Non-Hodgkin's lymphoma complicated with human coronavirus HKU1 pneumonia: A case report and literature review.

Objective: To analyze the clinical manifestations, diagnostic methods and treatment process of the patients with non-Hodgkin's lymphoma complicated with human coronavirus(HCoV)-HKU1 pneumonia and improve the clinical medical staff's awareness of the disease, and to reduce the occurrence of clinical adverse events. Method(s): The clinical data of a patient with non-Hodgkin's lymphoma complicated with HCoV-HKU1 pneumonia with hot flashes and night sweats, dry cough and dry throat as the main clinical features who were hospitalized in the hospital in January 2021 were analyzed, and the relevant literatures were reviewed and the clinical manifestations and diagnosis of HCoV-HKU1 were analyzed. Result(s): The female patient was admitted to the hospital due to diagnosed non-Hodgkin's lymphoma for more than 2 months. The physical examination results showed Karnofsky score was 90 points;there was no palpable enlargement of systemic superfical lymph nodes;mild tenderness in the right lower abdomen, no rebound tenderness, and slightly thicker breath sounds in both lungs were found, and a few moist rales were heard in both lower lungs. The chest CT results showed diffuse exudative foci in both lungs, and the number of white blood cells in the urine analysis was 158 muL-1;next generation sequencing technique(NGS) was used the detect the bronchoalveolar lavage fluid, and HCoV-HKU1 pneumonia was diagnosed. At admission, the patient had symptoms such as dull pain in the right lower abdomen, nighttime cough, and night sweats;antiviral treatment with oseltamivir was ineffective. After treatment with Compound Sulfamethoxazole Tablets and Lianhua Qingwen Granules, the respiratory symptoms of the patient disappeared. The re-examination chest CT results showed the exudation was absorbed. Conclusion(s): The clinical symptoms of the patients with non-Hodgkin's lymphoma complicated with HCoV-HKU1 pneumonia are non-specific. When the diffuse shadow changes in the lungs are found in clinic, and the new coronavirus nucleic acid test is negative, attention should still be paid to the possibility of other HCoV infections. The NGS can efficiently screen the infectious pathogens, which is beneficial to guide the diagnosis and treatment of pulmonary infectious diseases more accurately.Copyright © 2023 Jilin University Press. All rights reserved.

Herpes Zoster Co-Infection with COVID-19: A Case Series

Clinical presentation of COVID-19 infection can be variable in the current pandemic even in patients presenting to the clinic with a mild history of upper respiratory complaints. Various cutaneous manifestations have been noticed in COVID-19 patients with herpes zoster (HZ) being one among them. HZ is an infection that results when varicella zoster virus reactivates from its latent state in the posterior dorsal root ganglion. Here, we aim to expand our knowledge by reporting three cases of associated zoster infection in COVID-19 patients admitted to our intensive care unit in view of respiratory complaints. All the three patients admitted, had revealed lymphocytopenia at the time of HZ diagnosis, and were managed conservatively throughout the course. In all the cases, acyclovir/valacyclovir led to the resolution of lesions in 10 days. No postherpetic sequelae were observed. We here suggest that the clinical presentation of HZ at the time of the current pandemic should be considered as an alarming sign for a latent subclinical SARS CoV-2 infection and thorough follow-up of such patients be adopted.Copyright © 2021 Bali Journal of Anesthesiology. All rights reserved.

Clinical and laboratory manifestations and pathological anatomical picture of a severe course of a new coronavirus infection COVID-19 with a fatal outcome

Aim - to study the clinical and laboratory manifestations of a severe course of COVID-19 in a lethal outcome with an assessment of the pathomorphological picture based on autopsy material. Material and methods. A retrospective analysis of demographic, clinical and laboratory parameters, as well as the results of a pathoanatomical study of 54 patients with severe COVID-19 who died in the intensive care unit, was carried out. Results. Among the patients included in the study, women and men were equally divided. The mean age was 73.1+/-1.86 years (median 73 years). An increase in body temperature above 38 degreeS was observed in 81.5% of cases, weakness - in 70.4%, dry cough - in 46.3%, a feeling of lack of air - in 46.3%, muscle pain - in 40.7%. The volume of lung damage by the type of bilateral polysegmental pneumonia with areas of compaction of the type of "frosted glasses" and consolidation was more than 75.0% and was determined in 68.5% of patients. Concomitant diseases were detected in 94.4% of patients. It was found that all patients had a pronounced systemic inflammatory response, as evidenced by an increase in the level of C-reactive protein and procalcitonin in all patients. A decrease in albumin levels was observed in 88.9% of cases. A hypercoagulable shift with intravascular coagulation was noted. Morphological studies revealed damage to the lungs, liver, kidneys and pancreas with the development of thrombovascular changes. Conclusion. A severe course of COVID-19 with a fatal outcome was observed in older patients with clinical, radiological and laboratory manifestations of a systemic inflammatory response, which was accompanied by damage to various organs and systems.Copyright © Authors, 2022.

