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1.
Crit Care Explor ; 2(9): e0218, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1795068

ABSTRACT

OBJECTIVES: To describe three coronavirus disease 2019 patients suffering from acute respiratory distress syndrome under venovenous extracorporeal membrane oxygenation therapy and tight anticoagulation monitoring presenting a novel pattern of multifocal brain hemorrhage in various degrees in all cerebral and cerebellar lobes. DESIGN: Clinical observation of three patients. Post mortem examinations. SETTING: Two ICUs at the University Hospital Erlangen. PATIENTS: Three patients (medium age 56.6 yr, two male with hypertension and diabetes, one female with no medical history) developed severe acute respiratory distress syndrome on the basis of a severe acute respiratory syndrome coronavirus 2 infection. All required mechanical ventilation and venovenous extracorporeal membrane oxygenation support. INTERVENTIONS: Clinical observation, CT, data extraction from electronic medical records, and post mortem examinations. MAIN RESULTS: We report on an unusual multifocal bleeding pattern in the white matter in three cases with severe acute respiratory distress syndrome due to coronavirus disease 2019 undergoing venovenous extracorporeal membrane oxygenation therapy. Bleeding pattern with consecutive herniation was found in CT scans as well as in neuropathologic post mortem examinations. Frequency for this unusual brain hemorrhage in coronavirus disease 2019 patients with extracorporeal membrane oxygenation therapy at our hospital is currently 50%, whereas bleeding events in extracorporeal membrane oxygenation patients generally occur at 10-15%. CONCLUSIONS: Multifocality and high frequency of the unusual white matter hemorrhage pattern suggest a coherence to coronavirus disease 2019. Neuropathological analyses showed circumscribed thrombotic cerebrovascular occlusions, which eventually led to microvascular and later on macrovascular disseminated bleeding events. However, signs of cerebrovascular inflammation could not be detected. Polymerase chain reaction analyses of brain tissue or cerebrospinal fluid remained negative. Increased susceptibility for fatal bleeding events should be taken into consideration in terms of systemic anticoagulation strategies in coronavirus disease 2019.

2.
Am J Case Rep ; 22: e931665, 2021 Jun 13.
Article in English | MEDLINE | ID: covidwho-1266947

ABSTRACT

BACKGROUND Since the outbreak of the SARS-CoV-2 infection, extensive research has been conducted on the pulmonary implications of this novel disease. However, there has been limited data on the extrapulmonary manifestations. There have been few documented causes of optic involvement and little is understood about the pathophysiology around its presentation and the possible treatments to prevent long-term complications. Here, we describe a case of optic neuritis in a female patient concurrently infected with SARS-CoV-2. Given the plethora of evidence supporting neurological manifestations of the virus, we hypothesize that there is an association between our patient's optic neuritis and her infection with SARS-CoV-2. CASE REPORT A 21-year-old woman with no past medical history who presented with blurry vision in her left eye. Optic neuritis was suspected with physical examination and confirmed with imaging of the optic nerve. Further diagnostic evaluation was nonsuggestive of multiple sclerosis and other demyelinating diseases; however, the patient was found to be positive for SARS-CoV-2. Steroids and remdesivir treatment were started, but without the presence of any respiratory symptoms. The patient's symptoms completely resolved by day 5 of hospitalization and she was discharged home without any complications. CONCLUSIONS Optic neuritis has remained an uncommon complication of SARS-CoV-2. This rather rare complication of SARS-CoV-2 is one that clinicians should be cognizant of due to the long-term implications of optic neuritis. Furthermore, it is pertinent to consider ophthalmic involvement in SARS-CoV-2 infection to appropriately guide patient care during the pandemic, as prompt treatment can lead to improved outcomes.


Subject(s)
COVID-19 , Multiple Sclerosis , Optic Neuritis , Adult , Female , Humans , Optic Neuritis/diagnosis , Optic Neuritis/etiology , Pandemics , SARS-CoV-2 , Young Adult
3.
Pan Afr Med J ; 38: 142, 2021.
Article in English | MEDLINE | ID: covidwho-1264677

ABSTRACT

Hemorrhagic manifestations during COVID-19 infections are increasingly described in the literature. We report the first case of spontaneous subcapsular hematoma of the liver revealing a COVID-19 infection in a 44-year-old woman with no underlying health condition history, a computerized tomography evaluation showed an aspect of lung ground-glass opacities, with moderate impairment estimated at about 20%. Reverse transcription-polymerase chain reaction confirmed the diagnosis of COVID-19 infection. During the COVID-19 pandemic, non-traumatic bleeding such as spontaneous hematomas in patients with no coagulation disorder could be a manifestation of COVID-19 infection.


