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1.
Journal of the Liaquat University of Medical and Health Sciences ; 21(1):70-74, 2022.
Article in English | EMBASE | ID: covidwho-1818980

ABSTRACT

OBJECTIVE: To understand the patient's knowledge and perception of the COVID-19 pandemic and associated preventative measures. METHODOLOGY: A cross-sectional research was carried out among dental patients visiting the Dow Dental College Karachi OPD from August to October 2020. The questionnaire was developed in compliance with the COVID-19 community recommendations of the CDC and WHO. The estimated number of dental patients attending the dental OPD each month is 3200;thus, using this as population size, the sample size computed was 344 by using open epi and retaining the power at 80%, the confidence interval at 95%, and the margin of error at 0.05 percent. RESULTS: In total, 344 patients took part in the research. Regarding the COVID-19 pandemic knowledge, most patients (317/344) thought that fever, fatigue, and dry cough were the most frequent symptoms linked with COVID-19. The majority of them believed that wearing a mask 314/344, i.e., 91.2%, and washing their hands 324/344, i.e.,94.1% properly, was required to reduce the effects of COVID-19. CONCLUSION: The findings revealed that most participants firmly understood COVID-19 as a pandemic. They demonstrated positive attitudes and excellent behaviors for avoiding disease infection transmission.

2.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816910

ABSTRACT

INTRODUCTION: COVID-19 has been declared as a pandemic by the World Health Organisation (WHO)in December 2019, as it spread globally and confirmed cases approach 5,000 000 patients and will exceed 365000 deaths on the 25 May 2020 across over 160 countries. Cancer patients are one of the most vulnerable groups in the current (COVID-19) pandemic. To date, the clinical characteristics of COVID-19-infected cancer patients remain widely not well understood. Patients and methods A retrospective study was conducted in Royal Wolverhampton NHS Trust for COVID-19 Cancer patients. Hospitalised cancer patients diagnosed with COVID-19 infection were identified between 30th March 2020 to 30th June 2020. Patients already have been diagnosed with cancer and had a laboratory-confirmed SARS-CoV-2 infection were enrolled. Clinical retrospective data were collected from hospital medical records, including demographic features, clinical features, laboratory findings, and chest radiograph and chest computed tomography (CT) images. Statistical analysis was done to assess the risk factors associated with severe events which required admission to an intensive care unit, the use of mechanical ventilation, or death Results Forty Cancer patients with Covid 19 infection during the period from 30th March 2020 to 30th June 2020 were enrolled. (52.6%) 22 of patients were females. Median age was 65 years .All patients were local residents of Wolverhampton. Among the cancer patients, Breast cancer was the most frequent type of cancer (n= 9;21.1%), followed by Gl cancers (n= 8;21%) and lymphoma (n = 6;15.8%).Twenty two patients (52.6%) were diagnosed with stage I-III cancer.18 patients (47.4%) were on active chemotherapy, 3 patients were on target therapy and 3 patients(7.9%) were on active immunotherapy. In addition to cancer, 31 (81.6%) patients had at least one or more coexisting chronic diseases. The most common clinical features on admission were fever (92.1%), dry cough (86.8%), and fatigue (92%);29 (76.3%) patients developed dyspnoea along with lymphopaenia (n = 32, 84.2%), high level C-reactive protein (n = 40, 100%), anaemia (n = 22, 57.9 %), and hypoproteinaemia (n = 21, 55.3%). The common chest computed tomography (CT) findings were ground-glass opacity (n = 13) and patchy consolidation (n= 4) .It is important to note that CT chest not done in 17 patients. A total of 19 patients had severe events and the mortality rate was (44.7%) .Median days of hospital admission was (12.5).It is noted that all patients with active immunotherapy had recovered despite disease progression. Conclusions: Cancer patients have deteriorating conditions and worse outcomes from the COVID-19 infection. It is recommended that cancer patients receiving antitumour therapies should have regular screening for COVID-19 infection and should avoid treatments causing immunosuppression or have dose reduction during COVID-19 Pandemic in second wave .Covid 19 has different response with patients on active immunotherapy need to be highlighted.

