scholarly journals A case report of COVID-19 infection and management during pregnancy

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110158
Author(s):  
Ifeoma Ogamba ◽  
Linus Chuang ◽  
Erin Panarelli ◽  
Dimitry Zilberman
Keyword(s):  
Clinical Symptoms ◽  
Laboratory Finding ◽  
Case Series ◽  
The United States ◽  
Limited Data ◽  
X Ray ◽  
Cough Headache ◽  
Abnormal Laboratory Finding ◽  
Chest X Ray ◽  
In Pregnancy

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which started in Wuhan, Hubei Province, China, and progressed to a pandemic affecting over 210 countries and territories including the United States. The severity of symptoms range from mild to critical disease involving multi-organ failure; however, many pregnant COVID-19 patients have mild symptoms. The understanding of COVID-19 is evolving and there is limited data about its effects in pregnancy. This case series features two pregnant patients with COVID-19 with a range of symptoms, including fever, non-productive cough, headache, and worsening dyspnea. Both patients had chest x-ray findings notable for lung opacities, and lymphopenia was a consistent abnormal laboratory finding. Both of the patients had hypoxia which was treated with hydroxychloroquine and lopinavir-ritonavir with significant improvement in clinical symptoms and prolongation of pregnancy.

scholarly journals Clinical, Radiological Features and Outcome of COVID-19 patients in a Secondary Hospital in Jakarta, Indonesia

2020 ◽  
Vol 14 (07) ◽  
pp. 750-757 ◽  
Author(s):  
Muhammad Hafiz ◽  
Aziza Ghanie Icksan ◽  
Annisa Dian Harlivasari ◽  
Rizky Aulia ◽  
Febrina Susanti ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Diagnostic Testing ◽  
Case Series ◽  
Cost Effective ◽  
Inflammation Marker ◽  
Laboratory Findings ◽  
X Ray ◽  
First Case ◽  
Case Series Study ◽  
Chest X Ray

Introduction: The numbers of people infected with SARS-CoV-2 in Indonesia especially in Jakarta as the epicenter continue to rise. Limited published clinical data, scarcity and long turn over time of diagnostic testing put clinician in dilemma to make diagnosis. Methodology: This is an observational case series study from confirmed COVID-19 patient in our hospital from first case admission on 17 March 30 April, 2020. We collected patient’s demography, symptoms, comorbidities, therapy, laboratory, chest x-ray and ECG consecutively. Results: Between 17 March 2020 and 30 April 2020, there were 30 confirmed COVID-19 cases, 16 (53.3%) were male. Clinical symptoms were dyspnea in 22 (73.3%) and dry cough 16 (53.3%). Comorbidities were diabetes in 14 (46.6%), hypertension 10 (33.3%) and Coronary Artery Disease (CAD) in 10 (33.3%) patients respectively. Laboratory findings showed lymphopenia in 21 (70%) patients, increased inflammation marker in Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) and Lactate Dehydrogenase (LDH) 21 (70%), 23 (76.6%) and 12 (40%) patients respectively. Twenty-seven (90%) cases had abnormal Chest X-Ray (CXR) and mostly severe 18 (60%). Descriptive finding for images included consolidation 16 (53.3%) and Ground Glass Opacities (GGO) in 10 (33.3%) patients. Conclusions: Based on our findings, most cases of COVID-19 admitted in secondary referral hospital were already in moderate to severe stages. This is most likely due to late referral from primary care and unspecific clinical features resemblance of other infectious diseases. Inflammation marker and CXR are cost effective findings and can be used as marker to determine further referral.

Clinical features of COVID-19 patients in Abdul Wahab Sjahranie Hospital, Samarinda, Indonesia (Preprint)

2020 ◽  
Author(s):  
Swandari Paramita ◽  
Ronny Isnuwardana ◽  
Marwan Marwan ◽  
Donni Irfandi Alfian ◽  
David Hariadi Masjhoer
Keyword(s):  
Hospital Admission ◽  
Sore Throat ◽  
Mild Condition ◽  
Clinical Symptoms ◽  
Average Length ◽  
Laboratory Finding ◽  
Rt Pcr ◽  
X Ray ◽  
East Kalimantan ◽  
Chest X Ray