Subject(s)
COVID-19/diagnosis , Hematoma/diagnosis , Liver Diseases/diagnosis , Adult , COVID-19/complications , Female , Hematoma/pathology , Hematoma/virology , Humans , Liver Diseases/pathology , Liver Diseases/virology , Reverse Transcriptase Polymerase Chain Reaction , Tomography, X-Ray Computed
4.
J Hematol ; 10(2): 83-88, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1234947

ABSTRACT

This is a case report of a 63-year-old African American female with a past medical history most significant for metastatic cholangiocarcinoma that presented for evaluation of persistent shortness of breath. Initial workup was remarkable for refractory anemia, moderate schistocytes on peripheral smear and lab work suggestive of a hemolytic anemia. Due to concern for thrombotic thrombocytopenic purpura (TTP), she subsequently underwent several rounds of plasma exchange without significant improvement. Secondary to progressive renal failure, patient eventually had a renal biopsy with findings remarkable for thrombotic microangiopathy (TMA). Simultaneously, patient was also diagnosed with coronavirus disease 2019 (COVID-19) infection. After a few weeks of supportive care, she was stable for discharge. Unfortunately, she did become dialysis dependent. Prior to hospital admission, she was being treated for metastatic cholangiocarcinoma and had received chemotherapy with gemcitabine. Her last chemotherapy session was approximately 3 weeks prior to her first hospitalization. Furthermore, although her hemolytic work did suggest TMA, it was not consistent with the diagnosis of TTP. She was transferred to a tertiary care center where hemolytic labs were trended, and supportive care was maximized. In light of the current COVID-19 pandemic, it is crucial to further investigate the pathophysiology of TMA in patients with active malignancies and COVID-19 infections. To our knowledge, this is the first case of TMA in a patient with both metastatic cholangiocarcinoma and COVID-19 infection.

5.
Radiol Case Rep ; 16(7): 1819-1821, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1213489

ABSTRACT

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the ongoing global pandemic. It can manifest a wide range of complications depending upon the severity of infection and comorbidities of the patient. Vaccines are very important measure to provide protection against COVID-19. We report a case of 72-year-old female with past medical history of hypertension and diabetes mellitus who underwent imaging with positron emission tomography (PET) scan imaging for staging of her small cell urinary bladder cancer and was found to have hypermetabolic uptake in the deltoid muscle of the left shoulder and hypermetabolic left axillary and pectoral lymph nodes due to mRNA BNT-162b2 (Pfizer-BioNTech COVID-19 vaccine) vaccine administrated 3 days ago prior to PET scan.

7.
Endocrine ; 72(1): 12-19, 2021 04.
Article in English | MEDLINE | ID: covidwho-1130911

ABSTRACT

OBJECTIVE: To analyze the clinical presentations of patients with endogenous Cushing's syndrome (CS) affected by Coronavirus disease-19 (COVID-19). MATERIALS AND METHODS: Patients who were referred to our clinic with active CS from 31st March to 15th May 2020 were screened for COVID-19 using real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Late-night serum cortisol (64-327 nmol/L), late-night salivary cortisol (LNSC) (0.5-9.4 nmol/L), or 24-h urinary free cortisol (24 hUFC) (100-379 nmol/24 h) were measured by electrochemiluminescence immunoassay. RESULTS: Among 22 patients with active CS we found three cases affected by COVID-19. Nonspecific inflammation markers were within the reference range or slightly elevated in these patients. A 71-year-old woman with newly diagnosed CS (late-night serum cortisol >1750 nmol/L, LNSC 908.6 nmol/L) developed dyspnea as an only symptom and died from bilateral polysegmantal hemorrhagic pneumonia 7 days later. A 38-year-old woman with a 5-year medical history of active Cushing's disease (CD) (late-night serum cortisol 581.3 nmol/L, 24 hUFC 959.7 nmol/24-h) suffered from dyspnea, cough, fever (39.3 °C) and chest pain. Oxygen therapy, antibiotics and symptomatic treatments lead to full recovery 24 days later. A 66-year-old woman with a 4-year medical history of mild CD (late-night serum cortisol 603.4 nmol/L, LNSC 10.03 nmol/L) tested positive for COVID-19 in routine screening and remained asymptomatic. CONCLUSIONS: The outcome of COVID-19 in patients with CS depends on the severity of hypercortisolism. Thus, severe hypercortisolism is a warning sign that CS affected by COVID-19 could require emergency care despite a lack of clinical presentations and low inflammation biomarkers.