A CLINICAL CASE OF SARS-CoV-2 INFECTION COMPLICATED BY NEPHROGENIC PULMONARY EDEMA AND COVID-ASSOCIATED PNEUMONITIS, ALVEOLITIS.

COVID-19 is a highly transmissible disease with severe course especially in patients with nephrogenic hypertensive disease and chronic kidney disease due to a higher incidence of all-type infections than in the general population. The aim of the study is to describe a clinical case of SARS-CoV-2 infection complicated by nephrogenic pulmonary edema and COVID-associated pneumonitis, alveolitis. Description of the case. Patient K.S., born in 1975, was hospitalized 24 hours after symptom onset at emergency hospital due to complaints of increased blood pressure up to 180-200/110-120 mm Hg, temperature up to 38.7degreeC, dry cough, feeling of heaviness in the chest, change in urine color. PCR smear for SARS-CoV-2 was positive. Computed tomography revealed a pattern of bilateral COVID-associated pneumonitis, alveolitis, with 75% involvement. The electrocardiogram revealed signs of left ventricular myocardial hypertrophy. Ultrasound examination showed numerous cysts in the kidneys. Urinalysis at admission: leukocytes - 499, erythrocytes - 386. Glomerular filtration rate (CKD-EPI: 29 ml/min/1.73 m2) and corresponds to stage IV of chronic kidney disease. Coagulogram: fibrinogen: 32.3 (1.6-4.0) g/l, D-dimer: 663 (0-250). Despite the treatment, the patient's condition worsened, the phenomena of cardiopulmonary and renal insufficiency increased, which led to a fatal outcome. During a virological study of sectional material: SARS-CoV-2 coronavirus RNA was found in the lung and kidneys. Signs of bilateral COVID-associated pneumonitis, alveolitis with diffuse cellular infiltrates in combination with changes in the alveolar apparatus, signs of pulmonary edema were revealed. Heart-related signs - swelling of the interstitium, fragmented muscle fibers, some of them hypertrophied, a wave-like deformation of cardiomyocytes, blurring of the transverse striation. Arteries with thickened sclerosed walls. In the kidneys - diffuse damage to the proximal tubules of the nephron with areas of cortical and proximal necronephrosis, areas of fibrinoid swelling. Conclusion. The cause of death of a 45-year-old patient was a severe course of bilateral COVID-associated pneumonitis, alveolitis, which contributed to the development of renal medullary hypoxia and type 1 cardiorenal syndrome, which led to early nephrogenic pulmonary edema.Copyright © 2023 Saint Petersburg Pasteur Institute. All rights reserved.

