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1.
Acta Haematologica Polonica ; 53(1):19-25, 2022.
Article in English | EMBASE | ID: covidwho-1822565

ABSTRACT

Hemophagocytic lymphohistiocytosis (HLH) is a condition of overexpressed inflammatory response resulting in hypercytokinemia, macrophages infiltration and subsequent multiple organ failure. Without treatment, it leads to death. The main etiological factors include: viral, bacterial and parasitic infections, malignancies and autoinflammatory diseases. The main clinical manifestations are: high fever ≥38°C, lymphadenopathy, splenomegaly, and hepatomegaly. Central nervous system involvement occurs in 30-70% of cases. Less common symptoms include: dyspnea, cough, arrhythmias, jaundice, peripheral edema, rashes, albinism and diarrhea. The picture of the disease seen in laboratory tests consists of: duopenia, hypofibrinogenemia (<150 mg/dL) high D-dimers level, and hyperferritinemia. Other abnormalities include hypertriglyceridemia, elevated liver enzymes, hyperbilirubinemia, hypoalbuminemia and hyponatremia. Diagnostics include: laboratory tests, histopathological examination, lumbar puncture, radiological imaging, functional test and genetic checking. It is important to rule out factors mimicking HLH. Some of the old, well-known criteria are of less relevance nowadays. The aim of the therapy is immunosuppressive, immunomodulatory and anti-cytokine treatment, using the HLH-2004 protocol. In secondary HLH, elimination of the causative agent is critical. In primary HLH, or relapse of secondary forms, allogeneic transplantation is the only curative treatment. The prognosis is uncertain.

2.
Vaccines ; 10(4), 2022.
Article in English | EMBASE | ID: covidwho-1822468

ABSTRACT

A unique case of multiple metastatic melanoma skin nodules regression in a heavily pretreated, 72-year-old Caucasian female, after administering the second dose of the SARS-CoV-2 mRNA Pfizer-BioNTech vaccine, is presented. Two days after vaccination, all her melanoma skin nodules became painful and were significantly reduced in size. Physical examination and ultrasound imaging confirmed the patient’s observation. The effect was sustained, and further reduction of the nodules occurred after the third vaccine dose. One of the reduced nodules was removed, histologically examined, and its histopathology was compared to that of another such nodule removed and examined earlier. Distinct differences were observed between the two histopathologies, with the most notable the unexpected finding of the absence of infiltrating lymphocytes in the reducer nodule’s melanoma tissue. Based on this observation, the possible immunological mechanism(s) leading to the vaccine’s effect are speculated. More possible is the vaccine’s antitumor and apoptotic activity via stimulation of the Tol Like Receptors 3, 7, and 8, and (downstream) the nuclear factor kappa-light-chain-enhancer of the activated B cells pathway of the non-lymphocytic immune effector cells.

3.
Frontiers in Pediatrics ; 10, 2022.
Article in English | EMBASE | ID: covidwho-1822391

ABSTRACT

Acute interstitial nephritis (AIN) has been recently recognized as one of the infrequent kidney involvement phenotypes among adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Although SARS-CoV-2 associated intrinsic kidney disease has been scarcely reported in children, only one case of AIN temporally associated with the infection has been described in the pediatric population so far. We presented a case of a 12-year old boy who presented with fatigue, anorexia, and polydipsia following an RT-PCR that confirmed SARS-CoV-2 infection seven weeks prior to admission. Initial workup revealed increased serum creatinine (235 μmol/L), glucosuria, low-molecular-weight proteinuria, mild leukocyturia, and microhematuria with hyaline and granular casts on microscopy. Antibodies against the SARS-CoV-2 S protein receptor-binding domain confirmed prior infection with high titers. Kidney biopsy showed diffuse active interstitial nephritis with negative immunofluorescence and positive immunohistochemistry for SARS-CoV-2 in the inflammatory cells within the interstitium. Electron microscopy revealed several SARS-CoV-2-like particles. Kidney function continued to deteriorate despite several days of supportive therapy only (peak serum creatinine 272 μmol/L);thus, treatment with methylprednisolone pulse-dose therapy was initiated and was followed by oral prednisolone with gradual tapering. Kidney function completely recovered after 3 weeks post-discharge and remained normal after 11 weeks of follow-up (last estimated glomerular filtration rate 106 ml/min/1.73 m2) with only residual microhematuria. Our case adds to the emerging evidence of SARS-CoV-2 as a potential etiological agent of AIN in children and also suggests that interstitial kidney injury may result from secondary inflammatory damage. Epidemiological history, serologic testing, and SARS-CoV-2 detection in biopsy should be considered in the work-up of children with AIN of unknown etiology.

