Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 6 de 6
Filter
1.
Open Access Macedonian Journal of Medical Sciences ; 10:217-221, 2022.
Article in English | EMBASE | ID: covidwho-2066680

ABSTRACT

INTRODUCTION: The first data for COVID-19 in pregnancy showed mild-to-moderate forms of the disease while the current data speak of severe forms in these subjects. Here, we present a case of a severe form of COVID-19 in a gemelar pregnant woman complicated with pneumomediastinum and pneumothorax, during her hospital stay, in a late stage of disease. CASE PRESENTATION: A 38-year-old multiparous woman was referred to university hospital at 25 weeks of gemelar pregnancy. On admission, the patient presented with signs of moderate respiratory insufficiency, which after 12 h progressed further to severe ARDS. She tested positive for SARS-CoV-2 on quantitative real-time polymerase chain reaction. Under these conditions, it was decided that the patient undergoes a cesarean section for termination of pregnancy. Remdesivir 200 mg/day and tocilizumab 8 mg/kg were administered, based on national guidelines. The patient’s fever subsided, but her SpO2 remained at 94%, even with a 15 L/min oxygen mask. After 12 days, the patient complains of a severe back pain and her respiratory condition rapidly worsened and reduced saturations up to 80% being under O2 therapy with facial mask with 15 l/min. Chest CT findings confirmed pneumomediastinum and pneumothorax, which deteriorated the patient’s status. Thereafter, tube thoracostomy was performed. There was a clinical and ABG analysis parameter’s improvement. The patient was discharged 34 days after cesarean delivery with a proper general health. CONCLUSION: Our case highlights even more convincingly the fact that, in pregnancy, can be severe to life-threating forms of COVID-19. Pneumothorax and pneumomediastinum are complications that can be encountered even in the late stages of severe forms cases with COVID-19 in pregnancy. Early diagnosis of these complications is essential in adequate management and treatment to avoid fatal outcome.

2.
South Eastern European Journal of Public Health ; 4, 2022.
Article in English | Scopus | ID: covidwho-1964600

ABSTRACT

On March 9, 2020 the first two cases of Sars-Cov-2 were identified and hospitalized in Albania. In this paper we present a retrospective analysis of 3000 consecutive COVID-19 confirmed cases in Albanian adults admitted at the Infectious Diseases Service which includes three tertiary care wards, part of Tirana University Hospital Center “Mother Teresa”. The period included in this analysis is from March 2020 – April 30, 2021. The paper provides a general overview including demographic distribution, symptomatic diversity and clinical signs manifested among cases, as well as the association observed with underlying pathologies. The analysis included 1944 males and 1056 females. Overall, the age groups included range from 15 to 99 years (median 65 years;mean value 63.4±13.4 years). There were no statistically significant age differences between males and females (mean ages were: 63.5±13.1 in females and 63.3±13.5 in males;median ages were: 64 years in females and 65 years in males;P=0.67). There was evidence of a statistically significant difference between sexes regarding the presence of symptoms, which were more predominant in males (P<0.001). On the whole, we observed 19 cases with specific signs and symptoms, most of them (82.9%) among patients who reported the presence of such symptoms 5-14 days before hospitalization. The comorbidities encountered were ranked according to systems and organs, classifying them in 22 categories, among which the most frequent were hypertension (52%) and diabetes mellitus (26.4%). Age was a strong risk factor for severe illness, complications, and death. Analyzing symptom onset with total symptoms and comorbidities, it showed that some patients were affected for many days with few symptoms and few comorbidities. It seems they started as mild cases for many days unpredictably precipitating. There were also a few cases with many comorbidities, but a few symptoms upon hospital admission. © 2022 Çomo et al.

