ABSTRACT
Background: The outbreak of the new coronavirus disease 2019 (COVID-19) is majorly threatening the health of people worldwide. Since patients with chronic diseases, including diabetes mellitus (DM), are among the main groups at risk of severe COVID-19;hence, this study was aimed to investigate the mortality rate of COVID-19 among patients with DM. Material(s) and Method(s): This cross-sectional study was performed on 211 DM patients with COVID-19 who were referred to Educational Kowsar Hospital in Semnan, Iran. After a definitive diagnosis of COVID-19, basic characteristics, including gender, weight, height, and clinical information (such as initial signs and symptoms, underlying diseases, complications during hospitalization, and type of treatment received) were collected. Result(s): The mean age of patients was 64.92+/-12.7 years, and 51.7% were male. Totally 20.9% of patients were expired. The most frequent underlying diseases were hypertension and ischemic heart disease. The simultaneous presence of cardiovascular diseases in DM patients with COVID-19 was correlated with a considerable mortality rate increment. Cough on arrival significantly predicted mortality reduction to less than one-third (P=0.009). Also, oxygen saturation of less than 90% on arrival was a significant predictor of an increase in mortality by more than double (P<0.001). Conclusion(s): According to the results of multivariate logistic regression, it was found that DM can increment the probability of contracting COVID-19, and the rate of mortality was also higher in these patients.Copyright © 2022, Galen Medical Journal.
ABSTRACT
Background: Coronavirus disease (COVID-19) is a recently prevalent infectious disease that is caused by a virus from the coronavirus family and causes acute respiratory syndrome. It is a pandemic catastrophe that has affected more than 60 million people around the world and has caused about 1.5 million deaths, as reported by the WHO. This disease affects the respiratory system and leads to different forms of symptoms and signs. Pneumonia is a common cause for hospitalization, with most patients treated in hospital wards and others requiring ICU. Although the number of complete recoveries from COVID-19 has increased, there is still concern about complications associated with the disease that appear after recovery. The studies that have looked at past types and other forms of coronavirus epidemics, such as SARS have shown that some cases had respiratory complications from the infection after being full recovered, as 36 and 30% of the entire study population had clinical and high-resolution computed tomography (HRCT) changes at 3 and 6 months after recovery, respectively. Mostly, the abnormalities seen in pulmonary function test (PFT) results are sequelae of diffusion capacity defect. In recovered cases of Middle East respiratory syndrome, 36% of patients showed HRCT sequelae at follow-up of 6 weeks, because of fibrosis. Data on COVID-19 indicate that prolonged disease and persistent symptoms show post-PFT affection and follow-up radiographic changes after recovery from COVID-19 as interstitial pulmonary changes and a degree of pulmonary vasculopathy. In recovered cases of COVID-19, capacity of diffusion is the commonest defect in lung function, followed by the restrictive pattern defects on spirometry;both are related to the degree of severity of pneumonic COVID-19. PFTs (involving spirometry as well as diffusion capacity) are considered as routine follow-up examinations for some of the recovered cases, especially severe cases. Rehabilitation programs of the respiratory system are an option strategy that might be considered. This study aims to show changes in pulmonary function and HRCT of chest in post-COVID-19-infected patients to detect long-term effects on the lungs after 3 months as obstructive or restrictive, or both, lung diseases. Patients and Methods: The study was conducted on 100 confirmed PCR-positive COVID-19 cases that were admitted to Ain Shams University Isolation Hospitals, and the follow-up was performed in the outpatient clinic. PCR samples (Combined nasopharyngeal and oropharyngeal swab) were taken after 3 months from discharge of patients above the age of 18 years who become negative with clinical improvement. PFT [spirometry and diffusion for carbon monoxide (DLCO)] and chest HRCT were done. All patients' clinical data were recorded, and CT chest imaging data of these patients were correlated with the clinical data. Result(s): A total of 100 patients were included in this study, where males represented 58% and female represented 42%. The mean+/-SD age of cases in this study was 45.05 +/- 11.80 years and ranged from 20 to 79 years. CT chest severity score (SS) of abnormality in COVID-19-infectedd patients based on HRCT chest findings before and after 3 months from treatment showed a highly significant correlation (P=0.000). The results of PFT in the studied group after 3 months of discharge showed restrictive pattern in 14.9%, obstructive pattern in 17.8%, and both obstructive and restrictive patterns in 5.9% of the total number of cases. There was a significant correlation between DLCO abnormality findings and age of studied group (P=0.032), a significant correlation between abnormality findings on PFT and HRCT chest SS after discharge of the studied group (P0.001). There was a significant correlation between abnormality findings of DLCO and HRCT chest SS after 3 months of the studied group (P=0.000) and before treatment (P=0.001), whereas there was no significant correlation between other findings of PFT and HRCT chest SS after 3 months and before. There was a significant correlation between H
