A multicentric observational study of imaging findings in COVID-19-related rhino-orbito-cerebral mucormycosis: a new Pandora’s box

Abstract Background There is a sudden rise of fungal infection with corona virus disease. This is attributed to the immunomodulation by the disease and the drugs used, diabetes mellitus, steroid use, oxygen inhalation using dirty water, use of zinc and iron supplements, etc. Early diagnosis and prompt medical and surgical intervention is the mainstay of treatment. This can greatly reduce the high morbidity and mortality associated with this disease. The objective of the study is to describe the imaging findings of acute invasive rhino-orbito-cerebral mucormycosis (ROCM) in 25 patients with severe acute respiratory syndrome corona virus 2, from three different centers with proven mucormycosis. Special emphasis is placed on the signal enhancement patterns of sinonasal mucosa, the earliest and most common findings. Statistical analysis was performed using descriptive statistics. Results Computed tomography (CT) and magnetic resonance imaging (MRI) of 25 patients showed most commonly involved sinuses as maxillary and ethmoid sinuses (19, 76%) together. Sino-nasal mucosal thickening was the most common finding (24, 96%). Periantral infiltration (18, 72%) preceded before orbital (15, 60%), cerebral (5, 20%) and vascular (2, 8%) complications, with grossly intact bones. Sinus wall erosions were seen in only 2 patients (8%). Palatal (22%) and maxillary alveolar arch erosion (39%) were frequent findings. CT showed minimally enhancing hypodense soft tissue thickening as the predominant finding in involved areas, while MRI showed T1 and T2 iso- to hypointense mucosal thickening (62%) and intense (43%) and no (33%) contrast enhancement as the main finding. Conclusions Contrast enhanced MRI is better at demonstrating early mucosal abnormalities, turbinate necrosis, non-enhancing devitalized tissues, orbital apex involvement and intra-cerebral extension. Imaging findings of inflammatory tissue infiltration adjacent to the paranasal sinuses in premaxillary, retroantral fat, facial muscles, pterygopalatine fossa, temporal, infratemporal fossa and extraconal orbital fat along with typical patterns of sinonasal mucosal enhancement should raise the suspicion of acute invasive fungal etiology given the short duration of history and immunocompromised status. High incidence of periantral and orbital extension of the disease is suggestive of acute invasive form of fungal infection. Also the rapidly progressive inflammatory changes without much bone involvement should suggest the suspicion of ROCM. Bony, cerebral and vascular involvements are relatively late complications.

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Novel Remedial Approaches Against Virulent Corona Viruses

International Journal of Infectious Diseases and Research ◽

10.47485/2693-2326.1004 ◽

2020 ◽

Keyword(s):

Virus Disease ◽

The Body ◽

Health Concern ◽

High Morbidity ◽

Respiratory Pathogens ◽

Corona Virus ◽

Group I ◽

The World ◽

Group Ii ◽

Corona Viruses

Novel Corona virus disease (COVID-19) was first identified in China, which eventually became a major global health concern due to its pathogenicity and widespread distribution around the world. In the mid-sixties of the previous century, the first two human Corona viruses (HCoV) were identified: HCoV-229E and HCoV-OC43. These two human Corona viruses were studied extensively from approximately 1965 to the mid-1980s. HCoV-229E is a member of the group I Corona viruses, and HCoV-OC43 is a member of group II. 1Besides the human Corona viruses, there are several group I and group II animal corona viruses that infect cattle, pigs, cats, dogs, mice, and other animals. There is one additional branch, the group III Corona viruses, which are found exclusively in birds. By infecting healthy volunteers, researchers learned that infection with HCoV-229E or HCoV-OC43 results in a common cold, and since then, HCoVs have been considered to be relatively harmless respiratory pathogens. This image was roughly disturbed when severe acute respiratory syndrome (SARS)-CoV was introduced into the human population in the winter of 2002 to 2003 in China. SARS-CoV causes a severe respiratory illness with high morbidity and mortality. Currently, the Novel Corona Virus disease COVID 19 spreads around the world, killing people and turning them into corpses. The best way to do this in India, that is what it is there are many types of alkaloids in our Indian Medicinal Plants, which kill the virus of any kind and dispose of it. The alkaloids – Piperine, Curcumin, Allicin, Alliin, Allylsulfide, Allyldisulfide, Citric Acid, Acorbic Acid, Menthol, Gingerols, Shogaols, zingerone, oleanolic acid, ursolic acid, rosmarinic acid, eugenol, carvacrol, linalool, β-caryophyllene etc., the alkaloids that are mentioned are not only killing the virus but also stimulate, and activate the immune system in the body and at the same develops human energy to fight against COVID 19. The preparation and methodologies of simple medicine briefly explained in the topic Novel Remedial Approaches against Virulent Corona Viruses.