3.
Case Reports in Cardiology ; 2022, 2022.
Article in English | EMBASE | ID: covidwho-1816872

ABSTRACT

Background. Currently, the literature regarding the management of COVID-19 induced cardiomyopathy with reduced ejection fraction is limited. In this case report, we present the first documented case of COVID-19 induced myocardial stunning leading to severely reduced LV systolic function that was reversed by the administration of corticosteroids and tocilizumab. Case Summary. A 39-year-old female with well controlled systemic hypertension, tested positive for SARS-CoV-2 RNA and underwent self-isolation for 14 days. Patient presented to our facility a month later with one-week history of progressively worsening generalized body aches, chills, fever, watery diarrhea, nausea with associated mild dry nonproductive cough, shortness of breath and nonspecific chest pain. Initial labs demonstrated that she was COVID-19 positive, elevated troponin (4.295 ng/ml), and elevated BNP (2,291 pg/ml). Her initial Transthoracic echocardiography demonstrated an Left ventricular ejection fraction (LVEF) of 20-25% with apical akinesis. After administration of tocilizumab and corticosteroids, patient demonstrated interval improvement with LVEF improving to 50-55% within days. Her labs confirmed these findings with improved troponin (0.858 ng/ml) and BNP (209 pg/ml). Discussion. This case demonstrates that it can be safe and efficacious to use tocilizumab and corticosteroids in patients with COVID-19 induced cardiomyopathy. These finding suggest that cytokine storm is the predominant mechanism by which COVID-19 induced cardiomyopathy occurs. Additional studies are required to determine the role of corticosteroids and tocilizumab in management of this condition.

4.
Jundishapur Journal of Microbiology ; 15(1), 2022.
Article in English | EMBASE | ID: covidwho-1798772

ABSTRACT

Background: A novel Coronavirus first emerging in Wuhan, China, was named severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The disease caused by SARS-CoV-2 is known as Coronavirus disease 2019 (COVID-19). HIV-1 infected individuals may be at risk of COVID-19. Objectives: This cross-sectional study evaluated the SARS-CoV-2 infection rate and COVID-19 prevalence among Iranian HIV-1-infected people. Methods: The study was conducted on 155 HIV-1-infected patients from June 2020 to October 2020. COVID-19 Ab (IgG) was detected using an enzyme immunoassay in serum specimens. Furthermore, nasopharyngeal and oropharyngeal specimens were collected. Then, the genomic RNA of SARS-CoV-2 was detected using a real-time polymerase chain reaction (RT-PCR). Clinical symptoms of the studied participants with and without COVID-19 were examined. Results: Of 155 HIV-1-infected individuals, 12 (7.7%) had positive real-time PCR results for SARS-CoV-2. Out of 12 (7.7%) patients with COVID-19, four (33.3%) were males. Anti-COVID Ab (IgG) was detected in 10 (6.5%) participants, of whom eight (80.0%) were males. The most common COVID-19 clinical symptoms, including dry cough, fever, runny nose, anosmia, and hypogeusia, were observed in seven (58.3%), five (41.7%), five (41.7%), five (41.7%), and five (41.7%) patients with COVID-19, respectively. Conclusions: A recent study has shown that the risk of SARS-CoV-2 infection in HIV-infected individuals is similar to that in the general population.

5.
Avicenna Journal of Medical Biotechnology ; 14(2):104-113, 2022.
Article in English | EMBASE | ID: covidwho-1771952

ABSTRACT

Coronaviruses (CoVs) are a group of very diverse viruses that cause a broad spectrum of diseases from mild to severe enteric, respiratory, systemic diseases, and common cold or pneumonia among humans and animals. This virus is associated with Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), and lung disease that lead to Acute Respiratory Distress Syndrome (ARDS). In December 2019, researchers identified a novel coronavirus type, called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2), which was associated with symptoms of high fever, dry cough, headache, diarrhea, and reduction of White Blood Cells (WBC). Coronavirus-associated acute respiratory disease was named Coronavirus Disease 19 (COVID-19). No proven treatment has been discovered for COVID-19 so far, but researchers are trying to find the best effective way to treat this disease. Therefore, therapeutic strategies that facilitate the recovery of COVID-19 patients and reduce life-threatening complications are urgently needed now. Today, Mesenchymal Stem Cells (MSCs) and their secretion are utilized as one of the most applied tools to treat various diseases such as inflammation and cancer. MSC-derived vesicles are rich in various growth factors, cytokines, and interleukins that are produced and secreted under different physiological or pathological conditions. These vesicles were considered a suitable and effective tool in regeneration medicine because of their high power in repairing damaged tissues and modulating immune responses. Recently, evidence has shown MSC-derived vesicles through reduced expression of pro-inflammatory cyto-kines could improve damaged tissues in COVID-19 patients. In addition to MSCs and MSC-derived exosomes, Natural Killer (NK) cells, T cells, and platelet lysates were used against viral infection. In this review, we tried to provide an overview of MSC secretion and immune cells for COVID-19 therapy.

