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1.
Ophthalmic Plast Reconstr Surg ; 38(1): 96, 2022.
Article in English | MEDLINE | ID: covidwho-1606757
2.
BMC Nephrol ; 22(1): 376, 2021 11 11.
Article in English | MEDLINE | ID: covidwho-1511729

ABSTRACT

BACKGROUND: There have been cases of minimal change disease (MCD) reported following previous vaccines. During the COVID-19 era, only 3 cases of new-onset MCD and a case of MCD relapse were reported following the Pfizer-BioNTech COVID-19 vaccine. We herein report the first case of MCD after receiving the Moderna COVID-19 vaccine. CASE PRESENTATION: A 43-year-old man presented to hospital 3 weeks after receiving the first dose of the Moderna vaccine, with both bilateral lower extremities and scrotal edema. He initially developed a sudden-onset bilateral lower extremities swelling on day 7 post-vaccine. He, then, developed dyspnea and scrotal swelling over a time span of 2 weeks. On physical examination, his blood pressure was 150/92 mmHg. There was a decreased air entry at lung bases, bilateral lower extremities and scrotal edema. Labs revealed hypoalbuminemia, hyperlipidemia and 15 g of proteinuria. His immunologic and serologic work up was negative. Renal biopsy showed concomitant MCD and IgA nephropathy. Patient was treated with oral steroids and had a good response; his edema resolved, serum albumin improved, and proteinuria decreased to 1 g within 2 weeks of treatment. CONCLUSIONS: To the best of our knowledge, MCD has not been previously reported after receiving the Moderna COVID-19 vaccine. It remains unclear whether the COVID-19 mRNA vaccines are associated with the development of MCD, or it coincided with the mass vaccination. Further studies are needed to determine the incidence of MCD post COVID-19 vaccines and the underlying pathophysiology of glomerular injury post vaccination.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Edema/etiology , Lower Extremity , Nephrosis, Lipoid/chemically induced , Scrotum , Adult , Dyspnea/etiology , Glomerulonephritis, IGA/chemically induced , Glomerulonephritis, IGA/complications , Glomerulonephritis, IGA/pathology , Humans , Hypoalbuminemia/etiology , Male , Nephrosis, Lipoid/complications , Nephrosis, Lipoid/pathology , SARS-CoV-2
4.
BMC Nephrol ; 22(1): 323, 2021 09 27.
Article in English | MEDLINE | ID: covidwho-1440916

ABSTRACT

BACKGROUND: This is a case report of an asymptomatic SARS-CoV-2 infection associated with new-onset nephrotic syndrome in a pediatric patient. This is the third case of new-onset nephrotic syndrome in children associated with SARS-CoV-2 infection, but is the first case report describing a new-onset nephrotic syndrome presentation in a patient who had asymptomatic COVID-19 infection. CASE PRESENTATION: This is a case of a previously healthy 5 year old female who presented with new-onset nephrotic syndrome in the setting of an asymptomatic COVID-19 infection. She presented with progressive edema, and laboratory findings were significant for proteinuria and hypercholesterolemia. She was treated with albumin, diuretics, and corticosteroid therapy, and achieved clinical remission of her nephrotic syndrome within 3 weeks of treatment. Though she was at risk of hypercoagulability due to her COVID-19 infection and nephrotic syndrome, she was not treated with anticoagulation, and did not develop any thrombotic events. CONCLUSIONS: Our case report indicates that SARS-CoV-2 infection could be a trigger for nephrotic syndrome, even in the absence of overt COVID-19 symptoms.


