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1.
J Laryngol Otol ; 135(11): 1025-1030, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1569188

ABSTRACT

OBJECTIVE: Patients with coronavirus disease vaccine associated lymphadenopathy are increasingly being referred to healthcare services. This work is the first to report on the incidence, clinical course and imaging features of coronavirus disease vaccine associated cervical lymphadenopathy, with special emphasis on the implications for head and neck cancer services. METHODS: This was a retrospective cohort study of all patients referred to our head and neck cancer clinics between 16 December 2020 and 12 March 2021. The main outcomes measured were the proportion of patients with vaccine-associated cervical lymphadenopathy, and the clinical and imaging characteristics. RESULTS: The incidence of vaccine-associated cervical lymphadenopathy referrals was 14.8 per cent (n = 13). Five patients (38.5 per cent) had abnormal-looking enlarged and rounded nodes with increased vascularity. Only seven patients (53.9 per cent) reported full resolution within an average of 3.1 ± 2.3 weeks. CONCLUSION: Coronavirus disease vaccine associated cervical lymphadenopathy can mimic malignant lymphadenopathy and therefore might prove challenging to diagnose and manage correctly. Healthcare services may encounter a significant increase in referrals.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Head and Neck Neoplasms/immunology , Lymphadenopathy/chemically induced , Lymphadenopathy/epidemiology , Adult , Aged , Aged, 80 and over , Female , Head and Neck Neoplasms/virology , Humans , Incidence , Male , Middle Aged , Neck/pathology , Neck/virology , Retrospective Studies , SARS-CoV-2
2.
J Comput Assist Tomogr ; 45(4): 592-599, 2021.
Article in English | MEDLINE | ID: covidwho-1284963

ABSTRACT

OBJECTIVE: The aim of the study was to aggregate neuroradiological findings in patients with coronavirus disease 2019 (COVID-19) in the brain, head and neck, and spine to identify trends and unique patterns. METHODS: A retrospective review of neuroimaged COVID-19 patients during a 6-week surge in our 8-hospital campus was performed. The brain imaging with reported acute or subacute infarction, intraparenchymal hemorrhage, and all neck examinations were reinterpreted by 2 reviewers. RESULTS: Six hundred seventy-one patients met criteria and were reviewed. Acute or subacute infarction was seen in 39 (6%), intraparenchymal hemorrhage in 14 (2%), corpus callosum involvement in 7, and thalamus in 5 patients. In spine and neck studies, lung opacities and adenopathy were seen in 46 and 4 patients, respectively. CONCLUSIONS: Infarction followed by intraparenchymal hemorrhage was the most common acute findings in the brain with frequent involvement of the corpus callosum and thalami. In the neck, lung abnormalities were frequently present, and adenopathy was almost always associated with a second pathology.


Subject(s)
COVID-19/complications , COVID-19/pathology , Central Nervous System Diseases/complications , Central Nervous System Diseases/diagnostic imaging , Neuroimaging/methods , Adolescent , Adult , Aged , Aged, 80 and over , Brain/diagnostic imaging , Brain/pathology , COVID-19/diagnostic imaging , Central Nervous System Diseases/pathology , Child , Child, Preschool , Female , Head/diagnostic imaging , Head/pathology , Humans , Infant , Magnetic Resonance Imaging/methods , Male , Middle Aged , Neck/diagnostic imaging , Neck/pathology , Pandemics , Retrospective Studies , SARS-CoV-2 , Spine/diagnostic imaging , Spine/pathology , Tomography, X-Ray Computed/methods , Young Adult
3.
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
4.
Diabetes Metab Res Rev ; 37(1): e3354, 2021 01.
Article in English | MEDLINE | ID: covidwho-1059440

ABSTRACT

AIMS: COVID-19 is especially severe for elderly subjects with cardiometabolic and respiratory comorbidities. Neck circumference (NC) has been shown to be strongly related to cardiometabolic and respiratory illnesses even after adjustment for body mass index (BMI). We performed a prospective study to investigate the potential of NC to predict the need for invasive mechanical ventilation (IMV) in adult COVID-19 inpatients. MATERIALS AND METHODS: We prospectively and consecutively enrolled COVID-19 adult patients admitted to dedicated medical wards of two Italian hospitals from 25 March to 7 April 2020. On admission, clinical, biochemical and anthropometric data, including BMI and NC were collected. As primary outcome measure, the maximum respiratory support received was evaluated. Follow-up time was 30 days from hospital admission. RESULTS: We enrolled 132 subjects (55.0-75.8 years, 32% female). During the study period, 26 (19.7%) patients underwent IMV. In multivariable logistic regression analyses, after adjusting for age, sex, diabetes, hypertension and COPD, NC resulted independently and significantly associated with IMV risk (adjusted OR 1.260-per 1 cm increase 95% CI:1.120-1.417; P < .001), with a stronger association in the subgroup with BMI ≤30 Kg/m2 (adjusted OR 1.526; 95% CI:1.243-1.874; P < .001). NC showed a good discrimination power in predicting patients requiring IMV (AUC 0.783; 95% CI:0.684-0.882; P < .001). In particular, NC > 40.5 cm (>37.5 for females and >42.5 for males) showed a higher and earlier IMV risk compared to subjects with lower NC (Log-rank test: P < .001). CONCLUSIONS: NC is an easy to measure parameter able to predict the need for IMV in adult COVID-19 inpatients.


Subject(s)
COVID-19/mortality , Neck/pathology , Respiration, Artificial/statistics & numerical data , SARS-CoV-2/isolation & purification , Adult , Aged , COVID-19/epidemiology , COVID-19/therapy , COVID-19/virology , Female , Humans , Italy/epidemiology , Male , Middle Aged , Predictive Value of Tests , Prospective Studies , Survival Rate
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