6.
Infectious Diseases in Clinical Practice ; 30(2), 2022.
Article in English | EMBASE | ID: covidwho-1769446

ABSTRACT

Curvularia species are dematiaceous filamentous fungi that can cause a variety of infections in both immunocompetent and immunocompromised hosts. We present 2 cases of severely immunosuppressed patients with acute invasive fungal sinusitis due to Curvularia species. Both patients had a history of hematologic malignancy with refractory disease and prolonged neutropenia. They presented with facial and sinus pain, which prompted maxillofacial computed tomography that showed acute sinusitis. Subsequently, they underwent nasal endoscopy with a biopsy that revealed a definitive diagnosis of invasive fungal sinusitis. Dematiaceous fungi are responsible for most fungal sinusitis cases, with Curvularia being one of the most common species isolated. Generally, invasive fungal rhinosinusitis may follow a relatively innocuous and nonspecific course. In addition, fungal infections may complicate chronic allergic sinusitis. Computed tomography scan is the first imaging modality of choice, and magnetic resonance imaging has a role in prognostication in acute invasive fungal rhinosinusitis. Endoscopic sinus surgery with biopsy yields a definitive diagnosis and is therapeutic. Management typically includes a combination of surgery and antifungal agents. Severe neutropenia is a significant risk factor for infection and is associated with poor outcomes. Aggressive surgical debridement, combined with antifungal therapy, should be emphasized in leukemic patients despite their prolonged neutropenia and bleeding tendency.

7.
Journal of Clinical and Diagnostic Research ; 16(2):OD7-OD9, 2022.
Article in English | EMBASE | ID: covidwho-1761187

ABSTRACT

Pseudomonas is an uncommon cause of community-acquired pneumonia in immunocompetent patients. It is an opportunistic pathogen resulting in serious infection in patients who are hospitalised, mechanically ventilated, or immunocompromised. A 47-year-old male, forest worker without any co-morbidities presented with a history of chronic cough, fever, and shortness of breath complicated with pseudohemoptysis for 45 days. This patient was admitted and treated as a lower respiratory tract infection. Work-up for tuberculosis, invasive fungal balls, was negative but sputum culture revealed Pseudomonas aeruginosa growth. This case report demonstrates a rare Pseudomonas infection which can also cause chronic indolent respiratory illness in immunocompetent.

8.
Journal of the Hong Kong College of Cardiology ; 28(2):72, 2020.
Article in English | EMBASE | ID: covidwho-1743557

ABSTRACT

Regarding the most critical health threat in 21st century, caused by the coronavirus, identifying its controlling methods and treatments is the first priority of the medical society. Up-to-date methods are required for identifying and controlling coronavirus, due to its raising pervalence and mutations. In this presentation, we discuss cardiac, pulmonary, and musculoskeletal side effects of coronavirus. While COVID-19 may affect multiple organ systems, symptoms are most often located in the respiratory tract. Approximately 80% of symptomatic patients present with mild disease: symptoms of fever, runny nose, sore throat or dry cough. Moderate to severe disease is characterized by pneumonia. Underlying CVD and/or development of acute cardiac injury are associated with significantly worse outcome in these patient, Information about other cardiovascular manifestations is very limited at patients with coronavirus disease 2019 (COVID-19) have underlying cardiovascular (CV) disease or develop acute cardiac injury during the course of the illness. Adequate understanding of the interplay between COVID-19 and CV disease is required for optimum management of these patients. COVID-19 is primarily a respiratory illness but cardiovascular involvement can occur through several mechanism Acute cardiac injury is the most reported cardiovascular abnormality in COVID-19, with average incidence 8-12%. Recently research about musculoskeletal disorders in COVID-19 represent, COVID-19 that has an affinity for neural tissue. There are reports of encephalitis, encephalopathy, cranial neuropathy, Guillain-Barrè syndrome, and myositis/rhabdomyolysis in patients with COVID-19. Moreover, Rehabilitation methods, especially exercise therapy, are discussed as supporting treatments for COVID-19. Considering cardiac side effects, like Myocarditis, and other pulmonary side effects, especially pneumonia, as well as identifying musculoskeletal side effects of COVID-19, including Neuropathy, have great importance. Furthermore, secondary side effects, caused by this disease due to deconditioning;results in a decrease in cardiac, respirational, and mobility performance of the patients after an acute period;however, by using an exact, scientific rehabilitation program, the recovery process can become shorter, and the patients can return to their normal lives cycles in a quicker way.

