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1.
Cytopathology ; 33(4): 556-558, 2022 07.
Article in English | MEDLINE | ID: covidwho-1807063
2.
Intern Med ; 61(6): 913-916, 2022 Mar 15.
Article in English | MEDLINE | ID: covidwho-1745229

ABSTRACT

A 33-year-old woman with a fever, cough, and pharyngitis was admitted after left-sided pleural effusion was detected. The fever and upper respiratory symptoms were confirmed, and she was diagnosed with coronavirus disease (COVID-19) after showing a positive polymerase chain reaction (PCR) test. After thoracentesis, pleural fluid revealed elevated adenosine deaminase values and a positive QuantiFeron test; tuberculous pleurisy was thus suspected. Subsequent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR and anti-SARS-CoV-2 Spike IgG tests were negative, suggesting that the initial PCR result had been erroneous. However, we were unable to confirm this. Data concerning COVID-19 diagnostics are insufficient at present. It is important to make comprehensive judgments regarding the diagnosis and treatment of patients as well as public health.


Subject(s)
COVID-19 , Pleural Effusion , Tuberculosis, Pleural , Adenosine Deaminase/analysis , Adult , COVID-19/diagnosis , Comorbidity , Female , Humans , Pleural Effusion/diagnosis , SARS-CoV-2 , Tuberculosis, Pleural/diagnosis
3.
Clin Med (Lond) ; 21(6): e561-e566, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1551865

ABSTRACT

Over 50 systemic conditions may affect the pleura and, thus, unilateral pleural effusions may present for a variety of reasons. Investigating the cause is essential to providing appropriate management. Various pleural interventions are available in current practice, but have varying diagnostic sensitivity. It is, therefore, vital to consider the intervention with the highest diagnostic yield appropriate to the particular clinical situation. The diagnostic pathway in unilateral pleural effusion is increasingly outpatient based, avoiding hospitalisation, which is particularly relevant with the recent COVID-19 pandemic.


Subject(s)
COVID-19 , Pleural Effusion , Humans , Pandemics , Pleural Effusion/diagnosis , Pleural Effusion/therapy , SARS-CoV-2 , Thoracoscopy
4.
J Med Virol ; 94(1): 229-239, 2022 01.
Article in English | MEDLINE | ID: covidwho-1544339

ABSTRACT

Observational studies indicate that pleural effusion has an association with risk and the clinical prognosis of COVID-19 disease; however, the available literature on this area is inconsistent. The objective of this systematic review and meta-analysis is to evaluate the correlation between COVID-19 disease and pleural effusion. A rigorous literature search was conducted using multiple databases. All eligible observational studies were included from around the globe. The pooled prevalence and associated 95% confidence interval (CI) were calculated using the random effect model. Mantel-Haenszel odds ratios were produced to report overall effect size using random effect models for severity and mortality outcomes. Funnel plots, Egger regression tests, and Begg-Mazumdar's rank correlation test were used to appraise publication bias. Data from 23 studies including 6234 COVID-19 patients was obtained. The overall prevalence of pleural effusion in COVID-19 patients was 9.55% (95% CI, I2 = 92%). Our findings also indicated that the presence of pleural effusions associated with increased risk of severity of disease(OR = 5.08, 95% CI 3.14-8.22, I2 = 77.4%) and mortality due to illness(OR = 4.53, 95% CI 2.16-9.49, I2 = 66%) compared with patients without pleural effusion. Sensitivity analyses illustrated a similar effect size while decreasing the heterogeneity. No significant publication bias was evident in the meta-analysis. The presence of pleural effusion can assist as a prognostic factor to evaluate the risk of worse outcomes in COVID-19 patients hence, it is recommended that hospitalized COVID-19 patients with pleural effusion should be managed on an early basis.


Subject(s)
COVID-19/complications , Pleural Effusion/complications , COVID-19/diagnosis , COVID-19/mortality , Female , Humans , Male , Pleural Effusion/diagnosis , Pleural Effusion/epidemiology , Prevalence , Prognosis , Severity of Illness Index
5.
Saudi Med J ; 42(8): 903-907, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1341991

ABSTRACT

Medical thoracoscopy (MT) has changed how we manage exudative pleural effusion. It is a minimally invasive procedure used as a diagnostic and therapeutic tool in pleural disease. Here, we report a case of a lymphocytic exudative pleural effusion that needed a pleural biopsy for diagnosis. Medical thoracoscopy was performed, a biopsy was taken, and adhesiolysis was performed. Medical thoracoscopy has been practiced for a while worldwide, but it has not been utilized in the Kingdom of Saudi Arabia and as we believe that it is useful in diagnosing exudative pleural effusions. It limits patients in hospital-stay and it may be less costly than surgical procedures. It is especially helpful in diagnosing and treating pleural effusions in elderly patients with multiple comorbidities. Such procedures are needed to ease ongoing financial constraints, and with the 2019 coronavirus disease (COVID-19) pandemic, less time in the hospital means better utilization of beds during the pandemic. Spreading the knowledge about this procedure and its availability in the country will improve the health services provided to the patients.


