alanine/therapeutic use , Antibodies, Monoclonal, Humanized/therapeutic use , Anticoagulants/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/therapy , Critical Illness , Dexamethasone/therapeutic use , Electromyography , Glucocorticoids/therapeutic use , Heparin, Low-Molecular-Weight/therapeutic use , Humans , Intensive Care Units , Magnetic Resonance Imaging , Male , Methicillin-Resistant Staphylococcus aureus , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/pathology , Muscular Diseases/blood , Muscular Diseases/diagnosis , Muscular Diseases/etiology , Neural Conduction , Pulmonary Embolism/diagnosis , Pulmonary Embolism/drug therapy , Pulmonary Embolism/etiology , Pulmonary Embolism/physiopathology , Quadriplegia/etiology , Respiration, Artificial , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , SARS-CoV-2 , Severity of Illness Index , Staphylococcal Infections/complications , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Ventilator Weaning
3.
Sensors (Basel) ; 21(4)2021 Feb 11.
Article in English | MEDLINE | ID: covidwho-1090302

ABSTRACT

The efficiency of cooperative communication protocols to increase the reliability and range of transmission for Vehicular Ad hoc Network (VANET) is proven, but identity verification and communication security are required to be ensured. Though it is difficult to maintain strong network connections between vehicles because of there high mobility, with the help of cooperative communication, it is possible to increase the communication efficiency, minimise delay, packet loss, and Packet Dropping Rate (PDR). However, cooperating with unknown or unauthorized vehicles could result in information theft, privacy leakage, vulnerable to different security attacks, etc. In this paper, a blockchain based secure and privacy preserving authentication protocol is proposed for the Internet of Vehicles (IoV). Blockchain is utilized to store and manage the authentication information in a distributed and decentralized environment and developed on the Ethereum platform that uses a digital signature algorithm to ensure confidentiality, non-repudiation, integrity, and preserving the privacy of the IoVs. For optimized communication, transmitted services are categorized into emergency and optional services. Similarly, to optimize the performance of the authentication process, IoVs are categorized as emergency and general IoVs. The proposed cooperative protocol is validated by numerical analyses which show that the protocol successfully increases the system throughput and decreases PDR and delay. On the other hand, the authentication protocol requires minimum storage as well as generates low computational overhead that is suitable for the IoVs with limited computer resources.

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