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1.
J Family Med Prim Care ; 13(6): 2511-2515, 2024 Jun.
Article in English | MEDLINE | ID: mdl-39027825

ABSTRACT

Hereditary motor and sensory neuropathy (HMSN), also known as Charcot-Marie-Tooth disease (CMT), is a member of the inherited neuropathy family with specific clinical and genetical manifestations. More than twenty genes have been linked to HMSN, and the number might increase. Regarding diagnosis, a healthcare provider should be suspicious if the patient is young with a family history. Integrative diagnosis, which includes electrophysiological, radiological, and genetic screening, is of great value to exclude metabolic, nutritive-toxic, infectious, and inflammatory or autoimmunological causes and to reach the exact subtype of hereditary neuropathy. Nowadays, next-generation sequencing-based analysis is becoming a routine diagnostic tool for inherited neuropathy, but if this facility is not available, electrophysiological and radiological diagnoses are the best diagnostic tools to be used. Differentiation between hereditary neuropathy and diabetic neuropathy is essential for primary care physicians to have the right plan.

2.
J Pediatr Clin Pract ; 11: 200100, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38827482

ABSTRACT

We present a newborn with transient generalized osteosclerosis and negative genetic workup. The etiology of this condition is unknown. Given overlapping radiologic signs with severe forms of osteopetrosis, familiarity with this condition is crucial for correct diagnosis and management.

3.
Braz J Infect Dis ; 28(3): 103768, 2024.
Article in English | MEDLINE | ID: mdl-38851212

ABSTRACT

We report an autochthonous case of mild unifocal chronic pulmonary paracoccidioidomycosis in a 48-year-old previously healthy woman with no history of possible environmental exposures in endemic rural areas, supposedly resulting from reactivation of a latent pulmonary focus secondary to the use of methotrexate for the control of Chikungunya arthropathy. Laboratory investigation ruled out other immunosuppression. Her only symptoms were a dry cough and chest pain. Diagnosis confirmed by needle lung biopsy. There were no abnormalities on physical examination nor evidence of central nervous system involvement. MRI of the total abdomen showed no involvement of other organs. Computed chest tomography showed a favorable evolution under the use of itraconazole (200 mg/day). Different tomographic presentations findings are highlighted when performed before and after treatment. CONCLUSIONS: PCM should be considered even in a woman without a history of consistent environmental exposure and in a non-endemic geographic area.


Subject(s)
Lung Diseases, Fungal , Methotrexate , Paracoccidioidomycosis , Humans , Female , Paracoccidioidomycosis/drug therapy , Middle Aged , Methotrexate/therapeutic use , Methotrexate/adverse effects , Lung Diseases, Fungal/drug therapy , Chronic Disease , Itraconazole/therapeutic use , Tomography, X-Ray Computed , Antifungal Agents/therapeutic use , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use
4.
Cureus ; 16(3): e56642, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38646370

ABSTRACT

We present an unusual case of a woman in her early 50s with a slow-growing calvarial exostosis. Exostoses are bony spurs or osteomas extending outward beyond a bone's surface and may be benign or malignant. Calvarial exostoses are a less common bone tumor that can occur in the population. We present a case of a rare, slow-growing calvarial exostosis with a combination of mandibular tori and a congenital iris cyst. We discuss differentials of this exostosis and different syndromes that may cause it such as hereditary multiple exostoses and Gardner syndrome. The current article aims to spread awareness of this atypical presentation of exostoses and present our institution's surgical proposition for removing a calvarial exostosis to obtain a further histological analysis of its composition. As these masses may commonly be benign, a definitive diagnosis cannot be made through imaging alone to rule out more threatening conditions. We have addressed radiological findings and diagnostic and treatment options offered to the patient. The patient decided not to move forward with removing the mass and would continue to monitor and return should she notice any unusual or acute changes.