BACKGROUND Coronavirus Disease (COVID-19) is caused by SARS-CoV-2 infection. Indonesia officially established the first COVID-19 confirmation case in early March 2020. East Kalimantan has been determined as a candidate for the new capital of Indonesia since 2019. This makes Abdul Wahab Sjahranie Hospital Samarinda as the largest hospital there has been designated as the main referral hospital for COVID-19 patients in East Kalimantan. OBJECTIVE We report the epidemiological, clinical, laboratory, and radiological characteristics of these patients. METHODS All patients with laboratory-confirmed COVID-19 by RT-PCR were admitted to Abdul Wahab Sjahranie Hospital in Samarinda. We retrospectively collected and analyzed data on patients with standardized data collection from medical records. RESULTS By May 8, 2020, 18 admitted hospital patients had been identified as having laboratory-confirmed COVID-19. Most of the infected patients were men (16 [88.9%] patients); less than half had underlying diseases (7 [38.9%] patients). Common symptoms at the onset of illness were cough (16 [88.9%] patients), sore throat (8 [44.4%] patients), and fever (8 [44.4%] patients). Laboratory findings of some patients on admission showed anemia. Levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were increased in 10 (55.6%) of 18 patients. On admission, abnormalities in chest x-ray images were detected in 6 (33.3%) patients who had pneumonia. The mean duration from the first hospital admission to discharge was 33.1 ± 9.2 days. The majority of COVID-19 patients are male. COVID-19 comorbidities were found in several patients. The main clinical symptoms of COVID-19 in this study were cough, sore throat, and fever. The abnormal laboratory finding in COVID-19 patients is anemia, an increase in AST and ALT levels, and chest x-ray images of pneumonia. All patients are in mild condition. The average length of hospital admission patients to discharge is more than 30 days. CONCLUSIONS Although all patients are in mild condition, the inability of a local laboratory to check for positive confirmation of COVID-19 makes the admission period of the patient in the hospital very long. The availability of RT-PCR tests at Abdul Wahab Sjahranie Hospital Samarinda will greatly assist the further management of COVID-19 patients.

scholarly journals Clinical features of COVID-19 patients in Abdul Wahab Sjahranie Hospital, Samarinda, Indonesia

2020 ◽  
Author(s):  
Swandari Paramita ◽  
Ronny Isnuwardana ◽  
Marwan Marwan ◽  
Donny Irfandi Alfian ◽  
David Hariadi Masjhoer
Keyword(s):  
Hospital Admission ◽  
Sore Throat ◽  
Mild Condition ◽  
Clinical Symptoms ◽  
Average Length ◽  
Laboratory Finding ◽  
Rt Pcr ◽  
X Ray ◽  
East Kalimantan ◽  
Chest X Ray

AbstractIntroductionCoronavirus Disease (COVID-19) is caused by SARS-CoV-2 infection. Indonesia officially established the first COVID-19 confirmation case in early March 2020. East Kalimantan has been determined as a candidate for the new capital of Indonesia since 2019. This makes Abdul Wahab Sjahranie Hospital Samarinda as the largest hospital there has been designated as the main referral hospital for COVID-19 patients in East Kalimantan. We report the epidemiological, clinical, laboratory, and radiological characteristics of these patients.MethodsAll patients with laboratory-confirmed COVID-19 by RT-PCR were admitted to Abdul Wahab Sjahranie Hospital in Samarinda. We retrospectively collected and analyzed data on patients with standardized data collection from medical records.ResultsBy May 8, 2020, 18 admitted hospital patients had been identified as having laboratory-confirmed COVID-19. Most of the infected patients were men (16 [88.9%] patients); less than half had underlying diseases (7 [38.9%] patients). Common symptoms at the onset of illness were cough (16 [88.9%] patients), sore throat (8 [44.4%] patients), and fever (8 [44.4%] patients). Laboratory findings of some patients on admission showed anemia. Levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were increased in 10 (55.6%) of 18 patients. On admission, abnormalities in chest x-ray images were detected in 6 (33.3%) patients who had pneumonia. The mean duration from the first hospital admission to discharge was 33.1 ± 9.2 days.DiscussionThe majority of COVID-19 patients are male. COVID-19 comorbidities were found in several patients. The main clinical symptoms of COVID-19 in this study were cough, sore throat, and fever. The abnormal laboratory finding in COVID-19 patients is anemia, an increase in AST and ALT levels, and chest x-ray images of pneumonia. All patients are in mild condition. The average length of hospital admission patients to discharge is more than 30 days.ConclusionAlthough all patients are in mild condition, the inability of a local laboratory to check for positive confirmation of COVID-19 makes the admission period of the patient in the hospital very long. The availability of RT-PCR tests at Abdul Wahab Sjahranie Hospital Samarinda will greatly assist the further management of COVID-19 patients.