Subject(s)
COVID-19 , Cushing Syndrome , Adrenocorticotropic Hormone , Adult , Aged , Circadian Rhythm , Cushing Syndrome/complications , Cushing Syndrome/diagnosis , Female , Humans , Hydrocortisone , SARS-CoV-2 , Saliva
8.
BMC Nephrol ; 22(1): 75, 2021 02 27.
Article in English | MEDLINE | ID: covidwho-1105702

ABSTRACT

BACKGROUND: Anti-glomerular basement membrane disease (GBM) disease is a rare autoimmune disease causing rapidly progressive glomerulonephritis and pulmonary haemorrhage. Recently, an association between COVID-19 and anti-glomerular basement membrane (anti-GBM) disease has been proposed. We report on a patient with recurrence of anti-GBM disease after SARS-CoV-2 infection. CASE PRESENTATION: The 31-year-old woman had a past medical history of anti-GBM disease, first diagnosed 11 years ago, and a first relapse 5 years ago. She was admitted with severe dyspnoea, haemoptysis, pulmonary infiltrates and acute on chronic kidney injury. A SARS-CoV-2 PCR was positive with a high cycle threshold. Anti-GBM autoantibodies were undetectable. A kidney biopsy revealed necrotising crescentic glomerulonephritis with linear deposits of IgG, IgM and C3 along the glomerular basement membrane, confirming a recurrence of anti-GBM disease. She was treated with steroids, plasma exchange and two doses of rituximab. Pulmonary disease resolved, but the patient remained dialysis-dependent. We propose that pulmonary involvement of COVID-19 caused exposure of alveolar basement membranes leading to the production of high avidity autoantibodies by long-lived plasma cells, resulting in severe pulmonary renal syndrome. CONCLUSION: Our case supports the assumption of a possible association between COVID-19 and anti-GBM disease.


Subject(s)
Anti-Glomerular Basement Membrane Disease/diagnosis , COVID-19/complications , Anti-Glomerular Basement Membrane Disease/etiology , Anti-Glomerular Basement Membrane Disease/physiopathology , Anti-Glomerular Basement Membrane Disease/therapy , Child , Cyclophosphamide/therapeutic use , Female , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Kidney/pathology , Kidney/physiology , Methylprednisolone/therapeutic use , Plasmapheresis , Prednisone/therapeutic use , Recurrence , SARS-CoV-2 , Urinary Bladder/physiopathology , Vesico-Ureteral Reflux/physiopathology
9.
Cureus ; 13(1): e12863, 2021 Jan 22.
Article in English | MEDLINE | ID: covidwho-1089176

ABSTRACT

A 47-year-old female with a past medical history of morbid obesity and hypertension presented with acute onset dizziness that started while she was at work one evening. She did not have chest pain or dyspnea. She had vital signs within an acceptable range, oxygen saturation of 98%-99%, and was not in acute distress. Examination including the Dix-Hallpike maneuver was unremarkable. Computed tomography angiography (CTA) of the head and neck disclosed bilateral pulmonary embolism without any evidence of cerebral ischemia. CTA chest confirmed the diagnosis of bilateral pulmonary emboli. Importantly, besides the obesity, the patient did not have any other risk factors of pulmonary embolism including recent immobilization, surgery, hormonal therapy or contraceptive use, and personal or family history of thromboembolic disorders. However, she was diagnosed with COVID-19 infection six months back with symptoms not requiring hospitalization. Following further workup for her dizziness and neurology evaluation, in the absence of any other plausible etiology, her presenting symptom was attributed to the atypical presentation of pulmonary embolism. She was treated with heparin in the hospital and discharged on apixaban. Her symptoms had resolved at the time of discharge.

10.
Brain Behav Immun Health ; 13: 100217, 2021 May.
Article in English | MEDLINE | ID: covidwho-1077784

ABSTRACT

OBJECTIVE: To report a patient with history of recurrent Bell's Palsy who developed Bell's Palsy 36 â€‹h after the administration of the second dose of the Pfizer-BioNTech COVID-19 vaccine. CASE: The patient is a 57-year-old female with past medical history of 3 episodes of Bell's Palsy. She responded to prednisone treatment and returned to her baseline after each occurrence. Less than 36 â€‹h following the second dose of the vaccine, the patient developed a left Bell's Palsy. The facial droop progressed in severity over the next 72 â€‹h. CONCLUSION: Given the expedited production of the vaccine and the novelty associated with its production, there may be information pertaining to side effects and individual response that remain to be discovered. Since both the Moderna and Pfizer Vaccine trials reported Bell's Palsy as medically attended adverse events, the association between vaccine administration and onset of symptomatic Bell's Palsy may warrant further investigation.

