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1.
Mod Rheumatol Case Rep ; 6(1): 75-79, 2022 Jan 07.
Article in English | MEDLINE | ID: covidwho-1868339

ABSTRACT

The case of a 75-year-old woman diagnosed with polymyalgia rheumatica (PMR), treated with low doses of prednisone, and with clinical and analytical remission is reported. Two years later, she presented with a clinical picture of giant cell arteritis (GCA), including headache, diplopia, jaw pain, feeling of swelling in both temples, and elevation of acute phase reactants. Symptoms spontaneously subsided 2 weeks later, while analytical parameters improved without any treatment. A high-resolution colour Doppler ultrasound showed thickening of the intima-media complex with 'halo' sign in the right temporal artery. A biopsy of the right temporal artery was performed, although it was not successful, as no artery could be found, and the procedure became more complicated with an eyebrow ptosis due to a lesion in the frontal branch of the facial nerve. GCA diagnosis was based on the clinical, laboratory, and ultrasound findings. The patient was treated with prednisone and methotrexate, without clinical or analytical relapse. Comments are presented on the described cases of GCA with spontaneous remission, and the most appropriate treatments in these cases are discussed. Other peculiarities of the case, such as the progression to GCA more than 2 years after the onset of PMR, and the complications from the temporal artery biopsy are also mentioned.


Subject(s)
Giant Cell Arteritis , Polymyalgia Rheumatica , Aged , Female , Giant Cell Arteritis/diagnosis , Giant Cell Arteritis/drug therapy , Humans , Prednisone/therapeutic use , Remission, Spontaneous , Temporal Arteries/diagnostic imaging
6.
Clin Lymphoma Myeloma Leuk ; 21(10): e810-e816, 2021 10.
Article in English | MEDLINE | ID: covidwho-1313014

ABSTRACT

BACKGROUND: We previously reported elsewhere of a follicular lymphoma patient suffering from persistent COVID-19 pneumonia that was still ongoing at 2 months after onset. MATERIALS AND METHODS: We provide a follow-up report of the case along with a literature review of immunocompromised lymphoma patients experiencing prolonged COVID-19 infections. RESULTS: Although requiring a full 1 year, the presented case eventually achieved spontaneous resolution of COVID-19 pneumonia. Anti-SARS-CoV-2 antibodies could not be detected throughout the disease course, but COVID-19-directed T-cell response was found to be intact. The patient also developed secondary immune thrombocytopenia subsequent to COVID-19 pneumonia. We found 19 case reports of immunocompromised lymphoma patients with prolonged COVID-19 infections in the literature. All 5 patients who died did not receive convalescent plasma therapy, whereas resolution of COVID-19 infection was achieved in 8 out of 9 patients who received convalescent plasma therapy. CONCLUSIONS: We demonstrate through the presented case that while time-consuming, resolution of COVID-19 infections may be achieved without aid from humoral immunity if cellular immunity is intact. Immunocompromised lymphoma patients are at risk of a prolonged disease course of COVID-19, and convalescent plasma therapy may be a promising approach in such patients.


Subject(s)
COVID-19/immunology , Lymphoma, Follicular/drug therapy , Pneumonia/immunology , Rituximab/therapeutic use , SARS-CoV-2/immunology , Thrombocytopenia/immunology , Antineoplastic Agents, Immunological/therapeutic use , COVID-19/virology , Female , Follow-Up Studies , Humans , Immunocompromised Host/immunology , Lymphoma, Follicular/complications , Lymphoma, Follicular/immunology , Maintenance Chemotherapy/methods , Middle Aged , Pneumonia/complications , Pneumonia/virology , Remission, Spontaneous , SARS-CoV-2/physiology , T-Lymphocytes/immunology , T-Lymphocytes/virology , Thrombocytopenia/complications
9.
Int Forum Allergy Rhinol ; 11(7): 1041-1046, 2021 07.
Article in English | MEDLINE | ID: covidwho-1136915

ABSTRACT

The frequent association between coronavirus disease 2019 (COVID-19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID-19-related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID-19-related olfactory dysfunction is high; and (3) corticosteroids have well-known potential adverse effects. We encourage randomized placebo-controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects.


Subject(s)
Adrenal Cortex Hormones/pharmacology , COVID-19 , Medication Therapy Management/statistics & numerical data , Olfaction Disorders , COVID-19/complications , COVID-19/physiopathology , Drug-Related Side Effects and Adverse Reactions/diagnosis , Drug-Related Side Effects and Adverse Reactions/etiology , Drug-Related Side Effects and Adverse Reactions/prevention & control , Global Health , Humans , Medication Therapy Management/standards , Needs Assessment , Olfaction Disorders/drug therapy , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Olfactory Mucosa/drug effects , Olfactory Mucosa/virology , Remission, Spontaneous , Research Design , SARS-CoV-2/pathogenicity
11.
Clin Exp Dermatol ; 46(3): 444-450, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-955618