scholarly journals Treatment and therapeutic strategies for pituitary apoplexy in pregnancy: a case series

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yuya Kato ◽  
Yoshikazu Ogawa ◽  
Teiji Tominaga
Keyword(s):  
Pituitary Apoplexy ◽  
Clinical Symptoms ◽  
Case Series ◽  
Optimal Timing ◽  
Presenting Symptoms ◽  
Pathological Evaluation ◽  
Mother And Child ◽  
Life Threatening ◽  
In Pregnancy

Abstract Background Pregnancy is a known risk factor for pituitary apoplexy, which is life threatening for both mother and child. However, very few clinical interventions have been proposed for managing pituitary apoplexy in pregnancy. Case presentation We describe the management of three cases of pituitary apoplexy during pregnancy and review available literature. Presenting symptoms in our case series were headache and/or visual disturbances, and the etiology in all cases was hemorrhage. Conservative therapy was followed until 34 weeks of gestation, after which babies were delivered by cesarean section with prophylactic bolus hydrocortisone supplementation. Tumor removal was only electively performed after delivery using the transsphenoidal approach. All three patients and their babies had a good clinical course, and postoperative pathological evaluation revealed that all tumors were functional and that they secreted prolactin. Conclusions Although the mechanism of pituitary apoplexy occurrence remains unknown, the most important treatment strategy for pituitary apoplexy in pregnancy remains adequate hydrocortisone supplementation and frequent hormonal investigation. Radiological follow-up should be performed only if clinical symptoms deteriorate, and optimal timing for surgical resection should be discussed by a multidisciplinary team that includes obstetricians and neonatologists.

scholarly journals Analysis of Separability of COVID-19 and Pneumonia in Chest X-ray Images by Means of Convolutional Neural Networks

Proceedings ◽  
2020 ◽  
Vol 54 (1) ◽  
pp. 31
Author(s):  
Joaquim de Moura ◽  
Lucía Ramos ◽  
Plácido L. Vidal ◽  
Jorge Novo ◽  
Marcos Ortega
Keyword(s):  
Neural Networks ◽  
Convolutional Neural Networks ◽  
Clinical Symptoms ◽  
Early Stage ◽  
World Health ◽  
Complete Analysis ◽  
Screening Process ◽  
X Ray ◽  
Chest X Ray ◽  
Health Organization

The new coronavirus (COVID-19) is a disease that is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). On 11 March 2020, the coronavirus outbreak has been labelled a global pandemic by the World Health Organization. In this context, chest X-ray imaging has become a remarkably powerful tool for the identification of patients with COVID-19 infections at an early stage when clinical symptoms may be unspecific or sparse. In this work, we propose a complete analysis of separability of COVID-19 and pneumonia in chest X-ray images by means of Convolutional Neural Networks. Satisfactory results were obtained that demonstrated the suitability of the proposed system, improving the efficiency of the medical screening process in the healthcare systems.

scholarly journals The diagnostic value of chest X-ray in coronavirus disease 2019: A comparative study of X-ray and CT

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110162
Author(s):  
Fengxia Zeng ◽  
Yong Cai ◽  
Yi Guo ◽  
Weiguo Chen ◽  
Min Lin ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Diagnostic Value ◽  
Rapid Identification ◽  
Chest Ct ◽  
Ct Scans ◽  
Ground Glass ◽  
X Ray ◽  
Chest X Ray ◽  
Laboratory Examinations ◽  
Sensitivity Specificity

