Examining the frequency of endoscopic findings in patients with COVID-19 with upper gastrointestinal bleeding referred to al-Zahra Hospital of Isfahan

Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan. Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al- Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings. Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070). Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.

A case series on upper GI bleeding among patients admitted with COVID-19 infection

Background: Patients with COVID-19 infection are liable to develop coagulopathies and bleeding. An increase in the use of anticoagulants among this group of patients may be associated with an increase in the risk of developing GI bleeding. We aimed to evaluate the endoscopic characteristics of patients with COVID-19 that developed a GI bleed. Methods: A retrospective analysis of patients admitted to Rashid hospital with Upper GI bleeding, and COVID was done. We collected details on patient demographics, comorbid conditions, the severity of COVID infection, use of antiplatelet/anticoagulants, and their endoscopic findings. Results: 14 cases of Upper GI bleeding were included, half of which were on antiplatelet/anticoagulant. Endoscopic findings included peptic ulcer disease, Mallory Weis, gastritis, dieulafouy lesion, esophageal varices, and small gastric erosions. Peptic ulcer disease was the most common finding on endoscopy. Conclusion: Coagulopathy and bleeding risk remains a challenge in patients with COVID-19. Although peptic ulcer disease was the commonest etiology, it is still unclear whether the risk of bleeding was secondary to COVID-19 infection itself or the use of anticoagulants. We recommend physicians to be cognizant of the possible endoscopic features that may be encountered in COVID-19 infected patients presenting with GI bleeding so as to provide optimal management.

Neurological manifestations in patients with COVID-19

Introduction: COVID-19 pandemic represents a challenge for healthcare systems, due to the impact on different systems, such as respiratory, cardiovascular and nervous systems. Background: to describe the neurological manifestations in patients with COVID-19. Methods: a search for information was carried out in the PubMed/Medline, SciELO, EBSCO, Lilacs and Scopus databases. A search strategy was applied by combining terms and using Boolean operators. Thirty references were chosen. Results: olfactory nerves and invasion of peripheral nerve terminals are suggested as routes of entry;the presence of severe neural symptoms associated with lesions of other organs and cytokine storm is also described. Headache was the most common neurological manifestation in patients with COVID-19, and rhabdomyolysis, acute hemorrhagic necrotizing encephalopathy, Guillain Barre syndrome, meningitis and encephalitis are rare neurological entities. In Guillain Barre syndrome, the literature suggests both a post infectious and para-infectious pattern. Conclusions: COVID-19 is associated with different neurological manifestations, including headache, dizziness, vertigo, vomiting, and alterations of consciousness, stroke and others not so frequent. These symptoms as a whole should be evaluated by healthcare personnel, with a view to their rapid detection and management, in order to guarantee the disappearance of sequelae that reduce the quality of life of patients, as well as to reduce the associated mortality records.

The effect of COVID-19 on the blood supply to the gums and the appearance of caries

The biological system of the oral cavity provides a number of protective mechanisms that fight pathogenic factors that arise due to a decrease in local immunity. This problem is found in patients after Covid-19. There is a violation of the blood supply to all organs and systems, including the mucous membrane of the oral cavity. As a result, patients have an increased risk of ulcers, plaques, fungal infections of the oral cavity, cracks, and spot hemorrhages. Due to a decrease in immune reactions in the oral cavity, the risk of caries in all groups of teeth increases, the permeability of enamel increases, and mineral substances exit from the hard tissues of the tooth.

Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital

AJOL : Background: Haemorrhages in coronavirus disease 2019 (COVID-19) patients require proper knowledge and management.Objectives: To highlight the characteristics of haemorrhages in patients with COVID-19 infection.Method: A retrospective study examined CT scans performed over a 13-month period in patients hospitalised with COVID-19 infection to determine those who developed spontaneous bleeding. The authors also investigated correlations between the bleeding events and the patients' characteristics.Results: Haemorrhages occurred in 2.22% (31/1396) of patients hospitalised with COVID-19 infection (7.88%, 19/241 in the intensive care unit). Bleeding, major in most cases, occurred in anticoagulated patients, especially males with multiple comorbidities, aged between 60 and 79 years and mainly appeared in a single anatomical region (especially retroperitoneal), with the most voluminous in the chest wall. The complication was diagnosed on average 16.7 days after admission and occurred predominantly in critically ill patients undergoing invasive ventilation and pronation-supination cycles. In just under half of the cases, the haematomas were active, and in these cases, mainly with a single contrast blush and with earlier onset after the start of anticoagulation than in non-active bleeding. Major bleeding was also earlier in the presence of multiple morbidity. The vast majority of patients were treated conservatively and survived.Conclusion: At COVID-19 hospital centres, it is advisable that there is knowledge of such a complication for which CT imaging is essential for diagnosis and proper management. Although some authors have expressed doubts about anticoagulant treatment in patients with COVID-19, the bleeding complication in this study did not significantly affect the outcome.Contribution: Spontaneous haemorrhage did not significantly affect the outcome in this series

