scholarly journals Loculated Empyema and SARS-CoV-2 Infection: A Report of Two Cases and Review of the Literature

Author(s):  
Sarah Ayad ◽  
Kirolos Gergis ◽  
Sherif Elkattawy ◽  
Noreen Mirza ◽  
Basel Abdelazeem ◽  
...  

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinical manifestations are diverse and can vary from mild respiratory symptoms to severe hypoxic respiratory failure. In severe cases, infection can cause gastrointestinal, renal, cardiac, neurological and haematological complications and result in multi-organ failure. There are very few reports of parapneumonic effusion in patients with COVID-19. We describe two patients with COVID-19 who had loculated empyema and discuss the clinical course and therapeutic options.

Author(s):  
VALENTINA TJANDRA DEWI ◽  
ANAK AGUNG AYU PUTRI LAKSMIDEWI ◽  
KETUT AYU SUDIARIANI

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or CoV disease 2019 (COVID-19) infection has spread throughout the world and becomes a global pandemic. Various studies are still ongoing to be able to understand this viral infection in terms of symptomatology, transmission, pathogenesis, its treatment, and prevention. In addition to respiratory symptoms that are commonly reported in SARS-CoV-2 infections, there are many reports of symptoms appearing in other organ systems with one of them being neurological manifestation. The neurological manifestations involve not only the central and peripheral nervous systems but also there was also a suspicion that the potential invasion of SARS-CoV-2 in the nervous system might be able to take part in the occurrence of respiratory failure that is found in patients with COVID-19. The continuity of the study and the awareness of medical personnel from various fields of science must be increased to fight against the COVID-19 pandemic and ensuring optimal treatment for patients.


2020 ◽  
Vol 31 (6) ◽  
pp. 904-905
Author(s):  
Laura Varela Barca ◽  
Isabel Torralba Cloquell ◽  
Jaime Herrero Cereceda ◽  
Jose Ignacio Sáez de Ibarra

Abstract We present a case report of fatal respiratory failure after cardiac surgery in the early stages of the coronavirus disease 2019 outbreak. Although not supported by epidemiological data nor clinical course, coronavirus disease 2019 infection was revealed post-mortem by immunohistochemical detection of the severe acute respiratory syndrome coronavirus 2 spike protein in lung tissue.


Hemato ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 463-476
Author(s):  
Ryann Quinn ◽  
Irina Murakhovskaya

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with a variety of clinical manifestations related to viral tissue damage, as well as a virally induced immune response. Hyperstimulation of the immune system can serve as a trigger for autoimmunity. Several immune-mediated manifestations have been described in the course of SARS-CoV-2 infection. Immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA) are the most common hematologic autoimmune disorders seen in the course of SARS-CoV-2 infection. Vaccine-induced thrombocytopenia is a unique autoimmune hematologic cytopenia associated with SARS-CoV-2 vaccination. This paper will review the current literature on the association of SARS-CoV-2 infection and vaccination with autoimmune cytopenias and the clinical course of autoimmune cytopenias in patients with COVID-19.


Children ◽  
2021 ◽  
Vol 8 (7) ◽  
pp. 613
Author(s):  
Michele Ghezzi ◽  
Enza D’Auria ◽  
Andrea Farolfi ◽  
Valeria Calcaterra ◽  
Alessandra Zenga ◽  
...  

