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1.
Psychiatry Res ; 317: 114890, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2061785

ABSTRACT

The SARS-CoV-2 (COVID-19) pandemic has increased healthcare worker (HCW) susceptibility to mental illness. We conducted a meta-analysis to investigate the prevalence and possible factors associated with post-traumatic stress disorder (PTSD) symptoms among HCW during the COVID-19 pandemic. We searched PubMed, SCOPUS and EMBASE databases up to May 4th, 2022. We performed random effects meta-analysis and moderator analyses for the prevalence of PTSD-relevant symptoms and severe PTSD symptoms. We identified 1276 studies, reviewed 209 full-text articles, and included 119 studies (117,143 participants) with a total of 121 data points in our final analysis. 34 studies (24,541 participants) reported prevalence of severe PTSD symptoms. Approximately 25.2% of participants were physicians, 42.8% nurses, 12.4% allied health professionals, 8.9% auxiliary health professionals, and 10.8% "other". The pooled prevalence of PTSD symptoms among HCWs was 34% (95% CI, 0.30-0.39, I2 >90%), and 14% for severe PTSD (95% CI, 0.11 - 0.17, I2 >90%). The introduction of COVID vaccines was associated with a sharp decline in the prevalence of PTSD, and new virus variants were associated with small increases in PTSD rates. It is important that policies work towards allocating adequate resources towards protecting the well-being of healthcare workers to minimize adverse consequences of PTSD.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Humans , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Health Personnel , Prevalence
2.
Cureus ; 14(5): e25075, 2022 May.
Article in English | MEDLINE | ID: covidwho-1884697

ABSTRACT

Infection with SARS-CoV-2, commonly referred to as COVID-19 disease, has been noted to involve a systemic inflammatory reaction affecting multiple organ systems. Patients present with a spectrum of symptoms from mild to severe respiratory distress requiring supplemental oxygen and, at times, intubation and mechanical intubation. Pulmonary involvement causes diffuse alveolar wall damage leading to destruction and collapse of the alveolar walls causing air leakage and introduction of the air into the mediastinum, pericardium, and interstitial spaces. We present a case of a 71-year-old patient who presented with respiratory distress requiring supplemental oxygen with subsequent rapid decline and decompensation requiring intubation and mechanical ventilation who was found to have pneumomediastinum and pneumopericardium.

3.
J Surg Case Rep ; 2022(3): rjac089, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1795233

ABSTRACT

[This corrects the article DOI: 10.1093/jscr/rjab198.].

4.
Trials ; 23(1): 250, 2022 Apr 04.
Article in English | MEDLINE | ID: covidwho-1775330

ABSTRACT

BACKGROUND: Major depression is the second leading cause of years lost to disability worldwide and is a leading contributor to suicide. However, first-line antidepressants are only fully effective for 33%, and only 40% of those offered psychological treatment attend for two sessions or more. Views gained from patients and primary care professionals are that greater treatment uptake might be achieved if people with depression could be offered alternative and more accessible treatment options. Although there is evidence that the Alpha-Stim Anxiety Insomnia and Depression (AID) device is safe and effective for anxiety and depression symptoms in people with anxiety disorders, there is much less evidence of efficacy in major depression without anxiety. This study investigates the effectiveness of the Alpha-Stim AID device, a cranial electrotherapy stimulation (CES) treatment that people can safely use independently at home. The device provides CES which has been shown to increase alpha oscillatory brain activity, associated with relaxation. METHODS: The aim of this study is to investigate the clinical and cost-effectiveness of Alpha-Stim AID in treatment-seeking patients (aged 16 years upwards) with moderate to moderately severe depressive symptoms in primary care. The study is a multi-centre parallel-group, double-blind, non-commercial, randomised controlled superiority trial. The primary objective of the study is to examine the clinical efficacy of active daily use of 8 weeks of Alpha-Stim AID versus sham Alpha-Stim AID on depression symptoms at 16 weeks (8 weeks after the end of treatment) in people with moderate severity depression. The primary outcome is the 17-item Hamilton Depression Rating Scale at 16 weeks. All trial and treatment procedures are carried out remotely using videoconferencing, telephone and postal delivery considering the COVID-19 pandemic restrictions. DISCUSSION: This study is investigating whether participants using the Alpha-Stim AID device display a reduction in depressive symptoms that can be maintained over 8 weeks post-treatment. The findings will help to determine whether Alpha-Stim AID should be recommended, including being made available in the NHS for patients with depressive symptoms. TRIAL REGISTRATION: ISRTCN ISRCTN11853110 . Registered on 14 August 2020.