Spontaneous Surgical Intracranial Haemorrhages Associated with SARS-Cov-2 Infection: Case Report.

Spontaneous surgical acute and chronic intracranial haemorrhage in patients with SARS-Cov-2 infection is a theoretical possibility. We report two cases of SARS-CoV-2 infection that was associated with spontaneous surgical acute and chronic intracranial haemorrhage. The two patients had successful surgical intervention. Surgical haemorrhages should be considered in patients with SARS-COV-2 infection especially if there is an associated altered sensorium.

A retrospective study to find out factors affecting maternal mortality in a tertiary care hospital in Ahmedabad city, Gujarat

Background : Data pertaining to preventable causes of maternal mortality are valuable in each set up to design interventional steps for the significant reduction of the maternal mortality ratio. Objectives : (1) To study the trend on Maternal Mortality Rate (MMR);(2) To find out the factors for the Maternal Mortality. Material and Methods : A retrospective cross-sectional study of maternal death was conducted in the Obstetrics Department of Tertiary Care Hospital of Ahmedabad city. The data of total 9 years from 1st April 2013 to 31st January 2021 were taken in the study. Epidemiological factors and causes affecting maternal mortality were assessed through pretested questionnaire that includes parity, duration between admission and mortality etc. Results: Maternal Mortality Rate (MMR) was 180.2 per 1 lac live births during the study period. Young mothersaged 20 to 30 years (78.5%), and rural residence (76.6%), multiparous mothers (66.7%)were at risk for Maternal Mortality. Obstetric haemorrhage (25.8%) was the most common cause whereas COVID-19 pandemic later on were indirect causes contributing to Maternal Mortality. Conclusion: Great Care should be taken for high-risk pregnancy like young age, multiparous women and also of postpartum women. Postpartum haemorrhage was the commonest direct cause of Maternal Mortality. Strengthening of existing obstetric care facilities, facility for easy transport, appropriate referral linkages are keys to reduce Maternal Mortality to further extent.

Global impact of the COVID-19 pandemic on subarachnoid haemorrhage hospitalisations, aneurysm treatment and in-hospital mortality: 1-year follow-up.

BACKGROUND: Prior studies indicated a decrease in the incidences of aneurysmal subarachnoid haemorrhage (aSAH) during the early stages of the COVID-19 pandemic. We evaluated differences in the incidence, severity of aSAH presentation, and ruptured aneurysm treatment modality during the first year of the COVID-19 pandemic compared with the preceding year. METHODS: We conducted a cross-sectional study including 49 countries and 187 centres. We recorded volumes for COVID-19 hospitalisations, aSAH hospitalisations, Hunt-Hess grade, coiling, clipping and aSAH in-hospital mortality. Diagnoses were identified by International Classification of Diseases, 10th Revision, codes or stroke databases from January 2019 to May 2021. RESULTS: Over the study period, there were 16 247 aSAH admissions, 344 491 COVID-19 admissions, 8300 ruptured aneurysm coiling and 4240 ruptured aneurysm clipping procedures. Declines were observed in aSAH admissions (-6.4% (95% CI -7.0% to -5.8%), p=0.0001) during the first year of the pandemic compared with the prior year, most pronounced in high-volume SAH and high-volume COVID-19 hospitals. There was a trend towards a decline in mild and moderate presentations of subarachnoid haemorrhage (SAH) (mild: -5% (95% CI -5.9% to -4.3%), p=0.06; moderate: -8.3% (95% CI -10.2% to -6.7%), p=0.06) but no difference in higher SAH severity. The ruptured aneurysm clipping rate remained unchanged (30.7% vs 31.2%, p=0.58), whereas ruptured aneurysm coiling increased (53.97% vs 56.5%, p=0.009). There was no difference in aSAH in-hospital mortality rate (19.1% vs 20.1%, p=0.12). CONCLUSION: During the first year of the pandemic, there was a decrease in aSAH admissions volume, driven by a decrease in mild to moderate presentation of aSAH. There was an increase in the ruptured aneurysm coiling rate but neither change in the ruptured aneurysm clipping rate nor change in aSAH in-hospital mortality. TRIAL REGISTRATION NUMBER: NCT04934020.