Subject(s)
Asymptomatic Infections , COVID-19 , Nephrotic Syndrome , Patient Care Management/methods , Remission Induction/methods , COVID-19/complications , COVID-19/diagnosis , COVID-19/physiopathology , Child, Preschool , Edema/diagnosis , Edema/etiology , Female , Humans , Hypercholesterolemia/diagnosis , Hypercholesterolemia/etiology , Nephrotic Syndrome/blood , Nephrotic Syndrome/etiology , Nephrotic Syndrome/therapy , Nephrotic Syndrome/urine , Proteinuria/diagnosis , Proteinuria/etiology , SARS-CoV-2/isolation & purification , Treatment Outcome
7.
BMJ Case Rep ; 14(8)2021 Aug 04.
Article in English | MEDLINE | ID: covidwho-1343954

ABSTRACT

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) is a rare inflammatory condition that occurs in older adults. Here, we report a case of an 80-year-old man with no history of rheumatic disease who presented with acute onset of bilateral hand pain, pitting oedema and synovitis after the second dose of the BNT162b2 mRNA C0VID-19 vaccine. Laboratory workup revealed elevated inflammatory markers and negative autoantibodies. Significant improvement was noted with prednisolone. This is the first reported case of RS3PE in an elderly patient with no previous rheumatic disease following mRNA COVID-19 vaccination.


Subject(s)
COVID-19 , Synovitis , Aged , Aged, 80 and over , COVID-19 Vaccines , Edema/etiology , Humans , Male , RNA, Messenger , SARS-CoV-2 , Synovitis/drug therapy , Vaccination
8.
J Pediatric Infect Dis Soc ; 10(9): 922-925, 2021 Oct 27.
Article in English | MEDLINE | ID: covidwho-1281866

ABSTRACT

We defined the prevalence of neck pain, trismus, or dysphagia (28.4%) and retropharyngeal edema (2.9%) among 137 patients with multisystem inflammatory syndrome in children (MIS-c). Retropharyngeal edema or phlegmon has been documented radiologically in at least 9 children. Symptoms of neck inflammation are common in MIS-c.


Subject(s)
Neck Pain , Systemic Inflammatory Response Syndrome , Child , Edema/epidemiology , Edema/etiology , Humans , Neck Pain/epidemiology , Neck Pain/etiology , Systemic Inflammatory Response Syndrome/complications , Systemic Inflammatory Response Syndrome/epidemiology
9.
J Drugs Dermatol ; 20(4): 374-378, 2021 Apr 01.
Article in English | MEDLINE | ID: covidwho-1184134

ABSTRACT

BACKGROUND: Recent reports have surfaced from the United States Food and Drug Administration hearings in December 2020 regarding the COVID-19 vaccines and study participants who developed facial and/or lip swelling after receiving the newly developed drug. Despite an incidence rate of 0.02% in the vaccine arm of the Moderna mRNA-1273 trial, concerns have been expressed about the association of adverse reactions following soft tissue filler injections and the COVID-19 vaccines. The International Society for Dermatologic and Aesthetic Surgery (ISDS) understands these concerns and has designed the following study. METHODS: A global survey was designed to capture the incidence of adverse events related to: (1) previous soft tissue filler injections, (2) soft tissue filler injections during positive testing for COVID-19, and (3) soft tissue filler injections during and after receiving any of the COVID-19 vaccines globally available. RESULTS: The information of 106 survey participants from 18 different countries was analyzed. 80.2% (n=85) never experienced any adverse reaction following their soft tissue filler injection whereas 15.1% (n=16) experienced swelling and 4.7% (n=5) experienced pain that lasted longer than two days. Of those who received at least one dose of the COVID-19 vaccine (n=78), 94.9% reported not to have experienced any adverse reaction related to their previous soft tissue filler injection, whereas 5.1% (n=4) reported to have perceived pain that lasted longer than two days. CONCLUSION: The data collected does not support the concern for an increased risk of developing adverse reactions following soft tissue filler injections associated with the COVID-19 vaccines compared to that risk associated with other previously described triggers or the default risk following soft tissue filler injections. J Drugs Dermatol. 20(4):374-378. doi:10.36849/JDD.2021.6041.