Subject(s)
COVID-19 , Pleural Effusion, Malignant , Pleural Effusion , Aged , Humans , Pleural Effusion/diagnosis , SARS-CoV-2 , Saudi Arabia , Thoracoscopy
6.
Infect Disord Drug Targets ; 21(3): 468-472, 2021.
Article in English | MEDLINE | ID: covidwho-1328038

ABSTRACT

BACKGROUND: Recently, COVID-19 infection has become a public health concern. On March 12th, 2020, the World Health Organization (WHO) announced it as a global pandemic. Early diagnosis of atypical cases of COVID-19 infection is critical in reducing the transmission and controlling the present pandemic. In the present report, we described a patient with the chief complaints of dyspnea and dry cough referred to the oncology center at Imam Khomeini Hospital, Tehran, with the differential diagnosis of lung cancer who was diagnosed and treated for COVID-19 infection in follow up. CASE PRESENTATION: A 59-year-old patient complained of fever, dry cough, and dyspnea from two weeks ago. The patient had been referred to this center with the differential diagnosis of lung cancer due to the massive pleural effusion in the initial chest CT scan. Dyspnea was the patient's main complaint at the time of admission in this center and the oxygen saturation was 84%. In the new chest CT scan, similar findings were observed. Due to the severe respiratory distress, a chest tube was placed in the chest cavity to remove the pleural effusion fluid on day one. The patient's felt relieved immediately after the procedure; however, the oxygen saturation did not rise above 85% despite the oxygen therapy. The cytology of pleural fluid was negative for malignant cells. On day 2, the lymphopenia and high level of CRP suggested the COVID-19 infection. Therefore, a control chest CT scan was conducted and the test for COVID-19 was performed. The CT report indicated the clear pattern of COVID-19's lung involvement in the absence of pleural effusion. Thus, the treatment for COVID-19 was immediately initiated. On day 4, the test reported positive for COVID-19. CONCLUSION: Currently, it is important to bear in mind the COVID-19 infection in evaluating patients with respiratory symptoms. This report indicated how misleading the presentation of a chest CT scan could be in clinical judgment. Therefore, we recommend ruling out the COVID-19 infection in all the patients with any pattern of lung involvement to avoid missing the potential cases of this vicious infection.


Subject(s)
COVID-19 , Pleural Effusion , COVID-19/diagnosis , Humans , Iran , Middle Aged , Pleural Effusion/diagnosis , Pleural Effusion/virology
8.
Emerg Infect Dis ; 27(4): 1196-1200, 2021 04.
Article in English | MEDLINE | ID: covidwho-1067635
10.
Ann Palliat Med ; 9(5): 3710-3715, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-854832

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified strain of coronavirus in the human body and was reported in Wuhan at the end of 2019. So far, the epidemic is continuing and very serious, with the number of infections and deaths increasing. Despite active investigations around the world to better understand the dynamics of transmission and the scope of clinical disease, COVID-19 continues to spread rapidly from person to person. The common signs and symptoms of SARS-CoV-2 infection include fever, fatigue, dry cough, and dyspnea; in severe cases, patients may have acute respiratory distress syndrome, septic shock, metabolic acidosis difficult to treat and coagulation disorder. However, some patients who test positive for SARS-CoV-2 in their respiratory tract may not have such clinical signs and symptoms. This report presents a case study analysis of a patient admitted in the Fourth Taiyuan People's Hospital, who had suffered traumatic injuries from a car accident and survived COVID-19, with pleural effusion as the initial symptom. We report a case of 2019-NCOV with pleural effusion as the first symptom. Describe in detail the differential diagnosis, diagnosis, clinical management, and cure of this case. In order to combat the novel CoronaviruscoVID-19 in the process to provide lessons and help.