Covid-19 Infection Presenting as Acute Pancreatitis

Purpose of study Introduction COVID-19 emerged at the end of 2019 as an epidemic of respiratory disease in Wuhan, China that later spread globally and was declared as pandemic. The common clinical manifestations of COVID-19 infection include fever, cough, myalgias, headache, sore throat, anosmia, nasal congestion, fatigue and chest pain. The most serious complications include bilateral multifocal pneumonia and acute respiratory distress syndrome. Acute pancreatitis is rarely reported in association with COVID-19 infection. We report a case of acute pancreatitis secondary to COVID-19 infection. Case Report: A 69-year-old man with past medical history of hyperlipidemia and seizure disorder presented with two days of epigastric pain radiating to back. The patient reported fever, malaise and dry cough for the last 3 days. Home medication included atorvastatin and carbamazepine for 10 and 15 years respectively. The patient denied smoking and alcohol use. COVID- 19 PCR was positive. Labs showed WBC of 3800/muL, hgb 11.8 g/dL, calcium 8.4 mg/dL , lipase 426 U/L, D-Dimer 179 ng/ml DDU, High sensitivity C-reactive protein 27.5 mg/L (normal <5 mg/L) ALT 26 U/L, AST 31 U/L, alkaline phosphatase 103 U/L and total bilirubin 0.3 mg/dL. Ultrasound of the right upper quadrant and CT abdomen showed normal pancreas, common bile duct and gallbladder with no evidence of gallstones. Triglyceride level was 70 mg/dL (<149 mg/dL) on the lipid panel. The patient was diagnosed with acute pancreatitis and received treatment with IV fluids and pain medication. The symptoms improved gradually and the patient was discharged home with resumption of home medications. Methods used Case Report Summary of results The common differentials for acute pancreatitis include alcohol use, gallstones, hypertriglyceridemia, viral infections like mumps and measles, hypercalcemia and medication-related, etc. Normal AST, ALT, alkaline phosphatase and total bilirubin along with absence of gallstones and normal common bile duct ruled out alcoholic and biliary pancreatitis. Normal calcium level and triglyceride level rule out hypercalcemia and hypertriglyceridemia as the cause of pancreatitis. Carbamazepine has rarely been reported to cause acute pancreatitis typically soon after the initiating the therapy or with increase in the dose. The use of carbamazepine for more than 15 years without any recent dose change makes this unlikely as the cause of pancreatitis. The onset of acute pancreatitis during the timeline of COVID-19 constitutional symptoms and absence of other risk factors suggests that COVID-19 infection is responsible for acute pancreatitis in our patient. Conclusions We report a case of acute pancreatitis secondary to COVID-19 infection. Further studies are warranted to better understand the etiology and the pathophysiology of acute pancreatitis secondary to COVID-19 infection.

Current Practices and Recommendations for Prioritizing Patients Mimicking Upper Respiratory Tract Symptoms in Period of Covid 19 Pandemic: A Strategic Perspective.

Upper respiratory tract symptoms can be caused by many diseases like Covid 19 disease, common cold, seasonal flu or allergy. This present a diagnostic dilemma in OPD to clinically identify which patient is suspected of Covid 19 disease and which is not. Which patient needs immediate Covid 19 testing, as not all patients presenting with these symptoms have Covid 19 disease. To develop a criteria which can help clinician in OPD while dealing with cases of upper respiratory tract symptoms and to highlight this grey area which needs further research. 107 patients with upper respiratory tract symptom over a period of 1 month, fulfilling the inclusion and exclusion criteria were evaluated and analysed. Patients were divided into 2 groups. Group I is High suspicion group having 43 cases, Group II Low Suspicion group having 64 cases. In group I there were 29 Covid 19 positive cases (67.44%). In group II there were 3 Covid 19 positive cases (4.6%). By dividing the patients of upper respiratory tract symptoms into three groups (I & II) a system can be made for proper, timely and efficient treatment of such cases.

A nontraumatic, right-sided diaphragmatic hernia in an adult diagnosed during an asthma attack

Case report We present a rare case of a right-sided diaphragmatic herniation of the ascending colon, in a 76-year-old asthmatic patient with a non-congenital diaphragmatic hernia, no history of trauma, surgery, or radiation. The patient presented at the emergency room with dyspnea, non-productive cough, wheezing, tachypnea, tight chest, respiratory failure. This patient has a 40-year history of severe persistent extrinsic asthma, treated with high doses of inhaled corticosteroids and LABA. Before the pandemic, this patient was hospitalized 3-4 times a year for her asthma attacks, but in the last 2 years, due to Covid-19, the patient was not hospitalized, resulting in uncontrolled asthma with daily symptoms. During the hospitalization, chest radiography was performed where the hernia was suspected and confirmed by a CT Scan. Despite the diagnosis of diaphragmatic herniation, she was clinically better with the proper asthma treatment and after consulting with her family she refused the intervention to correct the hernia. She has had two vaginal deliveries, no malignancies, no trauma, no intervention in her life. In this case, the only possible cause for the herniation of the colon is persistent cough combined with advanced age, chronic steroid use, and obstructive lung disease. Non-traumatic, right-sided diaphragmatic hernia of the colon in adults is very rare. Persistent cough with other predisposing conditions of this patient is the cause of this herniation. The chest X-ray and CT were essential for making the diagnosis. Rare hernias like this should be kept in mind when coming to a diagnosis.

