scholarly journals Multisystem inflammatory syndrome in children аssociated with COVID-19

2021 ◽  
Vol 17 (6) ◽  
pp. 67-70
Author(s):  
I.I. Gorelkin ◽  
V.N. Kapusta ◽  
I.A. Buinyi ◽  
E.V. Bachtina ◽  
S.A. Zhmychova
Keyword(s):  
Replacement Therapy ◽  
Clinical Manifestations ◽  
Antiplatelet Agents ◽  
Complete Recovery ◽  
The Elderly ◽  
Organ Damage ◽  
Multiple Organ ◽  
Chronic Obstructive ◽  
Tissue Ischemia ◽  
Inflammatory Syndrome

Coronavirus disease is severe in the elderly and in people with chronic diseases such as diabetes mellitus, heart disease, chronic obstructive pulmonary disease, and cancers. It is generally accepted that in children, COVID-19 is much milder, and often is even asymptomatic. But there are some children who, against the background of the coronavirus infection, developed multisystem inflammatory syndrome (MIS-C). Its pathophysiology is not fully understood. There are several hypotheses about the mechanisms of MIS-C development. It is assumed that the syndrome develops due to an excessive immune response to the virus. Having some similar mechanisms with Kawasaki disease, macrophage activation syndrome, the development of MIS-C still has significant diffe-rences. Multiple organ damage occurs due to systemic inflammation, hypoxia, tissue ischemia. As a result, multiple organ dysfunction syndrome develops. Clinical manifestations are specific and reflect changes in all body systems. Laboratory studies revealed an increase in inflammatory markers, transaminases, creatinine, urea, coagulation disturbances. Treatment of multisystem inflammatory syndrome includes immunomodulatory and glucocorticoid therapies. Antibiotics, anticoagulants, antiplatelet agents are also administered, and in case of renal failure symptoms — dialysis replacement therapy. The article describes cases of successful treatment of children with multisystem inflammatory syndrome associated with COVID-19, which show that MIS-C can mask a large number of diseases. Attention should be paid to the need for hospitalization of such patients into a unit with the possibility of hemodialysis, to the different approaches to treatment, the importance of renal replacement therapy. If the above requirements are met, it is possible to achieve a complete recovery of patients.

scholarly journals Role of combining anticoagulant and antiplatelet agents in COVID-19 treatment: a rapid review

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001628
Author(s):  
Kamal Matli ◽  
Raymond Farah ◽  
Mario Maalouf ◽  
Nibal Chamoun ◽  
Christy Costanian ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Anticoagulation Therapy ◽  
Antiplatelet Agents ◽  
Organ Damage ◽  
Multiple Organ ◽  
Rapid Review ◽  
Thromboembolic Events ◽  
Antithrombotic Agent ◽  
Heparin Resistance

Although primarily affecting the respiratory system, COVID-19 causes multiple organ damage. One of its grave consequences is a prothrombotic state that manifests as thrombotic, microthrombotic and thromboembolic events. Therefore, understanding the effect of antiplatelet and anticoagulation therapy in the context of COVID-19 treatment is important. The aim of this rapid review was to highlight the role of thrombosis in COVID-19 and to provide new insights on the use of antithrombotic therapy in its management. A rapid systematic review was performed using preferred reporting items for systematic reviews. Papers published in English on antithrombotic agent use and COVID-19 complications were eligible. Results showed that the use of anticoagulants increased survival and reduced thromboembolic events in patients. However, despite the use of anticoagulants, patients still suffered thrombotic events likely due to heparin resistance. Data on antiplatelet use in combination with anticoagulants in the setting of COVID-19 are quite scarce. Current side effects of anticoagulation therapy emphasise the need to update treatment guidelines. In this rapid review, we address a possible modulatory role of antiplatelet and anticoagulant combination against COVID-19 pathogenesis. This combination may be an effective form of adjuvant therapy against COVID-19 infection. However, further studies are needed to elucidate potential risks and benefits associated with this combination.

scholarly journals ETIOPATHOGENETIC ASPECTS OF LIVER INJURY IN PATIENTS WITH COVID-19

2020 ◽  
Vol 76 (4) ◽  
pp. 9-15
Author(s):  
V.I. Petrov ◽  
◽  
A.V. Ponomareva ◽  
I.V. Ivakhnenko ◽  
O.V. Razvalyaeva ◽  
...  
Keyword(s):  
Liver Damage ◽  
Liver Diseases ◽  
Inflammatory Process ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Multiple Organ ◽  
Pulmonary Manifestations ◽  
Coronavirus Infection ◽  
Factors Of Influence ◽  
Extra Pulmonary