Subject(s)
COVID-19 , Depressive Disorder, Major , Electric Stimulation Therapy , Adolescent , COVID-19/therapy , Cost-Benefit Analysis , Depression/drug therapy , Depression/therapy , Depressive Disorder, Major/therapy , Humans , Pandemics , Primary Health Care
5.
BMJ Open ; 12(3): e060294, 2022 03 31.
Article in English | MEDLINE | ID: covidwho-1774971

ABSTRACT

OBJECTIVES: This study aimed to: (1) understand the context for delivering a trauma vocational rehabilitation (VR) intervention; (2) identify potential barriers and enablers to the implementation of a VR intervention post-trauma. DESIGN: Qualitative study. Data were collected in person or via phone using different methods: 38 semistructured interviews, 11 informal 'walk-through care pathways' interviews, 5 focus groups (n=25), 5 codesign workshops (n=43). Data were thematically analysed using the framework approach, informed by the Consolidated Framework for Implementation Research. SETTING: Stakeholders recruited across five UK major trauma networks. PARTICIPANTS: A variety of stakeholders were recruited (n=117) including trauma survivors, rehabilitation physicians, therapists, psychologists, trauma coordinators and general practitioners. We recruited 32 service users (trauma survivors or carers) and 85 service providers. RESULTS: There were several issues associated with implementing a trauma VR intervention including: culture within healthcare/employing organisations; extent to which healthcare systems were networked with other organisations; poor transition between different organisations; failure to recognise VR as a priority; external policies and funding. Some barriers were typical implementation issues (eg, funding, policies, openness to change). This study further highlighted the challenges associated with implementing a complex intervention like VR (eg, inadequate networking/communication, poor service provision, perceived VR priority). Our intervention was developed to overcome these barriers through adapting a therapist training package, and by providing early contact with patient/employer, a psychological component alongside occupational therapy, case coordination/central point of contact, and support crossing sector boundaries (eg, between health/employment/welfare). CONCLUSIONS: Findings informed the implementation of our VR intervention within the complex trauma pathway. Although we understand how to embed it within this context, the success of its implementation needs to be measured as part of a process evaluation in a future trial.


Subject(s)
Delivery of Health Care , Rehabilitation, Vocational , Focus Groups , Humans , Qualitative Research , United Kingdom
6.
Journal of the American College of Cardiology (JACC) ; 79(9):2199-2199, 2022.
Article in English | Academic Search Complete | ID: covidwho-1751396
7.
Am Heart J Plus ; 13: 100111, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1712408

ABSTRACT

STUDY OBJECTIVE: This study sought to assess the predictive value of H2FPEF score in patients with COVID-19. DESIGN: Retrospective study. SETTING: Rush University Medical Center. PARTICIPANTS: A total of 1682 patients had an echocardiogram in the year preceding their COVID-19 admission with a preserved ejection fraction (≥50%). A total of 156 patients met inclusion criteria. INTERVENTIONS: Patients were divided into H2FPEF into low (0-2), intermediate (3-5), and high (6-9) score H2FPEF groups and outcomes were compared. MAIN OUTCOME MEASURES: Adjusted multivariable logistic regression models evaluated the association between H2FPEF score group and a composite outcome for severe COVID-19 infection consisting of (1) 60-day mortality or illness requiring (2) intensive care unit, (3) intubation, or (4) non-invasive positive pressure ventilation. RESULTS: High H2FPEF scores were at increased risk for severe COVID-19 infection when compared intermediate to H2FPEF score groups (OR 2.18 [CI: 1.01-4.80]; p = 0.049) and low H2FPEF score groups (OR 2.99 [CI: 1.22-7.61]; p < 0.05). There was no difference in outcome between intermediate H2FPEF scores (OR 1.34 [CI: 0.59-3.16]; p = 0.489) and low H2FPEF score. CONCLUSIONS: Patients with a high H2FPEF score were at increased risk for severe COVID-19 infection when compared to patients with an intermediate or low H2FPEF score regardless of regardless of coronary artery disease and chronic kidney disease.

