scholarly journals Dark urine as the initial manifestation of COVID-19: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Goar Egoryan ◽  
Sana Chaudry ◽  
Kritika Yadav ◽  
Tianyu Dong ◽  
Emre Ozcekirdek ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Single Case ◽  
Late Complication ◽  
Kidney Injury ◽  
Supplemental Oxygen ◽  
Initial Manifestation ◽  
Case Presentation ◽  
Dark Urine ◽  
Urine Color ◽  
Muscle Necrosis

Abstract Background Rhabdomyolysis is defined as a syndrome consisting of muscle necrosis and the release of intracellular muscle components into the bloodstream. Although rhabdomyolysis has been previously reported as an initial presentation or late complication of COVID-19, the data on it is still limited, and currently, there is no single case of COVID-19 in the literature that describes creatine kinase levels of more than 30,000 IU/L. Case presentation A 50-year-old African–American male presented to the hospital with decreased urine output, dark urine color, and constipation for the past couple of days. He was found to have acute kidney injury, liver injury, and creatinine kinase of 359,910 IU/L, for which aggressive intravenous fluid therapy was given. Infectious workup resulted in positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction. Two days after admission, the patient became symptomatic from a coronavirus disease 2019: he developed fever and hypoxia, and was placed on supplemental oxygen and started on a 10-day course of dexamethasone. The patient responded well to the treatment and supportive care for coronavirus disease 2019 and was successfully discharged. Conclusion Clinicians should be cognizant of atypical coronavirus disease 2019 presentations. The spectrum of damage of coronavirus disease 2019 is still an evolving topic, and more research is required to reveal the exact mechanisms by which severe acute respiratory syndrome coronavirus 2 leads to rhabdomyolysis.

Updates on coronavirus (COVID-19) and kidney

2020 ◽  
Vol 9 (4) ◽  
pp. e34-e34 ◽  
Author(s):  
Seyed Zanyar Athari ◽  
Daryoush Mohajeri ◽  
Mir Alireza Nourazar ◽  
Yousef Doustar
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Angiotensin Converting Enzyme ◽  
Enzyme Inhibitor ◽  
Case Reports ◽  
Angiotensin Receptor Blockers ◽  
Kidney Injury ◽  
Current Treatment ◽  
High Risk Group ◽  
Converting Enzyme ◽  
Renal Disorder

The severe acute respiratory syndrome (SARS) is an infectious disease developed in Wuhan, China, at first. It involves the respiratory system and other organs like kidney, gastrointestinal tract and nervous system as well. The recent reports indicated that renal disorder is prevalent in coronavirus patients. The aim of this study was to provide a review of nephropathy caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and its mechanisms. The Web of Science, Scopus, and PubMed databases were systematically searched. Articles reporting nephropathy, coronavirus disease (COVID-19), coronavirus and the renal injury were included for assessment. Study designs, contrast agents, case reports and results were assessed. Of the assessed studies, suggested mechanisms include sepsis which caused cytokine storm syndrome or perhaps direct cellular injury due to the virus. In patients who were studied, albuminuria, proteinuria, and hematuria as well as an elevation in blood urea nitrogen and serum creatinine were observed. Additionally CT scan of the kidneys showed a decrease in tissue density suggestive of inflammation and interstitial edema. On the other hand, dialysis patients are a high-risk group than the general population. The current treatment for COVID-19 in acute kidney injury includes supportive management or kidney replacement therapy. All patients need to be quarantined. An N95 fit-tested mask and protective clothing and proper equipment are necessary. Some drugs can be effective to inhibit the outcome of this infection such as lopinavir/ritonavir, remdesvir, Chloroquine phosphate, convalescent plasma, tocilizumab, ACEi/ ARBs (angiotensin-converting enzyme inhibitor/angiotensin receptor blockers), and hrsACE2 (human recombinant soluble angiotensin-converting-enzyme 2).

scholarly journals A case series of ischemic stroke with coronavirus disease 2019 in two Egyptian centers

2020 ◽  
Vol 56 (1) ◽  
Author(s):  
Nevine El Nahas ◽  
Tamer Roushdy ◽  
Eman Hamid ◽  
Sherien Farag ◽  
Hossam Shokri ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Severe Acute Respiratory Syndrome ◽  
Cerebrovascular Disorders ◽  
Case Series ◽  
Neurological Manifestations ◽  
Case Presentation ◽  
Novel Virus

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel virus that has been reported to have various neurological manifestations. Cerebrovascular disorders have been encountered as a coronavirus disease 2019 (COVID-19) presentation in our center during the pandemic. Case presentation We are presenting 10 cases with cerebrovascular manifestations after having COVID-19 few days prior to stroke. Conclusion Cerebrovascular manifestations can occur in association with COVID-19 and may have significant implications on prognosis and management.

scholarly journals Duodenal adenocarcinoma with skin metastasis as initial manifestation: A case report

