scholarly journals Symptoms and signs of conjunctivitis as predictors of disease course in COVID-19 syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Martina Ranzenigo ◽  
Elena Bruzzesi ◽  
Laura Galli ◽  
Antonella Castagna ◽  
Giulio Ferrari
Keyword(s):  
Clinical Laboratory ◽  
Clinical Phenotype ◽  
Severe Infection ◽  
Signs And Symptoms ◽  
Disease Spread ◽  
Nasopharyngeal Swab ◽  
Limited Information ◽  
Distribution Width ◽  
Viral Shedding ◽  
Ocular Signs

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can induce conjunctivitis signs and symptoms. However, limited information is available on their impact on COVID-19 disease phenotype. Quantification of ocular signs/symptoms can provide a rapid, non-invasive proxy for predicting clinical phenotype. Moreover, the existence and entity of conjunctival viral shedding is still debated. This has relevant implications to manage disease spread. The purpose of this study was to investigate conjunctivitis signs and symptoms and their correlation with clinical parameters, conjunctival viral shedding in patients with COVID-19. Methods Fifty-three patients hospitalized between February 25th and September 16th, 2020 at the San Raffaele Hospital, in Milan, Lombardy, Italy with a confirmed diagnosis of SARS-CoV-2 were evaluated. Presence of interstitial pneumonia was confirmed with computed tomography scan imaging. Ocular signs and symptoms, anosmia/ageusia, clinical/laboratory parameters, and reverse transcriptase–polymerase chain reaction (RT-PCR) from nasopharyngeal and conjunctival swabs for COVID-19 virus were analyzed. Results Forty-six out of 53 patients showed a positive nasopharyngeal swab for SARS-CoV-2 infection at the time of conjunctival evaluation. All the conjunctival swabs were negative. Conjunctivitis symptoms were present in 37% of patients. Physician-assessed ocular signs were detected in 28% of patients. Patients with ocular symptoms or signs tended to be older: 76.8 years (62.4–83.3) vs 57.2 years (48.1–74.0), p = 0.062 and had a longer hospitalization: 38 days (18–49) vs. 14 days (11–21), p = 0.005. Plasma levels of Interleukin-6 were higher in patients with signs or symptoms in comparison with those without them: 43.5 pg/ml (19.7–49.4) vs. 8 pg/ml (3.6–20.7), p = 0.02. Red cell distribution width was also significantly higher: 15 (14.3–16.7) vs 13.2 (12.4–14.4), p = 0.001. Conclusions We found that over a third of the patients had ocular signs or symptoms. These had higher prevalence in patients with a more severe infection. No viral shedding was detected in the conjunctiva. Our results suggest that prompt detection of conjunctivitis signs/symptoms can serve as a helpful proxy to predict COVID-19 clinical phenotype.

scholarly journals Wolman’s disease presenting with secondary hemophagocytic lymphohistiocytosis: a case report from Saudi Arabia and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahad Alabbas ◽  
Ghaleb Elyamany ◽  
Talal Alanzi ◽  
Tahani Bin Ali ◽  
Fatma Albatniji ◽  
...  
Keyword(s):  
Hemophagocytic Lymphohistiocytosis ◽  
Metabolic Disorder ◽  
Clinical Signs ◽  
Failure To Thrive ◽  
Severe Infection ◽  
Signs And Symptoms ◽  
Immune Deficiency Syndrome ◽  
Autoimmune Disorder ◽  
Deficiency Syndrome ◽  
Homozygous Deletion

Abstract Background Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal syndrome that is characterized by strong activation of the immune system from hyperinflammatory cytokines. Symptoms of HLH patients include fever, hepatosplenomegaly, cytopenia, and hyperferritinemia. Inherited HLH is classified as primary, whereas secondary HLH (sHLH) occurs when acquired from non-inherited reasons that include severe infection, immune deficiency syndrome, autoimmune disorder, neoplasm, and metabolic disorder. Wolman’s disease (WD) is a rare and fatal infantile metabolic disorder caused by lysosomal acid lipase deficiency, that exhibits similar clinical signs and symptoms as HLH. This paper reports the case of an infant diagnosed with WD and who presented with sHLH. Case presentation A 4-month-old infant presenting with hepatosplenomegaly, failure to thrive, and other abnormalities. WD diagnosis was confirmed by the presence of the LIPA gene homozygous deletion c.(428 + 1_967-1)_(*1_?)del. The infant also met the HLH-2004 diagnostic criteria. Conclusions Metabolic disorder such as WD should be investigated in infants fulfilling the HLH criteria to diagnose the underlying condition. More studies are needed to understand the link between WD and sHLH and to identify appropriate therapies.