As the coronavirus disease 2019 (COVID-19) epidemic spreads around the world, the demand for imaging examinations increases accordingly. The value of conventional chest radiography (CCR) remains unclear. In this study, we aimed to investigate the diagnostic value of CCR in the detection of COVID-19 through a comparative analysis of CCR and CT. This study included 49 patients with 52 CT images and chest radiographs of pathogen-confirmed COVID-19 cases and COVID-19-suspected cases that were found to be negative (non-COVID-19). The performance of CCR in detecting COVID-19 was compared to CT imaging. The major signatures that allowed for differentiation between COVID-19 and non-COVID-19 cases were also evaluated. Approximately 75% (39/52) of images had positive findings on the chest x-ray examinations, while 80.7% (42/52) had positive chest CT scans. The COVID-19 group accounted for 88.4% (23/26) of positive chest X-ray examinations and 96.1% (25/26) of positive chest CT scans. The sensitivity, specificity, and accuracy of CCR for abnormal shadows were 88%, 80%, and 87%, respectively, for all patients. For the COVID-19 group, the accuracy of CCR was 92%. The primary signature on CCR was flocculent shadows in both groups. The shadows were primarily in the bi-pulmonary, which was significantly different from non-COVID-19 patients ( p = 0.008). The major CT finding of COVID-19 patients was ground-glass opacities in both lungs, while in non-COVID-19 patients, consolidations combined with ground-glass opacities were more common in one lung than both lungs ( p = 0.0001). CCR showed excellent performance in detecting abnormal shadows in patients with confirmed COVID-19. However, it has limited value in differentiating COVID-19 patients from non-COVID-19 patients. Through the typical epidemiological history, laboratory examinations, and clinical symptoms, combined with the distributive characteristics of shadows, CCR may be useful to identify patients with possible COVID-19. This will allow for the rapid identification and quarantine of patients.

scholarly journals 1184. Making Pneumonia Surveillance Easy: Automation of Pneumonia Case Detection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S424-S425
Author(s):  
Dan Ding ◽  
Anna Stachel ◽  
Eduardo Iturrate ◽  
Michael Phillips
Keyword(s):  
Language Processing ◽  
Cost Effective ◽  
The United States ◽  
Surveillance Data ◽  
X Rays ◽  
Healthcare Facilities ◽  
X Ray ◽  
Chest X Ray ◽  
Sensitivity Specificity ◽  
Time Critical

Abstract Background Pneumonia (PNU) is the second most common nosocomial infection in the United States and is associated with substantial morbidity and mortality. While definitions from CDC were developed to increase the reliability of surveillance data, reduce the burden of surveillance in healthcare facilities, and enhance the utility of surveillance data for improving patient safety - the algorithm is still laborious. We propose an implementation of a refined algorithm script which combines two CDC definitions with the use of natural language processing (NLP), a tool which relies on pattern matching to determine whether a condition of interest is reported as present or absent in a report, to automate PNU surveillance. Methods Using SAS v9.4 to write a query, we used a combination of National Healthcare Safety Network’s (NHSN) PNU and ventilator-associated event (VAE) definitions that use discrete fields found in electronic medical records (EMR) and trained an NLP tool to determine whether chest x-ray report was indicative of PNU (Fig1). To validate, we assessed sensitivity/specificity of NLP tool results compared with clinicians’ interpretations. Results The NLP tool was highly accurate in classifying the presence of PNU in chest x-rays. After training the NLP tool, there were only 4% discrepancies between NLP tool and clinicians interpretations of 223 x-ray reports - sensitivity 92.2% (81.1–97.8), specificity 97.1% (93.4–99.1), PPV 90.4% (79.0–96.8), NPV 97.7% (94.1–99.4). Combining the automated use of discrete EMR fields with NLP tool significantly reduces the time spent manually reviewing EMRs. A manual review for PNU without automation requires approximately 10 minutes each day per admission. With a monthly average of 2,350 adult admissions at our hospital and 16,170 patient-days for admissions with at least 2 days, the algorithm saves approximately 2,695 review hours. Conclusion The use of discrete EMR fields with an NLP tool proves to be a timelier, cost-effective yet accurate alternative to manual PNU surveillance review. By allowing an automated algorithm to review PNU, timely reports can be sent to units about individual cases. Compared with traditional CDC surveillance definitions, an automated tool allows real-time critical review for infection and prevention activities. Disclosures All authors: No reported disclosures.

scholarly journals The Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in a Pediatric Healthcare Network in the United States

2020 ◽  
Vol 9 (5) ◽  
pp. 523-529 ◽  
Author(s):  
William R Otto ◽  
Sarah Geoghegan ◽  
Leila C Posch ◽  
Louis M Bell ◽  
Susan E Coffin ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Healthcare Providers ◽  
Case Series ◽  
The United States ◽  
Retrospective Case ◽  
White Children ◽  
Healthcare Network ◽  
Pediatric Healthcare