ABSTRACT
New coronavirus infection (COVID-19) is a modern global problem that requires the rapid development of diagnostic and treatment methods, as well as the study of pathological effects on body tissues. Due to severe damage to the respiratory organs, special attention is paid to the study of pneumothorax as a manifestation of gas syndrome, one of the complications of COVID-19. The purpose of the study was to assess the incidence of pneumothorax as a complication of COVID-19, the features of the development of the pathological process, and to determine the criteria for treatment tactics. Materials and methods. In total, for the period from April 2020 to May 2022 at the Clinical Infectious Diseases Hospital named after. S.P. Botkin treated 31532 patients with a confirmed diagnosis of COVID-19. As part of this study, the case histories of 316 patients with clinical manifestations of gas syndrome were retrospectively analyzed. All patients were diagnosed with COVID-19, the diagnostic criterion of which was a positive result of the PCR test - the detection of RNA in a swab taken from the nasopharynx and oropharynx. Results. Analysis of case histories showed that severe COVID-19 occurs in all age groups. Collapse of half of the lung was observed in most cases (59 patients). The main treatment method for pneumothorax was Bulau drainage. At the same time, in 47 patients (32%) this method required active aspiration. In 37 patients (26%), drainage was corrected and the pleural cavity was re-drained. In 37 patients, the result of hospitalization was a fatal outcome, the main causes of which were severe pneumonia and/or severe immunodeficiency, 75 patients (52%) were discharged from the hospital in a stable condition. Conclusions. The occurrence of pneumothorax in patients with COVID-19 is characterized by late onset, protracted course, the formation of purulent complications and a high incidence of fatal outcomes, which do not always correlate with the severity of pneumonia.Copyright © 2022 Authors. All rights reserved.
ABSTRACT
Preventing psychopathology and promoting well-being have always been objecting of concern in many fields of psychology and psychiatry. Prevention is a form of intervention aimed at preventing the onset of a symptom, disorder, and psychological and/or social distress. The symposium intends to compare prevention in various contexts and different developmental stages of life, through the presentation of 4 contributions: (a) "Coping strategies and mental health during the covid-19 pandemic: an Italian survey". The study aims to evaluate mental health starting from individual characteristics and to explore which coping strategies are effective in enhancing the Italian population's well-being in dealing with covid-19;(b) "The role of several aspects of personality in the construction of transversal competencies in a sample of young adults". The study aims to assess the role that self-criticism, dependency and efficacy play in enhancing the young adult's transversal skills to facilitate more adaptive and satisfying life trajectories;(c) "Mentalization and attachment representation in mother-child and teacher-student relationships". The study has two aims: the first is to evaluate the relationship between the mentalization abilities and the attachment representation of both mother and her child and the teacher and her/his pupils. The second is to verify whether the adult's (mother and teacher) mentalization abilities impact the child's mentalization abilities;(d) 'Psychopathological symptoms and mentalizing capabilities in adolescents with anorexia nervosa before and during COVID-19 pandemic. This study aims to compare Covid-Period vs. NON-Covid Period adolescent patients affected by Anorexia Nervosa (AN) considering their psychopathological symptoms and their mentalizing capabilities. In the symposium, three types of prevention are focused: primary, secondary, and tertiary. The primary aim is to avoid or minimise the risk of occurrence. Secondary prevention intervenes early on the problem to reduce its negative effects. A clear example is an early diagnosis, which is even more important when dealing with childhood disorders as it increases treatment opportunities, effectiveness, and positive outcomes. Tertiary prevention relates to preventing complications and reducing the risk of relapse. The symposium's objective is to compare various typologies of prevention in different contexts focusing on specific samples. The four contributions illustrate once again the greatest importance of prevention and how it can be broadly applied, in clinical, social, and developmental contexts.