5.
Radiol Case Rep ; 19(7): 2735-2740, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38680743

ABSTRACT

This case report delves into the intricate diagnostic journey of a 42-year-old male presenting with jaundice, abdominal distension, and ascites, where medical imaging, including CT scans and ultrasound, played a central role. Noteworthy radiological findings, such as irregular nodular margins and caudate lobe hypertrophy, illuminated the distinctive pathophysiology of cryptogenic cirrhosis. The study underscores the pivotal role of medical imaging in elucidating complex liver pathologies, emphasizing the relevance of radiological approaches in diagnosing cryptogenic cirrhosis and guiding comprehensive management strategies.

6.
Lab Med ; 2024 Mar 23.
Article in English | MEDLINE | ID: mdl-38520687

ABSTRACT

OBJECTIVE: To study the frequency of microbiological etiology of respiratory infections in patients with long COVID and their associated clinical and radiological findings. METHODS: Nasopharyngeal swabs and sputum specimens were collected from 97 patients with respiratory illness stemming from long COVID. The specimens were assessed for their microbiological profile (bacteria and virus) and their association with the overall clinical and radiological picture. RESULTS: In total, 23 (24%) patients with long COVID had viral infection (n = 12), bacterial infection (n = 9), or coinfection (n = 2). Microorganisms were detected at significantly higher rates in hospitalized patients, patients with moderate COVID-19, and patients with asthma (P < .05). Tachycardia (65%) was the most common symptom at presentation. A statistically significant number of patients with long COVID who had viral infection presented with cough and myalgia; and a statistically significant number of patients with long COVID who had bacterial infection presented with productive coughing (P < .05). Post-COVID fibrotic changes were found in 61% of cohort patients (31/51). CONCLUSION: A decreasing trend of respiratory pathogens (enveloped viruses and bacteria) was found in long COVID. An analysis including a larger group of viral- or bacterial-infected patients with long COVID is needed to obtain high-level evidence on the presenting symptoms (cough, myalgia) and their association with the underlying comorbidities and severity.

7.
Cureus ; 15(11): e48418, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38073981

ABSTRACT

Introduction Budd-Chiari syndrome (BCS) is a rare cause of ascites in children, and its clinical manifestation depends upon the extent and rapidity of the occlusion of hepatic veins. This study aimed to identify the clinical manifestations, causes, treatment options, and outcomes of BCS in children. Materials and methods A retrospective descriptive study of BCS in children under 15 years of age was conducted. This study was approved by the Pakistan Kidney and Liver Institute and Research Centre on June 23, 2023, with approval number 0128. The patients' medical records from December 2020 to July 2023 were obtained from Sisoft Healthcare Information System. In this study, we employ a set of predetermined questions to retrieve relevant data retrospectively and then organise it in Excel spreadsheets. SPSS version 26 (Armonk, NY: IBM Corp.) was used to analyse the data. Categorical variables are shown as frequencies (%), while continuous variables are reported as mean±SD. Results Of 37 (n) patients diagnosed with BCS, 19 (51.35%) were male and 18 (48.65%) were female. The mean age of presentation was 9.8±4.1 years. Ascites are the predominant clinical manifestation (100%), followed by hepatomegaly (37.8%). A total of 45.9% of patients had deranged liver function tests. Chronic BCS is the predominant mode of presentation. Protein C deficiency was present in nine patients (24.3%), two patients (5.4%) had protein S deficiency and two patients (5.4%) had antithrombin III deficiency. Hepatic veins exhibited the highest incidence of obstruction (73.0%). Liver biopsies were done in 15 (40.54%) patients to determine the staging of fibrosis. Eight patients (21.62%) had undergone radiological interventions, two patients had liver transplants and the rest were treated with medications, including anticoagulants. Conclusion BCS can present in acute, subacute or chronic forms. Ascites and hepatomegaly should raise the suspicion of BCS in children. Common radiological findings are non-visualisation of the hepatic veins. BCS has a wide range of aetiologies and treatment options. Protein C deficiency is the most predominant procoagulant disorder. Radiological interventions during the acute and subacute forms of BCS usually have excellent results. Liver transplant remains the definite treatment.

