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1.
J Card Surg ; 2022 Nov 06.
Article in English | MEDLINE | ID: covidwho-2108105

ABSTRACT

A 57-year-old man suffered chest pain during the COVID-19 pandemic, but he delayed medical treatment due to fear of infection. After 4 months, symptoms of chest tightness and shortness of breath appeared. Electrocardiogram (ECG) revealed old myocardial infarction; color sonography and myocardial computed tomography revealed apical myocardial defect. He refused surgery and percutaneous transcatheter closure, and follow-up observation. After 22 months, the symptoms of chest tightness and shortness of breath aggravated. He recovered after percutaneous transcatheter closure, and was discharged. This case shows delayed closure is one of the possible options for patients without severe organ dysfunction or hemodynamic disturbance.

2.
Neuroimmunology Reports ; : 100150, 2022.
Article in English | ScienceDirect | ID: covidwho-2105650

ABSTRACT

Background Delayed post-hypoxic leukoencephalopathy (DPHL) with associated microbleeds is a clinical entity presenting with cognitive impairment days or weeks after an episode of acute hypoxic brain injury. Case report We describe a 68-year-old male with SARS-CoV2 infection who had cardiac arrest, required sedation and mechanical ventilation for 17 days, and after sedation was discontinued, he became unresponsive. Brain MRI showed diffuse confluent hyperintense signals in the subcortical white matter and multiple subcortical white matter microhemorrhages. EEG revealed diffuse attenuation of brain electrical activity with isolated polymorphic delta waves in the frontal region without epileptiform activity. Conclusions Clinicians need to be aware that patients with Covid-19 can develop delayed post-hypoxic leukoencephalopathy.

3.
Leg Med (Tokyo) ; 59: 102154, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2105536

ABSTRACT

A male in his 90 s consulted a doctor because he experienced several days of general fatigue and dyspnea. He was diagnosed with heart failure, and diuretic medications taken for 3 days relieved his symptoms. However, he was found dead on the morning of the fourth day after consultation. He had received a third dose of coronavirus disease 2019 (COVID-19) vaccine approximately 2 weeks before death. An autopsy revealed dissection of the ascending aorta and pericardial hemotamponade. The heart showed a white villous surface, and the pericardium was fibrously thick. Microscopic examination revealed pericarditis with predominantly macrophage and lymphocyte infiltration. These histological findings were compatible with those of post-vaccination myocarditis. To the best of our knowledge, histopathologically proven pericarditis after COVID-19 vaccination has not been reported. In the present case, extended inflammation of the aortic adventitia was a possible cause of aortic wall fragility followed by dissection.


Subject(s)
Aneurysm, Dissecting , COVID-19 , Myocarditis , Pericarditis , Male , Humans , COVID-19/complications , COVID-19 Vaccines/adverse effects , Autopsy , RNA, Messenger , Pericarditis/etiology , Pericarditis/pathology , Aneurysm, Dissecting/etiology , Aorta/pathology , Myocarditis/complications , Inflammation/complications , Inflammation/pathology , Vaccination , Diuretics
4.
Surg Endosc ; 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2103900