11.
Cureus ; 13(1): e12690, 2021 Jan 13.
Article in English | MEDLINE | ID: covidwho-1073761

ABSTRACT

Latent autoimmune diabetes in adults (LADA) is a type of slow-onset, immune-mediated insulin deficiency involving progressive destruction of beta-cell function. Despite sharing some similarities with both type 1 and type 2 diabetes, LADA is a separate entity that should be given equal attention as patients with this condition are subject to severe complications and preventable hospitalizations without proper medical management if not diagnosed in a timely manner. Herein, we describe the case of a 45-year-old Hispanic female with a past medical history of presumed noninsulin-dependent type 2 diabetes managed with metformin for six years who presented with fatigue, dry cough, and intermittent presyncope for one week. Laboratory data revealed evidence of diabetic ketoacidosis. She also tested positive for coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although her respiratory status was stable and did not require treatment for COVID-19, she required high doses of insulin to normalize hyperglycemia and spent two days in the intensive care unit (ICU). Further evaluation revealed positive islet autoantibodies and decreased C-peptide levels, leading to a diagnosis of LADA. SARS-CoV-2 has been shown to enter islet cells via the angiotensin-converting enzyme-2 (ACE2), causing damage and inducing acute diabetes and associated complications, including ketoacidosis. It is conceivable that this patient had acute worsening of her diabetes through this mechanism. Recognition of this association may contribute to the timely diagnosis of LADA and prevention of medical complications due to inappropriate diabetes therapy.

12.
Explore (NY) ; 18(2): 165-169, 2022.
Article in English | MEDLINE | ID: covidwho-1046457

ABSTRACT

INTRODUCTION: Neuropathic pain is a debilitating condition caused by lesion or disease of the somatosensory nervous system. Integrative modalities such as yoga, acupuncture, and massage are evidenced therapies for pain management. Additionally, medical cannabis and cannabinoids are emerging therapies for treatment of neuropathic pain (4,28). The authors of this study report a case of chronic neuropathic pain treated with integrative interventions. CASE PRESENTATION: The patient is a 71-year-old female with a past medical history of chronic neuropathic pain in her lower back and legs, degenerative arthritis, restless leg syndrome, carpal tunnel syndrome, and severe, chronic anxiety, presenting with worsening neuropathic pain. After over a decade of unsuccessful allopathic treatment, the patient sought out a more integrative approach to her pain management. A regimen of acupuncture, massage, gentle yoga, and medical cannabis was recommended. During the COVID-19 pandemic, she was unable to continue most of the integrative modalities and reported a significant increase in pain. The patient then joined a weekly Mind and Body program and began acupuncture treatments again, reporting a steady improvement in pain. CONCLUSION: The patient's chronic neuropathic pain was effectively treated using an integrative approach, with a combination of acupuncture, massage, yoga, mind-body approaches, and medical cannabis. While this case originally presented similarly to other cases of chronic neuropathic pain, it is unique in that it demonstrates the importance of an individualized complex approach, highlighting the patient's driven engagement in integrative modalities and medical cannabis.


Subject(s)
COVID-19 , Integrative Medicine , Neuralgia , Aged , Female , Humans , Neuralgia/therapy , Pandemics , SARS-CoV-2
13.
Cureus ; 12(11): e11795, 2020 Nov 30.
Article in English | MEDLINE | ID: covidwho-970853

ABSTRACT

A pneumonia outbreak with an unknown microbial etiology was reported in Wuhan, Hubei province of China, on December 31, 2019. This was later attributed to a novel coronavirus, currently called as severe acute respiratory system coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19) mainly affects the respiratory system and can also cause acute or chronic damage to the cardiovascular system. We present a case of a 64-year-old female with past medical history of diabetes mellitus and hypertension who presented to the Emergency Medicine Department with shortness of breath and worsening chest discomfort, then had a ventricular fibrillation (VF) arrest while in triage, in the context of COVID-19 diagnosis. Cardiovascular complications during the COVID-19 pandemic should be brought to medical attention; it is crucial that physicians be aware of the complications and treat it as an emergency.