4.
Chinese Medicine (United Kingdom) ; 17(1), 2022.
Article in English | EMBASE | ID: covidwho-1822198

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) causes a global pandemic and has devastating effects around the world, however, there are no specific antiviral drugs and vaccines for the constant mutation of SARS-CoV-2. Purpose: In this study, we evaluted the antiviral and anti-inflammatory activities of Liushen Capsules (LS) on different novel coronavirus in vitro, studied its therapeutic effects on novel SARS-CoV-2 infected mice and observed the LS’s clinical efficacy and safety in COVID-19. Methods: The antiviral and aiti-inflammatory effects of LS on the 501Y.V2/B.1.35 and G/478K.V1/ B.1.617.2 strains were determined in vitro. A hACE2 mouse model of novel SARS-CoV-2 pneumonia was established. Survival rates, histological changes, inflammatory markers, lung virus titers and the expression of the key proteins in the NF-κB/MAPK signaling pathway was detected by western blotting and immumohistochemical staining in the lungs were measured. Subsequently, the disease duration, prognosis of disease, time of negative nucleic acid and the cytokines levels in serum were used to assess the efficacy of treatment with LS in patients. Results: The results showed that LS (2, 1, 0.5 μg/mL) could significantly inhibit the replication of the two SARS-CoV-2 variants and the expression of pro-inflammatory cytokines (IL-6, IL-8, IP-10, CCL-5, MIP-1α, IL-1α) induced by the virus in vitro. As for the survival experiment in mice, the survival rate of virus group was 20%, while LS-treatment groups (40, 80, 160 mg/kg) could increase the survival rate to 60, 100 and 100%, respectively. LS (40, 80, 160 mg/kg) could significantly decrease the lung titers in mice and it could improve the pathological changes, inhibit the excessive inflammatory mediators (IFN-α, IFN-γ, IP-10, MCP-1) and the protein expression of p-NF-κB p65 in mice. Moreover, LS could significantly decrease SARS-CoV-2-induced activation of p-NF-κB p65, p-IκBα, and p-p38 MAPK and increase the protein expression of the IκBα. In addition, the patient got complete relief of symptoms after being treated with LS for 6 days and was proven with negative PCR test after being treated for 23 days. Finally, treatment with LS could reduce the release of inflammatory cytokines (IL-6, PDGF-AA/BB, Eotaxin, MCP-1, MIP-1α, MIP-1β, GRO, CCL-5, MCP-3, IP-10, IL-1α). Conclusion: LS effectively alleviated novel SARS-CoV-2 or variants induced pneumonia in vitro and in vivo, and improved the prognosis of COVID-19. In light of the efficacy and safety profiles, LS could be considered for the treatment of COVID-19 with a broad-spectrum antiviral and anti-inflammatory agent.