Coagulopathy of Dengue and COVID-19: Clinical Considerations.

Thrombocytopenia and platelet dysfunction commonly occur in both dengue and COVID-19 and are related to clinical outcomes. Coagulation and fibrinolytic pathways are activated during an acute dengue infection, and endothelial dysfunction is observed in severe dengue. On the other hand, COVID-19 is characterised by a high prevalence of thrombotic complications, where bleeding is rare and occurs only in advanced stages of critical illness; here thrombin is the central mediator that activates endothelial cells, and elicits a pro-inflammatory reaction followed by platelet aggregation. Serological cross-reactivity may occur between COVID-19 and dengue infection. An important management aspect of COVID-19-induced immunothrombosis associated with thrombocytopenia is anticoagulation with or without aspirin. In contrast, the use of aspirin, nonsteroidal anti-inflammatory drugs and anticoagulants is contraindicated in dengue. Mild to moderate dengue infections are treated with supportive therapy and paracetamol for fever. Severe infection such as dengue haemorrhagic fever and dengue shock syndrome often require escalation to higher levels of support in a critical care facility. The role of therapeutic platelet transfusion is equivocal and should not be routinely used in patients with dengue with thrombocytopaenia and mild bleeding. The use of prophylactic platelet transfusion in dengue fever has strained financial and healthcare systems in endemic areas, together with risks of transfusion-transmitted infections in low- and middle-income countries. There is a clear research gap in the management of dengue with significant bleeding.

Optimizing CNN-LSTM hybrid classifier using HCA for biomedical image classification

In medical science, imaging is the most effective diagnostic and therapeutic tool. Almost all modalities have transitioned to direct digital capture devices, which have emerged as a major future healthcare option. Three diseases such as Alzheimer's (AD), Haemorrhage (HD), and COVID-19 have been used in this manuscript for binary classification purposes. Three datasets (AD, HD, and COVID-19) were used in this research out of which the first two, that is, AD and HD belong to brain Magnetic Resonance Imaging (MRI) and the last one, that is, COVID-19 belongs to Chest X-Ray (CXR) All of the diseases listed above cannot be eliminated, but they can be slowed down with early detection and effective medical treatment. This paper proposes an intelligent method for classifying brain (MRI) and CXR images into normal and abnormal classes for the early detection of AD, HD, and COVID-19 based on an ensemble deep neural network (DNN). In the proposed method, the convolutional neural network (CNN) is used for automatic feature extraction from images and long-short term memory (LSTM) is used for final classification. Moreover, the Hill-Climbing Algorithm (HCA) is implemented for finding the best possible value for hyper parameters of CNN and LSTM, such as the filter size of CNN and the number of units of LSTM while fixing the other parameters. The data-set is pre-processed (resized, cropped, and noise removed) before feeding the train images to the proposed models for accurate and fast learning. Forty-five MR images of AD, Sixty MR images of HD, and 600 CXR images of COVID-19 were used for testing the proposed model ‘CNN-LSTM-HCA'. The performance of the proposed model is evaluated using six types of statistical assessment metrics such as;Accuracy, Sensitivity, Specificity, F-measure, ROC, and AUC. The proposed model compared with the other three types of hybrid models such as CNN-LSTM-PSO, CNN-LSTM-Jaya, and CNN-LSTM-GWO and also with state-of-art techniques. The overall accuracy of the proposed model received was 98.87%, 85.75%, and 99.1% for COVID-19, Haemorrhage, and Alzheimer's data sets, respectively. © 2023 John Wiley & Sons Ltd.

