Effects of nonsteroidal anti-inflammatory drugs on ultrasound findings of mRNA COVID-19 vaccine-related lymphadenopathy.

BACKGROUND: Previous studies reported axillary lymphadenopathy (LAP) as a side effect of the anti-COVID-19 vaccine. However, the effects of nonsteroidal anti-inflammatory drug (NSAID)s on mRNA COVID-19 vaccine-related LAP have not been investigated. PURPOSE: We aimed to investigate the effects of NSAIDs on temporal changes in sonographic findings of COVID-19 vaccine-associated LAP. METHODS: Our single-center retrospective cohort study was conducted between October 2021 and April 2022. We included patients (aged ≥ 18 years) who applied with complaints of swelling in the ipsilateral axillary region after the COVID-19 vaccine and had axillary region ultrasound (US) scans in electronic medical records within 30 days pre-vaccination. The serial US was performed on the third, 10th, and 30th days post-vaccination. RESULTS: Our study included 38 patients with a median age of 36 (IQR, 32-43) years. In 18 (47.4%) patients used NSAIDs in the early post-vaccination period. Measurements of LAPs on ultrasound scans increased at day 3 post-vaccination compared with pre-vaccination both in NSAID users and non-users. On the 10th day, a statistically insignificant decrease in LAP diameters and cortical thickness was observed in NSAID users compared to non-users. On the post-vaccination 30th day, axillary LAPs regressed similarly in both groups. CONCLUSION: In our study, post-vaccine NSAID use had no statistically significant effect on the course of axillary LAPs.

Is a high chest CT severity score a risk factor for an increased incidence of long-term neuroimaging findings after COVID-19?

OBJECTIVES: We aimed to determine the incidences of neuroimaging findings (NIF) and investigate the relationship between the course of pneumonia severity and neuroimaging findings. MATERIALS AND METHODS: Our study was a retrospective analysis of 272 (>18 years) COVID-19 patients who were admitted between "March 11, 2021, and September 26, 2022". All patients underwent both chest CT and neuroimaging. The patient's chest CTs were evaluated for pneumonia severity using a severity score system (CT-SS). The incidence of NIF was calculated. NIF were categorized into two groups; neuroimaging positive (NIP) and neuroimaging negative (NIN). Consecutive CT-SS changes in positive and negative NIF patients were analyzed. RESULTS: The median age of total patients was 71; IQR, 57-80. Of all patients, 56/272 (20.6%) were NIP. There was no significant relationship between NIP and mortality (p = 0.815) and ICU admission (p = 0.187). The incidences of NIF in our patients were as follows: Acute-subacute ischemic stroke: 47/272 (17.3%); Acute spontaneous intracranial hemorrhage: 13/272 (4.8%); Cerebral microhemorrhages: 10/272 (3.7%) and Cerebral venous sinus thrombosis: 3/25 (10.7%). Temporal change of CT-SSs, there was a statistically significant increase in the second and third CT-SSs compared to the first CT-SS in both patients with NIP and NIN. CONCLUSION: Our results showed that since neurological damage can be seen in the late period and neurological damage may develop regardless of pneumonia severity.

Investigation of comorbidities of COVID-19 patients with hepatosteatosis using latent class analysis

Introduction Coronavirus Disease 2019 (COVID-19) disease first appeared in Wuhan, China in December 2019. Subsequently, the pandemic spread rapidly throughout the entire world. The number of people who died from COVID-19 is rising daily due to the growing number cases. This retrospective study aims to classify patients with hepatosteatosis (HS) who had COVID-19, depending on additional disease characteristics and to compare survival times and death rates. Material and methods The study included 433 individuals with COVID-19 and HS at Amasya University Sabuncuoglu Serefeddin Education and Research Hospital. Additional disease characteristics of patients with HS were analyzed using latent class analysis (LCA) and the patients were divided into two groups. Results The study results indicate that the survival time of the first group, which was formed as a result of the LCA, was significantly lower than that of the second group (p = 0.038). The rate of diabetes, coronary artery disease, chronic rhythm disorder, chronic obstructive pulmonary disease (COPD) and chronic kidney disease was significantly higher in group 1 than in group 2 (respectively p < 0.001;p < 0.001;p < 0.001;p < 0.001;p = 0.015). Discussion In patients with HS, the presence of diabetes, coronary artery disease, chronic rhythm problem, COPD, and chronic renal disorders contributes to an increase in death rates due to COVID-19.