Cerebellar syndrome as a complication of COVID-19 disease

COVID-19 disease is caused by the new coronavirus SARS-CoV-2. The disease first appeared in China in 2019 and quickly spread throughout the world. It primarily affects the respiratory tract, manifested by fever, cough and the devel-opment of dyspnoea, but the symptoms and complications can affect any organ system. Neurological symptoms include headaches, muscle and joint pain, taste and smell disorders. Complications include inflammatory diseases of the central nervous system, ataxia, peripheral nerve and muscle diseases, worsening of extra-pyramidal diseases, and neuropsychiatric disorders. This paper presents a case report of a 62-year-old man with cere bellar syndrome, ataxia, intentional tremor and hypermetria when dealing with COVID-19 disease.Copyright © 2021 Neuroendocrinology Letters.

Human Monkeypox Virus (hMPXV) Remerges-Another Global Health Concern during the COVID-19 Disaster

The increase in human monkeypox virus (hMPXV) cases amidst the COVID-19 pandemic has raised fear among the general public. The monkeypox virus and the now-extinct smallpox virus belong to the orthopox family of viruses. Although first discovered in 1958, Monkeypox was only well recognized outside the sub-Saharan African countries until the world experienced a monkeypox pandemic in May 2022. The virus is common in some areas of Africa and is often spread through close contact with an infected person or animal. However, recent international trade, travel, and tourism developments have caused viral outbreaks outside Africa. The most recent pandemic in 2022 has been strange because epidemiologists have not found a link between cases and the virus's ability to spread through sexual contact. The structural and pathogenic activities of the virus that attack host cells need to be better understood. Because of this, it is important to know how viruses and the immune system work together to develop effective ways to treat and prevent diseases. To summarize existing research on Monkeypox, we conducted a narrative review using the MEDLINE, EMBASE, PUBMED, and Scopus databases to look at simultaneous zoonotic pandemics caused by the SARS-CoV-2 or COVID-19 coronavirus and presented the most to date information on the symptoms, epidemiology, diagnosis, prevention, and treatment of Monkeypox. However, more research on epidemiological details, ecology, and virus biology in endemic areas is required to understand the virus better and prevent further human infection. This short review discusses the research results that have already been published about how the monkeypox virus affects humans. © 2023, Liaquat University of Medical and Health Sciences. All rights reserved.

COVID-19 and Spontaneous Coronary Artery Dissection: Association or Causality

Clinical Information Patient Initials or Identifier Number: JS Relevant Clinical History and Physical Exam: A 55-year old woman was brought to emergency department complaining of sudden onset squeezing chest pain radiating to her arm and jaw and associated with giddiness. She had flu like illness a day prior to her presentation associated with malaise, arthralgia and dry cough. She had history of hypertension. Physical examination revealed dual heart sounds and clear lung fields to auscultation. Relevant Test Results Prior to Catheterization: Electrocardiogram (ECG) showed normal sinus rhythm and the cardiac enzymes were elevated;high sensitivity troponin-I, 23000 ng/L (range0-10 ng/L). RNA PCR was positive for SARS-CoV-2 (COVID-19). D-Dimer was 303microgram/L (normal <500). Transthoracic echocardiogram showed severe hypokinesis of the mid inferolateral wall with left ventricular ejection fraction (LVEF) 52%. Chest X-ray showed no focal consolidation. [Formula presented] [Formula presented] Relevant Catheterization Findings: Invasive coronary angiogram showed tortuous coronary arteries with abrupt narrowing of mid- distal Ramus Intermiedius and discrete lesion of mid PDA. SCAD (spontaneous Coronary dissection) of Ramus Intermedius and mid PDA (posterior descending artery) was suspected, and patient was treated conservatively. Repeat coronary angiography, few months later showed complete resolution of SCAD with normal appearance of affected vessels. [Formula presented] [Formula presented] [Formula presented] Interventional Management Procedural Step: After obtaining an informed consent right Radial access was achieved with 6F Terumo sheath using over the wire technique. 1% lignocaine was used as local anaesthetic. 5F JL 3.5 (Judkin's) and JR 4 catheters were used to engage left main stem (LMS) and right coronary artery (RCA) and selective coronary angiography was performed. No percutaneous coronary intervention was performed. After the procedure hemoband (TR band) was applied to access site. Patient remained hemodyanamically stable throughout the procedure. [Formula presented] [Formula presented] [Formula presented] Conclusion(s): SCAD is a potential cause of type II myocardial infarction in patients with COVID-19, but more studies are needed to establish causality. Infection-related SCAD may occur at any time during index events and could be difficult to diagnose. Conservative management seems like a safe strategy.Copyright © 2023

