ABSTRACT
BACKGROUNDS: Fortunately, much has been studied about COVID-19 in patients with inflammatory bowel diseases (IBD). Evidence suggests that these patients do not appear to be at increased risk of severe COVID-19. However, there are still some uncertainties regarding the clinical manifestations of COVID-19 in patients with immune-mediated diseases. OBJECTIVE: This study aimed to describe the main symptoms of COVID-19 and their frequency in IBD patients and evaluate the impact of the IBD therapeutic drugs on clinical presentation of COVID-19 and to determine factors associated with COVID-19 in this population. METHODS: Adult patients with IBD from three tertiary-care public, teaching hospitals in Ceará, Northeastern Brazil, were evaluated during one scheduled appointment from March to December 2020. Patients with possible or confirmed COVID-19 were compared with patients without COVID-19. Furthermore, incidences of each symptom were evaluated based on the use of IBD therapeutic drugs. RESULTS: A total of 515 patients with IBD were included in the study: 234 with CD, and 281 with UC. Of these, 174 patients (34%) had possible/confirmed COVID-19 of whom 156 (90%) were symptomatic. Main symptoms were fever (65%) and headache (65%); gastrointestinal symptoms occurred in one third of patients and were higher than COVID-19 in general population. The factors associated with having COVID-19 were female gender (OR 1.71, 95%CI: 1.17-2.50); contact at home (OR 5.07, 95%CI: 3.31-7.78) and outside the home (OR 3.14, 95%CI: 2.10-4.71) with a case of COVID-19; work outside of the home (OR 1.87, 95%CI: 1.26-2.78); family history of COVID-19 (OR 2.29, 95%CI 1.58-3.33) use of salicylate (OR 1.71, 95%CI: 1.17-4.28); and asthma (OR 7.10, 95%CI: 1.46-34.57). CONCLUSION: IBD patients at high risk of COVID-19 infection may need to avoid salicylate therapy but further studies are necessary to confirm this association.
Subject(s)
COVID-19 , Inflammatory Bowel Diseases , Salicylates , Humans , COVID-19/complications , Female , Male , Adult , Inflammatory Bowel Diseases/drug therapy , Inflammatory Bowel Diseases/complications , Middle Aged , Salicylates/adverse effects , Salicylates/therapeutic use , Brazil/epidemiology , SARS-CoV-2 , Risk Factors , AgedABSTRACT
Bacterial and fungal infections are common in acquired immunodeficiency syndrome (AIDS). Histoplasmosis is a common fungal disease in severely immunocompromised patients infected with human immunodeficiency virus (HIV) in endemic areas. In this population the most frequent form of presentation of histoplasmosis is disseminated, with the clinical manifestations being similar to those of disseminated tuberculosis. Esophageal histoplasmosis and the association of histoplasmosis with tuberculosis are infrequent. We report here a rare case of esophageal histoplasmosis associated with disseminated tuberculosis in AIDS.
Subject(s)
Esophageal Diseases/complications , Esophageal Diseases/microbiology , HIV Infections/complications , Histoplasmosis/complications , Tuberculosis/complications , Adult , Anti-HIV Agents/therapeutic use , Antitubercular Agents/therapeutic use , Esophageal Diseases/pathology , Fatal Outcome , HIV Infections/drug therapy , Histoplasmosis/pathology , Humans , Male , Tuberculosis/drug therapyABSTRACT
É relatado o caso clínico de uma paciente de 52 anos, portadora de síndrome de Sjogren (SS), sem associação encontrada com outra doença auto-imune, diagnosticada háá 10 anos e que nos últimos anos apresentou quadro de hipertensão pulmonar (HP) severa. Além de a HP não ser uma complicação comum da SS primária, também são incomuns as alterações de imagens da rede arterial pulmonar (estenose segmentar, grave, na emergência de ambas as arteriais pulmonares principais), que foram encontradas neste caso.