Subject(s)
Biocompatible Materials/adverse effects , COVID-19 Vaccines/adverse effects , COVID-19 Vaccines/therapeutic use , Dermatology/standards , Adult , Aged , Aged, 80 and over , Edema/epidemiology , Edema/etiology , Face , Female , Humans , Incidence , Lip/pathology , Male , Middle Aged , Surgery, Plastic , Surveys and Questionnaires , Young Adult
10.
Am J Kidney Dis ; 78(1): 142-145, 2021 07.
Article in English | MEDLINE | ID: covidwho-1174714

ABSTRACT

We report on the development of minimal change disease (MCD) with nephrotic syndrome and acute kidney injury (AKI), shortly after first injection of the BNT162b2 COVID-19 vaccine (Pfizer-BioNTech). A 50-year-old previously healthy man was admitted to our hospital following the appearance of peripheral edema. Ten days earlier, he had received the first injection of the vaccine. Four days after injection, he developed lower leg edema, which rapidly progressed to anasarca. On admission, serum creatinine was 2.31 mg/dL and 24-hour urinary protein excretion was 6.9 grams. As kidney function continued to decline over the next days, empirical treatment was initiated with prednisone 80 mg/d. A kidney biopsy was performed and the findings were consistent with MCD. Ten days later, kidney function began to improve, gradually returning to normal. The clinical triad of MCD, nephrotic syndrome, and AKI has been previously described under a variety of circumstances, but not following the Pfizer-BioNTech COVID-19 vaccine. The association between the vaccination and MCD is at this time temporal and by exclusion, and by no means firmly established. We await further reports of similar cases to evaluate the true incidence of this possible vaccine side effect.


Subject(s)
Acute Kidney Injury , COVID-19 Vaccines , COVID-19/prevention & control , Nephrosis, Lipoid , Nephrotic Syndrome , Prednisone/administration & dosage , Acute Kidney Injury/etiology , Acute Kidney Injury/pathology , Biopsy/methods , COVID-19/epidemiology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Creatinine/blood , Edema/diagnosis , Edema/etiology , Glucocorticoids/administration & dosage , Humans , Male , Middle Aged , Nephrosis, Lipoid/diagnosis , Nephrosis, Lipoid/drug therapy , Nephrosis, Lipoid/etiology , Nephrosis, Lipoid/physiopathology , Nephrotic Syndrome/diagnosis , Nephrotic Syndrome/etiology , Renal Elimination/drug effects , SARS-CoV-2 , Treatment Outcome , Urinalysis/methods
12.
Int J Pediatr Otorhinolaryngol ; 144: 110667, 2021 May.
Article in English | MEDLINE | ID: covidwho-1116865

ABSTRACT

Multisystem inflammatory syndrome in children (MIS-C) is thought to follow SARS-CoV-2 infection and presents with fever and multisystem dysfunction. We report three children with suspected MIS-C found to have retropharyngeal edema without evidence of a bacterial etiology. We raise the possibility that an association between MIS-C and retropharyngeal edema exists.


Subject(s)
COVID-19 , Child , Edema/diagnosis , Edema/etiology , Humans , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
13.
BMC Infect Dis ; 21(1): 232, 2021 Feb 27.
Article in English | MEDLINE | ID: covidwho-1105699

ABSTRACT

BACKGROUND: Although there are reports of otolaryngological symptoms and manifestations of CoronaVirus Disease 19 (COVID-19), there have been no documented cases of sudden neck swelling with rash in patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection described in literature. CASE PRESENTATION: We report a case of a sudden neck swelling and rash likely due to late SARS-CoV-2 in a 64-year-old woman. The patient reported COVID-19 symptoms over the previous three weeks. Computed Tomography (CT) revealed a diffuse soft-tissue swelling and edema of subcutaneous tissue, hypodermis, and muscular and deep fascial planes. All the differential diagnoses were ruled out. Both the anamnestic history of the patient's husband who had died of COVID-19 with and the collateral findings of pneumonia and esophageal wall edema suggested the association with COVID-19. This was confirmed by nasopharyngeal swab polymerase chain reaction. The patient was treated with lopinavir/ritonavir, hydroxychloroquine and piperacillin/tazobactam for 7 days. The neck swelling resolved in less than 24 h, while the erythema was still present up to two days later. The patient was discharged after seven days in good clinical condition and with a negative swab. CONCLUSION: Sudden neck swelling with rash may be a coincidental presentation, but, in the pandemic context, it is most likely a direct or indirect complication of COVID-19.