ABSTRACT

OBJECTIVE OF THE STUDY: In esophageal surgery, anastomotic leak (AL) remains one of the most severe and critical adverse events after oncological esophagectomy. Endoscopic vacuum therapy (EVT) can be used to treat AL; however, in the current literature, treatment outcomes and reports on how to use this novel technique are scarce. The aim of this study was to evaluate the outcomes of patients with an AL after IL RAMIE and to determine whether using EVT as an treatment option is safe and feasible. MATERIAL AND METHODS: This study includes all patients who developed an Esophagectomy Complications Consensus Group (ECCG) type II AL after IL RAMIE at our center between April 2017 and December 2021. The analysis focuses on time to EVT, duration of EVT, and follow up treatments for these patients. RESULTS: A total of 157 patients underwent an IL RAMIE at our hospital. 21 patients of these (13.4%) developed an ECCG type II AL. One patient died of unrelated Covid-19 pneumonia and was excluded from the study cohort. The mean duration of EVT was 12 days (range 4-28 days), with a mean of two sponge changes (range 0-5 changes). AL was diagnosed at a mean of 8 days post-surgery (range 2-16 days). Closure of the AL with EVT was successful in 15 out of 20 patients (75%). Placement of a SEMS (Self-expandlable metallic stent) after EVT was performed in four patients due to persisting AL. Overall success rate of anastomotic sealing independently of the treatment modality was achieved in 19 out of 20 Patients (95%). No severe EVT-related adverse events occurred. CONCLUSION: This study shows that EVT can be a safe and effective endoscopic treatment option for ECCG type II AL.

5.
Cureus ; 14(9): e28830, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2100363

ABSTRACT

Studies show a low progression rate of prediabetes to Type 2 diabetes mellitus (DM) that we commonly seek to reverse, but we don't associate prediabetes as a lead-up to the first presentation of ketosis. We present a prediabetic who, in less than a year, converted to GAD65 antibody-positive diabetes mellitus with a diabetic ketoacidosis presentation. A 69-year-old male presented with three weeks of fatigue, polyuria, polydipsia, abdominal pain, and weight loss. Vital signs and physical exam were normal except for abdominal tenderness and dry oral mucosa. Complete blood count (CBC) was normal; blood glucose was severely elevated with mild corrected hyponatremia; elevated anion gap metabolic acidosis with glucosuria and ketonuria. He received an insulin drip, normal saline, and potassium in the intensive care unit. His anion gap closed overnight and was switched to basal-bolus insulin. Hemoglobin A1c (HbA1c) came out to be higher than expected as compared to last year of low prediabetic value, decreased c-peptide levels, and positive anti-GAD65 antibody. His first abnormal HbA1c was 5.8% a year ago and no autoimmune marker was checked before. He was vaccinated with the messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccine a year ago with an mRNA vaccine booster two months earlier. He was not COVID-19 infected. We discharged him with a basal-bolus insulin regimen. Type I DM passes from autoimmunity-positive normoglycemia to dysglycemia to the symptomatic stage, typically progressing more rapidly in children than in older adults. A new Type I or dysglycemia in Type II DM is increasingly reported after COVID-19 vaccines/infection. Mechanisms could be cytokine-mediated beta-cell damage or autoimmunity after mRNA vaccines or as a part of autoimmune syndrome induced by vaccine adjuvants. This case reports the rapid progression of prediabetes to Type 1 rather than Type 2 DM and highlights the possibility of dysglycemia after COVID-19 vaccines and calls for measures to prevent or early management of these side effects.

6.
Int J Gen Med ; 15: 7995-8001, 2022.
Article in English | MEDLINE | ID: covidwho-2098942

ABSTRACT

Introduction: Influenza B viruses are less common than influenza A viruses in most seasons and cause relatively milder forms of infection that are less studied. We witnessed a dominance of influenza B in Shijiazhuang, China, in the 2021-2022 winter season. In this study, we comparatively investigated the severe and critical influenza B in pediatric patients. Methods: Children who were hospitalized from December 2021 to January 2022 and diagnosed with influenza B were included in this study. Those who tested positive for COVID-19 were excluded. Demographic data, clinical features, underlying medical conditions, laboratory testing results, and treatment outcomes were retrieved and analyzed retrospectively. Disease severity was classified as severe or critical according to Chinese expert consensus on diagnosis and treatment of influenza in children. Results: A significantly greater proportion of patients with critical influenza had extra-pulmonary complications and bacterial coinfections. Children with critical influenza B had substantially higher levels of procalcitonin and lactate dehydrogenase, a markedly higher neutrophil percentage and a significantly lower CD4+ lymphocyte percentage. Conclusion: Our findings suggest that, to effectively manage critical influenza B, therapeutic regimens should consist of organ-specific supportive care, antibiotic application if bacterial coinfection is present, and anti-inflammatory and immune-boosting treatments.