8.
Cureus ; 15(11): e48547, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38084182

ABSTRACT

Emergency physicians (EPs) frequently integrate point-of-care ultrasound (POCUS) into the initial bedside evaluation of patients presenting to the emergency department with acute flank pain. A POCUS-first diagnostic approach can allow EPs to promptly assess for life-threatening pathologies of the aorta and gallbladder. POCUS is also a critical bedside tool to determine renal causes of acute flank pain, such as hydronephrosis in the setting of nephrolithiasis, subcapsular hematomas, renal abscesses, pyelonephritis, and renal masses. This report illustrates a case in which EP-performed POCUS led to the incidental diagnosis of a malignant renal mass in a patient presenting with flank pain. We review the specifics of the ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) Bosniak classification system used by radiologists for risk stratification of cystic renal masses (CRMs).

9.
J Child Orthop ; 17(6): 618-625, 2023 Dec.
Article in English | MEDLINE | ID: mdl-38050589

ABSTRACT

Purpose: Scurvy is an uncommon medical condition that affects children and is caused by an inadequate intake of vitamin C. This study presents the characteristics of patients with scurvy to raise awareness of the diagnostic process in developing countries where laboratory testing for vitamin C levels is often not available. Methods: A retrospective study was performed from period of 2018 to 2023. Data extraction includes patient age, sex, body mass index, constitutional symptoms, musculoskeletal, mucosal, cutaneous symptoms, other accompanying disorders, anemia, erythrocyte sedimentation rate, C-reactive protein, radiographic examination, vitamin C dose, and duration of treatment. Descriptive statistical analysis was performed in this study. Results: Eighteen cases (17 males, 1 female) of scurvy were referred to our institution. Thirteen of 18 patients were misdiagnosed before referral. The median age at presentation was 4.5 (range, 2-11) years. The average body mass index was 13.93 ± 0.63 kg/m2. Half of patients had healthy weight. All patients presented with lower limb pain and 17 of 18 with refusal to walk. The median onset of diagnosis was 11 (range 4-48) weeks. White line of Frankel was described in all patients. Seven had anemia and 6 of 18 had increase in erythrocyte sedimentation rate and/or C-reactive protein levels. Only one patient had ascorbic acid levels evaluation before treatment since it was not readily available in our country. Treatment length varied from 2 weeks to 6 months. Conclusion: The diagnosis of scurvy is frequently delayed due to its extreme rarity in modern society and its ability to mimic numerous other conditions. In children presenting with limb pain and/or reluctance to walk and pathognomonic radiological findings, physicians must prioritize scurvy as a differential diagnosis. In scurvy, vitamin C supplementation is curative.

10.
Surg Neurol Int ; 14: 401, 2023.
Article in English | MEDLINE | ID: mdl-38053706

ABSTRACT

Background: Capillary hemangioma is a rare benign hemangioma that occurs in the soft tissues of the skin, orbit, head, and neck. Intracranial cases, especially intraparenchymal cases, are extremely rare. In this study, we report the course of an intracranial parenchymal capillary hemangioma with left mild motor paresis and involuntary movements of the left upper extremity and was successfully treated by surgical resection, including radiological and pathological examinations. Case Description: This is a case of a 60-year-old woman who presented with motor weakness and involuntary movement of the left upper extremity. Computed tomography and magnetic resonance imaging revealed the right frontal hemorrhagic mass lesion without enhancement of contrast medium. Cerebral digital subtraction angiography showed no vascular stain and abnormal arteriovenous shunt. Preoperatively, we diagnosed cavernous hemangioma with a hemorrhagic component located in the right motor cortex. Because this case was symptomatic, we performed a craniotomy and gross total resection of the right frontal lesion. The diagnosis of capillary hemangioma was made by histological examination, including immunohistological study. Conclusion: Because intraparenchymal capillary hemangiomas are difficult to diagnose with preoperative imaging, surgical treatment, and histopathological examination are important.