scholarly journals Covid-19 and acute conjunctivitis: Controversial data from a tertiary refferral Italian center

2021 ◽  
pp. 112067212199104
Author(s):  
Giuseppe D’Amico Ricci ◽  
Claudia Del Turco ◽  
Elena Belcastro ◽  
Marco Palisi ◽  
Mario R Romano ◽  
...  
Keyword(s):  
Emergency Department ◽  
Odds Ratio ◽  
Signs And Symptoms ◽  
Time Span ◽  
Nasopharyngeal Swab ◽  
Eye Disorders ◽  
Eye Examination ◽  
The Relationship ◽  
Acute Conjunctivitis ◽  
Piedmont Region

Purpose: Although acute conjunctivitis has been listed from the beginning as a possible sign of COVID-19, the likelihood of this association remains unclear. The aim of this study was to investigate the relationship between COVID-19 and conjunctivitis. Methods: In this retrospective, observational study, we recruited all patients with signs and symptoms of acute conjunctivitis seen at the Eye Emergency Department (ED), Turin Eye Hospital, between 01/01/2020 and 12/05/2020 and cross-checked our data with the Piedmont Region online COVID-19 registry in the same period. Results: Among 10,065 patients seen at our ED during the timespan considered, 88 underwent a nasopharyngeal swab (NS) for SARS-CoV-2 detection within 4 weeks before/after our examination. On average, NS was performed −0.72 ± 1.8 weeks before/after eye examination. Of the 77 patients with a negative NS, 26 (33.8%) had a diagnosis of acute conjunctivitis, whereas the remaining 51 (66.2%) had other eye disorders. Among the 11 patients with COVID-19, 7 (63,6%) had a diagnosis of acute conjunctivitis. We found a non-statistically significant increase in NS positivity rate (21.2%) among cases examined at our ED for acute conjunctivitis, compared to the NS positivity rate (7.3%) in patients examined for all other eye conditions ( p = 0.092). The Odds Ratio of having a positive NS in patients with acute conjunctivitis was 3.43 (95% I.C. = 0.9–12.8, p = 0.06). Considering online-registry data of Turin population during the same time-span, among 2441 positive NS cases only 27 (1.1%) presented with acute conjunctivitis. Conclusion: Our results do not reveal a statistically significant correlation between COVID-19 and acute conjunctivitis. Synopsis The present study analyzes retrospectively data from a tertiary eye referral center to investigate the relationship between COVID-19 infection and conjunctivitis.

scholarly journals Making a Difference: Adaptation of the Clinical Laboratory in Response to the Rapidly Evolving COVID-19 Pandemic

2021 ◽  
Vol 8 ◽  
pp. 237428952110239
Author(s):  
Nikhil S. Sahajpal ◽  
Ashis K. Mondal ◽  
Sudha Ananth ◽  
Allan Njau ◽  
Sadanand Fulzele ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Nasopharyngeal Swab ◽  
Next Generation Sequencing Technology ◽  
Making A Difference ◽  
Scale Population ◽  
Wide Scale ◽  
Pooling Strategy ◽  
Polymerase Chain ◽  
Phylogenetic Evolution