7.
J Cosmet Dermatol ; 2022 Oct 31.
Article in English | MEDLINE | ID: covidwho-2097822

ABSTRACT

BACKGROUND: The aim of our study was to identify and evaluate the complications related to hyaluronic acid during the COVID-19 pandemic. METHOD: Twelve dermatologists participated in this study. A cohort and a non-cohort follow-up were ensured. RESULTS: (1) Cohort follow-up: 1041 patients. 8% had a COVID-19 infection, 27% had received COVID-19 vaccination. 2% had immediate side effects (edema, erythema, bruising). 0.5% had delayed side effects (two inflammatory nodules, one nodule without inflammation, one edema). None of these side effects occurred in the context of infection or COVID-19 vaccinations. (2) Non-cohort follow-up: 7900 syringes used. Two early side effects (inflammatory edema) were reported, of which one occurred 15 days after vaccination. Two cases of delayed side effects such as inflammation on the injected area and inflammatory nodules occurred of which one was in the context of vaccination and one during COVID-19 infection. We estimate the frequency of complications possibly attributable to the disease or to the COVID vaccination to be 0.06% in our population. DISCUSSION: Complications of HA injections in the context of COVID-19 disease or vaccination appear to be very rare but the frequency could be underestimated because of the low rate of vaccination/infection in our population. Our study shows a very good tolerance of hyaluronic acid injections during the COVID-19 pandemic.

8.
Cureus ; 14(9): e29786, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2090855

ABSTRACT

Our knowledge about the clinical spectrum of COVID-19 has continued to evolve. The clinical features of the infection and vaccine are continuously updated. We present a case of bullous pemphigoid after receiving a second dose of the COVID-19 vaccine. This case highlights autoimmune skin findings seen in a patient after COVID-19 vaccination. A 70-year-old male presented with the chief complaint of blistering skin rash. He received his second dose of Pfizer COVID-19 vaccine two days before developing a painful pruritic maculopapular rash that started on his hands and extended proximally to his trunk. Physical exam was remarkable for tense bullae with negative Nikolsky sign. Biopsy and direct immunofluorescence lead to the diagnosis of bullous pemphigoid. The lesions improved significantly with steroids. Various cutaneous eruptions have been reported with Moderna and Pfizer COVID-19 vaccines, including the new onset of bullous pemphigoid. Based on our case, we suggest that bullous pemphigoid after COVID-19 vaccination is responsive to steroids and the prognosis is excellent. Understanding the clinical course and prognosis of bullous pemphigoid from the COVID-19 vaccine is of significant importance as we strive to keep our patients and communities safe. More data is needed to better guide recommendations, but so far looking at the example from our case, the benefits of COVID-19 vaccination seem to outweigh the risks. Therefore, patients should be advised to continue with future vaccinations.

9.
Vaccines (Basel) ; 10(11)2022 Oct 25.
Article in English | MEDLINE | ID: covidwho-2090378

ABSTRACT

With the promotion of mass COVID-19 vaccination in the elimination of the SARS-CoV-2 pandemic, new side effects, including ocular complications, are emerging. In this study, we report on a 62-year-old Chinese man who developed Vogt-Koyanagi-Harada (VKH) disease six days after his third dose of an inactivated COVID-19 vaccine, with a preceding severe headache and tinnitus. His medical history included tuberculosis 20 years prior and hypertension. Systemic prednisone was administered, resulting in completely relieved inflammation and improved visual acuity. Another three and a half months later, the visual acuity of his right eye slightly decreased due to complicated central serous chorioretinopathy (CSC) disease. By gradually replacing prednisone with cyclosporine within 2 months, the subretinal fluid was completely absorbed at the last visit. Steroid-related CSC during the treatment course of VKH disease after COVID-19 vaccination has never been reported before. By reviewing relative literature, we discuss the mechanism of CSC onset in our case and the potential therapeutic strategies. Complicated CSC may develop in the eyes with vaccine-related VKH after steroid treatment. Ophthalmologists should be aware of this condition, carefully distinguish complicated CSC with inflammation relapse, and adjust the medication in a timely manner.