Retrobulbar ocular blood flow and choroidal vascular changes in patients recovering from COVID-19 infection.

BACKGROUND: To evaluate the effects of COVID-19 infection on the ocular vascular structure including choroidal thickness and retrobulbar blood flow values in comparison with healthy subjects. METHODS: Ninety eyes of 90 patients were included in this study. Participants were divided into Group 1 (n = 30) with mild COVID-19 infection, Group 2 (n = 31) with moderate disease, and Group 3 with age- and sex-matched healthy subjects (n = 29). Choroidal thickness was measured at the subfoveal area and at 500-µm intervals nasal and temporal to the fovea up to a distance of 1500 µm, using the enhanced depth imaging (EDI) technique of spectral coherence tomography (SD-OCT). The peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI), and pulsatility index (PI) values of the central retinal artery (CRA) and ophthalmic artery (OA) were evaluated with color Doppler ultrasonography (CDU). RESULTS: The choroidal thickness was significantly thinner in Group 1 and Group 2 than in Group 3 at all measurement points (p <0.001). This difference was not present between Group 1 and Group 2 who had COVID-19 disease of different severity (p>0.05).Among the retrobulbar blood flow parameters, OA PSV value was significantly lower in Group 1 and Group 2 compared to Group 3 (p = 0.025, p = 0.016, respectively). However, the CRA PSV and EDV and OA EDV values, and the CRA and OA PI and RI values were not statistically different between the groups (p> 0.05). CONCLUSION: COVID-19 infection may predispose patients to ocular vascular pathologies by affecting both choroidal and retrobulbar blood flow.

Mediastinal lymph node enlargement in COVID-19: Relationships with mortality and CT findings.

BACKGROUND: The presence of mediastinal lymph node enlargement (MLNE) in computed tomography (CT) of Coronavirus disease 2019 (COVID-19) patients can be associated with disease severity. OBJECTIVES: To investigate the relationship between MLNE with intensive care unit admission (ICU), mortality rates, and CT findings, especially in early-stage COVID-19 patients. METHODS: This single-center retrospective case-control study, included aged ≥18 years, 250 COVID-19 patients with positive RT-PCR tests. We included two patient groups, 125/250 with and without MLNE. Demographic information of the patients, laboratory findings, length of stay in hospital or ICU, mortality rates, initial CT imaging findings and CT severity scores (CT-SS) were recorded and their relationship with MLNE was investigated. RESULTS: Patients with MLNE were older (69.61 ± 11.16; p < 0.001) and had a higher CT-SS (14.67 ± 7.55; p < 0.001). There was a significant difference between the presence of MLNE with mortality (58/77, 75.3%; p < 0.001) and ICU admission (49/61, 80.3%; p < 0.001). Also, a statistical association was found between MLNE with ICU admission (p = 0.001) and (p < 0.001) mortality rates in patients with CORADS≤2 CT findings. In multivariate logistic regression analysis, MLNE was 8.8-fold (95% CI: 1.62-47.86, p =  0.01) more correlated with linear opacity and 0.25-fold with bronchial wall thickening (95% CI: 0.07-0.92, p =  0.04). CONCLUSION: Mediastinal lymph node enlargement is an important CT finding that can predict the severe prognosis of COVID-19 patients. Even in patients without lung involvement on initial CT, the presence of MLNE should be carefully examined as it is associated with disease severity.