Secondary Complications in COVID-19 Patients: A Case Series.

INTRODUCTION: Coronavirus SARS-CoV-2, the causative agent of COVID-19, primarily causes a respiratory tract infection that is not limited to respiratory distress syndrome, but it is also implicated in other body systems. Systemic complications were reported due to an exaggerated inflammatory response, which involves severe alveolar damage in the lungs and exacerbates the hypercoagulation that leads to venous thrombosis, ischemic attack, vascular dysfunction and infarction of visceral abdominal organs. Some complications are related to anticoagulant drugs that are administrated to stabilize hypercoagulability, but increase the risk of bleeding, hematoma and hemorrhage. The aim of this study is to report the diagnostic role of CT in the early diagnosis and management of patients with severe COVID-19 complications through the most interesting cases in our experience. MATERIAL AND METHODS: The retrospective analysis of patients studied for COVID-19 in our institution and hospitals, which are part of the university training network, was performed. CASES: Pneumomediastinum, cortical kidney necrosis, splenic infarction, cerebral ischemic stroke, thrombosis of the lower limb and hematomas are the most major complications that are reviewed in this study. CONCLUSIONS: Since the onset of the COVID-19 pandemic, the CT imaging modality with its high sensitivity and specificity remains the preferred imaging choice to diagnose early the different complications associated with COVID-19, such as thrombosis, ischemic stroke, infarction and pneumomediastinum, and their management, which significantly improved the outcomes.

Prevalence of Patients Affected by Fibromyalgia in a Cohort of Women Underwent Mammography Screening.

Fibromyalgia is a widespread condition which is currently underdiagnosed; therefore we conceived this study in order to assess whether a diagnostic suspicion may be assumed during widespread screening procedures, so that patients for which a reasonable diagnostic suspicion exist may be redirected towards rheumatologic evaluation. We analyzed a sample of 1060 patients, all of whom were female and undergoing standard breast cancer screening procedures, and proceeded to evaluate the level of pain they endured during mammographic exam. We also acquired a range of other information which we related to the level of pain endured; we suggested a rheumatologic examination for those patients who endured the highest level of pain and then we evaluated how many patients in this subgroup were actually diagnosed with fibromyalgia. Out of the 1060 patients who participated to our study, 139 presented level 4 pain intensity; One patient did not go for rheumatologic examination; the remaining 138 underwent rheumatologic evaluation, and 50 (36%, 28-44, 95% CI) were diagnosed with fibromyalgia. Our study shows that assessing the level of pain endured by patients during standard widespread screening procedures may be an effective asset in deciding whether or not to suggest specialist rheumatologic evaluation for fibromyalgia.