5.
British Journal of Haematology ; 197(2):171-187, 2022.
Article in English | EMBASE | ID: covidwho-1822046

ABSTRACT

Scope: The objective of this guideline is to provide healthcare professionals with clear guidance on the management of patients with Waldenström macroglobulinaemia. In individual patients, circumstances may dictate an alternative approach. Methodology: This guideline was compiled according to the British Society for Haematology (BSH) process at http://www.b-s-h.org.uk/guidelines/proposing-and-writing-a-new-bsh-guideline/. Recommendations are based on a review of the literature using Medline, Pubmed, Embase, Central, Web of Science searches from beginning of 2013 (since the publication of the previous guidelines) up to November 2021. The following search terms were used: Waldenström(’s) macroglobulin(a)emia OR lymphoplasmacytic lymphoma, IgM(-related) neuropathy OR cold h(a)emagglutinin disease OR cold agglutinin disease OR cryoglobulin(a)emia AND (for group a only) cytogenetic OR molecular OR mutation OR MYD88 OR CXCR4, management OR treatment OR transfusion OR supportive care OR plasma exchange OR plasmapheresis OR chemotherapy OR bendamustine OR bortezomib OR ibrutinib OR fludarabine OR dexamethasone OR cyclophosphamide OR rituximab OR everolimus, bone marrow transplantation OR stem cell transplantation. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature was used to evaluate levels of evidence and to assess the strength of recommendations. The GRADE criteria can be found at http://www.gradeworkinggroup.org. Review of the manuscript was performed by the British Society for Haematology (BSH) Guidelines Committee Haemato-Oncology Task Force, the BSH Guidelines Committee and the Haemato-Oncology sounding board of BSH. It was also on the members section of the BSH website for comment. It has also been reviewed by UK Charity WMUK;these organisations do not necessarily approve or endorse the contents.

6.
Current Tropical Medicine Reports ; 9(1), 2022.
Article in English | EMBASE | ID: covidwho-1821070

ABSTRACT

Purpose of Review: Cryptococcosis of the central nervous system due to Cryptococcus gattii species complex is a serious mycosis with worldwide distribution but of great importance in the tropics. This article aims to review the progress made in these regions in the knowledge of this disease and its etiological agent. Recent Findings: They can be summarized in the presence in apparently immunocompetent patients of autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF), which is a hidden risk factor for acquiring C. gattii infection;this finding strengthens the concept that C. gattii is an opportunistic pathogen. A greater knowledge of the clinical and molecular epidemiology of C. gattii infection and of the different environmental niches of this fungus in the tropics. The discovery of a new lineage of C. gattii, VGV, in environmental samples from Africa. Until now, the COVID-19 pandemic has not meant an increase in cryptococcosis cases. Summary: Advances have been made in the identification of risk factors for cryptococcosis due to C. gattii as well as in the knowledge of its etiological agent and its relationship with the environment. Remarkably, there have been no significant achievements in diagnosis and treatment notwithstanding the documented importance.

7.
Profilakticheskaya Meditsina ; 24(12):79-83, 2021.
Article in Russian | EMBASE | ID: covidwho-1818838

ABSTRACT

The article describes a clinical case of death of a 57-year-old patient from idiopathic AL-amyloidosis after infection with SARS-CoV-2. Histological examination revealed signs of pneumonia with symptoms of pneumosclerosis, histologically determined di-apedesic hemorrhages, necrosis and desquamation of the alveolar epithelium, along the contours of the alveolar passages, al-veolar sacs — hyaline membranes. In many areas, the histoarchitectonics of the pulmonary parenchyma was sharply disturbed, connective tissue was determined in the alveolar passages, in the lumens of the alveoli. The interalveolar septa were thickened due to the proliferation of connective tissue. Positive Congo red staining was visualized mainly in the perivascular and interalveo-lar septa, along the vessels;in the heart — between cardiomyocytes, in the kidneys — in the capillary loops of the glomeruli, base-ment membranes of individual tubules of the cortical layer, in the walls of blood vessels. Thus, the cause of death of the patient was the severe course of infection with SARS-CoV-2;the presence of a concomitant disease in the form of idiopathic AL-amyloi-dosis of internal organs and chronic diseases, obviously, aggravated the patient’s condition and contributed to the onset of death.