11.
Orthop J Sports Med ; 11(11): 23259671231206712, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37941889

ABSTRACT

Background: Sumo wrestling is a traditional sport in Japan and becoming popular worldwide. Risk factors for lower back injuries in sumo wrestlers are heavier weight and larger body mass index (BMI). The mawashi (loincloth belt) worn by sumo wrestlers has been shown to restrict motion of the lumbar spine. Purpose: To study the effects of sumo wrestling on the lumbar spine of high school and freshmen collegiate wrestlers, investigating the relationship between radiological findings, wearing of the mawashi during training, and lower back symptoms. Study Design: Case series; Level of evidence, 4. Methods: From 2001 to 2017, a total of 197 members of the Japanese Sumo Federation (55 high school and 142 college freshman students) underwent routine radiographic examination of their lumbar spines and answered a questionnaire regarding lumbar symptoms. Wrestlers were classified as symptomatic and asymptomatic based on responses to a custom questionnaire. We used the unpaired t test to evaluate patient demographics and the chi square test to analyze radiographic lumbar spine abnormalities between symptomatic and asymptomatic wrestlers. Results: The wrestlers' mean height, weight, BMI, and duration in the sport were 174.0 ± 6.7 cm, 107.1 ± 22.4 kg, 35.2 ± 6.4, and 8.0 ± 3.2 years, respectively. There were 91 participants in the symptomatic group (46.2%) and 106 (53.8%) in the asymptomatic group. Ten wrestlers (5.1%) had osteophyte formations in the lumbar body; 8 of the 11 osteophytes (72.7%) appeared in the upper lumbar spine. Of the total, 48 wrestlers (24.4%) had deformities (Schmorl nodules) in the lumbar body, and 23 of 50 (46.0%) and 10 of 16 (62.5%) deformities were found in the upper lumbar spine of collegiate and high school wrestlers, respectively. Five wrestlers of the total 197 athletes (2.5%) had disc space narrowing in the lumbar body, with 3 of the 5 cases of disc space narrowing (60.0%) found in the upper lumbar spine. Spondylolysis in the lumbar body was found in 25 wrestlers (12.7%); 19 of the 91 symptomatic wrestlers (20.9%) had spondylolysis, compared with 6 of the 106 (5.7%) asymptomatic wrestlers (P = .0028). Conclusion: Almost one-third of sumo wrestlers had ≥1 abnormal radiological finding in the lumbar spine. There was a significant relationship between symptomatic wrestlers and spondylolysis.

12.
J Fungi (Basel) ; 9(11)2023 Nov 06.
Article in English | MEDLINE | ID: mdl-37998889

ABSTRACT

Chronic pulmonary aspergillosis (CPA) is a chronic progressive lung disease associated with a poor prognosis and a 5-year mortality rate of approximately 40-50%. The disease is characterized by slowly progressive destruction of the lung parenchyma, in the form of multiple cavities, nodules, infiltrates or fibrosis. CPA can be challenging to diagnose due to its non-specific symptoms and similarities with other respiratory conditions combined with the poor awareness of the medical community about the disease. This can result in delayed treatment even for years and worsening of the patient's condition. Serological tests certainly play a significant role in diagnosing CPA but cannot be interpreted without radiological confirmation of CPA. Although many data are published on this hot topic, there is yet no single definitive test for diagnosing CPA, and a multidisciplinary approach which involves a combination of clinical picture, radiological findings, microbiological results and exclusion of other mimicking diseases, is essential for the accurate diagnosis of CPA.

