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Pharmacotherapy ; 41(6): 546-550, 2021 06.
Article in English | MEDLINE | ID: covidwho-1173838


Myasthenia gravis and the associated pharmacologic management options could place patients at higher risk of contracting severe acute respiratory syndrome coronavirus 2 and exhibiting more severe manifestations of the novel coronavirus disease 2019 (COVID-19). Multiple agents have been studied for the management of the COVID-19, including remdesivir. To date, no published reports have evaluated the utilization of the antiviral remdesivir in patients with myasthenia gravis. We describe the first reported clinical course of three patients with myasthenia gravis who safely received remdesivir in combination with dexamethasone for the management of COVID-19.

Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/drug therapy , Myasthenia Gravis/complications , Myasthenia Gravis/drug therapy , Adenosine Monophosphate/therapeutic use , Adult , Aged , Alanine/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Dexamethasone/therapeutic use , Fatal Outcome , Female , Humans , Male , Middle Aged , Treatment Outcome
J Thromb Thrombolysis ; 51(4): 985-988, 2021 May.
Article in English | MEDLINE | ID: covidwho-1053058


OBJECTIVES: Infection with the SARS-COV2 virus (COVID-19) may be complicated by thrombotic diathesis. This complication often involves the pulmonary microcirculation. While macrovascular thrombotic complications of the lung may include pulmonary artery embolism, pulmonary artery thrombus in situ has also been hypothesized. Pulmonary vein thrombosis has not been described in this context. METHODS/RESULTS: Herein, we provide a case of an otherwise healthy male who developed an ischemic stroke with left internal carotid thrombus. Further imaging revealed pulmonary emboli with propagation through the pulmonary veins into the left atrium. This left atrial thrombus provides a source of atypical "paradoxic arterial embolism". CONCLUSIONS: Thrombotic outcomes in the setting of severe COVID 19 pneumonia may include macrovascular venous thromboembolism, microvascular pulmonary vascular thrombosis and arterial thromboembolism. Pulmonary vein, herein described, provides further mechanistic pathway for potential arterial embolic phenomenon.

COVID-19 , Carotid Artery Thrombosis , Ischemic Stroke , Pulmonary Embolism , Pulmonary Veno-Occlusive Disease , Brain/diagnostic imaging , COVID-19/blood , COVID-19/complications , COVID-19/physiopathology , Carotid Artery Thrombosis/complications , Carotid Artery Thrombosis/diagnosis , Diagnosis, Differential , Heart Atria/diagnostic imaging , Heart Atria/pathology , Hemiplegia/diagnosis , Hemiplegia/etiology , Humans , Ischemic Stroke/diagnosis , Ischemic Stroke/etiology , Ischemic Stroke/physiopathology , Lung/diagnostic imaging , Male , Middle Aged , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/etiology , Pulmonary Veno-Occlusive Disease/complications , Pulmonary Veno-Occlusive Disease/diagnosis , Pulmonary Veno-Occlusive Disease/physiopathology , SARS-CoV-2/pathogenicity , Tomography, X-Ray Computed/methods
Neurology-Neuroimmunology & Neuroinflammation ; 7(5), 2020.
Article | Web of Science | ID: covidwho-810326