Infection caused by the new coronavirus SARS-CoV-2 initially associated with respiratory damage and the development of respiratory symptoms. However, it was subsequently shown that COVID-19 can be considered as a systemic inflammatory process with multiple organ damage. One of the most frequent extra pulmonary manifestations of SARS-CoV-2 infection is liver damage. Several factors of influence on the liver in COVID-19 are currently being considered: viral immunological damage, hypoxia, systemic inflammatory process, drug toxicity and progression of existing liver diseases. This review is devoted to the analysis of available data on the mechanisms and clinical manifestations of liver damage in a new coronavirus infection.

scholarly journals Sysyemic Lupus Erythematosus with Multiple Organ Damage

2020 ◽  
Vol 17 (5) ◽  
pp. 63-73
Author(s):  
Andreea Alexandra Nicola ◽  
Mădălina Dună ◽  
Ioana Miler ◽  
Nicoleta Petre ◽  
Denisa Predeţeanu
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Multiple Organ ◽  
Alveolar Haemorrhage ◽  
Interdisciplinary Management ◽  
Childbearing Age ◽  
Pulmonary Infarction ◽  
Pulmonary Manifestations

Abstract Systemic lupus erythematosus (SLE) is a heterogeneous rheumatic disease with various clinical manifestations and a multifactorial pathogenesis. Although the etiology of SLE is unknown, certain risk factors have been identified as promoters of an imbalance in the immune system with antibody formation and tissue damage secondary to the deposition of immune complexes. Women of childbearing age are predominantly affected, regardless of ethnicity. SLE affects the kidneys in about 50% of patients, lupus nephritis (LN) being a major risk factor for overall morbidity and mortality. The lungs are commonly involved later in the course of the disease, pulmonary involvement in SLE being extremely varied. It includes along with pleuritis which is the most common manifestation, acute lupus pneumonitis, pulmonary vasculitis, pulmonary embolism, diffuse alveolar haemorrhage; opportunistic pulmonary infections or drug toxicity could be other pulmonary manifestations. We present the case of a young woman with SLE complicated with lupus nephritis class V and pulmonary infarction due to thromobosis of a pulmonary artery. It is a case of SLE with multiple organ damage and life-threatening complications that require interdisciplinary management and appropriate treatment.

scholarly journals Use of CytoSorb in Traumatic Amputation of the Forearm and Severe Septic Shock

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Heinz Steltzer ◽  
Alexander Grieb ◽  
Karim Mostafa ◽  
Reinhard Berger
Keyword(s):  
Combined Treatment ◽  
Complete Recovery ◽  
Organ Damage ◽  
Severe Trauma ◽  
Multiple Organ ◽  
Traumatic Amputation ◽  
Rapid Improvement ◽  
Septic Episode ◽  
Systemic Inflammatory Reaction ◽  
Lactate Levels

Severe trauma associated with later disability and mortality still constitutes a major health and socioeconomic problem throughout the world. While primary morbidity and mortality are mostly related to initial injuries and early complications, secondary lethality is strongly linked to the development of systemic inflammatory response syndrome, sepsis, and ultimately multiple organ dysfunction syndrome. We herein report on a 49-year-old male patient who was admitted to the hospital after a traumatic amputation of his right forearm that was cut off while working on a landfill. After initial treatment for shock, he received immediate replantation and was transferred to the ICU. Due to the anticipated risk of a complex infection, continuous renal replacement therapy in combination with CytoSorb was initiated. During the course of the combined treatment, a rapid improvement in hemodynamics was noticed, as well as a significant reduction of IL-6 and lactate levels. Despite a recurring septic episode and the necessity for amputation, the patient clinically stabilized and underwent complete recovery. The early treatment with a combination of CVVHDF and CytoSorb was accompanied by an attenuation of the systemic inflammatory reaction, which subsided without major or permanent organ damage, despite the impressive pathogen spectrum and the pronounced local damage.

scholarly journals Role of Combining Anticoagulant and Antiplatelet Agents in COVID-19 Treatment: A Rapid Review

2021 ◽  
Author(s):  
Kamal Matli ◽  
Raymond Farah ◽  
Mario Maalouf ◽  
Christy Costanian ◽  
Nibal Chamoun ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Anticoagulation Therapy ◽  
Antiplatelet Agents ◽  
Organ Damage ◽  
Multiple Organ ◽  
Rapid Review ◽  
Antithrombotic Agent ◽  
Effective Form ◽  
Heparin Resistance