10.
Korean J Radiol ; 21(5): 541-544, 2020 05.
Article in English | MEDLINE | ID: covidwho-2089767

ABSTRACT

The coronavirus disease 2019 (COVID-19) pneumonia is a recent outbreak in mainland China and has rapidly spread to multiple countries worldwide. Pulmonary parenchymal opacities are often observed during chest radiography. Currently, few cases have reported the complications of severe COVID-19 pneumonia. We report a case where serial follow-up chest computed tomography revealed progression of pulmonary lesions into confluent bilateral consolidation with lower lung predominance, thereby confirming COVID-19 pneumonia. Furthermore, complications such as mediastinal emphysema, giant bulla, and pneumothorax were also observed during the course of the disease.


Subject(s)
Coronavirus Infections/complications , Mediastinal Emphysema/etiology , Pneumonia, Viral/complications , Pneumothorax/etiology , Adult , Betacoronavirus , Blister , COVID-19 , COVID-19 Testing , China , Clinical Laboratory Techniques , Coronavirus , Coronavirus Infections/diagnosis , Coronavirus Infections/diagnostic imaging , Disease Progression , Humans , Lung/pathology , Male , Pandemics , Pneumonia, Viral/diagnostic imaging , SARS-CoV-2 , Tomography, X-Ray Computed
11.
Embase; 24.
Preprint in English | EMBASE | ID: ppcovidwho-346564

ABSTRACT

Introduction Some reports have suggested that as many as one-half of all hospital inpatients identified as COVID-19-positive during the Omicron BA.1 variant-driven wave were incidental cases admitted primarily for reasons other than their viral infections. To date, however, there are no prospective longitudinal studies of a representative panel of hospitals based on pre-established criteria for determining whether a patient was in fact admitted as a result of the disease. Materials and Methods To fill this gap, we developed a formula to estimate the fraction of incidental COVID-19 hospitalizations that relies upon measurable, population-based parameters. We applied our approach to a longitudinal panel of 164 counties throughout the United States, covering a 4-week interval ending in the first week of January 2022. Results Within this panel, we estimated that COVID-19 incidence was rising exponentially at a rate of 9.34% per day (95% CI, 8.93-9.87). Assuming that only one-quarter of all Omicron BA.1 infections had been reported by public authorities, we further estimated the aggregate prevalence of active SARS-CoV-2 infection during the first week of January to be 4.89%. During the same week, among 250 high-COVID-volume hospitals within our 164-county panel, an estimated 1 in 4 inpatients was COVID-positive. Based upon these estimates, we computed that 15.2% of such COVID-19-positive hospitalized patients were incidental infections. Across individual counties, the median fraction of incidental COVID-19 hospitalizations was 13.7%, with an interquartile range of 9.5 to 18.4%. Conclusion Incidental COVID-19 infections appear to have been a nontrivial fraction of all COVID-19positive hospitalized patients during the Omicron BA.1 wave. In the aggregate, however, the burden of patients admitted for complications of their viral infections was far greater. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-ND 4.0 International license.