Background: Few studies have been carried out with the aim of describing the clinical course and follow-up of patients with tracheomalacia. We aim to describe the symptoms at diagnosis and the post-treatment clinical course of patients affected by airway malacia. Methods: We retrospectively analyzed characteristics of pediatric patients with a diagnosis of airway malacia. Patients were classified into three groups: bronchomalacia (BM), tracheomalacia (TM) and tracheo-bronchomalacia (TBM). Demographic and clinical data, diagnostic work-up and surgical treatment were recorded. Results: 13/42 patients were affected by congenital syndromes (30.9%). Esophageal atresia with or without tracheal-esophageal fistula (EA/TEF) was detected in 7/42 patients (16.7%). Cardiovascular anomalies were found in 9/42 (21.4%) and idiopathic forms in 13/42 (30.9%). BM occurred in 7/42 (16.6%), TM in 23/42 (54.7%) and TBM in 12/42 (28.6%). At the diagnosis stage, a chronic cough was reported in 50% of cases with a higher prevalence in EA/TEF (p = 0.005). Surgery was performed in 16/42 (40%) of children. A chronic cough and acute respiratory failure were correlated to the need for surgery. During follow-up, there was no difference in persistence of symptoms between conservative vs surgical treatment (p = 0.47). Conclusion: the management of tracheomalacia remains a challenge for pediatricians. Clinical manifestations, such as a barking cough and acute respiratory failure may suggest the need for surgery. Follow-up is crucial, especially in those patients affected by comorbidities, so as to be able to manage effectively the possible persistence of symptoms, including those that may continue after surgical treatment.


Stroke ◽  
2020 ◽  
Vol 51 (9) ◽  
pp. 2674-2682 ◽  
Author(s):  
Lijuan Zhang ◽  
Wenwu Sun ◽  
Yujun Wang ◽  
Xiaopin Wang ◽  
Yanli Liu ◽  
...  

Background and Purpose: No studies have reported the effect of the coronavirus disease 2019 (COVID-19) epidemic on patients with preexisting stroke. We aim to study the clinical course of COVID-19 patients with preexisting stroke and to investigate death-related risk factors. Methods: We consecutively included 651 adult inpatients with COVID-19 from the Central Hospital of Wuhan between January 2 and February 15, 2020. Data on the demography, comorbidities, clinical manifestations, laboratory findings, treatments, complications, and outcomes (ie, discharged or death) of the participants were extracted from electronic medical records and compared between patients with and without preexisting stroke. The association between risk factors and mortality was estimated using a Cox proportional hazards regression model for stroke patients infected with severe acute respiratory syndrome coronavirus 2. Results: Of the 651 patients with COVID-19, 49 with preexisting stroke tended to be elderly, male, had more underlying comorbidities and greater severity of illness, prolonged length of hospital stay, and greater hospitalization expenses than those without preexisting stroke. Cox regression analysis indicated that the patients with stroke had a higher risk of developing critical pneumonia (adjusted hazard ratio, 2.01 [95% CI, 1.27–3.16]) and subsequent mortality (adjusted hazard ratio, 1.73 [95% CI, 1.00–2.98]) than the patients without stroke. Among the 49 stroke patients, older age and higher score of Glasgow Coma Scale or Sequential Organ Failure Assessment were independent risk factors associated with in-hospital mortality. Conclusions: Preexisting stroke patients infected with severe acute respiratory syndrome coronavirus 2 were readily predisposed to death, providing an important message to individuals and health care workers that preventive measures must be implemented to protect and reduce transmission in stroke patients in this COVID-19 crisis.


2020 ◽  
Vol 9 (3) ◽  
pp. 229-238 ◽  
Author(s):  
Susanna Price ◽  
Suveer Singh ◽  
Stephane Ledot ◽  
Paolo Bianchi ◽  
Matthew Hind ◽  
...  

The severe acute respiratory syndrome coronavirus 2 pandemic is to date affecting more than a million of patients and is challenging healthcare professionals around the world. Coronavirus disease 2019 may present with a wide range of clinical spectrum and severity, including severe interstitial pneumonia with high prevalence of hypoxic respiratory failure requiring intensive care admission. There has been increasing sharing experience regarding the patient’s clinical features over the last weeks which has underlined the need for general guidance on treatment strategies. We summarise the evidence existing in the literature of oxygen and positive pressure treatments in patients at different stages of respiratory failure and over the course of the disease, including environment and ethical issues related to the ongoing coronavirus disease 2019 infection.