Subject(s)
COVID-19/complications , Exanthema/etiology , SARS-CoV-2 , COVID-19/diagnostic imaging , COVID-19/drug therapy , Edema/etiology , Female , Humans , Middle Aged , Neck/pathology , Tomography, X-Ray Computed
14.
BMJ Case Rep ; 14(1)2021 Jan 11.
Article in English | MEDLINE | ID: covidwho-1020900

ABSTRACT

Here we present the case of a 37-year-old previously healthy man who developed fever, headache and a unilateral, painful neck swelling while working offshore. He had no known contact with anyone with COVID-19; however, due to the ongoing pandemic, a nasopharyngeal swab was performed, which was positive for the virus. After transfer to hospital for assessment his condition rapidly deteriorated, requiring admission to intensive care for COVID-19 myocarditis. One week after discharge he re-presented with unilateral facial nerve palsy. Our case highlights an atypical presentation of COVID-19 and the multifaceted clinical course of this still poorly understood disease.


Subject(s)
Alkalosis, Respiratory/blood , Bell Palsy/physiopathology , COVID-19/physiopathology , Myocarditis/physiopathology , Adult , Alkalosis, Respiratory/etiology , Blood Gas Analysis , C-Reactive Protein/metabolism , COVID-19/blood , COVID-19/therapy , Echocardiography , Edema/etiology , Electrocardiography , Humans , Hypotension/etiology , Hypotension/physiopathology , Lymphadenitis/etiology , Lymphadenitis/physiopathology , Magnetic Resonance Imaging , Male , Myocarditis/blood , Myocarditis/diagnostic imaging , Myocarditis/therapy , Natriuretic Peptide, Brain/blood , Neck , Oxygen Inhalation Therapy , Peptide Fragments/blood , Procalcitonin/blood , Recovery of Function , SARS-CoV-2 , Troponin T/blood , Vasoconstrictor Agents/therapeutic use
16.
Am J Case Rep ; 21: e928342, 2020 Dec 16.
Article in English | MEDLINE | ID: covidwho-979222

ABSTRACT

BACKGROUND Coronavirus disease 2019 (COVID-19) is a novel infectious disease with an evolving understanding of its clinical manifestations, complications, and therapeutic implications. Thromboembolic disease and coagulopathy are common and have been seen in COVID-19 patients. Phlegmasia cerulea dolens had been reported in previous cases associated with malignancy which is a known cause of a procoagulable state. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may also induce a procoagulable state and be associated with PCD. CASE REPORT A 61-year-old man presented with a painful, swollen limb and gangrene, findings consistent with a diagnosis of PCD due to venous thrombosis. The patient tested positive for SARS-CoV-2 infection after a nasopharyngeal swab sample using the XPRSARS-COV2-10 reverse transcription polymerase chain reaction kit. He had bilateral leg swelling with a gangrenous left fourth digit in the presence of a palpable peripheral pulse. His venous duplex showed bilateral acute deep venous thrombosis, whereas his arterial Doppler scan was normal and his skin biopsy was negative for vasculitis. One of our screening blood tests was suggestive of an antiphospholipid-like syndrome. These clinical and radiologic findings were consistent with PCD. This patient was promptly anticoagulated; other supportive treatments were also initiated. He had a significant resolution of his pedal swelling with the associated revitalization of his previously gangrenous toe. CONCLUSIONS This case report shows the importance of testing for SARS-CoV-2 infection in patients who present with unusual thrombotic symptoms and signs and highlights the potential severity of these thrombotic complications.