3.
Nephrology Dialysis Transplantation ; 37(SUPPL 3):i61-i62, 2022.
Article in English | EMBASE | ID: covidwho-1915660

ABSTRACT

BACKGROUND AND AIMS: Renal manifestations are common in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report here the case of a patient with confirmed SARS-CoV-2 infection with the clinical picture of atypical haemolytic uremic syndrome (aHUS). METHOD: Case report RESULTS: Our case is a 31-year-old man with a nasopharyngeal swab with real-time reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2 positive, who was hospitalized in the Clinic of Infectious Diseases. His medical history had a respiratory illness of 7-day evolution characterized by cough, fever, dyspnoea, muscle pain, nausea, vomiting and non-bloody diarrhoea, and decreased urine output with dark colour urine. The chest computed tomography (CT) scan showed few rounded ground-glass opacities. Laboratory tests at admission revealed the following: (i) acute kidney injury stage 3 with a serum creatinine of 3.85 mg/dL (basal value 0.9 mg/dL);serum urea 221 mg/dL. His urinary volume in the first 24 h of hospitalization was 800 mL. (ii) Severe haemolytic anaemia with haemoglobin (Hgb) level of 3.7 g/dL, and peripheral smear showing large number of schistocytes, haptoglobin <10 mg/dL and indirect bilirubin 9.7 mg/dL, direct coombs testing was negative;reticulocyte count 8.9%. (iii) Severe thrombocytopaenia with platelet count of 25 000/μL, prothrombin time 45%, international normalized ratio 1.7, D-dimer 1082 ng/dL and fibrinogen 880 mg/dL. Increased blood levels of enzymes and inflammatory markers were present: lactate dehydrogenase 1867 U/L and protein C reactive 9.1 mg/dL. Electrolyte disturbances characterized by hyperkalaemia, hyperphosphatemia, hypocalcaemia and severe metabolic acidosis. Dynamic changes of laboratory data are presented in Table 1. The usual liver panel tests, alkaline phosphatase, γ -glutamyl transferase and albuminemia were normal. Toxic hepatitis was excluded. Hepatobiliary and spleen imaging (ultrasonography) was normal. ELISA serologic tests for HIV, hepatitis B, hepatitis C virus and cytomegalovirus were negative. Serological and virological tests for hepatitis A, B, C, HIV and CMV were negative. Stool was negative for Shiga toxin-producing Escherichia coli (STEC). The results of antinuclear antibodies and anti-smooth-muscle antibodies were negative, C3 serum level was mildly depressed (82 mg/dL;normal range 88- 201 mg/dL) and C4 serum level was normal (20 mg/dL;normal range 10-44 mg/dL). ADAMTS13 activity was 90% on day 10. He was treated with broad spectrum antibiotics, intravenous dexamethasone and supportive therapy. One week from admission, renal function recovered, and 1 week after intravascular haemolysis and thrombocytopaenia recovered. The patient was hospitalized for 21 days. CONCLUSION: Close monitoring and early intervention can help for a better outcome of SARS-CoV-2 patients complicated with aHUS.

4.
Jac-Antimicrobial Resistance ; 4:1, 2022.
Article in English | Web of Science | ID: covidwho-1769302
5.
Hiv Medicine ; 22:215-215, 2021.
Article in English | Web of Science | ID: covidwho-1519269
6.
South Eastern European Journal of Public Health ; 17, 2021.
Article in English | Scopus | ID: covidwho-1395294

ABSTRACT

Aim: The objective of this study was to assess the current status regarding Infection Prevention and Control (IPC) in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic which continues unabated. Methods: A cross-sectional study was conducted in April 2021 including a nationwide representative sample of 505 health professionals working mostly in primary health care centres in Albania (84 men and 421 women;response rate: 95%). A structured questionnaire developed by the World Health Organization was administered online to all participants inquiring about a wide range of measures and practices employed at health facility level for an effective IPC approach. Fisher’s exact test was used to assess potential urban-rural differences in the distribution of characteristics regarding IPC aspects reported by survey participants. Results: About 47% of health facilities did not have a designated focal point for IPC issues;the lack of one patient per bed standard was evident in more than one-third of health facilities (37%);and the lack of an adequate distance between patient beds was reported in a quarter of health facilities (which was twice as high among health facilities in urban areas compared to rural areas). Furthermore, water services were always available only in about two-thirds of health facilities (63%), whereas an adequate number of toilets (at least two) was evident in slightly more than half of the health facilities surveyed (53%). Also, one out of four of the health facilities did not have functional hand hygiene stations and/or sufficient energy/power supply. A completely adequate ventilation was evidenced in slightly more than half of the health facilities (51%). Four out of five health facilities had always available materials for cleaning and about half (49%) had always available personal protective equipment. Functional waste collection containers were available in nine out of ten health facilities, of which, four out of five were correctly labelled. Conclusion: This study informs about the existing structures, capacities and available resources regarding IPC situation in different health facilities in Albania. Policymakers and decision-makers in Albania and in other countries should prioritize investments regarding IPC aspects in order to meet the basic requirements and adequate standards in health facilities at all levels of care. © 2021, Jacobs Verlag. All rights reserved.

SELECTION OF CITATIONS
SEARCH DETAIL