8.
Chest ; 158(4):A352-A352, 2020.
Article in English | PMC | ID: covidwho-1385242

ABSTRACT

SESSION TITLE: Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: The radiological changes in the lungs of patients infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) have not been fully characterized, but different radiological patterns have been observed at different times throughout the disease course. Pleural effusions range between 5% and 9.7% of the patients with confirmed COVID-19 pneumonia. In this study we aimed to calculate the prevalence of pleural effusions in COVID-19 hospitalized patients and to objectively describe the pleural fluid characteristics in this subgroup of patients. METHOD(S): Retrospective medical records review of patients diagnosed with pleural effusions and SARS-CoV-2 between January 1, 2020 and May 20, 2020 at Beth Israel Deaconess Medical Center, Boston, MA. Patients were identified from our institutional database. Demographics, baseline comorbidities, mortality, intensive care unit (ICU) stay, interventions and pleural fluid analysis (PFA) were recorded. RESULT(S): A total of 587 patients were admitted with SARS-CoV-2 infection (Age 65.29 years [SD 16.9];49.9% males). Nineteen (3.2%) developed pleural effusions during hospitalization course. There was no statistical difference between the baseline characteristics of both groups. Patients who developed pleural effusions had a prolonged ICU stay (7 vs 2 days, p=0.01). There was no statistically significant increased mortality rate in the pleural effusions group. Six (31.6%) of patients with pleural effusions required fluid drainage with tube thoracostomy. All PFA of the six patients were non complicated neutrophilic exudates. CONCLUSION(S): Pleural effusions are an infrequent finding in patients with COVID-19. Most effusions are small and don't require drainage. Pleural effusions may not be associated with an increased mortality in COVID-19 patients, but further prospective large cohort studies are needed. CLINICAL IMPLICATIONS: Characterization of pleural effusions in COVID-19. DISCLOSURES: No relevant relationships by Ramsy Abdelghani, source=Web Response No relevant relationships by Alvaro Ayala, source=Web Response No relevant relationships by Alex Chee, source=Web Response No relevant relationships by Fayez Kheir, source=Web Response Consultant relationship with Boston Scientific Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with olympus Please note: $5001 - $20000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with pinacle biologics Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with cook medical Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Rachel Martinez, source=Web Response No relevant relationships by Mihir Parikh, source=Web Response No relevant relationships by Priya Patel, source=Web Response No relevant relationships by Alichia Paton, source=Web Response No relevant relationships by Juan Pablo Uribe, source=Web ResponseCopyright © 2020 American College of Chest Physicians

9.
Chest ; 158(4):A296-A297, 2020.
Article in English | PMC | ID: covidwho-1385240

ABSTRACT

SESSION TITLE: Respiratory Infections: What have We Learned About COVID-19 and New Trial Data for Management of Aspergilloma SESSION TYPE: Original Investigations PRESENTED ON: October 18-21, 2020 PURPOSE: Previous studies have shown that demographics, baseline characteristics and comorbidities may play an important role in the outcomes of patients diagnosed with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Older patients, and those with respiratory or cardiovascular conditions, appear to be at greater risk for severe complications. We aim to describe baseline characteristics and mortality in patients with confirmed SARS-CoV-2 infection at our institution. METHOD(S): Retrospective medical records review of patients diagnosed with SARS-CoV-2 between January 1, 2020 and May 8, 2019 at Beth Israel Deaconess Medical Center, Boston MA. Patients were identified from our institutional database (Clinical Query 2). Demographics, baseline comorbidities, medications at admission and initial laboratories results were collected. Clinical outcomes such as mortality, ICU admission and mechanical ventilation were also recorded. RESULT(S): A total of 449 subjects were included (Age 57 years [IQR 41-69];BMI 30.2 kg/m [IQR 25.9-35.3];44.5% males). One hundred-fifteen patients (25.6%) required hospital admission with a median hospital stay of 6 days (IQR 3-12). From those, 28 patients (24.35 %) required ICU management with a median stay of 9 days (4-15.5). Seventeen subjects (14.78%) required mechanical ventilation with a mean time for of 10.65 days (SD 7.84). From the intubated patients, 2 (11.74%) ended up with tracheostomy. Twenty-nine (6.46%) of the total died due to SARS-CoV-2 complications. Elderly (82 vs 55 years, p=<0.001), smokers (37.9% vs 14.8%, p=0.003), congestive heart failure (31% vs 11%, p=0.004), dementia (24.1% vs 4%, p=<0.001), diabetes mellitus (44.8% vs 26.2%, p=0.05), chronic kidney disease (62.1% vs 13.6%, p=<0.001) and cancer patients (20.7% vs 7.9%, p=0.042) died more frequently due to SARS-CoV-2 related complications. Mortality for patients requiring ICU admission was 37.9% compared 4% (p=<0.001). For patient requiring mechanical ventilation, mortality was 24.1% compared to 2.4% (p=<0.001). CONCLUSION(S): Our review showed that elderly, presence of comorbidities, ICU admission and patient requiring mechanical ventilation died more frequently due to SARS-CoV-2 related complications. CLINICAL IMPLICATIONS: Impact of baseline characteristics and comorbid conditions in the outcomes of patients diagnosed with SARS-CoV-2 infection. DISCLOSURES: No relevant relationships by Ramsy Abdelghani, source=Web Response No relevant relationships by Alvaro Ayala, source=Web Response No relevant relationships by Alex Chee, source=Web Response No relevant relationships by Fayez Kheir, source=Web Response Consultant relationship with Boston Scientific Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with olympus Please note: $5001 - $20000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with pinacle biologics Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee Consultant relationship with cook medical Please note: $1001 - $5000 by Adnan Majid, source=Web Response, value=Consulting fee No relevant relationships by Mihir Parikh, source=Web Response No relevant relationships by Priya Patel, source=Web Response No relevant relationships by Juan Pablo Uribe, source=Web ResponseCopyright © 2020 American College of Chest Physicians