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2, led to unprecedented demands assigned to clinical diagnostic laboratories worldwide, forcing them to make significant changes to their regular workflow as they adapted to new diagnostic tests and sample volumes. Herein, we summarize the modifications/adaptation the laboratory had to exercise to cope with rapidly evolving situations in the current pandemic. In the first phase of the pandemic, the laboratory validated 2 reverse transcription polymerase chain reaction–based assays to test ∼1000 samples/day and rapidly modified procedures and validated various preanalytical and analytical steps to overcome the supply chain constraints that would have otherwise derailed testing efforts. Further, the pooling strategy was validated for wide-scale population screening using nasopharyngeal swab samples and saliva samples. The translational research arm of the laboratory pursued several initiatives to understand the variable clinical manifestations that this virus presented in the population. The phylogenetic evolution of the virus was investigated using next-generation sequencing technology. The laboratory has initiated the formation of a consortium that includes groups investigating genomes at the level of large structural variants, using genome optical mapping via this collaborative global effort. This article summarizes our journey as the laboratory has sought to adapt and continue to positively contribute to the unprecedented demands and challenges of this rapidly evolving pandemic.

Children With Influenza A Infection: Treatment With Rimantadine

PEDIATRICS ◽  
1987 ◽  
Vol 80 (2) ◽  
pp. 275-282
Author(s):  
Caroline Breese Hall ◽  
Raphael Dolin ◽  
Christine L. Gala ◽  
David M. Markovitz ◽  
Yu Qin Zhang ◽  
...  
Keyword(s):  
Influenza A ◽  
Clinical Signs ◽  
Severity Of Illness ◽  
Signs And Symptoms ◽  
Clinical Isolates ◽  
Double Blind Study ◽  
Double Blind ◽  
Viral Shedding ◽  
Development Of Resistance ◽  
Clinical Signs And Symptoms

Treatment with rimantadine of influenza in children and the potential development of resistance in clinical isolates associated with therapy have not been previously studied. We compared rimantadine to acetaminophen therapy in a controlled, double-blind study of 91 children with influenza-like illness. Of 69 children with proven influenza A/H3N2 infection, 37 received rimantadine and 32 received acetaminophen for five days. Children receiving rimantadine showed significantly greater reduction in fever and improvement in daily scores for symptoms and severity of illness during the first three days. Viral shedding also diminished significantly during the first two days but subsequently increased such that by days 6 and 7 the proportion of children shedding virus, as well as the quantity of virus shed, was significantly greater in the rimantadine group. During the seven-day study, of the 22 children in the rimantadine group with serial isolates tested, ten (45.5%) had resistant isolates compared with two (12.5%) of those with serial isolates in the acetaminophen group (P < .03). Thus, of the total 37 children in the rimantadine group, 27% were found to have resistant isolated compared with 6% in the total group receiving acetaminophen (P < .04). Furthermore, the mean inhibitory concentration of rimantadine increased with time in the rimantadine group (r = .4, P = .002) but not in the acetaminophen group. Rimantadine therapy, thus, appears to be significantly more effective than acetaminophen in ameliorating the clinical signs and symptoms of influenza in children. Treatment with rimantadine was also associated with increased viral shedding after the medication was discontinued and with the development of resistance in the clinical isolates, the significance of which is unknown.

scholarly journals Pulmonary abscess as a complication of COVID-19 associated pneumonia: a clinical case

2022 ◽  
Vol 99 (12) ◽  
pp. 7-12
Author(s):  
T. I. Kalenchits ◽  
S. L. Kabak ◽  
S. V. Primak ◽  
N. M. Shirinaliev
Keyword(s):  
Clinical Laboratory ◽  
Lower Lobe ◽  
Pleural Empyema ◽  
Lung Abscess ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pulmonary Abscess ◽  
Causative Factors ◽  
The Right ◽  
Test Result

The article describes a case of polysegmental destructive viral-bacterial pneumonia complicated with acute pulmonary abscess, pleural empyema, and pneumopleurofibrosis in a 50-year-old female patient infected with the SARS-CoV-2 virus. The first clinical, laboratory and radiological signs of purulent-necrotic inflammation appeared only 20 days after receiving a positive RT-PCR test result with a nasopharyngeal swab. A month later, an emerging abscess in the lower lobe of the right lung was diagnosed. Subsequently, it spontaneously drained into the pleural cavity.Coagulopathy with the formation of microthrombi in small pulmonary vessels is one of the causative factors of lung abscess in patients infected with the SARS-CoV-2 virus.

