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1.
Int J Surg Case Rep ; 82: 105865, 2021 May.
Article in English | MEDLINE | ID: covidwho-1174316

ABSTRACT

INTRODUCTION AND IMPORTANCE: Several complications after corona viral infection-19 (COVID-19) have been reported. The study aims is to present a case with post-covid-19 pulmonary fungal infection with antifungal resistance characteristics. CASE PRESENTATION: A 50-year-old male presented with hemoptysis, dyspnea, cough, fever, and rigor for 4-month duration. Three weeks before this complaint, he had cured of COVID-19. Investigations showed multiple ill-defined cavitary lesions involving the left upper lobe. The patient underwent a left upper lobectomy. The post-operative period was uneventful. CLINICAL DISCUSSION: All studies of COVID-19 fungal infections reported occurrence during the COVID-19 infection, mostly 14 days after the appearance of COVID-19 symptoms. The case in the current study was a 50-year-old patient, who was previously diagnosed with COVID-19 for a period of 4 months. After a few days from his recovery, the patient developed dyspnea, cough, fever, and rigor again. CONCLUSION: Pulmonary aspergillosis is a serious complication of COVID-19 patients that may not respond well to medical therapy. Pulmonary resection is the last and effective strategy to control the disease.

2.
Gen Thorac Cardiovasc Surg ; 69(8): 1258-1260, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1173992

ABSTRACT

We present two cases of lobectomy in lung cancer patients who recovered from COVID-19 before surgical treatment. In both cases, video-assisted thoracoscopic surgery was initiated and hilar fibrosis was detected; as a result, conversion was performed in one case. There were no postoperative complications and mortality. Also, we demonstrate the results of pathological examination in patients who have recovered from COVID-19.


Subject(s)
COVID-19 , Lung Neoplasms , Humans , Length of Stay , Lung Neoplasms/surgery , Pneumonectomy , Retrospective Studies , SARS-CoV-2 , Thoracic Surgery, Video-Assisted
3.
Gen Thorac Cardiovasc Surg ; 69(7): 1159-1162, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1163151

ABSTRACT

A 65-year-old man with coronavirus disease 2019 (COVID-19) was admitted to our hospital. Computed tomography detected bilateral pneumonia with a lung nodule suspicious for lung cancer. Lobectomy was performed 3 months after the treatment for COVID-19 without any complications. The surgical specimen revealed fibrosis below the pleura with a small collection of lymphocytes and intravascular hemorrhagic thrombosis, and no residual RNA was detected. This is the first report describing a surgical specimen after recovery from COVID-19 pneumonia, and suggests that elective thoracic surgery can be performed safely, depending on the patient's respiratory function, without infectious risk.


Subject(s)
COVID-19 , Pneumonia , Aged , Elective Surgical Procedures , Humans , Lung/diagnostic imaging , Lung/surgery , Male , SARS-CoV-2
4.
Interact Cardiovasc Thorac Surg ; 33(1): 150-152, 2021 06 28.
Article in English | MEDLINE | ID: covidwho-1118995

ABSTRACT

We report a rare case of solitary peripheral pulmonary artery aneurysm in a patient who was evaluated for haemoptysis. Incidentally, his total antibodies were positive for Coronavirus 2019 infection. Patient underwent right lower lobectomy uneventfully. Peripheral pulmonary artery aneurysms arising from segmental or intrapulmonary branches are extremely rare. Untreated, the majority end fatally due to sudden rupture and exsanguination. The purpose of this article is to report our rare case and review the pertinent literature.


Subject(s)
Aneurysm/pathology , Pulmonary Artery/pathology , Adult , Aneurysm/diagnostic imaging , Aneurysm/surgery , Humans , Male , Pulmonary Artery/diagnostic imaging , Pulmonary Artery/surgery , Tomography, X-Ray Computed
5.
Ann Thorac Surg ; 111(4): e241-e243, 2021 04.
Article in English | MEDLINE | ID: covidwho-956092

ABSTRACT

We report a case of necrotizing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia complicated by a bronchopleural fistula and treated by decortication and salvage lobectomy. Owing to the unknown characteristics of the underlying SARS-CoV-2 infection, treatment of the abscess and bronchopleural fistula was delayed. This may have resulted in further deterioration of the patient, with ensuing multiple organ dysfunction. Complications of SARS-CoV-2 pneumonia, such as a bacterial abscess and a bronchopleural fistula, should be treated as if the patient were not infected with SARS-CoV-2.