Subject(s)
COVID-19/complications , Edema/etiology , Gangrene/etiology , Venous Thrombosis/complications , Anticoagulants/therapeutic use , Humans , Lower Extremity/pathology , Male , Middle Aged
17.
Neurology ; 95(23): e3145-e3152, 2020 12 08.
Article in English | MEDLINE | ID: covidwho-966472

ABSTRACT

OBJECTIVE: To assess the physiopathology of olfactory function loss (OFL) in patients with coronavirus disease 2019 (COVID-19), we evaluated the olfactory clefts (OC) on MRI during the early stage of the disease and 1 month later. METHODS: This was a prospective, monocentric, case-controlled study. Twenty severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)-infected patients with OFL were included and compared to 20 age-matched healthy controls. All infected patients underwent olfactory function assessment and 3T MRI, performed both at the early stage of the disease and at the 1-month follow-up. RESULTS: At the early stage, SARS-CoV2-infected patients had a mean olfactory score of 2.8 ± 2.7 (range 0-8), and MRI displayed a complete obstruction of the OC in 19 of 20 patients. Controls had normal olfactory scores and no obstruction of the OC on MRI. At the 1 month follow-up, the olfactory score had improved to 8.3 ± 1.9 (range 4-10) in patients, and only 7 of 20 patients still had an obstruction of the OC. There was a correlation between olfactory score and obstruction of the OC (p = 0.004). CONCLUSION: OFL in SARS-CoV2-infected patients is associated with a reversible obstruction of the OC.


Subject(s)
Anosmia/diagnosis , Anosmia/etiology , COVID-19/complications , Edema/pathology , Nasal Cavity/pathology , Nasal Obstruction/pathology , Adult , Anosmia/pathology , Anosmia/physiopathology , COVID-19/diagnostic imaging , COVID-19/pathology , COVID-19/physiopathology , Case-Control Studies , Edema/diagnostic imaging , Edema/etiology , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Nasal Cavity/diagnostic imaging , Nasal Obstruction/diagnostic imaging , Nasal Obstruction/etiology , Young Adult
19.
Chest ; 158(6): e267-e268, 2020 12.
Article in English | MEDLINE | ID: covidwho-860852

ABSTRACT

Systemic capillary leak syndrome is a rare disorder characterized by dysfunctional inflammatory response, endothelial dysfunction, and extravasation of fluid from the vascular space to the interstitial space leading to shock, hemoconcentration, hypoalbuminemia, and subsequent organ failure. The condition may be idiopathic or secondary to an underlying cause, which can include viral infections. Here we describe a patient with acute coronavirus disease 2019 (COVID-19) infection who presented with hemoconcentration, shock, and hypoalbuminemia. The patient subsequently developed rhabdomyolysis and compartment syndrome of all four extremities, requiring fasciotomies. This is the first reported case of systemic capillary leak syndrome associated with COVID-19 infection. This case adds to the evolving spectrum of inflammatory effects associated with this viral infection.


Subject(s)
COVID-19/physiopathology , Capillary Leak Syndrome/physiopathology , Compartment Syndromes/physiopathology , Hypoalbuminemia/physiopathology , Shock/physiopathology , Abdominal Pain/etiology , Acidosis, Lactic/etiology , Acidosis, Lactic/physiopathology , Acidosis, Lactic/therapy , Acute Kidney Injury/etiology , Acute Kidney Injury/physiopathology , Acute Kidney Injury/therapy , COVID-19/complications , COVID-19/therapy , Capillary Leak Syndrome/etiology , Compartment Syndromes/etiology , Compartment Syndromes/surgery , Continuous Renal Replacement Therapy , Crystalloid Solutions/therapeutic use , Edema/etiology , Edema/physiopathology , Fasciotomy , Fatal Outcome , Fluid Therapy , Hematocrit , Humans , Hypoalbuminemia/etiology , Hypoalbuminemia/therapy , Male , Middle Aged , Respiration, Artificial , Rhabdomyolysis/etiology , Rhabdomyolysis/physiopathology , Shock/etiology , Shock/therapy , Tomography, X-Ray Computed , Vasoconstrictor Agents/therapeutic use
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