Optimizing CNN‐LSTM hybrid classifier using HCA for biomedical image classification

In medical science, imaging is the most effective diagnostic and therapeutic tool. Almost all modalities have transitioned to direct digital capture devices, which have emerged as a major future healthcare option. Three diseases such as Alzheimer's (AD), Haemorrhage (HD), and COVID‐19 have been used in this manuscript for binary classification purposes. Three datasets (AD, HD, and COVID‐19) were used in this research out of which the first two, that is, AD and HD belong to brain Magnetic Resonance Imaging (MRI) and the last one, that is, COVID‐19 belongs to Chest X‐Ray (CXR) All of the diseases listed above cannot be eliminated, but they can be slowed down with early detection and effective medical treatment. This paper proposes an intelligent method for classifying brain (MRI) and CXR images into normal and abnormal classes for the early detection of AD, HD, and COVID‐19 based on an ensemble deep neural network (DNN). In the proposed method, the convolutional neural network (CNN) is used for automatic feature extraction from images and long‐short term memory (LSTM) is used for final classification. Moreover, the Hill‐Climbing Algorithm (HCA) is implemented for finding the best possible value for hyper parameters of CNN and LSTM, such as the filter size of CNN and the number of units of LSTM while fixing the other parameters. The data‐set is pre‐processed (resized, cropped, and noise removed) before feeding the train images to the proposed models for accurate and fast learning. Forty‐five MR images of AD, Sixty MR images of HD, and 600 CXR images of COVID‐19 were used for testing the proposed model ‘CNN‐LSTM‐HCA'. The performance of the proposed model is evaluated using six types of statistical assessment metrics such as;Accuracy, Sensitivity, Specificity, F‐measure, ROC, and AUC. The proposed model compared with the other three types of hybrid models such as CNN‐LSTM‐PSO, CNN‐LSTM‐Jaya, and CNN‐LSTM‐GWO and also with state‐of‐art techniques. The overall accuracy of the proposed model received was 98.87%, 85.75%, and 99.1% for COVID‐19, Haemorrhage, and Alzheimer's data sets, respectively. [ FROM AUTHOR]

Hepatic and pulmonary involvement in a patient with PR3-ANCA vasculitis following SARS-CoV-2 vaccination: A case report.

We here report the first case of anti-proteinase 3-positive anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis following the severe acute respiratory syndrome coronavirus 2 Pfizer-BioNTech vaccine presenting with prominent liver involvement and alveolar haemorrhage. Two weeks after vaccination, a 49-year-old man developed inflammatory arthralgias and hypertransaminasaemia. Two months later, fever and haemoptysis appeared; the patient tested positive for anti-proteinase 3 autoantibodies. High-dose steroids and rituximab were started, and complete remission was achieved. Systemic autoimmune diseases, including ANCA-associated vasculitis, should always be considered in the differential diagnosis of hypertransaminasaemia, especially when the clinical context is suspicious.

A rare presentation of Multisystem Inflammatory Syndrome in Neonates (MIS-N) with a cerebral haemorrhage

Covid-19 infection during pregnancy poses diverse challenges to the developing fetus1. Multisystem Inflammatory Syndrome in Children (MIS-C) usually develops around 4-8 weeks after Covid-19 infection due to immune dysregulation2. Pathogenesis of MIS-N is similar to MIS-C but the Covid-19 infection occurs in the mother while the multiorgan inflammation occurs in the neonate due to the transfer of maternal antibodies3. Gastrointestinal bleeding and thrombotic events are known associations of MIS-N3;however, there are only a few cases with cerebral haemorrhage4. We describe a case of MIS-N with cerebral haemorrhage and microangiopathic haemolytic anaemia (MAHA) that showed a good response to immunotherapy with intravenous immunoglobulin (IVIG) © Open Access Article published under the Creative Commons Attribution CC-BY License

Low risk of haematomas with intramuscular vaccines in anticoagulated patients: a systematic review with meta-analysis.