8.
Journal of Gastrointestinal and Liver Diseases ; 31(1):9, 2022.
Article in English | EMBASE | ID: covidwho-1818804
9.
Vaccines ; 10(3), 2022.
Article in English | EMBASE | ID: covidwho-1818229

ABSTRACT

Introduction: Onset of oral lichenoid lesions (OLL) or oral lichen planus (OLP) can be rare adverse reactions to vaccines. Recently, the first solitary cases were reported after COVID-19 vaccination. The aim of the present study was to assess if an increased frequency of OLL/OLP can be found after COVID-19 vaccination within a large real-world cohort. It was assumed that the incidence of OLL/OLP was significantly higher in subjects who received COVID-19 vaccine (cohort I) compared to individuals who were not vaccinated (cohort II). Patients and Methods: Initial cohorts of 274,481 vaccinated and 9,429,892 not vaccinated patients were retrieved from the TriNetX database (TriNetX, Cambridge, Massachusetts, USA), and matched for age, gender and the frequency of use of non-steroidal anti-inflammatory drugs, beta blockers, and angiotensin-converting enzyme inhibitors. Results: After matching each cohort, we accounted for 217,863 patients. Among cohort I, 146 individuals had developed OLL/OLP within 6 days after COVID-19 vaccination (88 and 58 subjects had received mRNA-and adenovirus vector-based vaccines), whereas in cohort II, 59 patients were newly diagnosed with OLL/OLP within 6 days after having visited the clinic for any other reason. The risk of developing OLL/OLP was calculated as 0.067% vs. 0.027%, for cohorts I and II, whereby the risk difference was highly significant (p < 0.001;log-rank test). RR and OR were 2.475 (95% CI = 1.829;3.348) and 2.476 (95% CI = 1.830;3.350), respectively. Discussion: The hypothesis was confirmed. Accordingly, the obtained results suggest that the onset of OLL/OLP is a rare adverse drug reaction to COVID-19 vaccines, especially to mRNA vaccines. Thus far, it remains unknown if specific components of the formulations cause a type IV hypersensitive reaction corresponding to OLL, or if the immune response post vaccination triggers a T cell-driven autoimmune reaction directed against the basal layer of keratinocytes of the oral mucosa in terms of OLP. Although OLL and OLP are both classified as premalignant lesions, spontaneous remission may be expected over time, at least in the case of OLL. Therefore, the presented findings should not place any limitation toward the use of COVID-19-vaccines in broad levels of the population.

10.
Gastroenterology Insights ; 13(1):77, 2022.
Article in English | ProQuest Central | ID: covidwho-1818066

ABSTRACT

(1) Background: Currently available guidelines require upper gastrointestinal (GI) endoscopy with biopsy sampling for adult celiac disease (CD) diagnosis. Based on the pediatric experience, there has been a growing interest if serology-based diagnosis would be possible for adult CD also. Our aim was to analyze the associated upper GI tract lesions in newly diagnosed CD patients, to see if significant associated pathology is detected during index endoscopy, which might impact patient management not related to CD. (2) Methods: We performed a retrospective analysis of newly diagnosed CD cases diagnosed over a period of 7 years (2014–2020). Demographic, clinical, laboratory, endoscopy and histopathology data were collected from the patients’ charts. Diagnosis was set according to ACG Guideline 2013. (3) Results: Altogether 79 patients were recruited for this study purpose, 75.9% female, median age 39 years. All patients had positive CD-specific serology and atrophic mucosal injury in duodenal biopsy samples. Besides villous atrophy, associated endoscopic findings were detected in 42/79 (53.16%) of patients. Most of the gastric lesions were minor endoscopic findings—small sliding hiatal hernias, non-specific chronic gastritis, but we also found two cases of peptic ulcers, one case of metaplastic gastritis, six cases of atrophic gastritis and one subepithelial lesion. Only one patient had changes in the duodenum except CD-related findings—an inflammatory polyp in the duodenal bulb. No malignancies were found. (4) Conclusions: In our cohort, there was a significant number of newly diagnosed CD patients who had associated lesions during the index upper GI endoscopy, but most of them were minor endoscopic findings.

