Tracheitis Diagnosed With 68 Ga-PSMA PET/CT in a Patient With COVID-19.

ABSTRACT: A 57-year-old man with newly diagnosed with prostate cancer was admitted to our department for 68 Ga-prostate-specific membrane antigen PET/CT imaging. The patient, who was asymptomatic at the time of imaging, had increased diffuse 68 Ga-prostate-specific membrane antigen uptake in the trachea on PET/CT. No ground-glass density suggestive of pneumonia in both lungs was observed. The patient, whose symptoms developed 2 days after PET/CT imaging, was diagnosed with coronavirus disease 2019 by real-time polymerase chain reaction.

Non-COVID-19 viral respiratory tract infection as causes of death amid the pandemic: a report of two autopsy cases and tips for safe practice.

Autopsy practice is one of the most well-defined procedures in medicine, with strict safety instructions in place to protect medical personnel from infectious agents. However, for various reasons, these precautionary measures are often overlooked. Herein we report two autopsy cases of patients who died during the COVID-19 pandemic and the national state of emergency declared in Bulgaria. One patient was a 77-year-old female who had a medical history of a viral respiratory tract infection in February 2020 but had not undergone any test. She had multiple comorbidities including hypertension, cerebral and cardiovascular disease, and type 2 diabetes. The other patient was a 53-year-old female with morbid obesity with previous medical history of malignancy, hypertension, and type 2 diabetes. Both patients were tested for COVID-19 during the autopsy. Gross and histological findings in both patients showed respiratory tract viral infection with severe complications, incompatible with life. The first patient had serous desquamative tracheitis, hemorrhagic pneumonia, pericarditis, meningitis, and acute necrotizing encephalitis. The second patient had serous tracheitis, interstitial pneumonia, and diffuse alveolar damage and pneumocyte cytopathic effect, the alveolar septi had undergone a fibrotic change, with serous meningitis and non-necrotizing encephalitis also noted histologically. Autopsy-wise, it is always important, against the backdrop of an epidemic, to use full precautionary measures and exclude epidemic strands in cases where gross findings are suggestive of a viral infection.

Hospital-Acquired Pneumonia/Ventilator-Associated Pneumonia and Ventilator-Associated Tracheobronchitis in COVID-19.

Although few studies evaluated the incidence of hospital-acquired pneumonia (HAP) or ventilator-associated tracheobronchitis in COVID-19 patients, several studies evaluated the incidence of ventilator-associated pneumonia (VAP) in these patients. Based on the results of a large multicenter European study, VAP incidence is higher in patients with SARS-CoV-2 pneumonia (36.1%), as compared with those with influenza pneumonia (22.2%), or no viral infection at intensive care unit (ICU) admission (16.5%). Potential explanation for the high incidence of VAP in COVID-19 patients includes long duration of invasive mechanical ventilation, high incidence of acute respiratory distress syndrome, and immune-suppressive treatment. Specific risk factors for VAP, including SARS-CoV-2-related pulmonary lesions, and bacteria-virus interaction in lung microbiota might also play a role in VAP pathogenesis. VAP is associated with increased mortality, duration of mechanical ventilation, and ICU length of stay in COVID-19 patients. Further studies should focus on the incidence of HAP especially in ICU non-ventilated patients, better determine the pathophysiology of these infections, and evaluate the accuracy of currently available treatment guidelines in COVID-19 patients.

Impact of social distancing in response to COVID-19 on hospitalizations for laryngitis, tracheitis, otitis media, and mastoiditis in children aged 0 to 9 years in Brazil.

OBJECTIVE: The objective of this study is to evaluate the impact of social distancing resulting from COVID-19 in hospitalizations for infections of the upper airways (URTI), such as acute laryngitis, tracheitis, and otitis media in children aged 0 to 9 years in Brazil, considering that they share the same forms of transmission. METHODS: Data on hospitalizations for acute airway changes and their complications in children <9 years old were obtained from the Database of the Brazilian Department of Public Health Informatics for the period 2015 to 2020. These data were also analyzed by macroregions of Brazil (North, Northeast, Southeast, South, and Midwest). The effect of the social distancing strategy on the increase of acute laryngitis, tracheitis, otitis media, and mastitis, as absolute and relative reductions, was calculated by analyzing the annual calculation of 2015-2019 vs 2020. RESULTS: All the hospitalizations compared in the Unified Health System (SUS) for laryngitis and acute tracheitis and otitis media decreased, considering all states of Brazil. The largest reduction in hospitalization reduction was in the North, with -94% in 2015-2019 vs 2020 in cases of laryngitis and acute tracheitis, and in the Midwest, with - 85% in 2015-2019 vs 2020 in cases of otitis media. CONCLUSION: Hospitalizations for laryngitis, acute tracheitis, and acute otitis media in children <9 years old decreased between March and July 2020 in Brazil, when social distancing measures were adopted due to the COVID-19 pandemic.

SARS-CoV-2 tracheitis in laryngectomized patients: a consecutive case-series study. (preprint)

Key points • SARS-CoV-2 is a possible cause of acute severe tracheitis in laryngectomees. • In our series, the clinical picture was characterized by a hemorrhagic tracheitis with a slow resolution pattern. • We observed a histological pattern of erosive inflammation of the respiratory epithelium. • Planned tracheo-bronchoscopy and tracheal toilettes are recommended to prevent critical obstruction of the airway, which can be fatal in patients with associated impairment of lung function caused by SARS-CoV-2 infection. • The present cases highlight the need for close interdisciplinary working and communication in the management of airway complications of COVID-19 infection.

A Curious Case of Croup: Laryngotracheitis Caused by COVID-19.

We describe a case of croup in a 14-month-old boy caused by severe acute respiratory syndrome coronavirus 2, the virus that causes coronavirus disease 2019. The patient presented with classic signs and symptoms consistent with croup. Workup was remarkable for a positive point-of-care test for severe acute respiratory syndrome coronavirus 2. This case represents recognition of a new clinical entity caused by coronavirus disease 2019.