Clinical and paraclinical manifestation COVID-19 in different age children

Purpose - to establish the clinical and paraclinical manifestations of the course of COVID-19 in children, depending on age to predict the severity of the disease's manifestation. Materials and methods. The 60 children aged from 3 months to 17 years old with laboratory-confirmed SARS-CoV-2 were examined. All patients underwent general clinical, laboratory, and instrumental examinations and received therapy according to Ukrainian National protocol. SARS-CoV-2 infection was confirmed by real-time PCR. Results. Thus, in young children COVID-19 begins acutely (90.0%) with intoxication (75.0%), fever (65.0%), nasal congestion (25.0%), rhinorrhea (20.0%), dry cough (60.0%), increased ESR and C-reactive protein (55.0%). The course of COVID-19 in children 4-6 years is accompanied by acute onset (85.71%), fever (85.71%), pharyngitis (85.71%), lymphopenia (28.56%), and no CT signs of lesions (71.43%). In children 7-12 years old, COVID-19 causes intoxication (88.89%), fever (83.33%), pharyngitis (55.56%), dry cough (77.78%), lymphocytosis (16.67%) with accelerated ESR (38.89%) and pneumonia (38.89%). The course of COVID-19 in children was older than 13 years old characterized by fever (73.33%), pharyngitis (66.67%), dry cough (73.33%), olfactory loss (20.0%), leukopenia (20.0%), ESR acceleration (20.0%), and a decrease in prothrombin (13.33%) without pulmonary lesions (73.33%). Conclusions. These data suggest that the severity and duration of clinical and laboratory manifestations of COVID-19 depend on the child's age. The course of COVID-19 in children of all age groups is mostly of moderate severity with a favorable prognosis ((56.67%) hospitalized children did not have any complications). Only children from 7 to 12 years old need additional attention due to the severe manifestations of intoxication (88.89%) and the risk of complications with pneumonia (38.89%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.Copyright © 2022 Modern Pediatrics. Ukraine. All rights reserved.

The most common symptoms of COVID-19 patients in Yazd

The aim of this study was to investigate the most common symptoms of COVID-19 patients in Yazd. This study was done during 2020-2021. All patients with positive PCR test were entered to this study. Finally, data was analyzed by SPSS software. The most common symptoms of COVID-19 patients were shortness of breath, fever and cough. There was a significant relationship between diabetes, lethargy, myalgia, chills, fever and loss of taste. Several symptoms including weakness, lethargy, dry cough, decreased appetite, were significantly more in the autumn season. According to the findings, the symptoms could have different prevalence in patients with underlying disease.Copyright © 2021 Health Biotechnology And Biopharma. All Rights Reserved.

Anaphylaxis to trometamol excipient in Moderna COVID-19 vaccine: A case report

Case report The first approved COVID-19 vaccines include BNT162B2 Pfizer-BioNTech and mRNA-1273 Moderna mRNA vaccines. Some severe allergic reactions to these vaccines have been report, and even though there is a lack of robust evidence, IgE-mediated hypersensitivity to excipients may be the cause of several. The excipient polyethylene glycol (PEG) is present in both, whilst Moderna further contains trometamol (or tromethamine), a buffer additive present in drug formulations and contrast media. We report the case of a 40 year-old woman, with controlled allergic rhinitis and asthma, who was referred to our Immunoallergology Department due to an anaphylactic reaction to Moderna COVID-19 vaccine. She described an episode of cervical and facial pruritus 5 minutes after receiving the first dose of vaccine, which rapidly evolved to generalized urticaria. She was promptly given intravenous (IV) clemastine with improvement of symptoms. However, 1h later she developed respiratory symptoms (dry cough, shortness of breath and wheezing). IV hydrocortisone was also given, and the patient was kept under medical supervision for 6h, after which she was discharged home. The following day, she had urticaria that resolved with oral deflazacort (60 mg). She denies exercise practice, alcohol consumption or outset of new drugs prior to vaccination. During investigation, the patient described two similar reactions in the past, 5 minutes after the administration of trometamol-containing contrast media (10 years before with an iodinated contrast and 2 years ago with a gadolinium contrast, both with trometamol). A week after the reaction all laboratory evaluation were within normal limits, including tryptase level. Skin tests were performed, 2 months after, with contrast media that contain trometamol (iopromide, iomeprol, iodixanol, ioversol, gadobutrol) and that do not (ioxitalamate, amidotrizoate, gadoterate meglumine), in accordance with the EAACI/ENDA guidelines. Iopromide and iodixanol were positive on intradermal testing (1:10 dilution), suggesting trometamol as the culprit excipient. She was advised not to receive the 2nd dose of Moderna vaccine. She received Pfizer-BioNTech vaccine at the hospital, without any reactions. This case demonstrates that an IgE-mediated reaction to trometamol may be an underlying mechanism for immediate hypersensitivity to mRNA Moderna vaccine. The risk of an allergic reaction to it increases when a previous history of hypersensitivity to contrast media exists.