9.
Indian Journal of Medical Microbiology ; 39:S70, 2021.
Article in English | EMBASE | ID: covidwho-1734507

ABSTRACT

Background:The recent emergence of SARS CoV2 pandemic has posed formidable challenges for the clinical laboratories seeking diagnostic confirmation. The clinical and epidemiologic management of the SARS-CoV-2 pandemic is critically dependent on molecular assays with short turn-around time. To face the current COVID 19 pandemic, the need for the automated rapid diagnostic tool is essential. Early diagnosis with XPERT Xpress SARS -CoV2 can aid in therapeutic man- agement and outbreak control Methods:A retrospective study was performed on a total of 373 samples (nasopharyngeal, oropharyngeal, nasal or mid turbinate swabs/aspirate) from clinically suspected cases of SARS CoV 2 infection from March 30, 2020, to November 15, 2020, in the department of microbiology of our institute. The specimens were collected, placed in VTM and run on the Gene Xpert Dx according to manufacturer’s protocol. Results: Out of 373 samples tested 46 (12.3%) were positive, 319 (85.5%) were negative, 1 (0.26%) was presumptive positive and 7 (1.8%) samples were excluded due to Xpert error. Travel history was present in 79.2% of positive cases and 73.2% of the positive cases had flu-like symptoms (fever, dry cough, headache, myalgias, arthralgias and sore throat). The total tested patients had various emergency conditions: 109(29.2%) had RTA, 116(31.09%) had surgical emergencies, 64(17.1%) patients admitted with head injury and 84(22.5%) were delivery patients. Conclusions:Xpert Xpress SARS CoV2 is one step confirmatory test with a quick turnaround time and is ideal in cases of emergency conditions of patients. It can be utilized in multiple settings where actionable test results are needed to make informed treatment decisions quickly

10.
Journal of Investigative Medicine ; 70(2):519-520, 2022.
Article in English | EMBASE | ID: covidwho-1702425

ABSTRACT

Purpose of The Study Awareness of Covid-19 virus infection can precipitate decompensation of chronic diseases such as type 2 diabetes Mellitus. Euglycemic diabetic ketoacidosis (eu- DKA) has been seen in patients using sodium-glucose co-transporter 2 inhibitor (SGLT2i) and with COVID-19 infection. Methodology Authors identified the case while providing clinical care of a 61-year-old man with medical history of Diabetes Mellitus Type II using SGLT2i and hypertension presented to the Emergency Room with chief complaint of fever, chills, dry cough, watery diarrhea and general malaise 5 days prior arrival to the hospital. Summary of Results A 61-year-old man Puerto Rican male with medical history of Diabetes Mellitus Type II using sodium-glucose co-transporter 2 inhibitor (SGLT2i), and hypertension, already vaccinated against COVID-19, who presented to the Emergency Room with chief complaint of fever, chills, dry cough, watery diarrhea and general malaise 5 days prior arrival to the hospital after returning from a recent family trip to Florida. Home medications include Empagliflozin. Patient referred he had a recent travel to Florida (United States) and was in contact with a family member infected with COVID-19 infection. Physical examination was remarkable for dry oral mucosa and laboratories showed a metabolic acidosis with a high anion gap of 20 mEq/L with a marked increase in plasma b-hydroxybutyrate of 57.8 mg/dL and a central glucose <300 g/dL. Patient tested positive for COVID- 19 infection. Chest X-ray showed bilateral scattered peripheral hazy groundglass opacities. Considering mentioned findings patient placed on airborne isolation precautions and was admitted to Medical Intensive Care Unit where he was started on DKA protocol with continuous intravenous regular, D5W and aggressive hydration. Medical therapy also included Remdesivir and Dexamethasone. Patient improved after 2 days with resolved eu-DKA. Patient transferred to Internal Medicine Ward. Conclusion Eu-DKA has been seen in patients using SGLT2i and with COVID-19 infection;several cases described in literature are suggestive of a specific association between these factors. Our case also highlights the importance of early recognition and management of euglycemic DKA in patients using SGLT2i infected with COVID-19, both increase the risk of dehydration. Physicians must be aware and identify this patients earlier in outpatient setting and be more aggressive in hydration, maintaining euvolemic status to avoid admission to Intensive Care Unit.

