Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 11 de 11
Filter
1.
Clin Infect Pract ; 16: 100158, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1966438

ABSTRACT

Background: TAFRO syndrome, a subtype of idiopathic multicentric Castleman disease, is an acute or subacute systemic inflammatory disease that causes fever, generalized oedema (pleural effusion or ascites), and thrombocytopenia and is associated with renal impairment, anaemia, and organomegaly (hepatosplenomegaly and lymph node enlargement). Coronavirus disease 2019 (COVID-19)-associated hyperinflammation is caused by dysregulation of proinflammatory cytokines. Cytokine storm syndrome is common to both COVID-19 and TAFRO syndrome.Case report.A 66-year-old man with TAFRO syndrome was admitted because of worsening renal function, right pleural effusion, and ascites. He was taking 20 mg prednisolone orally and 25 mg cyclosporin A orally twice daily. Despite administration of maximum oxygenation and remdesivir, the patient developed acute respiratory distress syndrome (ARDS) and was transferred to the intensive care unit. Results: Chest radiography showed bilateral lung infiltration. COVID-19 was confirmed with a positive polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2. Chest and abdominal computed tomography showed massive ground-glass opacities in both lungs, slight right pleural effusion, hepatomegaly, splenomegaly, and ascites. Conclusion: To the best of our knowledge, this is the first report of COVID-19 in a patient with TAFRO syndrome. Despite receiving a moderate dose of a corticosteroid and a monoclonal antibody against the IL-6 receptor, our patient developed severe pneumonia, suggesting that strong immunomodulatory therapy in the antiviral phase of COVID-19 may promote viral growth and induce ARDS.

2.
Intern Med ; 61(7): 1113-1114, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1834088
3.
Microorganisms ; 10(1)2021 Dec 23.
Article in English | MEDLINE | ID: covidwho-1630058

ABSTRACT

Patients with severe Coronavirus disease 2019 (COVID-19) are at high risk for secondary infection with multidrug-resistant organisms (MDROs). Secondary infections contribute to a more severe clinical course and longer intensive care unit (ICU) stays in patients with COVID-19. A man in his 60s was admitted to the ICU at a university hospital for severe COVID-19 pneumonia requiring mechanical ventilation. His respiratory condition worsened further due to persistent bacteremia caused by imipenem-non-susceptible Klebsiella aerogenes and he required VV-ECMO. Subsequently, he developed a catheter-related bloodstream infection (CRBSI) due to Candida albicans, ventilator-associated pneumonia (VAP) due to multidrug-resistant Pseudomonas aeruginosa (MDRP), and a perianal abscess due to carbapenem-resistant K. aerogenes despite infection control procedures that maximized contact precautions and the absence of MDRO contamination in the patient's room environment. He was decannulated from VV-ECMO after a total of 72 days of ECMO support, and was eventually weaned off ventilator support and discharged from the ICU on day 138. This case highlights the challenges of preventing, diagnosing, and treating multidrug-resistant organisms and healthcare-associated infections (HAIs) in the critical care management of severe COVID-19. In addition to the stringent implementation of infection prevention measures, a high index of suspicion and a careful evaluation of HAIs are required in such patients.

4.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-293392

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) pandemic has spread rapidly worldwide. To prevent the spread of COVID-19, mRNA-based vaccines made by Pfizer/BioNTech (BNT162b1) and Moderna (mRNA-1273) have been widely used worldwide, including in Japan. Various adverse events after COVID-19 mRNA vaccinations have been reported, with differences observed among individuals. However, the analysis on the genetic background for susceptibility to side effects has been limited. In the present work, we performed genome-wide association studies (GWAS) for self-reported adverse events of COVID-19 mRNA vaccination in 4,545 Japanese individuals and identified 14 associated loci. Among these, 6p21 was associated with 37.5°C or higher fever, 38 °C or higher fever, and muscle pain. Our results may enable one to prepare for and manage side effects by knowing their susceptibility to the occurrence of adverse events. Furthermore, we obtained valuable data that can lead to the understanding of the mechanism of action of COVID-19 mRNA vaccines.