10.
Cardiovasc Pathol ; 55: 107374, 2021.
Article in English | MEDLINE | ID: covidwho-1380577

ABSTRACT

BACKGROUND: The variability of coronavirus disease 2019 (COVID-19) illness severity has puzzled clinicians and has sparked efforts to better predict who would benefit from rapid intervention. One promising biomarker for in-hospital morbidity and mortality is cardiac troponin (cTn). METHODS: A retrospective study of 1331 adult patients with COVID-19 admitted to the Rush University System in Illinois, USA was performed. Patients without cTn measurement during their admission or a history of end stage renal disease or stage 5 chronic kidney disease were excluded. Using logistic regression adjusted for baseline characteristics, pre-existing comorbidities, and other laboratory markers of inflammation, cTn was assessed as a predictor of 60-day mortality and severe COVID-19 infection, consisting of a composite of 60-day mortality, need for intensive care unit, or requiring non-invasive positive pressure ventilation or intubation. RESULTS: A total of 772 patients met inclusion criteria. Of these, 69 (8.9%) had mild cTn elevation (> 1 to < 2x upper limit of normal (ULN)) and 46 (6.0%) had severe cTn elevation (≥ 2x ULN). Regardless of baseline characteristics, comorbidities, and initial c-reactive protein, lactate dehydrogenase, and ferritin, when compared to the normal cTn group, mild cTn elevation and severe cTn elevation were predictors of severe COVID-19 infection (adjusted OR [aOR] aOR 3.00 [CI: 1.51 - 6.29], P < 0.01; aOR 9.96 [CI: 2.75 - 64.23], P < 0.01, respectively); severe cTn elevation was a predictor of in-hospital mortality (aOR 2.42 [CI: 1.10 - 5.21], P < 0.05) and 60-day mortality (aOR 2.45 [CI: 1.13 - 5.25], P < 0.05). CONCLUSION: In our cohort, both mild and severe initial cTn elevation were predictors of severe COVID-19 infection, while only severe cTn elevation was predictive of 60-day mortality. First cTn value on hospitalization is a valuable longitudinal prognosticator for COVID-19 disease severity and mortality.


Subject(s)
COVID-19/diagnosis , Troponin/blood , Aged , Biomarkers/blood , COVID-19/blood , COVID-19/mortality , COVID-19/therapy , Female , Hospital Mortality , Humans , Illinois , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , Time Factors , Up-Regulation
11.
Am Heart J Plus ; 4: 100022, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1272279