scholarly journals Transmission dynamics of the delta variant of SARS-CoV-2 infections in Daejeon, South Korea

2021 ◽  
Author(s):  
Hari Hwang ◽  
Jun-Sik Lim ◽  
Sun-Ah Song ◽  
Chiara Achangwa ◽  
Woobeom Sim ◽  
...  
Keyword(s):  
South Korea ◽  
Symptom Onset ◽  
Credible Interval ◽  
Transmission Dynamics ◽  
Contact Tracing ◽  
Nasopharyngeal Swab ◽  
Strict Adherence ◽  
Virus Shedding ◽  
Viral Shedding ◽  
Asymptomatic Patients

Abstract Background The delta variant of SARS-CoV-2 is now the predominant variant worldwide. However, its transmission dynamics remain unclear. Methods We analyzed all case patients in local clusters and temporal patterns of viral shedding using contact tracing data from 405 cases associated with the delta variant of SARS-CoV-2 between 22 June and 31 July 2021 in Daejeon, South Korea. Results Overall, half of the cases were aged under 19 years, and 20% were asymptomatic at the time of epidemiological investigation. We estimated the mean serial interval as 3.26 days (95% credible interval 2.92, 3.60), and 12% of the transmission occurred before symptom onset of the infector. We identified six clustered outbreaks, and all were associated with indoor facilities. In 23 household contacts, the secondary attack rate was 63% (52/82). We estimated that 15% (95% confidence interval, 13–18%) of cases seeded 80% of all local transmission. Analysis of the nasopharyngeal swab samples identified virus shedding from asymptomatic patients, and the highest viral load was observed two days after symptom onset. The temporal pattern of viral shedding did not differ between children and adults (P = 0.48). Conclusions Our findings suggest that the delta variant is highly transmissible in indoor settings and households. Rapid contact tracing, isolation of the asymptomatic contacts, and strict adherence to public health measures are needed to mitigate the community transmission of the delta variant.

A RARE CASE OF NEONATE WITH SEVERE LUNG DISEASE SECONDARY TO COVID 19 DISEASE

2021 ◽  
pp. 4-5
Author(s):  
Vishal Dnyaneshwar Sawant ◽  
Murtuja Shaikh ◽  
Sushma Malik ◽  
Poonam Wade ◽  
Santosh Kondekar
Keyword(s):  
Age Groups ◽  
Severe Infection ◽  
Complete Recovery ◽  
Nasopharyngeal Swab ◽  
Global Pandemic ◽  
Similar Disease ◽  
Life Threatening ◽  
History Of ◽  
Polymerase Chain ◽  
Protective Strategies

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome Corona virus 2 (SARS-CoV-2), has caused a global pandemic affecting many countries. The disease is affecting all age groups but data so far has shown that infants and children seem to be at a lower risk of severe infection. This case emphasis that neonates too can have life threatening pulmonary disease that mimics a similar disease course to that described in adults with COVID-19 infection. We report a 21-day-old neonate who presented with fever and signicant positive history of COVID 19 infection in family and developed acute respiratory distress syndrome (ARDS). The SARSCoV-2 polymerase chain reaction (PCR) of nasopharyngeal swab was positive and chest computed tomography had classical changes of COVID 19 infection. Good hydration, lung protective strategies, intravenous immunoglobulin and supportive care led to complete recovery in the patient.

scholarly journals Association between Platelet Parameters and Glaucoma Severity in Primary Open-Angle Glaucoma

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Yi Ma ◽  
Jianping Han ◽  
Shengjie Li ◽  
Aiping Zhang ◽  
Wenjun Cao ◽  
...  
Keyword(s):  
Primary Open Angle Glaucoma ◽  
Clinical Laboratory ◽  
Open Angle Glaucoma ◽  
Large Cell ◽  
Control Group ◽  
Mean Deviation ◽  
Open Angle ◽  
Regression Analyses ◽  
Distribution Width ◽  
Department Of Ophthalmology