11.
Critical Care Medicine ; 50(1 SUPPL):570, 2022.
Article in English | EMBASE | ID: covidwho-1691819

ABSTRACT

INTRODUCTION: Osimertinib is a molecular targeted antineoplastic tyrosine kinase inhibitor that is primarily used in the treatment of non-small cell lung cancer (NSCLC). It has been associated with the development of interstitial lung disease/pneumonitis that requires discontinuation of the drug and occurs usually within the first 2-3 months of therapy. Approximately 3% of patients treated with osimertinib will experience lung toxicity. Acute fibrinous and organizing pneumonia (AFOP) is a rare form of interstitial pneumonitis that has been associated with drug toxicity but to our knowledge has not yet been described in association with osimertinib. Here we present one such case. DESCRIPTION: A 77 year old woman with a history of EGFR+ stage IIB adenocarcinoma presented with two weeks of shortness of breath, fevers, and dry cough. She had been started on osimertinib two months prior to presentation. On admission she was noted to be hypoxic with new oxygen requirement of 4L nasal cannula. CT chest showed bilateral ground glass opacities. She was started on empiric vancomycin and zosyn without improvement in symptoms. She underwent bronchoscopy on hospital day 3 with lung biopsy pathology showing AFOP. Infectious workup including bronchoalveolar lavage, blood, and sputum cultures, as well as respiratory viral panel and COVID-19 test was negative. Transthoracic echocardiogram showed normal cardiac function with an ejection fraction of 64%. Given these findings she was started on methylprednisolone 1 mg/kg for TKI-induced pneumonitis on day 5. Her oxygen requirements increased during hospitalization and on day 7 she acutely desaturated and was intubated. Repeat chest CT was negative for pulmonary embolism but showed interval worsening of infiltrates and consolidation at lung bases. Her methylprednisolone was increased to 2 mg/kg on day 10. Her pulmonary function improved and she was extubated to nasal cannula on day 12. DISCUSSION: Molecular targeted antineoplastic agents have been associated with lung toxicity, which can be severe and even fatal. To our knowledge this is the first known case of osimertinib-induced AFOP, which improved with discontinuation of the drug and initiation of high-dose methylprednisolone.

12.
Safety and Health at Work ; 13:S121, 2022.
Article in English | EMBASE | ID: covidwho-1677009

ABSTRACT

Background: Long COVID is defined as the persistence of symptoms beyond 1 to 3 months after SARS-CoV-2 infection. To better understand the long-term course and etiology of symptoms we analysed data of COVID-19 patients post discharge prospectively. Methods: A home care cell monitored COVID-19 patients post discharge. A paramedical staff interviewed the patient using the pretested questionnaire and refer the patient to doctor if required. The doctor spoke with these select cases and offered them treatment, counselling, referral to consultant/ hospital as per the need. Results: We followed up with 4354 (2724 employees and 1630 dependents) patients for 3 months. 592 (13%) patients were hospitalized for COVID and others were under home isolation. 4108 (94%) patients did not have any symptoms post COVID and 239 (6%) were known to have either one or more post COVID symptoms. For 153 (64%) patients symptoms lasted for more than a month post discharge and 86 (36%) patients were symptomatic for more than 2 months post discharge. The most common symptoms identified were fatigue and weakness (69%), dry cough (39%) body ache (31%), fever (23%) shortness of breath (15%) etc. Interpretation: Long COVID symptoms can persist for 1- 3months after recovery, this may lead to long absenteeism and may reduce productivity and quality of life significantly. Post COVID syndrome can also have an adverse effect on the mental health of an individual. Post COVID complications can be severe leading to hospitalization and disability. The continued assessment of patients with PCS is an important and effective step to reduce complications.