ABSTRACT

BACKGROUND: In the coronavirus disease 2019 (COVID-19) global pandemic, patients with cardiovascular disease represent a vulnerable population with higher risk for contracting COVID-19 and worse prognosis with higher case fatality rates. However, the relationship between COVID-19 and heart failure (HF) is unclear, specifically whether HF is an independent risk factor for severe infection or if other accompanying comorbidities are responsible for the increased risk. METHODS: This is a retrospective analysis of 1331 adult patients diagnosed with COVID-19 infection between March and June 2020 admitted at Rush University System for Health (RUSH) in metropolitan Chicago, Illinois, USA. Patients with history of HF were identified by International Classification of Disease, Tenth Revision (ICD-10) code assignments extracted from the electronic medical record. Propensity score matching was utilized to control for the numerous confounders, and univariable logistic regression was performed to assess the relationship between HF and 60-day morbidity and mortality outcomes. RESULTS: The propensity score matched cohort consisted of 188 patients in both the HF and no HF groups. HF patients did not have lower 60-day mortality (OR 0.81; p = 0.43) compared to patients without HF. However, those with HF were more likely to require readmission within 60 days (OR 2.88; p < 0.001) and sustain myocardial injury defined as troponin elevation within 60 days (OR 3.14; p < 0.05). CONCLUSIONS: This study highlights the complex network of confounders present between HF and COVID-19. When balanced for these numerous factors, those with HF appear to be at no higher risk of 60-day mortality from COVID-19 but are at increased risk for morbidity.

12.
Recent Pat Nanotechnol ; 16(4): 262-270, 2022.
Article in English | MEDLINE | ID: covidwho-1259295

ABSTRACT

BACKGROUND: The Covid-19 epidemic was declared a pandemic by the World Health Organization in March 2020. It is difficult to foresee the future length and severity; it may extend to weeks, months, or even years to deplete the energy and resources of the health care facilities and the providers as there is marginal to no pharmacological medication available to treat the Covid-19. Unless an effective pharmacological treatment such as medicines and vaccines is developed and released publicly, wearing protective face masks and protecting personal health and hygiene is merely a choice to avoid the Covid-19 spread. This review summarizes the background knowledge on the Covid-19 disease and currently available face masks for highly infectious disease primary prevention. According to recent studies of Covid-19 prevention, diagnosis, and treatment, nanotechnologists have provided a revolutionary approach that involves both pharmacological and non-pharmacological steps, one of which is the use of nanofibers in facemasks and respirators. METHODS: Various researches carried out in the field of nanomask and patented reports based on the application of nanomask were reviewed. CONCLUSION: The most recent developments of nanofibers, including research publications, patents and commercial products in Covid-19 prevention, are extensively reviewed from scientific literature and appropriately represented in this study.


Subject(s)
COVID-19 , Nanofibers , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Masks , Pandemics/prevention & control , Patents as Topic , SARS-CoV-2
13.
J Surg Case Rep ; 2021(5): rjab198, 2021 May.
Article in English | MEDLINE | ID: covidwho-1254792

ABSTRACT

Although primarily a respiratory virus, coronavirus-19 acts on the gastrointestinal tract to cause symptoms such as anorexia, nausea, vomiting and diarrhea. One possible mechanism involves the ACE2 receptor, which serves as the primary receptor for virus entry into the gastrointestinal epithelium. We describe the case of a 54-year-old-male with recent coronavirus disease 2019 (COVID-19) infection, who later presented with nausea, vomiting, diarrhea and progressively worsening diffuse abdominal pain for 1 week. He was diagnosed to have a small bowel obstruction; however, continued to have progressively worsening pain and failed conservative management. No cause for the obstruction was found in the operating room. Gastrointestinal involvement occurs in at least two-thirds of patients with coronavirus infection. Viral entry into the small bowel, triggering an inflammatory response, and virus-induced microthrombosis of the microcirculation have been postulated as a possible mechanism for paralytic ileus/small bowel obstruction.