ABSTRACT
Background: Unexpectedly, COVID-19 was less prevalent in Chronic Respiratory Disease(CRD) than in the general population (Gupta N et al. Lung India. 2021;38(5):454-9). The vaccine and infection-related immune status of CRD patients is unknown. Aims and Objectives: Our primary objective was to study the cross sectional seroprevalence among chronic respiratory disease patients attending the Pulmonary medicine outpatients service and comparing it with the national seroprevalence data. Method(s): Consecutive subjects with CRD were recruited. History of past COVID 19 infection and other relevant information was obtained. Blood sample was taken for Roche Elecsys SARS-CoV-2 assay to detect anti-N and anti-S antibodies. Result(s): We recruited 364 patients(Asthma & COPD-100 each, Bronchiectasis, ILD & PTB-sequelae- 50 each and other restrictive diseases-14). The overall seroprevalence in CRD(Anti-S) was 85.16%, which was significantly higher than the 4th national serosurvey seroprevalence of 67.60%(p=0.001) (ICMR, Ministry of Health and Family Welfare;2021). Asthma had the highest seroprevalence, which was higher than COPD [93% vs 78%, p=0.027] and bronchiectasis [93% vs 80%, p=0.018]. Seroprevalence dropped with increasing age: <40 yrs: 93%, 41-60 yrs: 87% and >= 61 yrs: 77% (p=0.004). Patients on inhaled-steroids had higher seroprevalence than those without (89% vs 80%;p=0.026) and those on inhaled-anticholinergics (89% VS 79%;p=0.013). Conclusion(s): COVID-19 seroprevalence is higher in CRD than in the general population. Asthmatics had the highest prevalence and the seroprevalence dropped with increasing age.
ABSTRACT
Background: Inflammatory bowel disease (IBD) is a global problem and Australia has amongst the highest prevalence rates. This study looked to assess the quality, safety and equity of care across four specialised IBD centres in Australia over a 12-month period using the cloud-based IBD clinical management system called Crohn's Colitis Care (CCCare). This study aimed to define existing care at each centre and the range of performance across each centre to propose potential benchmarks for optimal quality IBD care. Method(s): The study was conducted across four tertiary IBD centres in Australia (Centres A, B, and C were public hospitals and D was a private centre). De-identified data within the backend CCCare research registry was audited between 1st of July 2021 to 31st August 2022. People with IBD who had a clinical assessment documented within the platform during this 12-month period were included. We assessed quality of IBD care using disease activity based on patient reported outcome measures (PROMs), biomarkers and endoscopy;surgery rates;health maintenance indicators including vaccination and skin cancer screening rates and;key performance indicators including steroid use, smoking rates and current opioid use. Safety of care was assessed using adverse events from therapy and hospital admission due to therapeutic complications. Equity of care examined education levels and ethnicity. Result(s): A total of 1889 patients were included. 63% had Crohn's disease and 37% had ulcerative colitis. 51% of the cohort was female. The median age was 39 years (IQR 30-53) and the median disease duration was 8.4 years (IQR 3.3-15.7) (Table 1). Current steroid use was between 6% to 15.4%. Faecal calprotectin (FCP) remission rates (250mug/mg) were between 65-84% and patient reported outcome (PRO-2) remission rates were between 76-88% with the highest rates observed at Centre D (Figure 1). 74 patients underwent a surgical procedure. COVID-19 vaccination rates were between 40.1% to 88.8% with the highest rates once again observed at Centre D. 3% of the cohort was documented as currently using opioid medications. 12.2% were recorded as currently smoking at Centre A compared to 2.6% at Centre D. 55 medication related adverse events were recorded and 94 patients had a hospital admission during the study period. Conclusion(s): This study showcases how CCCare can readily provide researchers with granular, real-world data to audit the quality of IBD care at 4 specialised centres in Australia over a 12-month period. While there were some differences (higher vaccination rates, lower smoking and steroid use rates at Centre D), quality and safety of care was still fairly uniform across the various sites and can serve as a standard of care for IBD patients in Australia.