11.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816939

ABSTRACT

Background: Previous reports indicate that lung cancer patients are at an increased risk of severe COVID-19 disease and higher mortality rate compared to general population. However, prognostic factors are not yet clearly identified. The LunG canceR pAtients coVid19 Disease (GRAVID) study aimed to describe clinical characteristics, outcomes and predictors of poor prognosis in patients with lung cancer and COVID-19. Methods: In this large nationwide prospective study, medical records of lung cancer patients with COVID-19 diagnosis from 65 spanish hospitals were included. Clinical features, treatments and disease outcomes were collected. The primary endpoint was to determine any-cause mortality;secondary endpoints were hospitalization and admission at intensive care units (ICU). Risk factors of poor prognosis were identified by univariable and multivariable logistic regression models. Results: Overal, 447 patients were analysed. Mean age was 67.1 ± 9.8 years, and the majority were men (332, 74.3%) and current/former smokers (383 (85.7%). NSCLC was the most frequent cancer type (377, 84.5%), being adenocarcinoma (228, 51.0%) the predominant histology. 354 patients (79.2%) had unresectable stage III or metastatic disease, and 266 (59.5%) where receiving anticancer treatment, mostly first-line chemotherapy. 350 (78.3%) patients were hospitalized for a mean of 13.4 ± 11.4 days, 9 (2.0%) patients were admitted to ICU, and 146 (32.7%) patients died. Advanced disease and corticosteroid treatment at hospitalization were predictors of mortality. Non-terminal stage hospitalized patients with lymphocytopenia and high LDH showed an increased risk of death. Severity of COVID-19 correlated to mortality, admission at ICU and mechanical ventilation. Conclusion: With underlying comorbidities and immunocompromised status, patients with lung cancer and COVID-19 present high hospitalization and mortality rates. These outcomes, alongside the identification of prognostic factors, may inform physicians on risks and benefits for this population to provide individualized oncological care.

12.
Wound Repair and Regeneration ; 30(2):A56-A57, 2022.
Article in English | EMBASE | ID: covidwho-1816664

ABSTRACT

Background: Antiviral and anti-inflammatory activity of a unique solution of Ag released from Acticoat was tested in standard lab and animal models. Clinical effects of nebulized inhalation of the Ag solution in ventilated patients with MDR bacterial pneumonia, TENS, and COVID-19 were assessed. Methods: Ag release kinetics was determined using integration of absorption spectra at 350-650 nm. Inactivation of hHSV1 and SARSCoV- 2 by the Ag solution, colloidal silver, or stable silver nanoparticles was assessed using the ASTM E1052-20 protocol for antiviral testing of agents in solution. Rat lungs infected for 24 hours with Pseudomonas aeruginosa were treated with lavage of silver solution, tobramycin, or water, and rat survival and lung histology were assessed at 48 hours. Anti-inflammatory activity of the Ag solution was assessed using a pig contact dermatitis model. Eight patients, six with burn wounds who developed MDR pneumonia, one with burns who developed COVID-19, and one with TENS, all of whom were placed on ventilators, were treated with nebulized inhalation of the Ag solution and clinical parameters were measured. Results: Silver species (Ag0, Ag+, Ag3+) were rapidly released from the nanocrystalline silver dressing into distilled water at RT, reaching 50% saturation at 24 hours and 90% saturation at 48 hours with a concentration of γ400 mg/mL. The Ag solution inactivated hHSV1 by 4-logs and 5-logs at 4 and 24 hours, and inactivated 1-log and 6-logs of SARS-CoV-2 after 4 and 24 hours, respectively. Neither a colloidal silver product nor a stable Ag nanoparticle product inactivated hHSV1 or SARS-Cov-2 viruses. Lavage of infected rat lungs with the Ag solution prevented death and preserved normal lung tissue histology. Silver nitrate or tobramycin treatments did not prevent death, and massive inflammation and lung tissue destruction was observed histologically. The Ag solution was highly anti-inflammatory in the pig contact dermatitis model. Nebulized inhalation of the Ag solution via ventilator rapidly reversed clinical parameters in all six patients with MDR pneumonia, in the TENS patient, and the COVID-19-infected burn patient. Chest x-rays showed no evidence of silver deposits in lung tissues of any treated patients. Conclusions: Nebulized inhalation of a unique solution of Ag species released from the nanocrystalline silver wound dressing appears to be a highly effective new treatment for patients with MDR pneumonia, TENS, and COVID-19 due to its unique triple combination of antimicrobial, anti-inflammatory, and anti-viral actions.