2021 ◽  
Vol 16 (1) ◽  
pp. 395-398
Author(s):  
Yixiao Fu ◽  
Cuiping Zheng ◽  
Jian Huang ◽  
Shenghao Wu ◽  
Yanyan Dai
Keyword(s):  
Oral Treatment ◽  
Duodenal Biopsy ◽  
Skin Metastasis ◽  
Metastatic Adenocarcinoma ◽  
Duodenal Adenocarcinoma ◽  
Initial Manifestation ◽  
Case Presentation ◽  
Replacement Treatment ◽  
Lost To Follow Up

Abstract Background Duodenal adenocarcinoma (DA) with skin metastasis as initial manifestation is clinically rare. In this study, we report a rare case of skin metastasis of DA. Case presentation An 84-year-old male patient developed multiple ecchymoses on the trunk and lower extremities. Physical examination showed that the ecchymosis was dark red and had a hard texture, but showed no bulging, rupture, or tenderness. The skin biopsy implied skin metastatic adenocarcinoma. After an endoscopic duodenal biopsy, the patient was finally diagnosed with DA with skin metastasis. The patient received two courses of oral treatment of Tegafur (40 mg, bid d1–d14). However, the patient stopped taking Tegafur because of its poor effect and received Chinese medicine as a replacement treatment. Unfortunately, he was lost to follow-up. Conclusions Early diagnosis of DA metastasis is of significant importance as prognosis of these patients is poor.

scholarly journals Unexplained worsening of parkinsonian symptoms in a patient with advanced Parkinson’s disease as the sole initial presentation of COVID-19 infection: a case report

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Walaa A. Kamel ◽  
Ismail Ibrahim Ismail ◽  
Mohamed Ibrahim ◽  
Jasem Y. Al-Hashel
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Viral Infections ◽  
Neurological Complications ◽  
Initial Presentation ◽  
Nasopharyngeal Swab ◽  
Initial Manifestation ◽  
Advanced Parkinson’S Disease ◽  
Case Presentation ◽  
Dystonic Posturing

Abstract Background Parkinson’s disease (PD) is a neurodegenerative condition that has been reported following viral infections in rare occasions. Several neurological complications have emerged in association with coronavirus disease 2019 (COVID-19), since its declaration as a pandemic. Herein, we present a novel case of unexplained worsening of PD as the sole initial presentation of COVID-19, in the absence of fever or respiratory symptoms. Case presentation A 56-year-old male with advanced PD presented with severe rigidity, dystonic posturing of both feet, and confusion of 4 days duration. His condition progressed to an akinetic-rigid state and confusion during the following week, and a routine nasopharyngeal swab tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the 9th day of onset. He developed fever and dyspnea later and was intubated on the 10th day. Conclusion To our knowledge, worsening of PD symptoms as the sole initial manifestation of SARS-CoV-2 infection, in the absence of other cardinal features of COVID-19, has not been reported in the literature. We suggest testing for COVID-19 infection in patients with PD, especially advanced cases, who present with unexplained worsening of symptoms, even in the absence of COVID-19 cardinal features.

Short report: craniosynostosis, a late complication of nutritional rickets

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Lydia Y. Forestier-Zhang ◽  
Paul Arundel ◽  
Robyn Gilbey-Cross ◽  
Mohammed Zulf Mughal ◽  
Amaka C. Offiah ◽  
...  
Keyword(s):  
Early Identification ◽  
Late Complication ◽  
Psychosocial Problems ◽  
Short Report ◽  
Delayed Presentation ◽  
Brain Growth ◽  
Case Presentation ◽  
Nutritional Rickets ◽  
Potential Association

Abstract Objectives Nutritional rickets may be a preventable cause of craniosynostosis. This potential association is under-recognised. A late diagnosis of craniosynostosis may result in reduced brain growth, raised intracranial pressure and long-term psychosocial problems. Case presentation We present four cases of craniosynostosis associated with nutritional rickets. Those who had delayed presentation underwent emergency craniotomy. Conclusions Treatment of nutritional rickets and early identification of craniosynostosis can reduce morbidity in these children.

scholarly journals Human kidney is a target for novel severe acute respiratory syndrome coronavirus 2 infection

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Bo Diao ◽  
Chenhui Wang ◽  
Rongshuai Wang ◽  
Zeqing Feng ◽  
Ji Zhang ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Kidney Injury ◽  
Human Kidney ◽  
The Elderly ◽  
Tubular Damage ◽  
Clinical Parameters ◽  
Double Staining ◽  
Protein Deposits ◽  
Prostaglandin D Synthase

