scholarly journals „Dum spiro spero”: a SARS-CoV-2-fertőzés klinikopatológiája 26 eset kapcsán

2021 ◽  
Vol 162 (45) ◽  
pp. 1791-1802
Author(s):  
Tamás Zombori ◽  
Levente Kuthi ◽  
Tibor Hortobágyi ◽  
Erika Csörgő ◽  
János Árgyelán ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Diffuse Alveolar Damage ◽  
Coronary Thrombosis ◽  
Chronic Obstructive ◽  
Hemorrhagic Complication ◽  
Symptomatic Disease ◽  
Immunohistochemical Reaction ◽  
Clostridioides Difficile ◽  
Elderly Males ◽  
Chronic Obstructive Pulmonary Diseases

Összefoglaló. Bevezetés: A kórboncolás hozzájárul a súlyos akut légzőszervi szindrómát okozó koronavírus-2 (SARS-CoV-2-) fertőzés klinikopatológiai vonatkozásainak megismeréséhez. Célkitűzés: A SARS-CoV-2-fertőzöttek boncolása során gyűjtött tapasztalatok bemutatása. Módszer: Egymást követően boncolt, védőoltásban nem részesült, SARS-CoV-2-fertőzött elhunytak klinikai adatait, makro- és mikroszkópos észleleteit összegeztük; a tüdőkimetszéseket SARS-CoV-2-nukleokapszid-immunfestéssel vizsgáltuk. Eredmények: A boncolást a halálok megállapítására (n = 14), tumorgyanú (n = 9), illetve törvényi kötelezettség (n = 3) miatt végeztük. A fertőzést a klinikai észlelés vagy a boncolás során (n = 4) végzett SARS-CoV-2-nukleinsav-teszt igazolta. A tünetes betegség átlagos hossza 12,9 nap volt. 21 betegnél (medián életkor 69 év; 18 férfi) állt fenn COVID–19-pneumonia, mely 16 esetben önmagában, 4 esetben bakteriális pneumoniával vagy álhártyás colitisszel szövődve okozott halált; 1 antikoagulált pneumoniás beteg heveny retroperitonealis vérzésben halt meg. 3 betegnél a halált disszeminálódott malignus tumor, 1 betegnél coronariathrombosis, 1 mentálisan retardált betegnél pedig pulmonalis emboliás szövődmény okozta. A COVID–19-pneumoniás tüdők nehezek, tömöttek és vörösen foltozottak voltak. Szövettanilag a betegség időtartamától függően diffúz alveolaris károsodás korai exsudativ vagy későbbi proliferativ fázisa látszott atípusos pneumocytákkal; gyakori volt a microthrombosis (n = 7), a macrothrombosis (n = 5), illetve a pulmonalis embolia (n = 4). A SARS-CoV-2-immunfestés pozitívnak bizonyult az esetek 38,5%-ában, dominálóan az exsudativ fázisban. Minden elhunyt társbetegség(ek)ben szenvedett, így magasvérnyomás-betegségben (n = 17), érelmeszesedésben (n = 14), 2-es típusú diabetesben (n = 8), rosszindulatú daganatban (n = 6), krónikus obstruktív tüdőbetegségben (n = 4), elhízásban (n = 3), vesetranszplantáció utáni immunszuppresszióban (n = 3). Következtetés: Az irodalmi adatokkal összhangban, halálos COVID–19-pneumonia túlnyomóan idős, társbetegség(ek)től sújtott férfiakban alakult ki. A boncolási gyakorlatban a SARS-CoV-2-nukleokapszid-immunfestéstől a diffúz alveolaris károsodás korai fázisában várható pozitivitás. Orv Hetil. 2021; 162(45): 1791–1802. Summary. Introduction: Autopsy is an important tool for the evaluation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Objectice: The aim of this study was to present our experience with autopsies of patients diagnosed with SARS-CoV-2 infection. Method: Clinical data, macroscopic and microscopic findings of consecutive postmortems of non-vaccinated SARS-CoV-2 patients are summarized. Lung samples were evaluated with SARS-CoV-2 nucleocapsid immunohistochemistry. Results: Autopsies were performed to determine the cause of death (n = 14), suspected tumours (n = 9) or due to legal obligation (n = 3). SARS-CoV-2 infection was verified by ante mortem (n = 22) and post mortem (n = 4) polymerase chain reaction. The mean duration of symptomatic disease was 12.9 days. Of 21 patients with COVID-19 pneumonia, 16 died of respiratory failure, 4 had additional bacterial pneumonia or Clostridioides difficile infection, and 1 developed hemorrhagic complication (n = 1). Other causes of death included disseminated malignancies (n = 3), coronary thrombosis (n = 1) and pulmonary embolism (n = 1). The affected lungs were heavy and had patchy red appearance. Exudative or proliferative phases of diffuse alveolar damage (DAD) were detected with atypical pneumocytes. Microthrombosis (n = 7), macrothrombosis (n = 5) and pulmonary embolism (n = 4) were frequent. The SARS-CoV-2 immunohistochemical reaction was positive in 38.5% of cases. All patients had co-morbidities, namely, hypertension (n = 17), atherosclerosis (n = 14), diabetes (n = 8), malignancies (n = 6), chronic obstructive pulmonary diseases (n = 4), obesity (n = 3) and immunosuppression after kidney transplantation (n = 3). Conclusion: Fatal COVID-19 pneumonia occurred mostly in elderly males with co-morbidities. In the autopsy practice, the SARS-CoV-2 nucleocapsid immunohistochemical reaction may confirm the infectious etiology in the early phase of DAD. Orv Hetil. 2021; 162(45): 1791–1802.