13.
Respirology ; 27(SUPPL 1):118, 2022.
Article in English | EMBASE | ID: covidwho-1816644

ABSTRACT

Introduction/Aim: Children with wheeze and asthma present with airway epithelial vulnerabilities, such as impaired responses to viral infection. It is postulated that the in utero environment may contribute to the development of such airway epithelial vulnerabilities, that may predispose children to wheeze and asthma outcomes. To explore developmental mechanisms, further research is required using epithelial samples at birth. Our study asked whether amniotic epithelial samples from placentas show similar viral receptor expression to nasal epithelial cells at birth. We aimed to investigate expression of respiratory viral receptors for human rhinovirus (HRV), respiratory syncytial virus (RSV) and COVID-19-causing coronavirus (SARS-CoV-2) in nasal and amniotic epithelial samples. Methods: Unmatched nasal (n = 20 births) and amniotic (n = 33 newborns) epithelial samples were collected from ORIGINS cohort participants recruited into the AERIAL study. Using purified RNA, receptor expression for HRV (ICAM-1, LDLR, CDHR3), RSV (NCL, TLR4) and SARSCoV- 2 (ACE2, TMPRSS2) was assessed by qPCR. In addition, receptor protein expression was quantified through western blot and localized using immunohistochemistry in amniotic samples only. Results: Nasal epithelial and amniotic samples expressed various receptors for HRV, RSV and SARS-CoV-2 at the gene level in nasal (median(IQR) arbitrary units (AU);ICAM-1: 11.44(63.18);LDLR: 4.00(7.32);CDHR3: 0.40 (1.14);NCL: 2.32(2.18);CX3CR1: 2.17(2.33);TLR4: 2.20 (6.20);TMPRSS2: 1.99(4.85);ACE2: 0.36(0.52) AU) and amnion (ICAM-1: 0.69(2.21);LDLR: 0.39(1.38);CDHR3: 1.0 x 10-4(3.0x10-4);NCL: 1.03(0.55);CX3CR1: 0.12(0.24);TLR4: 0.10(0.13);TMPRSS2: 3.0 x 10-4 (16.0x10-4);ACE2: 0.01(0.02) AU). Amniotic samples also expressed these receptors at the protein level (ICAM-1: 0.03(0.05);LDLR: 0.06(0.03);CDHR3: 0.28(0.15);NCL: 0.96(1.19);CX3CR1: 0.08(0.08);TMPRSS2: 0.09(0.06);ACE2: 0.34(0.92) AU) and expression within the amniotic epithelium was confirmed by immunohistochemistry. Conclusion: Newborn nasal and amniotic epithelial samples expressed receptors for respiratory viruses, HRV, RSV, SARS-CoV-2. These findings warrant further investigation of the clinical significance of receptor expression in relation to prenatal and postnatal exposures, as well as childhood asthma development.

14.
Experimental Dermatology ; 31(2):e80-e81, 2022.
Article in English | EMBASE | ID: covidwho-1816549

ABSTRACT

COVID-19 still has a big impact on health care and economics all over the world. The major task is to protect the most vulnerable persons from being infected. Skin lesions have been reported since the beginning of the pandemic more or less systematically. Data to their general prevalence differ a lot. A wide variety of lesions have been described: early appearing popular or pustular rash, maculopapulous or urticarial rash during the course of the disease and late appearing perniosis like acral lesions. The latter are associated with childhood, a mild course of the disease and appear around 4 weeks after the onset of COVID-19 symptoms. Here we report histologic results of perniosis like acral lesions and the comparison of immune histochemic results in these cases. Skin biopsies were formalin fixed and paraffin embedded sections were stained with hematoxylin/eosine and immune histochemically with antibodies against lymphocytic antigens. Kryosections were analysed by immunofluorescence for pathologic deposits of immunglobulins or complement. We could confirm association of perniosis like lesions with mild COVID-19. The inflammatory differs a lot in the specimens of different patients with being nearly absent in some cases whereas showing dense dermal lymphocytic infiltrates with a pronouncement around adnexial structures in others. IgG deposits in small blood vessels could be detected in one patient. In general our data are in line with others that perniosis like lesions are more common in young patients, after mild disease and that there are no specific histologic signs for the diagnosis, hence histology must be interpreted in the context of anamnestic data.