5.
Front Med (Lausanne) ; 8: 718641, 2021.
Article in English | MEDLINE | ID: covidwho-1463484

ABSTRACT

Acute respiratory distress syndrome (ARDS) is the leading cause of mortality in hospitalized patients with coronavirus disease 2019 (COVID-19) because of limited effective therapies. During infection, the accumulation and activation of macrophages and monocytes in the lungs induce inflammatory mediators and contribute to tissue injury, leading to ARDS. However, therapeutic strategies that directly target activated macrophage and monocytes have not been reported. Combination treatment with etoposide (a cytotoxic agent) and a corticosteroid has been widely used for treating hemophagocytic lymphohistiocytosis characterized by the systemic activation of macrophages with overwhelming inflammation. Herein, we present five cases of COVID-19-associated ARDS treated with etoposide and corticosteroids. Three of the five patients were over 65 years of age and had various underlying diseases, including multiple myeloma. Four patients required invasive mechanical ventilation (MV), and one patient refused to be placed on MV due to underlying diseases. All patients were pre-treated with antiviral and/or other anti-inflammatory agents, but their condition deteriorated and hyperinflammation was noted. All five patients responded well to treatment and had an immediate response, as reflected by improvement in their respiratory condition and inflammatory marker levels and rapid resolution of fever after etoposide administration; however, some patients required a second dose of etoposide and longer course of steroids. All patients recovered, and there were no severe adverse events related to the drugs. Following successful treatment in these five patients, we plan to conduct a clinical trial to evaluate the efficacy and safety of combination therapy with etoposide and corticosteroid for treating COVID-19 patients in Japan.

7.
Clin Infect Dis ; 72(11): 2052-2061, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1249287

ABSTRACT

The healthcare environment serves as one of the possible routes of transmission of epidemiologically important pathogens, but the role of the contaminated environment on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission remains unclear. We reviewed survival, contamination, and transmission of SARS-CoV-2 via environmental surfaces and shared medical devices as well as environmental disinfection of SARS-CoV-2 in healthcare settings. Coronaviruses, including SARS-CoV-2, have been demonstrated to survive for hours to days on environmental surfaces depending on experimental conditions. The healthcare environment is frequently contaminated with SARS-CoV-2 RNA in most studies but without evidence of viable virus. Although direct exposure to respiratory droplets is the main transmission route of SARS-CoV-2, the contaminated healthcare environment can potentially result in transmission of SARS-CoV-2 as described with other coronaviruses such as SARS and Middle East respiratory syndrome coronaviruses. It is important to improve thoroughness of cleaning/disinfection practices in healthcare facilities and select effective disinfectants to decontaminate inanimate surfaces and shared patient care items.


Subject(s)
COVID-19 , Middle East Respiratory Syndrome Coronavirus , Delivery of Health Care , Humans , RNA, Viral , SARS-CoV-2
8.
Infect Ecol Epidemiol ; 11(1): 1852681, 2020 Nov 23.
Article in English | MEDLINE | ID: covidwho-1005855
9.
11.
J Infect Chemother ; 26(10): 1100-1103, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-627186

ABSTRACT

We report a coronavirus disease 2019 (COVID-19) case with rheumatoid arthritis taking iguratimod. The patient who continued iguratimod therapy without dose reduction was treated with ciclesonide had an uneventful clinical course, but prolonged detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was observed after resolution of symptoms. The effects of disease-modifying antirheumatic drugs (DMARDs) and ciclesonide on clinical course and viral shedding remain unknown and warrant further investigation.


Subject(s)
Arthritis, Rheumatoid/drug therapy , Betacoronavirus , Chromones/therapeutic use , Coronavirus Infections/complications , Pneumonia, Viral/complications , Pregnenediones/therapeutic use , Sulfonamides/therapeutic use , Adult , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/complications , COVID-19 , Coronavirus Infections/diagnosis , Female , Humans , Pandemics , Pneumonia, Viral/diagnosis , RNA, Viral , Real-Time Polymerase Chain Reaction , SARS-CoV-2 , Thorax/diagnostic imaging , Virus Shedding
SELECTION OF CITATIONS
SEARCH DETAIL