13.
Curr Med Imaging ; 2023 Sep 01.
Article in English | MEDLINE | ID: mdl-37654125

ABSTRACT

BACKGROUND: The jaws can be affected by several lesions that manifest in the oral cavity, but little is known about non-odontogenic benign and malignant lesions and their radiological findings. INTRODUCTION: Our aim was to discuss the imaging findings of non-odontogenic jaw lesions to help the surgeon in the diagnosis and formulating a differential diagnosis for this vast spectrum of jaw lesions with overlapping clinical and imaging appearances. METHODS: CT and MR images of the mandible, maxillofacial region, and neck were retrieved from the archive of the Radiology Department of Pamukkale University for the duration between 2012-2023 and assessed. RESULTS: A total of 8125 CT and MR images were retrospectively analyzed. The mean age of the patients was 39.5 years in females and 43.2 in males, with a range varying from 15 to 72 years. Histopathologically approved benign and malignant non-odontogenic lesions were detected in only 19 patients out of 8125 images (0.23%). Osteomyelitis and abscess were the most common (n=3; 0.03%), followed by two cases (n=2; 0.02%) of each fibrous dysplasia, hemangioma, osteosarcoma, squamous cell carcinoma, and multiple myeloma, and one case (n=1; 0.01%) of each ossifying fibroma, osteoma, lymphoma, metastasis, and solitary bone cyst. CONCLUSION: Although non-odontogenic benign and malignant lesions of the jaw are rare, awareness of the radiological features of these lesions plays an important role in their diagnosis and management.

14.
Cureus ; 15(8): e43316, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37700999

ABSTRACT

Intracranial dermoid cysts are rare, benign, congenital, and slow-growing cystic lesions. They contain mature squamous epithelium, apocrine, eccrine, sebaceous glands, and ectodermal structures. The rupture of intracranial dermoid cysts is a rare event and can cause life-threatening conditions.

15.
Med Int (Lond) ; 3(5): 50, 2023.
Article in English | MEDLINE | ID: mdl-37745152

ABSTRACT

The present study describes a case of cystic neutrophilic granulomatous mastitis. The clinical and radiological findings of the patient were consistent with idiopathic granulomatous mastitis. Cystic neutrophilic granulomatous mastitis is a rare subtype of mastitis with a distinct histological pattern that is associated with the Corynebacterium species. The diagnosis and treatment of cystic neutrophilic granulomatous mastitis remains a significant challenge due to the scarcity of available data. The present study describes a classic case of cystic neutrophilic granulomatous mastitis that includes clinical, radiological and histopathological findings. To the best of our knowledge, this is the first case documenting radiological findings before and after treatment. This report encourages the consideration of this entity in the differential diagnoses of mastitis.

16.
Pathogens ; 12(8)2023 Jul 28.
Article in English | MEDLINE | ID: mdl-37623948

ABSTRACT

BACKGROUND: Nontuberculous mycobacteria (NTM) are the cause of chronic lung disease called NTM lung disease (NTM-LD). There are about 180 known species of NTM. Nowadays the number of NTM-LD is increasing. OBJECTIVE: To evaluate the clinical significance of NTM isolated from specimens and assess the frequency and clinical relevance of isolation of NTM in the Regional Center of Pulmonology in Bydgoszcz, hospital of Northern Poland. DESIGN: Clinical, radiological, and microbiological data were collected from all patients from whom NTM was isolated between 2013 and 2022. Data were reviewed retrospectively. Diagnostic criteria for NTM-LD published by the American Thoracic Society (ATS) were used to determine clinical relevance. MATERIAL AND METHODS: The study comprised 81,985 clinical specimens submitted for mycobacterial culture in the Department of Microbiology at the Regional Center of Pulmonology in Bydgoszcz between 2013 and 2022. Clinical specimens were processed according to the standard procedure in mycobacteria laboratories in Poland. NTM strains were identified using analysis of mycolic acids by chromatography as well as GenoType NTM-DR, GenoType Mycobacterium AS, and GenoType Mycobacterium CM. RESULTS: There were 395 patients with NTM strains between 2013 and 2022. Out of them, 149 cases met the diagnostic criteria of NTM-LD and were classified as definite cases. M. kansasii (n = 77) was the most common species in the group (51.68%), followed by M. avium complex (n = 46). Patients with NTM-LD were 22-88 years old (median age was 60 years). There were 81 men and 68 women. The most common symptoms were cough, hemoptysis, and fever. Radiological X-ray images were dominated by infiltrative lesions in the upper and middle lobe of the right lung with cavities; the changes were in the upper lobe of the left lung and on both sides of the chest. They were smokers in 61%. The most common concomitant diseases were chronic obstructive pulmonary disease (COPD), diabetes mellitus, pulmonary carcinoma, and human immunodeficiency virus (HIV) infection, and other immunodeficiencies. The most common treatment was isoniazid, ethambutol, rifampicin, and ofloxacin for 18 months with a minimum of 12 months of culture negativity. CONCLUSIONS: NTM-LD infections are present with other pulmonary illnesses and extrapulmonary diseases and may be connected to primary immunologic deficiencies. These diseases concern patients of all ages and have various clinical manifestations. M. kansasii and MAC are the most prevalent NTM isolates among respiratory samples in Northern Poland. In addition, an increase in MAC and a decrease in M. kansasii both in cultivation and the cause of NTM-LD were reported.