14.
Cureus ; 12(11): e11310, 2020 Nov 03.
Article in English | MEDLINE | ID: covidwho-962472

ABSTRACT

To date, several studies have suggested a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)-mediated hypercoagulability in the forms of pulmonary embolism, stroke, gangrene, "COVID toes," as well as other acute thrombotic complications, warranting the use of systemic anticoagulation. Currently, there are no definitive recommendations as to the timing and dosing of prophylactic or therapeutic anticoagulation in coronavirus disease 2019 (COVID-19) patients. In this manuscript, we report a case of SARS-CoV2-mediated hypercoagulability and review the literature pertaining to the incidence and pathophysiology of coronavirus-mediated coagulopathies. A 64-year-old female, with a medical history of hypothyroidism and remote tobacco abuse, presented to the ED with fever and nonproductive cough. She had multiple negative SARS-CoV2 nasopharyngeal PCR tests during her hospital stay, but chest imaging and elevated inflammatory markers were suggestive of SARS-CoV2 infection. Computed tomography showed a left upper lobe pulmonary embolism with associated right heart strain, and an enlargement of the main pulmonary artery, for which she was initiated on therapeutic anticoagulation with low molecular weight heparin. Despite the medical management of her pulmonary embolism and conservative management of her SARS-CoV2, her clinical condition worsened requiring intubation and mechanical ventilation. After seven days, she was successfully extubated and was transferred to the medical service where her clinical course remained stable and subsequently discharged home on apixaban. In patients with SARS-CoV1-, SARS-CoV2-, and the Middle East respiratory syndrome coronavirus (MERS-CoV)-mediated hypercoagulability, the risk of thrombosis appears to be multifactorial - direct viral cytopathological effects, a pro-inflammatory state, cytokine storm, hypoxia-inducible thrombosis, and endothelial inflammation culminating in the formation of intra-alveolar or systemic fibrin clots. While initial guidelines have been developed to assist clinicians in selecting appropriate chemoprophylaxis as well as therapeutic anticoagulation, a consensus statement remains lacking. Further studies are needed to evaluate the pathogenesis and treatment of coronavirus-induced thrombosis.

15.
SN Compr Clin Med ; 2(12): 2899-2902, 2020.
Article in English | MEDLINE | ID: covidwho-942677

ABSTRACT

A 15-year-old female with no significant past medical history who presented with abdominal pain, vomiting, and diarrhea, found to be in acute renal failure and was subsequently diagnosed with multisystem inflammatory syndrome in children (MIS-C). Critical manifestations seen in pediatric COVID-19 can be varied affecting different organ systems. Pediatric providers, during a pandemic with imperfect testing, must be keenly aware of how varied the pathogenesis of COVID-19 can be in children.

16.
Am J Case Rep ; 21: e925897, 2020 Oct 15.
Article in English | MEDLINE | ID: covidwho-874954

ABSTRACT

BACKGROUND Coronavirus disease (COVID 19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is the causative agent of a serious disease that is of great global public health concern. Palsy of the third cranial nerve is very rare in patients with confirmed 2019 novel coronavirus disease (COVID-19). We describe the case of a patient with an incomplete palsy of the left third cranial nerve sparing the pupils in the context of SARS-CoV-2 virus infection. CASE REPORT We report the case of a 24-year-old woman with confirmed COVID-19, which presented with acute onset of diplopia and strabismus of the left eye that occurred 3 days after the start of general symptoms. The patient had no significant medical history. Based on detailed ophthalmic and neurological examination, acute painless incomplete palsy of the third cranial nerve was suspected. Oculo-cerebral magnetic resonance angiography was unremarkable. Blood tests revealed mild normocytic regenerative anemia. According to the Moroccan recommendations, chloroquine and azithromycin were started. After what, a quick improvement of exotropia and diplopia was observed, and complete recovery was obtained by the sixth day of treatment. No adverse effects of the treatment were noted. CONCLUSIONS Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause neurological complications such as cranial nerve palsy. The pathological mechanism remains unclear. Full recovery of the ocular motricity is possible, and prognosis depends on the severity of the respiratory illness.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Cranial Nerve Diseases/complications , Diplopia/etiology , Oculomotor Nerve/physiopathology , Pneumonia, Viral/complications , Strabismus/etiology , COVID-19 , Coronavirus Infections/epidemiology , Female , Humans , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Young Adult
17.
Am J Case Rep ; 21: e927812, 2020 Oct 03.
Article in English | MEDLINE | ID: covidwho-854653