15.
Oxford Medical Case Reports ; 2022(3):110-111, 2022.
Article in English | EMBASE | ID: covidwho-1816226
16.
Oxford Medical Case Reports ; 2022(3):75-76, 2022.
Article in English | EMBASE | ID: covidwho-1816224
17.
Journal of Neurological Surgery, Part B Skull Base ; 83(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1815669

ABSTRACT

Objective: The purpose of this study was to evaluate the change in clinical spectrum and outcomes of invasive fungal disease involving the anterior skull base region. Study Design: This study represents a retrospective review of the patients diagnosed with acute and chronic invasive fungal rhinosinusitis based on imaging, fungal staining and culture, biochemical analysis, and histopathology report. Assessment of anterior, central skull base including orbital involvement was done clinicoradiologically and/or intraoperative findings. Setting: A tertiary referral hospital. Results: There was a total of 79 patients, of which 67% had skull base mucormycosis, 33% had invasive aspergillosis. In the skull base mucormycosis group, there were 53 patients, with 33 males and 20 females. 88% of patients had a history of COVID-19 infection. 98% of patients had type 2 diabetes mellitus. The mean duration of symptoms was 36 days, and 68% of them presented 30 days after onset of symptom. Mortality was seen in 7 (14%) patients. The most common symptom of the presentation was facial swelling followed by facial numbness, vision loss and headache. The most common area of skull base involved was pterygopalatine fossa (88%), followed by infratemporal fossa (71%), anterior and posterior cribriform area (60% each). The most common vessel involved was the sphenopalatine artery (75%), and the neural structure involved was infraorbital nerve (64%) and maxillary division of trigeminal nerve (52%). 13 patients had an intracranial disease, with 2 having cerebritis and rest with parenchymal abscess including one patient with cerebellar abscess. All patients had radical debridement with antifungal treatment. In the invasive aspergillosis group, there were 26 patients with 12 males and 14 females with a mean age of 42 years. The mean duration of presentation after the onset of the symptom was 33 weeks. Only 26% of patients had diabetes mellitus (type 2), and one patient had COVID-associated aspergillosis who presented within 28 days after onset of symptom with intracranial extension. Tissue diagnosis for confirmation of aspergillosis was obtained in 62% of patients, while the use of galactomannan assay and clinicoradiological diagnosis was done in 38%. A similar trend of skull base involvement was seen.

18.
Natural Volatiles & Essential Oils ; 8(5):1344-1352, 2021.
Article in English | GIM | ID: covidwho-1812987

ABSTRACT

AKI has been observed as a common problem of coronavirus disease 2019 (COVID-19) on frequent occasions in patients with moderate to severe disease. These patients showed presence of proteinuria and microscopic hematuria. Outcomes of such patients are bad with higher mortality and many of those surviving have become dialysis dependent. Kidney biopsy features show variety of tubular and glomerular involvement with acute tubular injury being a common finding.

19.
Biochemical and Cellular Archives ; 21(2):1-2, 2021.
Article in English | EMBASE | ID: covidwho-1812557
20.
Clinical Case Reports ; 10(4):e05775, 2022.
Article in English | Wiley | ID: covidwho-1802099

ABSTRACT

This narrative review article was conducted to lay out a summarized but exhaustive review of current literature over mucocutaneous manifestations in 4 dimensions of SARS-CoV-2 pandemic: virus itself, treatment-related, vaccine-induced, and alteration of chronic dermatologic diseases following infection. Virus and vaccine-related were mainly self-limited and non-severe. Treatment-related reactions could be life-threatening.

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