ABSTRACT

The current COVID-19 pandemic is caused by the SARS-CoV-2 coronavirus. The initial recognized symptoms were respiratory, sometimes culminating in severe respiratory distress requiring ventilation, and causing death in a percentage of those infected. As time has passed, other symptoms have been recognized. The initial reports of cutaneous manifestations were from Italian dermatologists, probably because Italy was the first European country to be heavily affected by the pandemic. The overall clinical presentation, course and outcome of SARS-CoV-2 infection in children differ from those in adults as do the cutaneous manifestations of childhood. In this review, we summarize the current knowledge on the cutaneous manifestations of COVID-19 in children after thorough and critical review of articles published in the literature and from the personal experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss one of the first and most widespread cutaneous manifestation of COVID-19, chilblain-like lesions. In Part 2, we review other manifestations, including erythema multiforme, urticaria and Kawasaki disease-like inflammatory multisystemic syndrome, while in Part 3, we discuss the histological findings of COVID-19 manifestations, and the testing and management of infected children, for both COVID-19 and any other pre-existing conditions.


Subject(s)
COVID-19/complications , Chilblains/virology , Adolescent , COVID-19/diagnosis , COVID-19/pathology , COVID-19/therapy , COVID-19 Testing , Chilblains/immunology , Chilblains/pathology , Child , Humans , Interferon Type I/immunology , Remission, Spontaneous , Risk Factors , SARS-CoV-2 , Thrombosis/etiology , Vasculitis/etiology
14.
Vaccine ; 38(48): 7629-7637, 2020 11 10.
Article in English | MEDLINE | ID: covidwho-879777

ABSTRACT

This work demonstrates the presence of immune regulatory cells in the cervical lymph nodes draining Bacillus Calmette-Guérin (BCG) vaccinated site on the dorsum of the ear in guinea pigs. It is shown that whole cervical lymph node cells did not proliferate in vitro in the presence of soluble mycobacterial antigens (PPD or leprosin) despite being responsive to whole mycobacteria. Besides, T cells from these lymph nodes separated as a non-adherent fraction on a nylon wool column, proliferated to PPD in the presence of autologous antigen presenting cells. Interestingly, addition of as low as 20% nylon wool adherent cells to these, sharply decreased the proliferation by 83%. Looking into what cells in the adherent fraction suppressed the proliferation, it was found that neither the T cell nor the macrophage enriched cell fractions of this population individually showed suppressive effect, indicating that their co-presence was necessary for the suppression. Since BCG induced granulomas resolve much faster than granulomas induced by other mycobacteria such as Mycobacterium leprae the present experimental findings add to the existing evidence that intradermal BCG vaccination influences subsequent immune responses in the host and may further stress upon its beneficial role seen in Covid-19 patients.


Subject(s)
Antigens, Bacterial/pharmacology , BCG Vaccine/pharmacology , Granuloma/immunology , Lymph Nodes/immunology , T-Lymphocytes/immunology , Animals , Antigen-Presenting Cells/drug effects , Antigen-Presenting Cells/immunology , Antigen-Presenting Cells/microbiology , COVID-19 , Cell Adhesion , Cell Proliferation , Coronavirus Infections/prevention & control , Ear , Female , Granuloma/microbiology , Guinea Pigs , Humans , Injections, Intradermal , Lymph Nodes/microbiology , Macrophages/drug effects , Macrophages/immunology , Macrophages/microbiology , Male , Mycobacterium bovis/immunology , Mycobacterium leprae/immunology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Remission, Spontaneous , T-Lymphocytes/classification , T-Lymphocytes/drug effects , T-Lymphocytes/microbiology
15.
J Basic Clin Physiol Pharmacol ; 31(6)2020 Sep 09.
Article in English | MEDLINE | ID: covidwho-750995

ABSTRACT

Objectives The number of coronavirus disease (COVID-19) cases is increasing in Bangladesh. Many people have suffered from symptoms like COVID-19 during this pandemic, and some people have cured without taking any treatment or taking minor pharmacological and non-pharmacological treatments. However, they might be spreading their infections among their family members and perhaps in the community. It is unsure that individuals with COVID-19-like symptoms are positive with COVID-19, but our concern is, during this pandemic, any types of symptoms such as flu-like symptoms should have been taken seriously. This study was observed in the cases from three families with COVID-19 like symptoms. Case presentation This observational study was done between May 20 and Jun 2, 2020, in Bangladesh. The members of the inspected families shared COVID-19 like symptoms that were lasted for 3-10 days. Conclusions COVID-19 might be spread and cured silently in Bangladesh, which recommends that awareness is needed throughout the country to prevent the spreading of the disease.


Subject(s)
Coronavirus Infections/transmission , Pneumonia, Viral/transmission , Adult , Bangladesh , COVID-19 , Child , Female , Humans , Male , Middle Aged , Pandemics , Remission, Spontaneous , Young Adult
16.
Echocardiography ; 37(9): 1465-1469, 2020 09.
Article in English | MEDLINE | ID: covidwho-733239

ABSTRACT

A previously healthy 49-year-old male patient presented with COVID-19 infection and required mechanical ventilation and extracorporeal membrane oxygenation due to severe hypoxemia. Echocardiography showed cardiac dysfunction with an apical sparing strain pattern, which rapidly normalized within a week. Apical sparing myocardial strain in patients with COVID-19 infection may suggest reverse-type stress cardiomyopathy.