Subject(s)
Bronchial Fistula/surgery , COVID-19/complications , Lung/diagnostic imaging , Pleural Diseases/surgery , Pneumonectomy/methods , Pneumonia, Viral/complications , Adult , Bronchial Fistula/diagnosis , Bronchial Fistula/etiology , COVID-19/diagnosis , COVID-19/epidemiology , Female , Humans , Lung/surgery , Pleural Diseases/diagnosis , Pleural Diseases/etiology , Pneumonia, Viral/diagnosis , Pneumonia, Viral/surgery , Tomography, X-Ray Computed
6.
Eur J Cardiothorac Surg ; 58(6): 1222-1227, 2020 12 01.
Article in English | MEDLINE | ID: covidwho-910370

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has resulted in patient reluctance to seek care due to fear of contracting the virus, especially in New York City which was the epicentre during the surge. The primary objectives of this study are to evaluate the safety of patients who have undergone pulmonary resection for lung cancer as well as provider safety, using COVID-19 testing, symptoms and early patient outcomes. METHODS: Patients with confirmed or suspected pulmonary malignancy who underwent resection from 13 March to 4 May 2020 were retrospectively reviewed. RESULTS: Between 13 March and 4 May 2020, 2087 COVID-19 patients were admitted, with a median daily census of 299, to one of our Manhattan campuses (80% of hospital capacity). During this time, 21 patients (median age 72 years) out of 45 eligible surgical candidates underwent pulmonary resection-13 lobectomies, 6 segmentectomies and 2 pneumonectomies were performed by the same providers who were caring for COVID-19 patients. None of the patients developed major complications, 5 had minor complications, and the median length of hospital stay was 2 days. No previously COVID-19-negative patient (n = 20/21) or healthcare provider (n = 9: 3 surgeons, 3 surgical assistants, 3 anaesthesiologists) developed symptoms of or tested positive for COVID-19. CONCLUSIONS: Pulmonary resection for lung cancer is safe in selected patients, even when performed by providers who care for COVID-19 patients in a hospital with a large COVID-19 census. None of our patients or providers developed symptoms of COVID-19 and no patient experienced major morbidity or mortality.


Subject(s)
COVID-19/prevention & control , Carcinoma, Non-Small-Cell Lung/surgery , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Lung Neoplasms/surgery , Pneumonectomy , Postoperative Complications/prevention & control , Adenocarcinoma/surgery , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/transmission , COVID-19 Testing , Cross Infection/diagnosis , Cross Infection/epidemiology , Cross Infection/prevention & control , Female , Follow-Up Studies , Health Services Accessibility , Hospitalization , Humans , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Male , Middle Aged , New York City/epidemiology , Pandemics , Patient Safety/statistics & numerical data , Patient Selection , Perioperative Care/methods , Postoperative Complications/diagnosis , Postoperative Complications/epidemiology , Retrospective Studies , Treatment Outcome
7.
Diabetes ; 69(12): 2691-2699, 2020 12.
Article in English | MEDLINE | ID: covidwho-836138

ABSTRACT

Increased expression of pulmonary ACE2, the SARS-CoV-2 receptor, could contribute to increased infectivity of COVID-19 in patients with diabetes, but ACE2 expression has not been studied in lung tissue of subjects with diabetes. We therefore studied ACE2 mRNA and protein expression in lung tissue samples of subjects with and without diabetes that were collected between 2002 and 2020 from patients undergoing lobectomy for lung tumors. For RT-PCR analyses, samples from 15 subjects with diabetes were compared with 91 randomly chosen control samples. For immunohistochemical staining, samples from 26 subjects with diabetes were compared with 66 randomly chosen control samples. mRNA expression of ACE2 was measured by quantitative RT-PCR. Protein levels of ACE2 were visualized by immunohistochemistry on paraffin-embedded lung tissue samples and quantified in alveolar and bronchial epithelium. Pulmonary ACE2 mRNA expression was not different between subjects with or without diabetes. In contrast, protein levels of ACE2 were significantly increased in both alveolar tissue and bronchial epithelium of patients with diabetes compared with control subjects, independent of smoking, chronic obstructive pulmonary disease, BMI, renin-angiotensin-aldosterone system inhibitor use, and other potential confounders. To conclude, we show increased bronchial and alveolar ACE2 protein expression in patients with diabetes. Further research is needed to elucidate whether upregulation of ACE2 expression in airways and lungs has consequences on infectivity and clinical outcomes of COVID-19.