13.
International Journal of Pharmaceutical Research ; 14(1):12-17, 2022.
Article in English | EMBASE | ID: covidwho-1668051

ABSTRACT

Introduction: The infection caused by COVID-19 ranges from mild to moderate infection, but it can also cause severe infection and death in some people mostly in people who are old, or immunocompromisedSARS-CoV-2 has shown evidence of having higher capacity of binding to human cells and can settle in upper and lower portion of the respiratory tract it being the two important hotspots. Symptoms localized to the upper respiratory tract are mild which usually includes anosmia/hyposmia, ageusia/ dysgeusia, rhinitis along with sore throat. Material and methods: This study included individuals who were diagnosed with COVID-19 having mild symptoms of the disease which could be managed at their homes.Random assignment (50/50 chance) of subjects was done into two groups (A and B) for this study. Participants in group A were asked to perform the nasal washing and gargling with salt water up to 10 times a day for 14 days or until they felt better.Results:The leading cause for hospitalization for 15 (53.57%) people was that the oxygen saturation fell to below 93. Some scores compared between the two groups showed significant results in parameters of headache, postnasal drip, anosmia, sinusitis, sore throat, body ache, dry cough by unpaired two tailed P test. The age groups of 26 to 35, and 56 to 65 had comparatively higher values of adherence as compared to different age groups.Conclusion:The study demonstrates the hypothesis that nasal irrigation and saline gargling can have promising results to reduce the severity of COVID-19 infection when initiated within 24 hours of a positive test.

14.
Egyptian Journal of Chest Diseases and Tuberculosis ; 71(1):88-96, 2022.
Article in English | EMBASE | ID: covidwho-1667462

ABSTRACT

Background Detection of the viral nucleic acid is the cornerstone to diagnose the novel coronavirus disease 2019 (COVID-19). Due to the limited resources, the clinical and laboratory biomarkers will help in the early and differential diagnosis of severe acute respiratory syndrome coronavirus 2 infection and predict the prognosis of the disease. These findings in patients with pneumonia include fatigue, dry cough, low-grade fever, along with normal white blood cell count, decreased lymphocyte count, and high C-reactive protein (CRP) and D-dimer levels. Chest computed tomography (CT) severity score relies on the opacification of lungs as a proof for disease extension. Several studies have settled the importance of CT chest in the diagnosis and follow up of COVID-19 patients. Otherwise, many scientific societies have disclaimed the routine CT screening of these patients. Hence, it is important to correlate the CT severity score in positive PCR COVID-19 patients to their laboratory findings to minimize the need of frequent CT chest as a tool of follow-up. Patients and methods The study included 198 positive PCR for COVID-19 health-care workers including physicians, nurses, employees, and workers of Ain Shams University Hospitals, who sought medical advice at the Chest OPC or the ER triage or through teleconsultations. Patients underwent history taking, laboratory workup including complete blood count with differential, serum ferritin, CRP, D-dimer levels, and high-resolution CT chest. Results The study included 198 health-care workers including physicians, nurses, employees, and workers of Ain Shams University Hospitals with 106 of them being females and 92 males. The age range of the included patients is from 21 years up to 85 years. The cases were classified according to their CT severity score into normal CT chest with 47.5% of cases, mild CT findings representing 21.2%, 34 patients with moderate findings in CT, and those with severe score were 28 patients. A significant relation was found between the age and CT severity score with P value less than 0.001. The severity score was higher in cases with lower total leukocyte count and lymphocytes with significant relation and the P value was less than 0.001. The median CRP and ferritin level show a highly significant relation with the CT severity score. A highly significant relationship was found between severity score and D-dimer level of patients with a P value of less than 0.001. Conclusion This work sets a semiquantitative framework to assess and follow up the severity of COVID-19 disease. This score could be possibly used to facilitate the clinical triage of COVID-19 moderate to severe patients, requiring admission in hospitals in relation to laboratory findings. Also, it could be used to evaluate the severity of lung involvement in patients objectively and quickly. However, it was proposed that the use of laboratory results is of value in the follow up of the cases to limit the exposure to radiations.