Subject(s)
COVID-19/complications , Echocardiography/methods , Remission, Spontaneous , Ventricular Dysfunction, Left/diagnostic imaging , Ventricular Dysfunction, Left/etiology , COVID-19/physiopathology , Heart Ventricles/diagnostic imaging , Heart Ventricles/physiopathology , Humans , Male , Middle Aged , Ventricular Dysfunction, Left/physiopathology
17.
Asian Pac J Allergy Immunol ; 38(2): 69-77, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-610528

ABSTRACT

During the initial pandemic wave of COVID-19, apart from common presenting symptoms (cough, fever, and fatigue), many countries have reported a sudden increase in the number of smell and taste dysfunction patients. Smell dysfunction has been reported in other viral infections (parainfluenza, rhinovirus, SARS, and others), but the incidence is much lower than SARS-CoV-2 infection. The pathophysiology of post-infectious olfactory loss was hypothesized that viruses may produce an inflammatory reaction of the nasal mucosa or damage the olfactory neuroepithelium directly. However, loss of smell could be presented in COVID-19 patients without other rhinologic symptoms or significant nasal inflammation. This review aims to provide a brief overview of recent evidence for epidemiology, pathological mechanisms for the smell, and taste dysfunction in SARS-CoV-2 infected patients. Furthermore, prognosis and treatments are reviewed with scanty evidence. We also discuss the possibility of using "smell and taste loss" as a screening tool for COVID-19 and treatment options in the post-SARS-CoV-2 infectious olfactory loss.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Olfaction Disorders/epidemiology , Olfaction Disorders/physiopathology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Adrenal Cortex Hormones/therapeutic use , Antiviral Agents/therapeutic use , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Humans , Incidence , Olfaction Disorders/diagnosis , Olfaction Disorders/drug therapy , Olfactory Mucosa/drug effects , Olfactory Mucosa/physiopathology , Olfactory Mucosa/virology , Olfactory Perception/drug effects , Pneumonia, Viral/diagnosis , Pneumonia, Viral/drug therapy , Practice Guidelines as Topic , Prognosis , Quinoxalines/therapeutic use , Remission, Spontaneous , SARS-CoV-2 , Taste Perception/drug effects , Vitamin A/therapeutic use
18.
R I Med J (2013) ; 103(6): 37-38, 2020 Jun 10.
Article in English | MEDLINE | ID: covidwho-604090

ABSTRACT

To date, there have been reports of neurologic manifestations in COVID-19 patients including ischemic strokes, Guillain-Barre Syndrome and anosmia. In this case report, we describe a patient who presented with dysosmia, dysgeusia, along with monocular peripheral vision loss after being diagnosed with COVID-19.


Subject(s)
Betacoronavirus/isolation & purification , Blindness , Diagnostic Techniques, Ophthalmological , Neurologic Examination/methods , Olfaction Disorders , Blindness/diagnosis , Blindness/etiology , Brain/diagnostic imaging , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/physiopathology , Female , Humans , Magnetic Resonance Imaging/methods , Middle Aged , Olfaction Disorders/diagnosis , Olfaction Disorders/etiology , Optic Nerve/diagnostic imaging , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Remission, Spontaneous , SARS-CoV-2 , Treatment Outcome
19.
Ann R Coll Surg Engl ; 102(6): e145-e147, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-598906

ABSTRACT

We present the case of a critically ill 47-year-old man diagnosed with SARS-CoV-2 (COVID-19) who developed extensive pneumatosis intestinalis and portal venous gas in conjunction with an acute abdomen during the recovery phase of his acute lung injury. A non-surgical conservative approach was taken as the definitive surgical procedure; a complete small-bowel resection was deemed to be associated with an unacceptably high long-term morbidity. However, repeat computed tomography four days later showed complete resolution of the original computed tomography findings. Pneumatosis intestinalis from non-ischaemic origins has been described in association with norovirus and cytomegalovirus. To our knowledge, this is the first time that this has been described in COVID-19.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Embolism, Air/diagnosis , Mesenteric Ischemia/diagnosis , Pneumatosis Cystoides Intestinalis/diagnosis , Pneumonia, Viral/complications , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Coronavirus Infections/virology , Diagnosis, Differential , Embolism, Air/complications , Humans , Intestines/diagnostic imaging , Intestines/pathology , Lung/diagnostic imaging , Male , Middle Aged , Pandemics , Pneumatosis Cystoides Intestinalis/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Portal Vein/diagnostic imaging , Radiography, Thoracic , Remission, Spontaneous , Respiration, Artificial , SARS-CoV-2 , Tomography, X-Ray Computed
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