INTRODUCTION: The summary of product characteristics of vaccines administered intramuscularly, including the vaccine for coronavirus SARS-CoV-2 (COVID-19) and Influenza, warned for risks of bleeding in patients treated with oral anticoagulants. We aimed to estimate the incidence of major bleeding events in this setting and to compare these risks against other vaccination routes. METHODS: This systematic review included all prospective and retrospective studies enrolling anticoagulated patients that received intramuscular vaccination, published until December 2020 in CENTRAL, MEDLINE and EMBASE. The outcomes of interest were major bleeding and haematoma related with vaccination. The incidence of the outcomes was estimated through a random-effects meta-analysis using the Freeman-Turkey transformation. The results are expressed in percentages, with 95%-confidence intervals (95%CI), limited between 0 and 100%. When studies compared intramuscular vaccination vs. other route, the data were compared and pooled using random-effects meta-analysis. Risk ratios (RR) with 95%CI were reported. RESULTS: Overall 16 studies with 642 patients were included. No major bleeding event was reported. The pooled incidence of haematomas following vaccination (mostly against Influenza) in patients treated with oral anticoagulants (mostly warfarin; no data with DOACs / NOACs) was 0.46% (95%CI 0-1.53%). Three studies evaluated the intramuscular vs. subcutaneous route of vaccination. Intramuscular vaccines did not increase the risk of haematoma (RR 0.53, 95%CI 0.10-2.82) compared with subcutaneous route. CONCLUSIONS: Intramuscular vaccination in anticoagulated patients is safe with very low incidence of haematomas and the best available evidence suggests that using the intramuscular route does not increase the risk of haematomas compared with the subcutaneous route.

Haemorrhage of human foetal cortex associated with SARS-CoV-2 infection.

Maternal viral infection and immune response are known to increase the risk of altered development of the foetal brain. Given the ongoing global pandemic of coronavirus disease 2019 (COVID-19), investigating the impact of SARS-CoV-2 on foetal brain health is of critical importance. Here, we report the presence of SARS-CoV-2 in first and second trimester foetal brain tissue in association with cortical haemorrhages. SARS-CoV-2 spike protein was sparsely detected within progenitors and neurons of the cortex itself, but was abundant in the choroid plexus of haemorrhagic samples. SARS-CoV-2 was also sparsely detected in placenta, amnion and umbilical cord tissues. Cortical haemorrhages were linked to a reduction in blood vessel integrity and an increase in immune cell infiltration into the foetal brain. Our findings indicate that SARS-CoV-2 infection may affect the foetal brain during early gestation and highlight the need for further study of its impact on subsequent neurological development.

Extracorporeal support of the respiratory system

Extracorporeal membrane oxygenation (ECMO) support of the respiratory system has undergone significant evolution over the past decade. Historically used as rescue therapy, the treatment is now being utilized earlier in the disease course, and its indications for use expanded. The coronavirus disease (COVID-19) pandemic has further increased the experience of ECMO centres and expanded the body of evidence. This article will review the physiology of veno-venous (V-V) ECMO, con-trol of oxygenation and carbon dioxide, principal equipment, patient se-lection and timing, complications and weaning from V-V ECMO.

The rate of bleeding during cesarean section in pregnant women with COVID-19 admitted to hospitals in Tabriz, 2021

Introduction: Intensification of immune system sensitivity after pregnancy with cytokine storm caused by Covid 19 can lead to coagulation disorders and increase the amount of bleeding after delivery. Since bleeding following cesarean section is more likely to occur in women with Covid-19 than in women without the disease, the present study was performed aimed to investigate the amount of bleeding during caesarean section in women with covid-19.

Spontaneous bleeding in COVID-19: A retrospective experience of an Italian COVID-19 hospital.

Background: Haemorrhages in coronavirus disease 2019 (COVID-19) patients require proper knowledge and management. Objectives: To highlight the characteristics of haemorrhages in patients with COVID-19 infection. Method: A retrospective study examined CT scans performed over a 13-month period in patients hospitalised with COVID-19 infection to determine those who developed spontaneous bleeding. The authors also investigated correlations between the bleeding events and the patients' characteristics. Results: Haemorrhages occurred in 2.22% (31/1396) of patients hospitalised with COVID-19 infection (7.88%, 19/241 in the intensive care unit). Bleeding, major in most cases, occurred in anticoagulated patients, especially males with multiple comorbidities, aged between 60 and 79 years and mainly appeared in a single anatomical region (especially retroperitoneal), with the most voluminous in the chest wall. The complication was diagnosed on average 16.7 days after admission and occurred predominantly in critically ill patients undergoing invasive ventilation and pronation-supination cycles. In just under half of the cases, the haematomas were active, and in these cases, mainly with a single contrast blush and with earlier onset after the start of anticoagulation than in non-active bleeding. Major bleeding was also earlier in the presence of multiple morbidity. The vast majority of patients were treated conservatively and survived. Conclusion: At COVID-19 hospital centres, it is advisable that there is knowledge of such a complication for which CT imaging is essential for diagnosis and proper management. Although some authors have expressed doubts about anticoagulant treatment in patients with COVID-19, the bleeding complication in this study did not significantly affect the outcome. Contribution: Spontaneous haemorrhage did not significantly affect the outcome in this series.