15.
Indian J Otolaryngol Head Neck Surg ; : 1-6, 2022 Jan 29.
Article in English | MEDLINE | ID: covidwho-1653771

ABSTRACT

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.

16.
Indian Journal of Hematology and Blood Transfusion ; 37(SUPPL 1):S108, 2021.
Article in English | EMBASE | ID: covidwho-1633567

ABSTRACT

Introduction: Drug induced leucopenia complicates any clinicalsituation especially when it's associated with COVID-19 infection.Here we report a case of vancomycin induced myeloid maturationarrest in a patient with COVID-19 infection where his conditionreverted to normal after stopping the drug.Aims &Objectives: It highlights the adverse effects of Vancomycinleading to promyelocyte proliferation posing a diagnostic challenge todifferentiate it from neoplastic promyelocyte proliferation.Materials &Methods: Case report: A 47 year old male presentedwith fever, dry cough and difficulty in breathing for 12 days. He wasCOVID-19 positive with CT lung showing bilateral pneumonic consolidations for which Vancomycin was started. Hemogram showedhemoglobin-6.8 gm/dl, total leucocyte count-3200/cumm with a differential count revealing: Neutrophil-28% (with left shift and featuresof dyspoiesis), Lymphocyte-66%, Monocyte-4%, Eosinophil-2%(Fig. 1a), and platelets-90,000/cumm. Bone marrow aspiration(BMA) and biopsy was advised. BMA was hypercellular for age withmarked promyelocyte proliferation &maturation arrest with strongMPO positivity (1b, c d). Bone marrow biopsy also reflected similarfindings (Fig-1e). FISH for PML-RARA translocation turned out to benegative, differentiating it from Acute promyeloytic Leukemia(Fig. 1f). A diagnosis of drug induced leucopenia with reactivepromyelocyte proliferation was made. Considering worsening of thesehematological findings, Vancomycin was stopped and patient'shematological findings improved drastically with stabilization ofhematological parameters.Result: Discussion: Drug induced leukopenia occurs in a dosedependent or dose-independent (idiosyncratic) reaction. Vancomycindependent antibodies against neutrophils lead to an autoimmunereaction directly affecting progenitor cell growth especially of myeloid cell lineage leading to maturation arrest. Secondly cytotoxicT-cell mediated response also has damaging effects on hematopoieticcells. Infections like COVID-19 can also lead to suppression ofnormal myeloid maturation due to release of interleukins.Conclusions: Myeloid maturation arrest with marked promyelocyteproliferation poses a diagnostic dilemma especially in patients presenting with cytopenia as they are confused with Acute promyelocytic Leukemia. This case highlights the importance of detailed knowledgerelated to drug induced myeloid maturation arrest which is reversibleafter stoppage of the offending drug.

17.
Cogent Medicine ; 8, 2021.
Article in English | EMBASE | ID: covidwho-1617059

ABSTRACT

Background: Coronavirus disease 19 (COVID-19) tends to be milder in children, but severe cases have been reported. We described a case report of a toddler admitted to our department with additional findings, highlighting the importance of assessing the patient as a whole. Case Presentation: A previously healthy, 15-month-year-old girl presented with fever and dry cough for 10 days, respiratory distress and PCR SARS-CoV-2 was positive. At admission, she presented with hypoxemia (SpO2 89-90% in room air), global retraction and bilateral bronchospasm. She was treated with bronchodilators, methylprednisolone, remdesivir and also amoxicillin/clavulanic acid. Her complete blood count revealed leucocytosis 16,160x109/L, 41% lymphocytes, C-reactive protein 57,9 mg/L, procalcitonin 0,13 ng/mL, sedimentation rate 44 mm/h, ferritin 218,4 ng/mL. Chest computed tomography (CT) scan revealed bilateral peripheral areas of ground glass, coexisting consolidation areas at inferior lobes but also revealed a 6 cm supra-renal mass. Abdominal ultrasound and CT confirmed an heterogeneous right supra-renal gland mass of 5,5cm along the greatest diameter with diffuse calcifications, evolving the inferior vena cava and the renal vascular pedicle, no signs of liver, bone, cutaneous or ganglionic metastization. These features were suggestive of neuroblastoma in stage L2. Vanillylmandelic acid, normetanephrine/creatinine ratio and metanephrine/creatinine ratio were elevated. The metaiodobenzylguanidine (Mibg) scan showed a localized disease. The total excision of the tumour mass was performed, and the histology confirmed neuroblastoma with no N-myc oncogene amplification, nor other bad prognosis chromosomal abnormalities. She is currently under oncological surveillance, with no signs of recurrence. Learning Points Discussion: Neuroblastoma is the most common extracranial solid tumour of childhood. It is known for its broad spectrum of clinical behaviour and outcome. In this case, although this toddler was admitted due to COVID-19 pneumonia, it allowed to identify a localized tumour, perform excision and due to the favourable biology tumour, she has a very good chances of being cured and free of disease.