17.
Diagnostics (Basel) ; 13(16)2023 Aug 15.
Article in English | MEDLINE | ID: mdl-37627938

ABSTRACT

Hydroxyapatite deposition disease (HADD) represents a multifaceted condition characterized by the accumulation of hydroxyapatite crystals in soft tissues, leading to subsequent inflammation and discomfort. The intricate etiology of HADD is the subject of this comprehensive review, which encompasses an in-depth analysis of the four proposed pathogenic mechanisms and a deliberation on the predisposing factors that instigate the development of this disease. In order to provide a thorough understanding of the disease's progression, this manuscript delineates the stages of HADD-those preceding calcification, occurring during calcification, and following calcification-in meticulous detail. This chronology forms the basis of a complete portrayal of the evolution of HADD. Moreover, this review encompasses an examination of the radiological findings associated with HADD, furnishing an extensive discourse on imaging characteristics. The potential of HADD to mimic other diseases, thereby posing diagnostic challenges, is also articulated. The discourse continues with an investigation of HADD's differential diagnosis. This section furnishes a robust framework for distinguishing HADD from other conditions based on imaging results. To enrich the understanding of this diagnostic process, case studies illustrating real-world applications are provided. An overview of treatment modalities for HADD, including both conservative and interventional approaches, forms the concluding discussion. The pivotal role of imaging specialists in the diagnosis and management of HADD is emphasized, highlighting their vital contribution to image-guided procedures and disease monitoring.

18.
J Thorac Dis ; 15(6): 2971-2983, 2023 Jun 30.
Article in English | MEDLINE | ID: mdl-37426134

ABSTRACT

Background: Long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection still under study. The objectives of this study were to identify persistent pulmonary lesions 1 year after coronavirus disease 2019 (COVID-19) hospitalization and assess whether it is possible to estimate the probability that a patient develops these complications in the future. Methods: A prospective study of ≥18 years old patients hospitalized for SARS-COV-2 infection who develop persistent respiratory symptoms, lung function abnormalities or have radiological findings 6-8 weeks after hospital discharge. Logistic regression models were used to identify prognostic factors associated with a higher risk of developing respiratory problems. Models performance was assessed in terms of calibration and discrimination. Results: A total of 233 patients [median age 66 years [interquartile range (IQR): 56, 74]; 138 (59.2%) male] were categorized into two groups based on whether they stayed in the critical care unit (79 cases) or not (154). At the end of follow-up, 179 patients (76.8%) developed persistent respiratory symptoms, and 22 patients (9.4%) showed radiological fibrotic lesions with pulmonary function abnormalities (post-COVID-19 fibrotic pulmonary lesions). Our prognostic models created to predict persistent respiratory symptoms [post-COVID-19 functional status at initial visit (the higher the score, the higher the risk), and history of bronchial asthma] and post-COVID-19 fibrotic pulmonary lesions [female; FVC% (the higher the FVC%, the lower the probability); and critical care unit stay] one year after infection showed good (AUC 0.857; 95% CI: 0.799-0.915) and excellent performance (AUC 0.901; 95% CI: 0.837-0.964), respectively. Conclusions: Constructed models show good performance in identifying patients at risk of developing lung injury one year after COVID-19-related hospitalization.

