ABSTRACT
This is a rare case-report of a young female with systemic lupus erythematosus and end-stage kidney disease (on maintenance hemodialysis) who was admitted to our intensive care unit due to life-threatening COVID-19. The patient was diagnosed with a flare of lupus; while being on maintenance hydroxychloroquine therapy. However, after the administration of steroids she made an uneventful recovery and was discharged home. In this report, the diagnostic dilemmas and the therapeutic challenges due to the overlapping clinical, imaging, and laboratory findings between lupus and COVID-19 pneumonitis are outlined. In conclusion, patients with lupus may be affected by COVID-19 despite the administration of hydroxychloroquine. The administration of steroids may have a beneficial effect on mitigating both the flare of SLE and the COVID-19 associated hyperinflammation.
Subject(s)
Nuclear Warfare , Nuclear Weapons/legislation & jurisprudence , Physician's Role , History, 20th Century , History, 21st Century , Humans , International Cooperation/history , Nobel Prize , Nuclear Warfare/history , Nuclear Warfare/legislation & jurisprudence , Nuclear Warfare/prevention & control , Organizations, Nonprofit/history , United NationsSubject(s)
Nuclear Warfare/prevention & control , Nuclear Weapons , Social Responsibility , Social Welfare/statistics & numerical data , Humans , International Cooperation , National Health Programs/organization & administration , Norway , Radioactive Hazard Release/prevention & control , Relief WorkABSTRACT
It is well documented that depression increases the risk of cardiovascular disease (CVD). Women of age 55 and younger with depression are more likely to have CVD. The present study aims to investigate CVD risk in depressed women of reproductive age (RA) and menopausal age (MA). Adult women of RA and MA were divided in to two groups; healthy and depressed. Women were screened for depression (ICD-10 criteria) at outpatients department of local psychiatric hospital. Fasting serum cortisol, estradiol and lipid profile levels were determined. Data was analyzed using two-way ANOVA followed by Newman's Keuls q-test. Total cholesterol (TC), low-density lipoproteins (LDL) and triglycerides (TGs) were raised in MA women however high density lipoprotein (HDL) and estradiol were lower as compared to RA women. Depressed RA women showed increased TC, LDL and HDL but decreased estradiol as compared to healthy women of similar age group. MA depressed women showed increased TC and LDL but decreased HDL and estradiol as compared to healthy controls. We found that MA depressed women had low HDL and estradiol as compared to RA depressed women. Circulating cortisol levels were increased in both depressed RA and MA women compared to respective healthy controls. Low HDL/LDL ratio was found in both healthy and depressed MA women when compared with respective RA women. A significant negative correlation of estradiol and cortisol was found in depressed RA women. It is concluded that low HDL/LDL ratio and hypercortisolemia in both healthy and depressed MA women make them more vulnerable to CVD.
