Demographic and clinical features of critically ill patients with COVID-19 in Greece: The burden of diabetes and obesity.

AIMS: The aim of the study was to investigate the association between type-2 diabetes mellitus, other underlying diseases and obesity with the outcomes of critically ill Covid-19 patients in Greece. METHODS: In this retrospective observational multi-centre study, data and outcomes of 90 RNA 2109-nCoV confirmed critically ill patients from 8 hospitals throughout Greece, were analysed. All reported information stand through April 13th 2020. RESULTS: The median age of the patients was 65.5 (IQR 56-73), majority were male (80%) and obesity was present in 34.4% of patients most prevalent to younger than 55 years. Hypertension was the prevailing comorbidity (50%), followed by cardiovascular diseases (21.1%) and type-2 diabetes (18.9%). At admission, common symptoms duration had a median of 8 (IQR 5-11) days. A 13.3% of the patients were discharged, 53.4% were still in the ICUs and 28.9% deceased who were hospitalised for fewer days than the survivors [6 (IQR 3-9) vs. 9 (IQR 7-14.5) respectively]. Aging was not a risk factor but diabetes deteriorates the outcomes. Obesity poses a suggestive burden as it was more notable in deceased versus survivors. CONCLUSIONS: Type 2 diabetes and obesity may have contributed to disease severity and mortality in COVID-19 critically ill patients in Greece.

Fibrous tumor of the lung: diagnostic and therapeutic considerations apropos of two cases.

Solitary fibrous tumor (SFT) of the pleura and the lung is an uncommon spindle cell neoplasm arising from the visceral pleura in the majority of the cases. Current diagnostic and therapeutic considerations are discussed apropos of 2 recent cases. 1st case: A 46-year-old male, heavy smoker, presented with nonspecific complaints and a mass in the left posterior mediastinum at the level of the 5th thoracic vertebra. Computed tomography (CT) and magnetic resonance imaging (MRI) of the chest confirmed the position of the mass in proximity to the thoracic wall at that level. Through a left posterolateral thoracotomy, a 4 x 5 x 2 cm mass, mushroom-shaped, stalky, completely covered by the lung parenchyma, was resected. Histopathological examination revealed a SFT of the lung. 2nd case: A 54-year-old woman presented with symptoms of respiratory distress and persistent hypoglycaemia. CT scan of the chest showed a huge mass within the right hemithorax, compressing the mediastinum and the contralateral lung. The mass was initially detected on chest radiography and CT scan 3 years before resection. Fine needle biopsy (FNB) results were inconclusive and resection of the mass through a right thoracotomy established the diagnosis of malignant SFT. Resection of the mass resulted in recovery of respiratory function and the paraneoplastic hypoglycaemia. Radiologic features and inconclusive fine needle aspiration (FNA)/FNB results make preoperative diagnosis of SFTs of the pleura and lung difficult. Diagnosis of SFT will be established with certainty after surgery. Resection with clear margins is the main important prognostic factor.