ABSTRACT

BACKGROUND This is a case report of an immunocompromised patient with a history of non-Hodgkin lymphoma and persistent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who was seronegative and successfully treated with convalescent plasma. CASE REPORT A 63-year-old woman with a past medical history of non-Hodgkin lymphoma in remission while on maintenance therapy with the anti-CD20 monoclonal antibody, obinutuzumab, tested positive for SARS-CoV-2 via nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) testing over 12 weeks and persistently tested seronegative for immunoglobulin G (IgG) antibodies using SARS-CoV-2 IgG chemiluminescent microparticle immunoassay technology. During this time, the patient experienced waxing and waning of symptoms, which included fever, myalgia, and non-productive cough, but never acquired severe respiratory distress. She was admitted to our hospital on illness day 88, and her symptoms resolved after the administration of convalescent plasma. CONCLUSIONS As the understanding of the pathogenesis of SARS-CoV-2 continues to evolve, we can currently only speculate about the occurrence of chronic infection vs. reinfection. The protective role of antibodies and their longevity against SARS-CoV-2 remain unclear. Since humoral immunity has an integral role in SARS-CoV-2 infection, various phase 3 vaccine trials are underway. In the context of this pandemic, the present case demonstrates the challenges in our understanding of testing and treating immunocompromised patients.


Subject(s)
Antibodies, Monoclonal, Humanized/administration & dosage , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Immunocompromised Host , Lymphoma, Non-Hodgkin/immunology , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Antineoplastic Agents, Immunological/administration & dosage , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques/methods , Coronavirus Infections/therapy , Female , Follow-Up Studies , Humans , Immunization, Passive/methods , Lymphoma, Non-Hodgkin/complications , Lymphoma, Non-Hodgkin/drug therapy , Middle Aged , Pandemics , Real-Time Polymerase Chain Reaction/methods , Serologic Tests/methods , Severity of Illness Index , Treatment Outcome
18.
Cureus ; 12(9): e10607, 2020 Sep 23.
Article in English | MEDLINE | ID: covidwho-836398

ABSTRACT

Fever of unknown origin (FUO) is defined as fever (>101°F) that lasts more than three weeks and for which a cause is not found within seven days of hospital evaluation. FUO has a broad list of differentials - infection, inflammatory diseases, and malignancy. A detailed history and meticulous clinical examination with thorough and stepwise investigations lead to a diagnosis in only two-thirds of cases. In this article, we present a 17-year-old adolescent girl, with no significant past medical history, who presented with FUO during the COVID pandemic. A high index of suspicion and extensive investigations revealed the final diagnosis.

19.
Korean J Gastroenterol ; 76(3): 164-166, 2020 09 25.
Article in English | MEDLINE | ID: covidwho-793520

ABSTRACT

The World Health Organization has declared novel coronavirus disease 2019 (COVID-19) a global public health emergency. Although respiratory symptoms predominate in COVID-19, thrombosis can occur in patients with COVID-19. This paper reports a case of an 82-year-old female with a prior medical history of hypertension, diabetes presenting with fever and cough, and was diagnosed with COVID-19. The patient subsequently developed progressively worsening of abdominal distention, tenderness, and underwent emergent laparotomy. She was found to have a gangrenous colon. This case adds to the limited literature regarding the extrapulmonary complications of COVID-19.


Subject(s)
Colitis/diagnosis , Coronavirus Infections/diagnosis , Pneumonia, Viral/diagnosis , Venous Thrombosis/diagnosis , Abdomen/diagnostic imaging , Abdomen/surgery , Acute Disease , Aged, 80 and over , Anticoagulants/therapeutic use , Betacoronavirus/isolation & purification , COVID-19 , Colitis/pathology , Coronavirus Infections/complications , Coronavirus Infections/virology , Female , Heparin/therapeutic use , Humans , Laparotomy , Necrosis , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/virology , SARS-CoV-2 , Tomography, X-Ray Computed , Venous Thrombosis/complications , Venous Thrombosis/drug therapy
20.
Case Rep Cardiol ; 2020: 8842150, 2020.
Article in English | MEDLINE | ID: covidwho-772146

ABSTRACT

A 67-year-old female with prior medical history of HTN and asthma presented with acute-onset dyspnea and nausea for 4 days prior to admission. Upon initial encounter in the emergency room, she was found to have findings of abnormal pulmonary infiltrates and consequent workup revealed COVID-19. During further hospital course, the patient developed abnormal EKG and echocardiographic findings consistent with stress-induced cardiomyopathy.

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