Abstract Background Understanding the prevalence and clinical presentation of coronavirus disease 2019 in pediatric patients can help healthcare providers and systems prepare and respond to this emerging pandemic. Methods This was a retrospective case series of patients tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) across a pediatric healthcare network, including clinical features and outcomes of those with positive test results. Results Of 7256 unique children tested for SARS-CoV-2, 424 (5.8%) tested positive. Patients aged 18–21 years had the highest test positive rate (11.2%), while those aged 1–5 years had the lowest (3.9%). By race, 10.6% (226/2132) of black children tested positive vs 3.3% (117/3592) of white children. By indication for testing, 21.1% (371/1756) of patients with reported exposures or clinical symptoms tested positive vs 3.8% (53/1410) of those undergoing preprocedural or preadmission testing. Of 424 patients who tested positive for SARS-CoV-2, 182 (42.9%) had no comorbidities, 87 (20.5%) had asthma, and 55 (13.0%) were obese. Overall, 52.1% had cough, 51.2% fever, and 14.6% shortness of breath. Seventy-seven (18.2%) SARS-CoV-2–positive patients were hospitalized, of whom 24 (31.2%) required respiratory support. SARS-CoV-2-targeted antiviral therapy was given to 9 patients, and immunomodulatory therapy to 18 patients. Twelve (2.8%) SARS-CoV-2-positive patients required mechanical ventilation, and 2 patients required extracorporeal membrane oxygenation. Two patients died. Conclusions In this large cohort of pediatric patients tested for SARS-CoV-2, the rate of infection was low but varied by testing indication. The majority of cases were mild and few children had critical illness.

scholarly journals Laryngo-Tracheal Displacement and Respiratory Distress in an Infant with Congenital Thymic Hyperplasia

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Michael Wolff ◽  
Süha Demirakca ◽  
Anna Kristina Kilian ◽  
Horst Schroten ◽  
Tobias Tenenbaum
Keyword(s):  
Young Children ◽  
Respiratory Distress ◽  
Corticosteroid Therapy ◽  
Clinical Symptoms ◽  
Thymic Hyperplasia ◽  
Feeding Disorder ◽  
X Ray ◽  
Chest X Ray

Thymic hyperplasia is usually an asymptomatic condition observed in infancy. A five-week-old boy presented with respiratory distress and feeding disorder, in which chest X-ray and bronchoscopy revealed a strong laryngotracheal displacement. Sonography and MRI confirmed the diagnosis of a thymic hyperplasia. Corticosteroid therapy led to improvement of clinical symptoms. Thymic hyperplasia may lead to laryngo-tracheal displacement and respiratory distress in neonates and young children.

scholarly journals Ekstraksi Benda Asing pada Kavum Nasi Melalui Bronkoskopi

2018 ◽  
Vol 4 (2) ◽  
pp. 45
Author(s):  
Isnu Pradjoko ◽  
Chandra Jaya
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
Upper Airway ◽  
The United States ◽  
Foreign Body Aspiration ◽  
Lower Airway ◽  
X Ray ◽  
Tracheobronchial Foreign Body ◽  
Chest X Ray ◽  
The Right

Background: Aspiration of a tracheobronchial foreign body is a serious and fatal event. Progress in terms of prevention, first aid, and endoscopic technology, caused a decline of almost 20% of deaths from foreign body aspiration that occurred in the United States. Statistically, the percentage of foreign body aspirations based on their respective location is: 5% hypopharynx, 12% larynx-trachea, and 83% bronchus. Most cases of foreign body aspiration occur in children aged <15 years old; about 75% of foreign body aspirations occur in children aged 1-3 years. The female-to-male ratio is 1.4:1. Case: A 11-year-old boy swallowed needles while playing flashlight about 2 hours before coming to Pulmonary Emergency Room of Dr. Soetomo General Hospital. Discussion: Chest X-ray examination found a shadow of metal density projected in the right lung. Fiber optic bronchoscopy (FOB) was performed for diagnostic and therapeutic indication to see the presence of a foreign body in the airway and remove the foreign body, but failed. When the needle was extracted, the patient coughed that the needle bounces to the supramaxilla area. FOB with nasal cavity approach successfully extracted the corpus alienum. Conclusion: Corpus alienum of airway sometimes is difficult to extract. FOB with nasal cavity approach can be done to manage corpus alienum in the upper airway that moved from lower airway when FOB was performed.

Sign in / Sign up

Export Citation Format

Share Document