18.
Mediterranean Journal of Infection, Microbes and Antimicrobials ; 10, 2021.
Article in English | EMBASE | ID: covidwho-1614127

ABSTRACT

The current outbreak of the Coronavirus, severe acute respiratory syndrome Coronavirus-2, which originated in the Wuhan province of the People's Republic of China became a pandemic. Although the clinical findings of the infection vary in adults, the most common symptoms are fever, dry cough, and shortness of breath. The diagnosis of the Coronavirus disease-2019 (COVID-19) is made by clinical symptoms, laboratory tests, and radiological methods. Many drugs such as antivirals, antibiotics, and corticosteroids are used in the treatment of COVID-19. For the successful control of the pandemic, prevention strategies are the key. There is strong consensus that, in addition to wearing masks, hand hygiene, and social distancing, an effective COVID-19 vaccine is probably the most effective approach to sustainably control the pandemic. In this article, current information about the pathogenesis, epidemiology, risk groups, diagnosis, treatment, prevention strategies, and vaccination of the disease in the first year of the COVID-19 pandemic are discussed.

19.
Atencion Familiar ; 29(1):9-14, 2021.
Article in Spanish | EMBASE | ID: covidwho-1599755

ABSTRACT

Objective: To describe the epidemiological and clinical characteristics at admission of patients hospitalized with Covid-19, in a General Hospital in Tabasco, Mexico. Methods: Cross-sectional analytic study conducted in the Medical Center of the Social Security of Tabasco State (isset) “md. Julián A. Manzur Ocaña”, in Tabasco, Mexico, from June 1st to July 3, 2020 in diagnostic modules with packages of suspected diagnostic or confirmed patients with sars-CoV-2. Results: It was obtained a sample of 140 positive cases of sars-CoV-2, the 51.42% corresponded to men. The main symptoms were dyspnea, dry cough and fever. It was observed a greater increase on inflammation and thrombotic factors in males. The treatment consisted of antipyretic, antiplatelet agents, antimicrobial and steroids. The supplementary oxygen requirement was similar in women and men, however, the oxygen saturation was higher in women. Conclusion: The rate of 140 positive cases of covid-19, with symptomatology property of the disease. With inflammatory and thrombotic parameters increase. The treatment was symptomatic with supplementary oxygen.

20.
Atencion Familiar ; 29(1):3-8, 2021.
Article in English | EMBASE | ID: covidwho-1591438

ABSTRACT

Objective: To describe the epidemiological and clinical characteristics at admission of patients hospitalized with Covid-19, in a General Hospital in Tabasco, Mexico. Methods: Cross-sectional analytic study conducted in the Medical Center of the Social Security of Tabasco State (isset) “md. Julián A. Manzur Ocaña”, in Tabasco, Mexico, from June 1st to July 3, 2020 in diagnostic modules with packages of suspected diagnostic or confirmed patients with sars-CoV-2. Results: It was obtained a sample of 140 positive cases of sars-CoV-2, the 51.42% corresponded to men. The main symptoms were dyspnea, dry cough and fever. It was observed a greater increase on inflammation and thrombotic factors in males. The treatment consisted of antipyretic, antiplatelet agents, antimicrobial and steroids. The supplementary oxygen requirement was similar in women and men, however, the oxygen saturation was higher in women. Conclusion: The rate of 140 positive cases of covid-19, with symptomatology property of the disease. With inflammatory and thrombotic parameters increase. The treatment was symptomatic with supplementary oxygen.

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