The importance of a comprehensive study in allergic reactions

Background: Polyethylene glycol (PEG) is a condensed polymer of ethylene glycol used as excipient in over 1000 commonly medicines, as well as for industrial products or cosmetics (shampoo, toothpaste.) where it can act as thickener, solvent, softener or humectant. In relation to the recently developed COVID-19 vaccines and their excipients some questions have arisen in our consultations. Method(s): A 48-year- old woman came to our clinic with doubts about the administration of COVID-19 vaccine. 8 years ago, after rectal administration of a healing suppository for an anal fissure she immediately presented a dry cough and a generalized urticaria which subsided spontaneously without attend to the emergency department. 5 years ago, with the application of an hemorrhoid cream se presented an immediate reaction consisting of cough, difficulty breathing and generalized urticaria. The symptoms subsided spontaneously after 30-45 minutes. The patient reported previous tolerance to both drugs. She has avoided them ever since. All these medicines have in common PEG as an excipient. We performed several studies to find out if PEG was the culprit. Result(s): *Prick test with Casenlax (which contains 10 grams of PEG 4000): negative. *Oral provocation test with Casenlax: we started with the intake of 2.5 grams of Casenlax and after 5 minutes she started with oropharyngeal pruritus, dry cough, feeling of shortness of breath and desaturation (since 98% to 92-90%). The patient was monitored and administered intramuscular adrenaline (0.3 ml), methylprednisolone 60 mg and dexchlorpheniramine 5 mg. The symptoms were controlled after 15-30 minutes. *COVID-19 AstraZeneca vaccine was administered without incident. Conclusion(s): Given the high incidence of reactions to the excipients accompanying the drugs, this should be taken into account when taking the patient's medical history and in the subsequent pharmacological study.

Mesenchymal Stem Cells: A Potent Cell Source for COVID-19

Coronaviruses are enveloped positive-stranded RNA viruses that cause mild to acute respiratory illness. Coronaviruses can merge envelope proteins with the host cell membranes and de-liver their genetic material. Coronavirus disease 2019 (COVID-19) is the seventh coronavirus clos-est to the severe acute respiratory syndrome (SARS) in bats that infects humans. COVID-19 at-tacks the respiratory system and stimulates the host inflammatory responses, promotes the recruit-ment of immune cells, and enhances angiotensin-converting enzyme 2 (ACE2) activities. Patients with confirmed COVID-19 have experienced fever, dry cough, headache, dyspnea, acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), and acute heart injury. Several strategies such as oxygen therapy, ventilation, antibiotic or antiviral therapy, and renal replacement therapy are commonly used to decrease COVID-19-associated mortality. Inflammation is a common and important factor in the pathogenesis of COVID-19. In recent years, stem cell-based therapies represent a promising therapeutic option against various diseases. Mesenchymal stem cells (MSCs) are multipotent stem cells that can self-renew and differentiate into various tissues of mesodermal ori-gin. MSCs can be derived from bone marrow, adipose tissue, and umbilical cord blood. MSCs, with their unique immunomodulatory properties, represent a promising therapeutic alternative against diseases associated with inflammation. Several previous studies have shown that MSCs with a strong safety profile can improve the treatment of patients with COVID-19. The information in this review provides a summary of the prevention and diagnosis of COVID-19. Also, we focus on the current clinical application of MSCs for treatments of patients with COVID-19.Copyright © 2021 Bentham Science Publishers.

The role of Trans-thoracic ultrasonography for rapid detection of Covid-19 pandemic-pneumonia(262cases)?