14.
Am J Case Rep ; 22: e927087, 2021 Mar 08.
Article in English | MEDLINE | ID: covidwho-1120748

ABSTRACT

BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease characterized by an intense immunologic response that results in multiorgan dysfunction. It typically manifests as a result of a familial genetic immunodeficiency disorder or secondary to a trigger such as an infection, malignancy, or autoimmune disease. The major factors involved in the development of the disease are an individual's genetic propensity to develop HLH, such as rare associated mutations, or inflammatory processes that trigger the immune system to go haywire. CASE REPORT Before the COVID-19 pandemic, a 22-year-old woman with a history of congenital absence of the right kidney, right-sided hearing loss, and leukopenia presented with a 3-week history of generalized malaise, fever, chest pain, cough, and shortness of breath. She developed an acute systemic cytomegalovirus infection further complicated by HLH. Based on her history and clinical course, an underlying primary immunodeficiency was suspected. An immunodeficiency gene panel revealed a monoallelic mutation in GATA2, a gene that encodes zinc-transcription factors responsible for the regulation of hematopoiesis. CONCLUSIONS GATA2 deficiency encompasses a large variety of mutations in the GATA2 gene and leads to disorders associated with hematologic and immunologic manifestations of monocytopenia and B-, and natural killer-cell deficiency. Over time, affected individuals are at high risk of developing life-threatening infections and serious hematologic complications, such as myelodysplastic syndromes and/or leukemias. We aimed to illustrate the importance of identifying an underlying genetic disorder associated with secondary HLH to help guide acute and long-term management.


Subject(s)
Cytomegalovirus Infections/complications , GATA2 Deficiency/diagnosis , Lymphohistiocytosis, Hemophagocytic/complications , Female , Humans , Lymphohistiocytosis, Hemophagocytic/virology , Young Adult
15.
Am J Case Rep ; 21: e926591, 2020 Dec 19.
Article in English | MEDLINE | ID: covidwho-994253

ABSTRACT

BACKGROUND Up to 47% of pregnant women with COVID-19 have preterm deliveries. A severe, symptomatic COVID-19 infection in close-to-term pregnancies can have a poor prognosis. Early identification of COVID-19 in pregnant women can prevent the progression of the disease. Currently, there is very little guidance on treating pregnant close-to-term women with COVID-19; this case report suggests changes to current management to maximize positive maternal and fetal outcomes. CASE REPORT A pregnant woman (37 weeks of gestation) presented to the Emergency Department with a chief complaint of fever with an associated cough for 2 days. She was diagnosed with COVID-19 in the Emergency Department, and discharged in a stable condition. She returned 5 days later in preterm labor with severe respiratory distress. After an emergency cesarean section, she remained intubated in the Surgical Intensive Care Unit; she was persistently hypotensive and hypoxic despite maximal ventilator and medical treatment. She died after a cardiac arrest and unsuccessful resuscitation, 15 days after the delivery. We discuss the possible benefit of a planned C-section for close-to-term pregnancies prior to the onset of COVID-19 symptoms. The patient's next of kin gave informed consent for this case report. Approval from the Institutional Review Board or Ethics Review Board was not required as this is a case report. CONCLUSIONS Currently, asymptomatic pregnant women are not tested for COVID-19 infection until hospitalization for delivery. It could be beneficial to have a protocol in place to screen asymptomatic pregnant women so they can be identified early and monitored, as COVID-19 symptoms can escalate quickly.


Subject(s)
COVID-19/complications , Cesarean Section , Emergency Treatment , Pregnancy Complications, Infectious/virology , Adult , Fatal Outcome , Female , Humans , Pregnancy
16.
Ann Vasc Surg ; 70: 297-301, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-733967

ABSTRACT

SARS-CoV-2 (COVID-19) patients with associated thromboembolic events have demonstrated poor outcomes despite the use of anticoagulation therapy and surgical intervention. We present a COVID-19 patient with acute limb ischemia, secondary to extensive thrombosis of an aortic aneurysm, iliac arteries, and infrainguinal arteries. Initial treatment with systemic thrombolysis, which restored patency of the aortoiliac occlusion, was followed by open thrombectomies of the infrainguinal occlusions.


Subject(s)
Aortic Aneurysm, Abdominal/complications , Arterial Occlusive Diseases/drug therapy , COVID-19/complications , Fibrinolytic Agents/administration & dosage , Iliac Artery , Thrombolytic Therapy , Thrombosis/drug therapy , Tissue Plasminogen Activator/administration & dosage , Aged , Aortic Aneurysm, Abdominal/diagnostic imaging , Arterial Occlusive Diseases/diagnostic imaging , Arterial Occlusive Diseases/etiology , Arterial Occlusive Diseases/physiopathology , COVID-19/diagnosis , Humans , Iliac Artery/diagnostic imaging , Iliac Artery/physiopathology , Infusions, Intravenous , Male , Thrombectomy , Thrombosis/diagnostic imaging , Thrombosis/etiology , Thrombosis/physiopathology , Treatment Outcome , Vascular Patency
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