12.
Embase; 26.
Preprint in English | EMBASE | ID: ppcovidwho-346543

ABSTRACT

While significant attention has been paid to the immunologic determinants of disease states associated with COVID-191,2, their contributions to post-acute sequelae of COVID-19 (PASC) remain less clear3-5. Due to the wide array of PASC presentations6, it is critical to understand if specific features of the disease are associated with discrete immune processes, and whether those processes may be therapeutically targeted. To this end, we performed wide immunologic and serological characterization of patients in the early recovery phase of COVID-19 across a breadth of symptomatic presentations. Using high-parameter proteomics screening and applied machine learning (ML), we identify clear signatures of immunologic activity between PASC patients and uncomplicated recovery, dominated by inflammatory cytokine signaling, neutrophil activity, and markers of cell death. Consistent with disease complexity, heterogeneity in plasma profiling reveals distinct PASC subsets with striking divergence in these ongoing inflammatory processes, here termed plasma quiescent (plaq) and inflammatory (infl) PASC. In addition to elevated inflammatory blood proteomics, inflPASC patients display positive clinical tests of acute inflammation including C-reactive protein and fibrinogen, increased B cell activity with extrafollicular involvement coupled with elevated targeting of viral nucleocapsid protein and clinical autoreactivity. Further, the unique plasma signatures of PASC patients allowed for the creation of refined models with high sensitivity and specificity for the positive identification of inflPASC with a streamlined assessment of 12 blood markers. Additionally, refined ML modeling highlights the unexpected significance of several markers of potential diagnostic or therapeutic use for PASC in general, including the peptide hormone, epiregulin. In all, this work identifies clear biological signatures of PASC with potential diagnostic and therapeutic potential and establishes clear disease subtypes that are both easily identifiable and highly relevant to ongoing efforts in both therapeutic targeting and epidemiological investigation of this highly complex disease. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. All rights reserved. No reuse allowed without permission.

13.
Consultant ; 62(10), 2022.
Article in English | EMBASE | ID: covidwho-2081427

ABSTRACT

This case report presents a patient with acute onset psychosis in the setting of a COVID-19 infection. Magnetic resonance imaging of the brain was ordered to evaluate for organic etiologies which revealed cytotoxic lesions of the corpus callosum. These lesions can be associated with infectious diseases which cause inflammation. She was treated with an antipsychotic and later also with an antiepileptic. This case demonstrates that COVID-19 can affect multiple systems. Neuropsychiatric symptoms are possible and neuroimaging may be helpful, especially if symptoms are acute in onset. Copyright © 2022 Cliggott Publishing Co.. All rights reserved.

15.
Eur J Radiol ; 152: 110341, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2076084

ABSTRACT

In the wake of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, a new epidemic of COVID associated mucormycosis (CAM) emerged in India. Early diagnosis and prompt treatment of this deadly disease are of paramount importance in improving patient survival. MRI is the cornerstone of diagnosis of early extrasinus disease, particularly intracranial complications which have traditionally been associated with a high mortality rate. In this review, we depict the sinonasal, perisinus, orbital and intracranial involvement in CAM. Special emphasis is laid on intracranial disease which is categorized into vascular, parenchymal, meningeal, bony involvement and perineural spread. Vascular complications are the most common form of intracranial involvement. Some unusual yet interesting imaging findings such as nerve abscesses involving the optic, trigeminal and mandibular nerves and long segment vasculitis of the internal carotid artery extending till its cervical segment are also illustrated. In our experience, patient outcome in CAM (survival rate of 88.5%) was better compared to the pre-pandemic era. Presence of intracranial disease also did not affect prognosis as poorly as traditionally expected (survival rate of 82.8%). Involvement of brain parenchyma was the only subset of intracranial involvement that was associated with higher mortality (p value 0.016). The aim of this review is to familiarise the reader with the MR imaging spectrum of CAM with special focus on intracranial complications and a brief account of their impact on patient prognosis in our experience.