2021 ◽  
Vol 30 (1) ◽  
pp. 5-15
Author(s):  
V.N. Khirmanov

COVID-19 usually manifests by respiratory symptoms. However, it would be an erroneous simplification to consider it as a local respiratory disease. The nervous system and intestines are often involved even in patients with mild infection, although the risk of dissemination of the infectious process and the development of severe systemic disease is mainly associated with lung damage. The addition of infectious thrombotic microvasculitis (endothelitis) to bronchopneumonia-alveolitis not only forms a substrate for respiratory failure, but also increases a risk of viruses entry into the bloodstream. Viral sepsis develops, whereas inflammatory thrombosis damages new areas of the vascular bed. These mechanisms or direct viral invasion can result in involvement of many tissues and organs in the pathological process. This review examines the molecular, cellular and clinical manifestations and complications of the new coronavirus disease.


Author(s):  
Lawrence Frenkel ◽  
Fernando Gomez ◽  
Joseph A Bellanti

Background: Since its initial description in December 2019 in Wuhan, China, coronavirus disease 2019 (COVID-19) has rapidly progressed into a worldwide pandemic, which has affected millions of lives. Unlike the disease in adults, the vast majority of children with COVID-19 have mild symptoms and are largely spared from severe respiratory disease. However, thereare children who have significant respiratory disease, and some may develop a hyperinflammatory response similar to thatseen in adults with COVID-19 and in children with Kawasaki disease (KD), which has been termed multisystem inflammatory syndrome in children (MIS-C).Objective: The purpose of this report was to examine the current evidence that supports the etiopathogenesis of COVID-19 in children and the relationship of COVID-19 with KD and MIS-C as a basis for a better understanding of the clinical course, diagnosis, and management of these clinically perplexing conditions.Results: The pathogenesis of COVID-19 is carried out in two distinct but overlapping phases of COVID-19: the first triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) itself and the second by the host immune response. Children with KD have fewer of the previously described COVID-19–associated KD features with less prominent acute respiratory distress syndrome and shock than children with MIS-C.Conclusion: COVID-19 in adults usually includes severe respiratory symptoms and pathology, with a high mortality. Ithas become apparent that children are infected as easily as adults but are more often asymptomatic and have milder diseasebecause of their immature immune systems. Although children are largely spared from severe respiratory disease, they canpresent with a SARS-CoV-2–associated MIS-C similar to KD.


2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Casey Meizinger ◽  
Bruce Klugherz

Abstract Background While it is understood that coronavirus disease 2019 (COVID-19) is primarily complicated by respiratory failure, more data are emerging on the cardiovascular complications of this disease. A subset of COVID-19 patients present with ST-elevations on electrocardiogram (ECG) yet normal coronary angiography, a presentation that can fit criteria for myocardial infarction with no obstructive coronary atherosclerosis (MINOCA). There is little known about non-coronary myocardial injury observed in patients with COVID-19, and we present a case that should encourage further conversation and study of this clinical challenge. Case summary An 86-year-old man presented to our institution with acute hypoxic respiratory failure and an ECG showing anteroseptal ST-segment elevation concerning for myocardial infarction. Mechanic ventilation was initiated prior to presentation, and emergent transthoracic echocardiography reported an ejection fraction of 50–55%, with no significant regional wall motion abnormalities. Next, emergent coronary angiography was performed, and no significant coronary artery disease was detected. The patient tested positive for COVID-19. Despite supportive management in the intensive care unit, the patient passed away. Discussion We present a case of COVID-19 that is likely associated with MINOCA. It is crucial to understand that in COVID-19 patients with signs of myocardial infarction, not all myocardial injury is due to obstructive coronary artery disease. In the case of COVID-19 pathophysiology, it is important to consider the cardiovascular effects of hypoxic respiratory failure, potential myocarditis, and significant systemic inflammation. Continued surveillance and research on the cardiovascular complications of COVID-19 is essential to further elucidate management and prognosis.


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