19.
J Infect Dev Ctries ; 17(6): 782-790, 2023 06 30.
Article in English | MEDLINE | ID: mdl-37406059

ABSTRACT

INTRODUCTION: Several previous studies have suggested a link between autoimmune activation and SARS-CoV-2 infection. This study aims to evaluate the excessive immune response via laboratory and radiological findings, treatment options, and previous acute phase reactants in patients with mild and moderate coronavirus disease 2019 (COVID-19) to identify the possible interaction between autoimmune response and SARS-CoV-2 infection. METHODOLOGY: A total of 345 hospitalized patients with a diagnosis of definitive COVID-19 were evaluated retrospectively in terms of their clinical, laboratory, and radiological data, comorbidities, treatment options, and the values of C-reactive protein (CRP) of all patients in the last year before COVID-19 during admission to the hospital for any reason. RESULTS: 162 (47%) of the patients were female and 183 (53%) were male. The mean age was 51.08 ± 15.52 years. Of all patients, 235 (68.1%) had mild disease and 110 (31.9%) had a moderate disease. There was a statistically significant difference between the two groups in terms of age, gender, the values of leukocytes, lymphocytes, and hemoglobin, the levels of AST, LDH, Na, Cl, Ca, CRP, ferritin and fibrinogen, duration of hospitalization, medical treatments as well as the CRP value of the patients in the last year. Male gender, shortness of breath, duration of hospitalization, the value of lymphocytes, and the levels of LDH, CRP, and fibrinogen were independent predictive factors for the severity of COVID-19. CONCLUSIONS: The SARS-CoV-2 infection could act as a triggering factor for developing autoimmune and/or autoinflammatory dysregulation in genetically predisposed individuals.


Subject(s)
COVID-19 , Adult , Aged , Female , Humans , Male , Middle Aged , Autoimmunity , C-Reactive Protein/analysis , Cross-Sectional Studies , Fibrinogen , Medical Records , Retrospective Studies , SARS-CoV-2
20.
BMC Pulm Med ; 23(1): 231, 2023 Jun 27.
Article in English | MEDLINE | ID: mdl-37370050

ABSTRACT

BACKGROUND: Few studies have evaluated the long-term impact on health-related quality of life (HRQoL) in patients who have been hospitalized for COVID-19 pneumonia. Specific follow-up should be carried out to detect and treat possible pulmonary abnormalities, and the worsening of HRQoL should be estimated to target necessary resources for care of these patients after acute phase. The objective was to know the impact on HRQoL of patients who have been admitted for COVID-19 pneumonia, and to evaluate the clinical-radiological and functional changes of patients who have overcome COVID-19 pneumonia at 3 and 10 months of follow-up. METHODS: Prospective observational study of patients who required hospitalization for COVID-19 pneumonia between April and December 2020. All patients filled out the EuroQol five-dimension (EQ-5D) questionnaire with the EuroQol Visual Analogue Scale (E-VAS) for self-assessment of health status. Respiratory function tests and chest X-ray were carried out at 3 and 10 months of follow-up. RESULTS: 61 patients were included in the study. The need for ventilatory support was associated with anxiety/depression on the EQ-5D scale, as well as patients admitted to the intensive care unit (ICU). The mean EQ-5D and E-VAS index scores decreased with hospitalization time, the number of days spent in intermediate respiratory care unit (IRCU) and the level of dyspnoea at the beginning of the hospitalization period. Pulmonary sequelae were observed in 25 patients (41%) at 3 months and 17 (27.9%) at 10 months. Patients improve their forced vital capacity (FVC) by 196 ml (p = 0.001) at 10 months as well as 9% in diffusing capacity of lung for carbon monoxide (DLCO) (p = 0.001) at 10 months. DLCO was found to be correlated to lymphopenia and time spent in IRCU. Low FVC values were detected 10 months after discharge for subjects exhibiting high levels of dyspnoea at 3 months after discharge. CONCLUSIONS: Hospitalization for COVID-19 pneumonia affects the HRQoL of patients, with greater anxiety/depression in those who were more serious affected and are younger. A significant percentage of patients present fibrotic abnormalities and lung function impairment at the first and second follow-up after discharge.


Subject(s)
COVID-19 , Quality of Life , Humans , Patient Discharge , Lung/diagnostic imaging , Dyspnea/etiology
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