Trends in Cardiovascular Surgery in HIV Patients: A 30-Year Single-Center Experience

Objective: to describe a single-center experience of Pneumocystis jirovecii pneumonia (PJP) in non-HIV patients recovering from COVID-19. Methods: We report the cases of five non-HIV patients with COVID-19 who also developed PJP at a University Hospital. Results: With the exception of one subject, who experienced an atypical and prolonged course of COVID-19, all the patients developed PJP after the clinical resolution of COVID-19 pneumonia. All but one patient had no pre-existing immunosuppressive conditions or other risk factors for PJP development at COVID-19 diagnosis. Nonetheless, following the course of COVID-19 infection, all the patients fulfilled at least one host factor for PJP; indeed, all the patients had received at least 2 weeks of high-dose steroids and three out of five had a CD4+ cell count <200/mm3. Conclusions: The use of corticosteroids for COVID-19 respiratory impairment seems to be the most common risk factor for PJP, together with viral-induced and iatrogenic lymphopenia. The worsening in respiratory function and the characteristic radiological picture during or after COVID-19 pneumonia should raise the suspicion of PJP, even in immunocompetent patients. PJP primary chemoprophylaxis can be considered in selected high-risk COVID-19 patients, but further studies are needed.

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Single Center Experience in Vascular and Endovascular Surgery during the COVID-19 Pandemic: Walking on the Icy Road

Clinical Cardiology and Cardiovascular Interventions ◽

10.31579/2641-0419/170 ◽

2021 ◽

Vol 4 (9) ◽

pp. 01-06

Author(s):

Görkem Yiğit

Keyword(s):

Normal Distribution ◽

Cardiovascular Surgery ◽

Interventional Treatment ◽

Continuous Variables ◽

Single Center ◽

Single Center Experience ◽

The Mean ◽

Vascular Emergencies ◽

Drug Eluting Balloon

Background: Along with other areas of specialization, the cardiovascular surgery clinic is a department that has a significant contribution to the COVID-19 pandemic process with both the management of vascular emergencies and the rapid and effective use of interventional methods. This study aims to present endovascular and open vascular surgical procedures performed in single center between March 2020 and December 2020 during the ongoing pandemic. Materials and methods: A total of 230 patients underwent open surgery 60 patients and endovascular / interventional treatment 170 patients by the Cardiovascular Surgery clinic were included in the study. It was aimed to determine the procedural details of the patients, follow-up results, complications and mortality rates. The compatibility of the variables to normal distribution was examined using visual and analytical methods. The Shapiro-Wilk test was used to check the normal distribution of continuous variables. Results: In the open vascular surgery group, the mean age was 51.4±23.2 years (range 12–90 years). Sixteen (26.7%) patients were female and 44 (73.3%) male. The median follow-up from the time of the open vascular procedure was 4.3±1.2 months. There were ten (16.7%) minor complications. There were five deaths after procedures. In the endovascular / interventional group, the mean age was 58.5±18.6 years (range 18–94 years). Ninety one (53.5%) patients were female and 79 (46.5%) male. The median follow-up from the time of the drug-eluting balloon angioplasty and pharmacomechanical thrombectomy patients were 4.0±1.1 months. There were thirty four (20%) minor complications and two deaths after procedures. Conclusion: Our experience and successful results shows how surgical and interventional procedures participated in the care of hospitalized COVID-19 patients during the height of the coronavirus pandemic.

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