ABSTRACT
Myocarditis is an important cardiovascular complication of COVID-19, a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been observed that hospitalized patients with pre-existing cardiac disease are at higher risk for the development of this complication. It is predominantly male, with the most affected population being adults over 50 years of age and pediatrics;however, its incidence and prevalence are not completely known. This disease is caused by direct and indirect lesions caused by SARS-CoV-2 infection to the myocardiocyte and other cells. Clinical manifestations vary from mild, such as fatigue and dyspnea, to severe, such as cardiogenic shock. Tests for the detection of this pathology are laboratory, imaging and histological. In this article we briefly review SARS-CoV-2 myocarditis in epidemiology, pathophysiology, clinic, diagnosis, treatment, as well as vaccination myocarditis.Copyright © 2023 Sociedad Espanola de Cardiologia
ABSTRACT
The article presents modern data about Kawasaki disease, which is a genetically determined systemic vasculitis with damage to the coronary arteries and multisystem manifestations. The etiology is not fully understood, but there is considered a possible role of viruses in the initiation of the aggravated immune response with possible development of macrophage activation syndromes and shock, which can lead to death. There are difficulties in diagnosing Kawasaki disease due to a variety of symptoms that are typical for a lot of infectious and autoimmune diseases (scarlet fever, measles, yersiniosis, systemic juvenile idiopathic arthritis). Early diagnosis and treatment (in the first 10 days of illness) using high doses of intravenous immunoglobulin and aspirin are associated with a low risk of development of coronary aneurysms and other complications. The authors also presented the data on the characteristics of severe Kawasaki-like diseases, which were recorded in several countries of Europe and America at the peak of the COVID-19 pandemic, and diagnostic criteria for the pediatric multisystem inflammatory syndrome associated with SARS-CoV-2, proposed by the Royal College of Pediatrics and Children Health (UK).Copyright © 2020, Professionalnye Izdaniya. All rights reserved.
ABSTRACT
The article presents modern data about Kawasaki disease, which is a genetically determined systemic vasculitis with damage to the coronary arteries and multisystem manifestations. The etiology is not fully understood, but there is considered a possible role of viruses in the initiation of the aggravated immune response with possible development of macrophage activation syndromes and shock, which can lead to death. There are difficulties in diagnosing Kawasaki disease due to a variety of symptoms that are typical for a lot of infectious and autoimmune diseases (scarlet fever, measles, yersiniosis, systemic juvenile idiopathic arthritis). Early diagnosis and treatment (in the first 10 days of illness) using high doses of intravenous immunoglobulin and aspirin are associated with a low risk of development of coronary aneurysms and other complications. The authors also presented the data on the characteristics of severe Kawasaki-like diseases, which were recorded in several countries of Europe and America at the peak of the COVID-19 pandemic, and diagnostic criteria for the pediatric multisystem inflammatory syndrome associated with SARS-CoV-2, proposed by the Royal College of Pediatrics and Children Health (UK).Copyright © 2020, Professionalnye Izdaniya. All rights reserved.
ABSTRACT
In sub-Saharan Africa, the COVID-19 pandemic has caused severe malnutrition in elderly populations with the appearance of vitamin deficiencies, in particular thiamine responsible for Gayet Wernicke's encephalopathy (EGW). We present a series of six (6) patients hospitalized in the Neurology Department of the CHU Ignace Deen for the management of a brain syndrome with vigilance disorders after recovery from COVID-19, including oculomotor disorders, motor incoordination on a course of severe weight loss. The six patients underwent an evaluation of malnutrition by determining the WHO body mass index, the Detsky index, the serum albumin assay, the thiamine assay and a neuroradiological assessment (MRI) and an electroencephalogram (EEG) examination although this does not seem necessary for diagnosis. Study of nutritional status: weight loss greater than 5%, patients in Desky group B and C, plasma albumin<30 g/l, lowered thiamine and MRI neuroradiological data: by the existence of hypersignals in certain regions of the neocortex, certain gray nuclei, the mammillary bodies the thalamic nuclei close to the wall of the 3rd ventricle and the regions bordering the 4th ventricle sign Gayet Wernicke's encephalopathy syndrome. This study shows a stereotyped clinical, biological, neuroradiological and evolutionary profile of Gayet Wernicke's encephalopathy in elderly subjects recovered from Covid-19 with proven malnutrition. These results are useful for the therapeutic and prognostic discussion.