AbstractIt is unclear whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can directly infect human kidney, thus leading to acute kidney injury (AKI). Here, we perform a retrospective analysis of clinical parameters from 85 patients with laboratory-confirmed coronavirus disease 2019 (COVID-19); moreover, kidney histopathology from six additional COVID-19 patients with post-mortem examinations was performed. We find that 27% (23/85) of patients exhibited AKI. The elderly patients and cases with comorbidities (hypertension and heart failure) are more prone to develop AKI. Haematoxylin & eosin staining shows that the kidneys from COVID-19 autopsies have moderate to severe tubular damage. In situ hybridization assays illustrate that viral RNA accumulates in tubules. Immunohistochemistry shows nucleocapsid and spike protein deposits in the tubules, and immunofluorescence double staining shows that both antigens are restricted to the angiotensin converting enzyme-II-positive tubules. SARS-CoV-2 infection triggers the expression of hypoxic damage-associated molecules, including DP2 and prostaglandin D synthase in infected tubules. Moreover, it enhances CD68+ macrophages infiltration into the tubulointerstitium, and complement C5b-9 deposition on tubules is also observed. These results suggest that SARS-CoV-2 directly infects human kidney to mediate tubular pathogenesis and AKI.

Fifteen-minute consultation: how to identify and treat children with acute kidney injury

2021 ◽  
pp. edpract-2020-319928
Author(s):  
Maura Scott ◽  
Grace McCall
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Management ◽  
Kidney Injury ◽  
Case Presentation ◽  
Mortality And Morbidity ◽  
Fluid Status ◽  
Close Observation ◽  
Long Term Follow Up

Acute kidney injury (AKI) is under-recognised in children and neonates. It is associated with increased mortality and morbidity along with an increased incidence of chronic kidney disease in adulthood. It is important that paediatricians are able to recognise AKI quickly, enabling prompt treatment of reversible causes. In this article, we demonstrate an approach to recognising paediatric AKI, cessation of nephrotoxic medication, appropriate investigations and the importance of accurately assessing fluid status. The mainstay of treatment is attempting to mimic the kidneys ability to provide electrolyte and fluid homeostasis; this requires close observation and careful fluid management. We discuss referral to paediatric nephrology and the importance of long-term follow-up. We present an approach to AKI through case-presentation.

scholarly journals Covid-19 and Acute Kidney Injury: Recent Updates

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Salman Tahir Shafi
Keyword(s):  
Acute Kidney Injury ◽  
Severe Acute Respiratory Syndrome ◽  
World Health Organization ◽  
Recent Literature ◽  
Kidney Injury ◽  
World Health ◽  
Related Disease ◽  
Increased Risk ◽  
The World ◽  
Health Organization

In January 2020, the pathogen was identified and named by the World Health Organization as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2). The consequent SARS-CoV-2-related disease was defined as coronavirus disease 2019 (COVID-19). As data emerged about characteristics of the disease, it was found to be associated with increased risk of acute kidney injury (AKI). We explore the recent literature and reports emerging from the epicenters of the pandemic to help our viewers understand the nature of AKI among these patients. 

scholarly journals Clinical features of acute kidney injury in Coronavirus disease 2019—A case report with review of literature

2020 ◽  
Author(s):  
Hai Yuan ◽  
Xiaohan Lu ◽  
E Guo ◽  
Fengqi Hu ◽  
Zhao Gao
Keyword(s):  
Acute Kidney Injury ◽  
Case Report ◽  
Kidney Function ◽  
Kidney Injury ◽  
Hubei Province ◽  
Review Of Literature ◽  
Case Presentation ◽  
High Incidence ◽  
Careful Management ◽  
High Incidence Area

Abstract Background: In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, Hubei province, China. We surveyed 91 patients who were diagnosis as coronavirus disease 2019 (COVID-19) in Xiangyang, Hubei province. And we found the incident of acute kidney injury (AKI) was 3.29% (3/91), which was higher than in the whole country but similar in Hubei province.Case presentation: We describe a case of 58-year-old man who was diagnosis as AKI stage 3 and non-oliguria AKI in the SARS-CoV-2 infection. After antiviral and other supporting treatment, his kidney function improved and he was transferred to normal ward.Conclusions: This case illustrated that careful management and strict monitoring of kidney function should be employed in COVID-19 patients especially in high incidence area of COVID-19.

scholarly journals Misfortune never comes singly - the first case of COVID-19 with rupture of thoracic aortic aneurysm

2020 ◽  
Author(s):  
Kun Zhao ◽  
Zhang Cao ◽  
Changju Zhu ◽  
Yi Zhang ◽  
Feifan Chen
Keyword(s):  
Aortic Aneurysm ◽  
Severe Acute Respiratory Syndrome ◽  
Hospital Admission ◽  
Thoracic Aortic Aneurysm ◽  
Warning Signs ◽  
Cytokine Storm ◽  
Case Presentation ◽  
First Case

Abstract Background: SARS-CoV-2 is a newly discovered virus, leading COVID-19 a global threaten nowadays. Case Presentation: The first case of a patient with a thoracic aortic aneurysm (TAA) that became infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported here. The patient died suddenly from a ruptured aorta 19 h after hospital admission. Conclusion: COVID-19 patients with TAA should attract the highest vigilance as COVID-19 might expedite the process of TAA rupture through cytokine storm syndrome, leading to rapid death with little or no warning signs.

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