Thromboembolism prophylaxis and anticoagulation in COVID-19 patients - A systematic review and meta analysis

Background: Thromboembolic events are common complications of COVID- 19. Study results on the safety and efficacy of thromboprophylaxis or anticoagulation in COVID-19 are controversial. This review with random-effects meta-analyses systematically summarises the current evidence. Method(s): We included randomised controlled trials (RCTs) published until February 2022 that investigated standard thromboprophylaxis or anticoagulation at any dosage with thromboprophylaxis or no prophylaxis in COVID-19 patients. Relevant outcomes were mortality, clinical status, thrombotic events or death and (severe) bleeding (28 days). Certainty of evidence was assessed according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Result(s): We included 13 RCTs with 7,364 patients. Two studies investigated thromboprophylaxis versus placebo in COVID-19 outpatients;three studies compared intermediate-dose and seven therapeutic-dose anticoagulation with standard thromboprophylaxis in hospitalised COVID-19 patients;one study investigated post-discharge thromboprophylaxis versus no prophylaxis. We are uncertain whether thromboprophylaxis is beneficial over placebo or no thromboprophylaxis in outpatient- or post-discharge-settings. Intermediatedose anticoagulation is not capable of reducing thrombotic events or death (RR 1.03, 95 % CI 0.86 - 1.24), but is associated with an increase of severe bleedings (non-significant) (RR 1.48, 95 % CI 0.53 - 4.15). Therapeutic-dose anticoagulation may decrease thrombotic events or deaths in patients with moderate COVID-19 (RR 0.64, 95 % CI 0.38-1.07;fixed-effect meta-analysis RR 0.72, 95 % CI 0.57 - 0.91) but showed no effect in patients with severe disease (RR 0.98, 95 % CI 0.86 - 1.12). The risk of severe bleeding may increase regardless of disease severity (RR 1.78, 95 % CI 1.15 - 2.74). Conclusion(s): Certainty of evidence is low. Hospitalised, moderately-ill COVID-19 patients may benefit from therapeutic-dose anticoagulation, however, with an increased risk of bleeding. Copyright © 2022 DIOmed Verlags GmbH. All rights reserved.

Analysis of Neuroimaging in COVID-19 Patients - A Correlation Between Lung Severity and Brain Findings

Background: Corona virus emerged in China in December 2019 and quickly spread over the world, causing a pandemic. The probable link between the occurrence of neurological abnormalities and the CT severity score (CTSS) in COVID-19 participants is less understood. The purpose of this study was to look at the neurological symptoms of COVID-19 on CT head and determine whether there was a link between thorax and brain imaging abnormalities in COVID-19 patients. Method(s): Total 135 Hospitalized COVID positive patients with acute neurological symptoms underwent both CT head and CT thorax during their hospital stay were included in the study. All the patients with neuroimaging were divided into 2 groups: first being patients with acute neuroimaging findings and the second being the patients with chronic/normal neuroimaging findings. Result(s): The most common CT head imaging findings in these individuals were acute ischemic infarcts in 54 (40%) and acute intracranial haemorrhage in 8 (6%). When compared to individuals with normal/chronic neurological results, a greater mean chest CTSS was found in patients with acute abnormalities on CT head (14.1 [SD-3.2] versus 6.5 [SD-3.3]). However, no statistical correlation could be shown between a greater CTSS and the occurrence of acute neurological disorders. Conclusion(s): There was no link between a greater CTSS and the occurrence of neurological disorders on CT scans. As a result, increased lung involvement severity may not be a good predictor of brain involvement in COVID patients. Copyright © 2022 Ubiquity Press. All rights reserved.