ABSTRACT
Novel coronavirus (nCoV-19) infection has been declared a pandemic by WHO. More than 223 countries are under the attack of this emergency situation. Primarily, pneumocytes encountered by the nCoV-19 via ACE-2 receptor cause pulmonary edema, damage to alveolar cells, production of inflammatory cells, and hypoxia. It has been found that patients with co-existing cardiovascular diseases are more prone to the infection, and severe cardiovascular dysfunction was further observed when infected with nCoV-19. There is no substantial mechanism available for the pathogenesis of this cardiovascular dysfunction;therefore, we herein present a possible mechanistic approach of cardiotoxicity by nCov-19 infection. The hypothesis of this study is based on immunopathology of nCoV-19 in pneumocytes, presence of ACE-2 on cardiomyocytes membrane, cytokine storm, genomic analysis of virus in cardiac tissue, and several reports published on the cardiovascular complications in nCoV-19 across the globe. We have also analyzed the cardiotoxic profile of recently used repurposed and investigational drugs and highlighted their possible cardiotoxic consequences and drug interactions with cardiovascular medicines, such as statins and anti-coagulants.Copyright © 2021 Bentham Science Publishers.
ABSTRACT
OBJECTIVE: Hydroxychloroquine (HCQ) has been used during the coronavirus disease 2019 (COVID-19) pandemic because of its reported anti-viral activity. This study examined the association of chronic HCQ use with the incidence and complications of COVID-19. METHODS: This retrospective cohort study included adults with rheumatoid arthritis and/or systemic lupus erythematosus who visited rheumatology clinics in three tertiary hospitals in Riyadh, Saudi Arabia between January 2019 and December 2020. Patients were categorized into two groups based on HCQ use. Data were obtained from the electronic health record and by interviews with patients. The primary study objective was the incidence of COVID-19 and its complications from March 2020 to February 2021. RESULTS: Almost 11% of the study cohort was positive for COVID-19, and the incidence of COVID-19 was similar between HCQ users (11.11%) and nonusers (10.86%). Disease complication rates were similar in the study arms, and they mainly included fever, dry cough, fatigue, and breathing difficulty. CONCLUSIONS: This study revealed no significant association between chronic HCQ use and the incidence of COVID-19, and disease complications were similar in the study arms.
Subject(s)
Antirheumatic Agents , Arthritis, Rheumatoid , COVID-19 Drug Treatment , COVID-19 , Lupus Erythematosus, Systemic , Adult , Antirheumatic Agents/adverse effects , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/drug therapy , COVID-19/epidemiology , Humans , Hydroxychloroquine/adverse effects , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/epidemiology , Retrospective StudiesABSTRACT
Case Report In April 2020, cases of multisystem inflammatory syndrome in children(MIS-C) were reported from the UK as clinical presentations similar to incomplete Kawasaki and toxic shock syndrome in the setting of COVID-19. MIS-C is a rare but significant complication of COVID-19. We present the case of direct hyperbilirubinemia associated with MIS-C with incidentally discovered gallbladder agenesis. Case presentation A 16-year-old male presented with fever, epigastric pain, jaundice, and rash. He tested positive for SARS-CoV-2 one month prior, improved clinically, but developed fever one day before presentation. Physical exam revealed a diffuse maculopapular rash, jaundice, and right upper quadrant tenderness. Vitally stable. Work up for MIS-C revealed positive SARS-CoV-2, lymphopenia, ESR 23 mm/hr, fibrinogen 552 mg/dl, CRP 8.94 mg/ dL. Troponin, BNP, and coagulation profile were normal. Echo and CXR were unremarkable. CMP showed ALT 242 IU/L, AST 145 IU/L, total bilirubin of 5.7 mg/dL with direct bilirubin of 3.9 mg/dL, GGT 178 IU/L, consistent with obstructive jaundice. Workup for autoimmune hepatitis and viral hepatitis was negative. US right upper quadrant was done to rule out an obstructive pathology, which was normal except that it showed an absent gallbladder. MRCP and HIDA scan also showed no obstructive pathology and confirmed gallbladder agenesis. With no clear reason for direct hyperbilirubinemia, treatment for mild MIS-C was initiated with IV dexamethasone. Repeat blood work after 24 hours showed down trending bilirubin levels and stable liver enzymes, patient was discharged shortly afterwards. At one month follow up, liver enzymes and bilirubin normalized. Discussion Presentations of MIS-C vary with the most common being persistent fever along with gastrointestinal, respiratory, neurological, skin, and/or cardiac involvement. Acute hepatitis with elevated liver enzymes is a well-documented lab finding but direct hyperbilirubinemia is rare. Another interesting finding in our case was gallbladder agenesis, which is a rare congenital anomaly (incidence 10-65 per 100,000). Conclusion We highlight in our case report that cholestatic jaundice, despite being a very rare manifestation of MIS-C, can still occur. A multidisciplinary approach should be taken when treating such patients including GI, cardiology, rheumatology, and infectious disease.