Subject(s)
COVID-19 , Mucormycosis , Orbital Diseases , Humans , Magnetic Resonance Imaging , Mucormycosis/complications , Mucormycosis/diagnostic imaging , Orbital Diseases/diagnostic imaging , Prognosis , SARS-CoV-2
16.
Front Biosci (Landmark Ed) ; 27(9): 257, 2022 09 06.
Article in English | MEDLINE | ID: covidwho-2067595

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of Coronavirus disease 2019 (COVID-19), which was announced as a pandemic leading to devastating economic and medical burden worldwide. The virus attacks the organ system across the body by binding to its receptor (for example, angiotensin converting enzyme 2) on the surface of the host cell of various organs. The patients present with a variety of pathological symptoms ranging from fever, cough and cytokine storm to acute respiratory distress syndrome (ARDS). Many combination therapies have been developed to combat the disease, via blocking one or more processes of the viral life cycle and/or relieving host complications simultaneously. In this review, the progress of those combination therapies containing at least one small molecule is updated. We believe it'll provide significant inspiration for further development of treatment strategy against SARS-CoV-2, especially its mutant variants.


Subject(s)
COVID-19 , Angiotensin-Converting Enzyme 2 , Antiviral Agents/therapeutic use , Humans , Pandemics , SARS-CoV-2
17.
Exp Ther Med ; 24(5): 693, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2066710

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic is a significant global concern that has had major implications for the healthcare system. Patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) undergoing elective or emergency surgical procedures have a substantial risk of mortality and peri-operative complications. The present study aimed to describe the characteristics of patients who underwent elective surgery and developed nosocomial SARS-CoV-2 infection post-surgery. Patients who underwent thoracic, upper and lower abdominal or peripheral elective surgery with a polymerase chain reaction diagnosis of COVID-19, at 3-7 days after the surgery, were enrolled in the present retrospective study. Demographics, vaccination status against SARS-CoV-2, Charlson comorbidity index (CCI) and laboratory data were recorded upon admission to the hospital unit. In total, 116 subjects (80 males, 36 females; mean age, 67.31±16.83 years) fulfilling the inclusion criteria were identified. Among the 116 participants, 14 (12.1%) were intubated. From the 116 individuals analyzed, 84 were alive after 30 days (survivors), and 32 had succumbed to the disease (non-survivors). The mortality rate was 27.6% (32/116). The non-survivors had an older age and a higher CCI score. At the evaluation upon admission to the hospital unit, the survivors presented with higher serum albumin levels and a higher number of blood lymphocytes. In addition, the survivors exhibited lower levels of lactate dehydrogenase, aspartate aminotransferase, alkaline phosphatase (ALP) and C-reactive protein (CRP), as well as a higher neutrophil to lymphocyte ratio (NLR) and CRP to albumin ratio (CAR) (P<0.05). The patients that were intubated had higher levels of gamma glutamyl-transferase (GGT), ALP and ferritin, as well as a higher NLR and platelet to lymphocyte ratio upon admission to the hospital unit (P<0.05). According to the Cox proportional hazards multivariate regression analysis, the only independent predictors of mortality and intubation were ALP and GGT upon admission, respectively (P<0.05). On the whole, the findings of the present study suggest that more stringent guidelines are required in order to prevent infection during the post-operative period.