Purpose. To evaluate platelet parameters in primary open-angle glaucoma (POAG) patients and to explore the association between platelet parameters and POAG severity. Methods. A total of 402 consecutive POAG patients and 408 healthy control subjects from the Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Fudan University, were consecutively recruited between January 2016 and October 2018. Detailed ophthalmological and systematic examinations were performed. Blood samples for platelet parameters, including platelet count (PLT), platelet distribution width (PDW), plateletcrit (PCT), mean platelet volume (MPV), and platelet large cell ratio (P-LCR), were analyzed using an automated hematology analyzer in the department of clinical laboratory science of the hospital. The POAG subgroups were classified according to age (<50, ≥50), gender, and visual field mean deviation (MD): mild (MD ≤ 6 dB), moderate (6 dB < MD ≤ 12 dB), and severe (MD > 12 dB). Results. In POAG patients, PLT counts (207.08 ± 54.70 ∗ 109/L) were significantly lower p=0.001 than those of the control group (220.46 ± 55.85 ∗ 109/L). In the POAG group, PDW (13.76 ± 3.16 fL) and MPV (10.46 ± 1.32 fL) values were significantly higher (all p<0.001) than those of the control group (PDW 11.82 ± 2.44 fL, MPV 10.13 ± 1.10 fL). PDW and MPV values were highest in the severe POAG group (PDW 14.49 ± 2.99 fL; MPV 10.74 ± 1.39 fL), followed by the moderate group (PDW 12.50 ± 3.14 fL; MPV 10.02 ± 1.08 fL) and then the mild group (PDW 11.82 ± 2.44 fL; MPV 9.92 ± 0.76 fL), with statistically significant differences observed between mild-severe POAG and moderate-severe POAG groups by LSD post hoc test. Multiple linear regression analyses showed a significant association between PDW and MD (β = 0.430, p<0.001) and MPV and MD (β = 0.363, p=0.001). Logistic regression analyses revealed that PDW (OR = 1.297, 95% CI = 1.011–1.663) was associated with the severity of POAG. Conclusions. PDW and MPV values were significantly elevated in POAG patients, and PDW was positively associated with disease severity, which suggested the possibility that platelet activation be involved in pathomechanisms of POAG.

scholarly journals Stroke in COVID-19: a single-centre initial experience in a hotspot of the pandemic

2020 ◽  
Vol 5 (4) ◽  
pp. 331-336 ◽  
Author(s):  
Ivo Bach ◽  
Pratibha Surathi ◽  
Nora Montealegre ◽  
Osama Abu-Hadid ◽  
Sara Rubenstein ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Mechanical Thrombectomy ◽  
Clinical Laboratory ◽  
Severe Disease ◽  
Nasopharyngeal Swab ◽  
Single Centre ◽  
Vessel Occlusion ◽  
Global Pandemic ◽  
Imaging Characteristics ◽  
Intravenous Alteplase

BackgroundCOVID-19, caused by SARS-CoV-2, is a global pandemic that has been an immense burden on healthcare systems all over the world. These patients may be at higher risk for acute ischaemic stroke (AIS). We present our experience with AIS in patients with COVID-19.MethodsWe reviewed all patients admitted to our hospital during a 6-week period with a positive nasopharyngeal swab test for SARS-CoV-2. Among these patients, we identified AIS. We reviewed the demographics, clinical, laboratory, imaging characteristics, treatments received and outcomes of AIS in patients with COVID-19.ResultsWe identified 683 patients admitted with COVID-19 during the study period, of which 20 patients had AIS. Large-vessel occlusion (LVO) was noted in 11 patients (55%). Intravenous alteplase was administered in four patients (20%) and mechanical thrombectomy was performed in five patients (25%). Respiratory symptoms preceded the onset of AIS in most of the patients (70%) by 1 to 21 days. Mortality in patients with AIS was 50% compared with 26% of all COVID-19 admissions. Most of these patients died due to non-neurological causes (70%). Three patients with AIS had clinical and imaging findings consistent with COVID-19, but were negative for multiple nasopharyngeal swab tests.InterpretationLVO was more common in patients with AIS and COVID-19. They had more severe disease and higher mortality rates. Most of the patients had respiratory symptoms preceding AIS by days to weeks. This could explain certain patients with clinical picture of COVID-19 but negative nasopharyngeal swab tests.

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