Subject(s)
Accidents, Traffic , Coronavirus Infections/diagnosis , Multiple Trauma/diagnosis , Pleural Effusion/diagnosis , Pneumonia, Viral/diagnosis , Adult , Betacoronavirus , COVID-19 , Cerebrospinal Fluid Otorrhea/complications , Cerebrospinal Fluid Otorrhea/diagnosis , Coronavirus Infections/complications , Disease Progression , Ethmoid Sinusitis/complications , Ethmoid Sinusitis/diagnosis , Female , Foot Injuries/complications , Foot Injuries/diagnosis , Humans , Lung/diagnostic imaging , Maxillary Fractures/complications , Maxillary Fractures/diagnosis , Maxillary Sinus/injuries , Multiple Trauma/complications , Orbital Fractures/complications , Pandemics , Pleural Effusion/etiology , Pneumonia, Viral/complications , Rib Fractures/complications , Rib Fractures/diagnosis , SARS-CoV-2 , Toe Phalanges/injuries , Tomography, X-Ray Computed , Ulna Fractures/complications , Ulna Fractures/diagnosis
11.
CEN Case Rep ; 9(4): 404-408, 2020 11.
Article in English | MEDLINE | ID: covidwho-603821

ABSTRACT

On 31 December 2019, cases of pneumonia whose cause was later identified as SARS-CoV-2 were detected in Wuhan City, Hubei Province of China, and now COVID-19 has spread worldwide. On March 1, 2020, a 69-year-old Japanese man who had been on hemodialysis for 3 years was diagnosed as having COVID-19 pneumonia and hospitalized at our Medical Center. Pulmonary CT revealed bilateral multiple consolidation with bilateral pleural effusion. Aggressive weight reduction was needed to improve the patient's respiratory condition. Hemodialysis therapy was performed in isolation with hydroxychloroquine administration, but the formation of a dialysis membrane clot forced the withdrawal of dialysis therapy. Changing the dialysis membrane material and anticoagulant enabled the resumption of dialysis therapy, allowing the body weight to correct downward. On the 5th hospitalization day, the patient's fever dropped and he showed improved oxygenation and chest X-ray. He was eventually discharged. The hydroxychloroquine and appropriate fluid management may have contributed to the patient's recovery. Clinicians should pay close attention to avoid dialysis-related problems when treating a patient with COVID-19.


Subject(s)
Coronavirus Infections , Hydroxychloroquine/administration & dosage , Kidney Failure, Chronic , Pandemics , Pleural Effusion , Pneumonia, Viral , Renal Dialysis , Aged , Anti-Infective Agents/administration & dosage , Anticoagulants/therapeutic use , COVID-19 , Combined Modality Therapy , Comorbidity , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Humans , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/therapy , Lung/diagnostic imaging , Male , Membranes, Artificial , Pleural Effusion/diagnosis , Pleural Effusion/etiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Pneumonia, Viral/epidemiology , Pneumonia, Viral/etiology , Pneumonia, Viral/physiopathology , Renal Dialysis/instrumentation , Renal Dialysis/methods , Tomography, X-Ray Computed/methods , Treatment Outcome
12.
Clin Med (Lond) ; 20(4): e62-e65, 2020 07.
Article in English | MEDLINE | ID: covidwho-245760

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a highly contagious illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pneumonia and acute respiratory distress syndrome (ARDS) are the most common severe complications. There is growing evidence regarding the imaging findings of COVID-19 in chest X-rays and computed tomography (CT); however, their availability to clinical staff in this pandemic outbreak might be compromised. At this moment, the role of lung ultrasound (LUS) has yet to be explored. The purpose of this case report is to describe the natural course of the disease in mild infection managed at home. CASE REPORT: We report a 35-year-old man with recently diagnosed COVID-19 infection. Clinical examination was unremarkable. The diagnosis of mild disease was made clinically which was later reaffirmed by LUS after identifying a bilateral small pleural effusion and a thickened pleural line. During follow up, subpleural consolidations appeared before symptoms slightly aggravated (cough, tiredness and fever). The patient's condition improved after adjustment of therapy at home. CONCLUSION: LUS is an excellent tool in the characterisation of COVID-19 infection and is more available than CT or X-ray. We emphasise the utility and the opportunity that LUS presents in some clinical scenarios, like this COVID-19 pandemic, and how it may serve as a monitoring and therapy guide.


Subject(s)
Coronavirus Infections , Home Care Services/organization & administration , Lung/diagnostic imaging , Pandemics , Pleural Effusion , Pneumonia, Viral , Point-of-Care Systems , Ultrasonography/methods , Adult , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Coronavirus Infections/therapy , Health Services Accessibility , Humans , Male , Monitoring, Physiologic/methods , Pleural Effusion/diagnosis , Pleural Effusion/etiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Pneumonia, Viral/therapy , SARS-CoV-2 , Severity of Illness Index , Symptom Assessment/methods , Treatment Outcome
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