18.
New Armenian Medical Journal ; 16(2):33-37, 2022.
Article in English | EMBASE | ID: covidwho-2067788

ABSTRACT

COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is re-sponsible for the recent global pandemic, with increasing number of cases reported globally. Our understanding of this novel respiratory virus deepens, it is increasingly clear that its effects extend beyond that of the respiratory system and can be extended to the almost all organ systems. SARS-CoV-2 causes lung inflammation which progresses to cytokine storm in the most severe cases. The lungs of patients with COVID-19 show extensive alveolar and interstitial inflammation. COVID-19 causes a spectrum of complications, with frequent involvement of the hemostatic system and there is a high incidence of venous thromboembolism in hospitalized COVID-19 patients, particularly those with severe illness. There is evidence of current body knowledge that COVID-19 induced by microvascular angiopathy can lead to a wide range of tissue pathology and clinical complications, such as Kawasaki disease, Buerger's syndrome and other systemic inflammatory disorders. Thromboangiitis obliterans (TAO) or Buerger's disease is a segmental occlusive inflammatory condition of arteries and veins, characterized by thrombosis and recana-lization of the affected vessels. Limb infection at diagnosis was associated with a 4-fold higher risk of amputation. Smoking cessation was strongly associated with a lower rate of vascular events and amputation. TAO appears more likely to be a systemic disorder rather than a localized vasculopathy. Therefore, treatment protocols based on systemic treatment of TAO patients may be more helpful than localized treatment, such as bypass surgery and endovascular procedures. We present a case of a 53-years-old male with positive SARS-CoV-2 PCR test. Furter exami-nation showed that patient had pneumonia, moreover, based on the duplex scan results the diagnosis of thromboangiitis obliterans (TAO) or Buerger's disease was confirmed. This disease itself is associated with a high risk of thrombosis and alongside with COVID-19 can cause unpredict-able outcome. Patient underwent the day-round observation, received the appropriate treatment and was successfully discharged from the hospital on the day 11. Copyright © 2022, Yerevan State Medical University. All rights reserved.

19.
Pakistan Journal of Medical and Health Sciences ; 16(8):403-406, 2022.
Article in English | EMBASE | ID: covidwho-2067753

ABSTRACT

COVID-19 pandemic has affected millions of individuals globally over the last three years and is spreading continuously. In view of different studies and clinical findings, patients suffering with COVID-19 frequently have deranged liver function tests (LFTs), but the clinical significance of this finding is debatable. Objective(s): The present study was aimed to estimate the prevalence, features, and clinical significance of deranged LFTs in COVID-19 infected individuals, who were hospitalized but were not critically ill. Method(s): We conducted a cross sectional from May 2021 to December 2021 at The Akbar Niazi Teaching Hospital Islamabd. A total of 250 COVID-19 patients were included in the current study. The patient's blood samples were collected to get laboratory results, which included LFTs. LFTs were performed at the time of admission and every 5 +/- 2 day throughout the stay. The outcome measure was either death or transfer of the patients to an intensive care unit. Result(s): At the time of admission, 160 patients (64%) showed deranged LFTs. Individuals with deranged LFTs experienced more severe inflammation, swelling, and organ damage than those who didn't. Patients with deranged LFTs had a greater proportion of transfer to the ICU (81 vs 17), hospital stay (17 vs 7 days), and death (17 vs 5) than those with normal LFTs. Conclusion(s): The results of the current investigation demonstrated that LFTs data might forecast the degree of illness in patients with COVID-19 infections at the time of admission and during their hospital stay. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

20.
Journal of the Medical Association of Thailand ; 105(9):915-923, 2022.
Article in English | EMBASE | ID: covidwho-2067677

ABSTRACT

The COVID-19 pandemic due to SARS-CoV-2 has proven to be a tremendous challenge to the medical community. The greatest challenge since the turn of the century. The authors summarized the main cardiovascular (CV) complications and mechanisms of COVID-19 and its vaccines. COVID-19 has lung tropism, but it has been reported to affect the CV system as well. The presence of comorbidities such as hypertension, CV disease, diabetes, and chronic obstructive pulmonary disease increased the risk of developing serious complications and in turn mortality significantly. The common CV complications include cardiac arrhythmia, myocardial infarction, myocarditis, and cardiac failure, which occurred in around 20% of all COVID-19 patients. The present difficulty in the diagnosis of CV complications were that COVID-19 symptoms often mimic CV events. Furthermore, the rapid diagnosis and management of serious CV events are sometimes overlooked due to COVID-19. Access to medical treatments were sometimes restricted due to the limited healthcare resources during the pandemic. The advent of various covid vaccines have reduced the number of these complications. However, CV events following mRNA vaccines or adenoviral vector vaccines are recognized as well as myocarditis and vaccine-induced immune thrombotic thrombocytopenia. With increasing experience in managing covid patients with CV complications, physicians are becoming better equipped in preventing, detecting, and treating these complications.

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