Background: Corona virus pandemic pneumonia has caused unmatchable damage to humanity. Early detection and prompt treatment is the only answer for effective control. RT-PCR is the gold standard diagnostic test but displays high false-negative rate. A large number of undetected patients remain a constant source of inadvertent disease dissemination in community, potentiating the ongoing pandemic. Objective(s): To determine the usefulness of transthoracic ultrasonography for early detection of covid-19 pulmonary infection during a pandemic. Methodology: This cross-sectional study was conducted in Pulmonology-OPD of Gulab Devi Teaching Hospital, Lahore-Pakistan, from April 21, 2020 to September 30, 2020. Total 262 patients with dry cough, fever and shortness of breath of sudden onset were included. Patients were investigated with chest x-ray/HRCT, transthoracic ultrasonography, covid-19-PCR and hematological tests. Sensitivity, Specificity, positive predictive value(PPV), negative predictive value(NPV) and diagnostic accuracy was calculated with clinical diagnosis as reference. Data was analyzed by SPSS-24-software. Result(s): Of 262-patients, 248 were detected as covid-19 pneumonia by ultrasound. Bilateral, multifocal, posteriolateral involvement and B-lines were common features. Ultrasound displayed sensitivity 99.60%, specificity, 69.23%, PPV 98.41%, NPV 90.0% and diagnostic accuracy 98.09%. PCR diagnosed 155/228(59.16%) cases. The P-value was 0.00001-significant at P<.05. Conclusion(s): Transthoracic ultrasonography is a tremendous tool furnishing instant detection of covid-19 pneumonia with high sensitivity and provides foundations for evidence based management during pandemic.

Pathogenesis and Immune Status in COVID-19 Pneumonia-A Minireview

The novel coronavirus (SARS-CoV-2), which was isolated in January 2020, emerged as a result of natural evolution and has already infected millions of people around the world due to its extensive human-to-human transmission capacity. Highlighting the clinical manifestations, pathology and immune response against the SARS-CoV-2 infection process, this review study was con-ducted through a comprehensive bibliographic search of academic papers that are available online at the following databases Science Direct, Pub Med, ACS Publications, Nature, BioRxiv and Me-dRxiv. According to the analyzed works, people infected with SARS-CoV-2 may display fever and dry cough as the main clinical symptoms and they may also present breathing difficulty, muscle pain (myalgia), chills, lack of appetite, fatigue, sore throat, altered consciousness, diarrhea, vomit-ing, nasal discharge and syncope. When considering the immune status of patients with COVID-19, it is highlighted that hypercytokinemia contributes to the severity that can even result in death. Lymphopenia is the most frequent prognosis described in cases of COVID-19. Thus, a de-tailed understanding of the specific inflammatory pathways that result in the pathology of COVID-19 is crucial for the immediate development of clinical therapeutic approaches.Copyright © 2021 Bentham Science Publishers.

Epidemiological Approach of SARS-CoV2 in the First Month of Appearance in the Kurdistan Region of Iraq

The new emerging coronavirus SARS-CoV2 is an alerting pandemic worldwide. Understanding the epidemiology, viral behavior in the host, and the severity of the disease in an infected patient is a demanding approach for the healthcare system which lead to plan and contemplate the response for further waves of the same virus and even other related viruses. The evaluation of the protection measurements along with analyzing the recorded data of epidemiology and spread provides thorough insights toward the new Coronavirus modes of transmission, infection, and severity. Kurdistan Region of Iraq was hit by the SARS-CoV2 on March 2020 when first confirmed case recorded. The present paper analyzed a full month data of confirmed hospitalized and quarantined cases with regard to age, sex, geographical distribution. The highest risks were shown to be males of their young ages of 30-39 years old in Sulaimani province due to the social structure of the Kurdish population and the geographical position of Sulaimani. Social integration played a significant role in the spreading the virus in all cities of Kurdistan first onset of the virus in the community. Diagnosed hospitalized cases were mostly suffered from high fever, dry cough and breathing difficulties. The mortality rate was shown to be reasonable, and the majority of the cases were recovered after hospitalization and receive supportive treatment. Social distancing and total lockdown played a significant role in viral spread containment. The health authorities prevented devastating outbreak through tracing all the cases and their contacts, isolating the suspicious contacts, quarantining the neighborhoods were the virus found. Further investigation is needed in a larger scale of data in order to be armed with adequate knowledge for any other waves of COVID-19 in the region.Copyright © 2020 Ubiquity Press. All rights reserved.