Subject(s)
Angiotensin-Converting Enzyme 2/metabolism , COVID-19/virology , Diabetes Mellitus, Type 2/complications , Lung/metabolism , SARS-CoV-2 , Angiotensin-Converting Enzyme 2/genetics , COVID-19/complications , Gene Expression Regulation , Humans , RNA, Messenger
8.
Gen Thorac Cardiovasc Surg ; 69(3): 577-579, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-807499

ABSTRACT

Here, we report a 54-year-old man who underwent double-sleeve left upper lobectomy for lung cancer and his postoperative course was complicated with COVID-19 pneumonia. Five days after his discharge from hospital, he was re-admitted with mild fever and bilateral multiple ground glass opacities on his chest CT. PCR testing confirmed COVID-19 infection and he was treated according to policies established by our nation's health authority. He is still receiving adjuvant chemotherapy and remains well at 3 months after the operation.


Subject(s)
COVID-19/etiology , Lung Neoplasms/surgery , Pneumonectomy/adverse effects , Pneumonia, Viral/etiology , RNA, Viral/analysis , SARS-CoV-2/genetics , COVID-19/epidemiology , Humans , Male , Middle Aged , Pneumonia, Viral/diagnosis , Pneumonia, Viral/virology , Tomography, X-Ray Computed
9.
Ann Thorac Surg ; 111(3): e183-e184, 2021 03.
Article in English | MEDLINE | ID: covidwho-797517

ABSTRACT

Patients with severe coronavirus disease 2019 from infection with severe acute respiratory syndrome coronavirus 2 mount a profound inflammatory response and are predisposed to thrombotic complications. Pulmonary vein thrombosis is a rare disease process resulting in pulmonary congestion, infarction, and potential mortality. This report describes a patient with coronavirus disease 2019 requiring venovenous extracorporeal membrane oxygenation for hypoxic respiratory failure who developed hemorrhagic infarction of the right lower lobe. During emergency exploration the patient was found to have a right inferior vein thrombosis and marked lobar hemorrhage mandating lobectomy.


Subject(s)
COVID-19/complications , Hemoptysis/surgery , Infarction/surgery , Lung/blood supply , Pneumonectomy/methods , Adult , COVID-19/epidemiology , Hemoptysis/etiology , Humans , Infarction/etiology , Lung/surgery , Male , Pandemics
10.
Ann Thorac Surg ; 111(3): e181-e182, 2021 03.
Article in English | MEDLINE | ID: covidwho-796736

ABSTRACT

Concomitant coronavirus disease 19 (COVID-19) is a major risk factor for complications in any type of surgical procedure, especially in thoracic surgery, were the primary organ involved, the lung, is manipulated to perform parenchymal resection. However, it is not clear whether previous infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may lead to increased morbidity and mortality for subsequent procedures once radiologic resolution is achieved. We report a young patient with lung cancer who successfully underwent a right upper lobectomy for primary adenocarcinoma by video-assisted thoracoscopic surgery with no complication in the early postoperative phase.


Subject(s)
COVID-19/epidemiology , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Pneumonectomy/methods , SARS-CoV-2 , Thoracic Surgery, Video-Assisted/methods , Carcinoma, Non-Small-Cell Lung/epidemiology , Comorbidity , Humans , Lung Neoplasms/epidemiology , Male , Middle Aged , Operative Time , Pandemics , Postoperative Period
11.
J Thorac Oncol ; 15(5): 700-704, 2020 05.
Article in English | MEDLINE | ID: covidwho-2529

ABSTRACT

There is currently a lack of pathologic data on the novel coronavirus (severe acute respiratory syndrome coronavirus 2) pneumonia, or coronavirus disease 2019 (COVID-19), from autopsy or biopsy. Two patients who recently underwent lung lobectomies for adenocarcinoma were retrospectively found to have had COVID-19 at the time of the operation. These two cases thus provide important first opportunities to study the pathology of COVID-19. Pathologic examinations revealed that apart from the tumors, the lungs of both patients exhibited edema, proteinaceous exudate, focal reactive hyperplasia of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Hyaline membranes were not prominent. Because both patients did not exhibit symptoms of pneumonia at the time of operation, these changes likely represent an early phase of the lung pathology of COVID-19 pneumonia.


Subject(s)
Adenocarcinoma/surgery , Coronavirus Infections/complications , Lung Neoplasms/surgery , Lung/pathology , Pneumonia, Viral/complications , Adenocarcinoma/complications , Aged , Aged, 80 and over , Betacoronavirus , COVID-19 , Female , Humans , Lung/diagnostic imaging , Lung/surgery , Lung Neoplasms/complications , Male , Pandemics , Retrospective Studies , SARS-CoV-2 , Tomography, X-Ray Computed
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