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Chest CT-based differential diagnosis of 28 patients with suspected corona virus disease 2019 (COVID-19)

British Journal of Radiology ◽

10.1259/bjr.20200243 ◽

2020 ◽

Vol 93 (1112) ◽

pp. 20200243 ◽

Cited By ~ 1

Author(s):

Sidong Xie ◽

Ziying Lei ◽

Xiuzhen Chen ◽

Weimin Liu ◽

Xiaohong Wang ◽

...

Keyword(s):

Virus Disease ◽

Laboratory Data ◽

Chest Ct ◽

Imaging Findings ◽

Negative Results ◽

Ct Findings ◽

Corona Virus ◽

Mixed Ground ◽

Bilateral Lung ◽

Interlobular Septal Thickening

Objectives: The chest CT findings that can distinguish patients with corona virus disease 2019 (COVID-19) from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative have not previously been described in detail. The purpose of this study was to determine the distinctions among patients with COVID-19 by comparing the imaging findings of patients with suspected confirmed COVID-19 and those of patients initially suspected to have COVID-19 who were ultimately negative for the disease. Methods: 28 isolated suspected in-patients with COVID-19 were enrolled in this retrospective study from January 22, 2020 to February 6, 2020. 12 patients were confirmed to have positive severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) RNA results, and 16 patients had negative results. The thin-section CT imaging findings and clinical and laboratory data of all the patients were evaluated. Results: There were no significant differences between the 12 confirmed COVID-19 (SARS-Cov-2-positive) patients and 16 SARS-CoV-2-negative patients in epidemiology and most of the clinical features or laboratory data. The CT images showed that the incidence of pure/mixed ground-glass opacities (GGOs) was not different between COVID-19 and SARS-CoV-2-negative patients [9/12 (75.0%) vs 10/16 (62.5%), p = 0.687], but pure/mixed GGOs in the peripheral were more common in patients with COVID-19 [11/12 (91.7%) vs 6/16 (37.5%), p = 0.006]. There were no significant differences in the number of lesions, bilateral lung involvement, large irregular/patchy opacities, rounded opacities, linear opacities, crazy-paving patterns, halo signs, interlobular septal thickening or air bronchograms. Conclusions: Although peripheral pure/mixed GGOs on CT may help distinguish patients with COVID-19 from clinically suspected but negative patients, CT cannot replace RT-PCR testing. Advances in knowledge: Peripheral pure/mixed GGOs on-chest CT findings can be helpful in distinguishing patients with COVID-19 from those with clinically suspected COVID-19 but subsequently found to be COVID-19 negative.

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Indikationen für chinesische Arzneimitteltherapie bei Covid-19-Erkrankungen

Zeitschrift für Komplementärmedizin ◽

10.1055/a-1189-9949 ◽

2020 ◽

Vol 12 (03) ◽

pp. 18-18

Author(s):

Christian Thede

Keyword(s):

Virus Disease ◽

Traditionelle Chinesische Medizin ◽

Chinesische Medizin ◽

Corona Virus ◽

Chinesische Arzneimitteltherapie

SummaryIn Reaktion auf den massiven Ausbruch von Covid-19-Erkrankungen in der Region Wuhan wurde von staatlicher Seite bereits Ende Januar 2020 eine Expertenkommission namhafter chinesischer TCM-Fachleute berufen. Nach der Sichtung einer größeren Anzahl von Patienten in Wuhan wurdenTherapieprotokolle für verschiedene Krankheitsstadien formuliert, die in den „Guidance for Corona Virus Disease 2019“ des Generalbüros der Nationalen Hygiene und Gesundheitskommission und des Büros der staatlichen Verwaltung für traditionelle chinesische Medizin aufgenommen wurden.

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