The role of thoracic surgery in the management of complicated acute and post-acute COVID-19 pneumonia (PASC).

INTRODUCTION: COVID-19 is considered a respiratory virosis in its classic form, although it may present with heterogeneous symptoms. Thoracic complications occur in a small percentage of patients. Our objective was to evaluate existing experience with this disease and its thoracic manifestations and to determine the real-world status of care of these patients. METHODS: This study is a retrospective, single-institution analysis of a group of patients hospitalized with acute and post-acute COVID-19 pneumonia at Thomayer Hospital in Prague in the period from December 2020 to March 2022 and indicated for a thoracic surgical procedure. RESULTS: During the peak of COVID-19 pandemic, a thoracic intervention was performed in 46 admitted patients. Thoracic drainage (due to pneumothorax in 18 cases, fluidothorax in 3 cases, CT-guided lung abscess drainage in 2 cases, and CT-guided pneumatocele drainage in 2 cases) were the most common thoracic surgical procedures. Pleurectomy/decortication surgery was done in 10 cases. Additionally, 12 lung parenchyma-sparing resections were performed, while lobectomy was required in 2 cases. Resection of postintubation tracheal stenosis due to a severe course of COVID-19 pneumonia was indicated in 2 patients. CONCLUSION: Even mild COVID-19 may cause a considerable morphological a functional alteration of the respiratory system. The most common complications of COVID-19 pneumonia that require a thoracic surgical intervention include pathologies associated with an air leak and accumulation of air (pneumothorax, pneumomediastinum and subcutaneous emphysema). The development of pulmonary necrosis, symptomatic bronchiectasis, pneumatocele, and bullous-fibrotic formations may result in pneumothorax, hemothorax or thoracic empyema in sporadic cases. An early thoracic surgical intervention to treat thoracic complications of COVID-19 pneumonia can improve the survival of COVID-19 patients.

[Epidemic keratoconjunctivitis. Laboratory study of patients infected with adenovirus type 8]. / Epidemická keratokonjunktivitída. Laboratorní studie nemocných, infikovaných adenovirem typu 8.

The authors tried to detect, using different methods, the causal agent of the disease in eight patients with epidemic keratoconjunctivitis. From the conjunctival sacs of one ambulatory patient and six of seven patients hospitalized on account of other eye diseases they isolated 11 strains of adenovirus type 8 on cell cultures from human embryonic lungs. Using direct and indirect ELISA, they detected adenovirus antigen in four of seven examined smears from the conjunctival sac without previous cultivation. In smears from the nasopharynx they did not detect adenoviruses by either of the two methods. Antibodies were assessed by micromodifications of the virus neutralizing test, by the complement fixation reaction and ELISA. A significant rise of antibodies against adenovirus type 8 and adenovirus hexone resp. was found in different six of eight examined pairs of sera. The combination of these three serological methods made it possible to confirm adenovirus infection in all eight patients.