ABSTRACT
We report an asymptomatic child with heterotaxy syndrome who had recurrent positive SARS-CoV-2 polymerase chain reaction testing. An aberrant lymphocyte population expressing CD19, CD16, and CD56 was identified; its phenotyping revealing atypical NK cells. This subset's role in protection from severe disease or in reinfection cannot be ascertained.
Subject(s)
Asymptomatic Infections , COVID-19 , Heterotaxy Syndrome , Killer Cells, Natural , Reinfection , Child , Humans , Male , COVID-19/complications , COVID-19/immunology , Heterotaxy Syndrome/complications , Killer Cells, Natural/immunology , Receptors, IgG/metabolism , Reinfection/complications , Reinfection/immunology , Antigens, CD19/metabolism , CD56 Antigen/metabolismABSTRACT
With limited time for analysing computed tomography (CT) data in medical emergencies, radiologists and clinicians are not always aware of congenital pathologies, especially in asymptomatic cases. We present a case report of heterotaxy syndrome detected incidentally in a 62-year-old female with massive pulmonary embolism, local saccular aneurysm of the aortic arch and COVID-19. The presented case describes an unusual combination of life-threatening conditions and congenital anomalies. Using the CT angiography, we reported the preserved topography and morphology of the heart chambers. The superior and inferior venae cavae were located on the left, draining into a significantly dilated coronary sinus. Disordered abdominal organ arrangement included midline liver, right-sided stomach, the central location of the short pancreas, malrotation of the intestine, polysplenia, and atypical rise of visceral branches of the abdominal aorta. A comprehensive assessment of CT images promoted verification of undiagnosed congenital anomalies. Prompt recognition of heterotaxy syndrome in life-threatening conditions significantly impacts treatment tactics and should be the course of diagnostic and cautious interventions to reduce further complications.
Subject(s)
Aortic Aneurysm , COVID-19 , Heterotaxy Syndrome , Pulmonary Embolism , Female , Humans , Middle Aged , Heterotaxy Syndrome/complications , Heterotaxy Syndrome/diagnostic imaging , COVID-19/complications , COVID-19/diagnostic imaging , Pancreas , Aortic Aneurysm/complications , Pulmonary Embolism/complicationsABSTRACT
BACKGROUND: COVID-19 can induce acute respiratory distress syndrome (ARDS). In patients with congenital heart disease, established treatment strategies are often limited due to their unique cardiovascular anatomy and passive pulmonary perfusion. CASE PRESENTATION: We report the first case of an adult with single-ventricle physiology and bidirectional cavopulmonary shunt who suffered from severe COVID-19 ARDS. Treatment strategies were successfully adopted, and pulmonary vascular resistance was reduced, both medically and through prone positioning, leading to a favorable outcome. CONCLUSION: ARDS treatment strategies including ventilatory settings, prone positioning therapy and cannulation techniques for extracorporeal oxygenation must be adopted carefully considering the passive venous return in patients with single-ventricle physiology.