scholarly journals Systematic Review of Microthrombi in COVID-19 Autopsies

2021 ◽  
pp. 1-8
Author(s):  
Rafael Parra-Medina ◽  
Sabrina Herrera ◽  
Jaime Mejia
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Pulmonary Embolism ◽  
Arterial Hypertension ◽  
Diabetes Mellitus Type 2 ◽  
Diffuse Alveolar Damage ◽  
Histopathological Analysis ◽  
Histopathological Changes ◽  
Age Range

<b><i>Background:</i></b> Histopathological analysis can provide additional clues in COVID-19 understanding. During the last year, autopsy reports have revealed that diffuse alveolar damage (DAD) is the most significant observed finding. The aim of this study is to review cases in the literature about COVID-19 autopsies that reported microthrombi in different organs. <b><i>Methods:</i></b> We performed a systematic literature review in PubMed, Virtual Health Library (VHL), and Google Scholar. <b><i>Results:</i></b> In total, 151 autopsies were included, and 91 cases presented microthrombi in the lung (73%), heart (11.2%), kidney (24%), and liver (16.3%). The age range was between 27 and 96 years. Males were 64.8%. The patients with microthrombi had more comorbidities such as arterial hypertension (62%), obesity or overweight (64%), diabetes mellitus type 2 (51%), and heart disease (53%). The most common histopathological changes found in patients with lung microthrombosis were DAD in exudative phase (78%), pulmonary embolism (59%), and lung infarct (81%). Presence of microthrombi was associated with arterial hypertension (<i>p</i> &#x3c; 0.0001) and DAD in exudative and proliferative phases (<i>p</i> = 0.02). <b><i>Discussion:</i></b> The analysis of these results shows that microthrombi in COVID-19 autopsies may be found in different organs and are more frequent in patients with comorbidities, pulmonary embolism, and lung infarct.

Anxiety and Depression among Patients with Chronic Obstructive Pulmonary Diseases in Pulmonology Unit of Nobel Medical College Teaching Hospital

2021 ◽  
Vol 6 (1) ◽  
pp. 1285-1290
Author(s):  
Nilam Kumari Jha ◽  
Komal Kant Jha
Keyword(s):  
Risk Factor ◽  
Teaching Hospital ◽  
College Teaching ◽  
Pulmonary Diseases ◽  
Anxiety And Depression ◽  
Chronic Obstructive ◽  
Early Assessment ◽  
Medical College ◽  
Copd Patients ◽  
Chronic Obstructive Pulmonary Diseases

Introduction: Anxiety and Depression is a common comorbidity in chronic obstructive pulmonary disease patients. Impaired lung function is a risk factor for depression In COPD patients, reduced recreational activities and social Isolation is a major risk factor resulting in anxiety and depression.  Objective: The objective of this study is to evaluate the prevalence of Anxiety and Depression among the COPD patients at Pulmonology unit of Nobel Medical College Teaching Hospital.  Methodology: A hospital based cross- sectional research design was used for the study. A total of 185 patients with previously diagnosed COPD. Data were collected by using a face to face interview technique in patients to evaluate anxiety and depression using Nepali version of Hospital Anxiety and Depression Scale questionnaire at Nobel Medical College Teaching Hospital, Biratnagar, Nepal from May to August 2020. Data analysis were done by descriptive and inferential statistics.  Results: A total of 185 patients participated in the study, 157 patients (84.9%) had anxiety, 107 patients (57.8%) had depression and 102 patients (55.1%) had both anxiety and depression. There was statistically significant association of anxiety and depression in COPD patients with age, religion, occupation, smoking status, duration of illness, history of previous hospitalization, number of hospitalization in previous year, type of family, domiciliary oxygen therapy.  Conclusion: The study concluded that anxiety and depression had been most prevalent in COPD patients. Therefore health personnel working in the Pulmonology unit should be aware the early assessment and treatment of anxiety and depression of chronic obstructive pulmonary diseases patients. 

Anti-aging natural compounds and their role in the regulation of metabolic pathways leading to longevity

2021 ◽  
Vol 21 ◽  
Author(s):  
Aqsa Muzammil ◽  
Muhammad Waqas ◽  
Ahitsham Umar ◽  
Muhammad Sufyan ◽  
Abdur Rehman ◽  
...  
Keyword(s):  
Natural Products ◽  
Metabolic Pathways ◽  
Natural Compounds ◽  
Chronic Obstructive ◽  
Telomere Shortening ◽  
Age Related ◽  
Chronic Obstructive Pulmonary Diseases ◽  
Extended Lifespan ◽  
Ancient Times

: Aging is an unavoidable process, leads to cell senescence due to physiochemical changes in an organism. Anti-aging remedies have always been of great interest since ancient times. The purpose of anti-aging activities is to increase the life span and the quality of life. Anti-aging activities are primarily involved in the therapies of age-related disorders such as Parkinson's disease (PD), Alzheimer's disease (AD), cardiovascular diseases, cancer and chronic obstructive pulmonary diseases. These diseases are triggered by multiple factors that are involved in numerous molecular pathways including telomere shortening, NF-κB pathway, adiponectin receptor pathway, insulin and IGF signaling pathway, AMPK, mTOR and mitochondria dysfunction. Natural products are known as effective molecules to delay the aging process through influencing metabolic pathways and thus ensure an extended lifespan. These natural compounds are being utilized in drug design and development through computational and high throughput techniques for effective pro-longevity drugs. A comprehensive study of natural compounds demonstrated with their anti-aging activities along with databases of natural products for drug designing was executed and summarized in this review article.

Sign in / Sign up

Export Citation Format

Share Document