ABSTRACTAlthough primarily affecting the respiratory system, COVID-19 causes multiple organ damage. One of its grave consequences is a prothrombotic state that manifests as thrombotic, microthrombotic, and thromboembolic events.Therefore, understanding the effect of antiplatelet and anticoagulation therapy in the context of COVID-19 treatment is important. The aim of this rapid review is to highlight the role of thrombosis in COVID-19 and provide new insights on the use of antithrombotic therapy in its management. A rapid systematic review was performed using preferred reporting items for systematic reviews. Papers published in English on antithrombotic agent use and COVID-19 complications were eligible. Results showed that the use of anticoagulants increased survival and reduced thromboembolic events in patients. However, despite the use of anticoagulants, patients still suffered thrombotic events likely due to heparin resistance. Data on antiplatelet use in combination with anticoagulants in the setting of COVID-19 is quite scarce. Current side effects of anticoagulation therapy emphasize the need to update treatment guidelines. In this rapid review, we address a possible modulatory role of antiplatelet and anticoagulant combination against COVID□19 pathogenesis. This combination may be an effective form of adjuvant therapy against COVID□19 infection. However, further studies are needed to elucidate potential risks and benefits associated with this combination.It was not appropriate or possible to involve patients or the public in the design, or conduct, or reporting, or dissemination plans of our research

scholarly journals Listeriosis: the review of a problem, presentation of a clinical case of listeria sepsis in a 4-month child

2021 ◽  
Vol 9 (4) ◽  
pp. 39-42
Author(s):  
L.P. Shostakovych-Koretskaya ◽  
I.V. Budayeva ◽  
M.A. Nikolaichuk
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Organ Damage ◽  
Multiple Organ ◽  
High Rate ◽  
Problem Presentation ◽  
The Central Nervous System ◽  
Progressive Course

Listeriosis is an infectious disease caused by Listeria monocytogenes microorganisms. A human can catch an infection through fecal-oral, aerogenous, or transplacental route. The listeriosis incidence in Ukraine is sporadic, single cases are not related to each other. Listeriosis is characterized by a high rate of mortality and polymorphism of clinical manifestations. The symptoms of the disease are multiple-organ: damage to the central nervous system, septic symptoms, aborts, mastitis; listeriosis can also be subclinical. The disorders of the central nervous system are associated with meningitis, meningoencephalitis, or brain abscess. The importance of the problem of diagnosis and treatment of listeriosis derived from the disease sporadicity, polymorphism of its manifestations, difficulties in etiological verification of the diagnosis. The case described is specific due to the diagnostic mistake: a child was not diagnosed with sepsis. Listeriosis in this child had a progressive course with sepsis development. Listeriosis is a rare infection, therefore it was difficult to suggest this particular infection intra vitam.

scholarly journals COVID-19-associated inflammatory syndrome in an adult woman with unexplained multiple organ failure: staying vigilant for COVID-19 complications as the pandemic surges

2021 ◽  
Vol 14 (4) ◽  
pp. e242034
Author(s):  
Maedeh Veyseh ◽  
Patrick Webster ◽  
Irene Blanco
Keyword(s):  
Organ Failure ◽  
Wide Spectrum ◽  
Organ Damage ◽  
Multiple Organ ◽  
Adult Woman ◽  
Antibody Detection ◽  
Antibody Testing ◽  
Positive Antibody ◽  
Control And Prevention ◽  
Inflammatory Syndrome

Since the emergence of SARS-CoV-2, clinicians have been challenged with a wide spectrum of disease severity. One of the serious complications associated with the virus is multisystem inflammatory syndrome in children (MIS-C). It is characterised by inflammation leading to organ damage, in the setting of positive SARS-CoV-2 infection. MIS-C is thought to be a postviral reaction where most children are negative on PCR testing but are positive for SARS-CoV-2 antibodies. The Centers for Disease Control and Prevention recently defined the same phenomenon occurring in adults as multisystem inflammatory syndrome in adults (MIS-A) and emphasised on the use of antibody testing in this population. Here we describe an adult woman with an exposure to SARS-CoV-2 who presented with unexplained organ failure and shock. Positive antibody testing was the only clue to the diagnosis of MIS-A. We stress the importance of SARS-CoV-2 antibody detection in order to identify these cases.

scholarly journals Atypical hemolytic-uremic syndrome as one of the causes of acute kidney injury in pregnant women

2018 ◽  
Vol 90 (6) ◽  
pp. 28-34 ◽  
Author(s):  
N L Kozlovskaya ◽  
Yu V Korotchaeva ◽  
E M Shifman ◽  
L A Bobrova
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Hemolytic Uremic Syndrome ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Multiple Organ ◽  
Aim Analysis ◽  
Uremic Syndrome

Obstetric atypical hemolytic uremic syndrome (aHUS) is one of the reasons for the development of acute kidney injury (AKI) and can determine the prognosis of both mother and child. Aim. Analysis of clinical manifestations, course and outcomes of obstetric aHUS. Materials and methods. 45 patients with aHUS development during pregnancy or immediately after childbirth were observed between 2011 and 2017, age from 16 to 42 years. Results and discussion. All patients had AKI (serum creatinine 521,5±388,0 µmol/l, oliguria or anuria that required initiation of hemodialysis). 93.3% pts had extrarenal manifestations of TMA with the development of multiple organ failure (MOF). The mean number of damage organs was 3,7±1,2. In all patients, the development of aHUS was preceded by obstetric complications, surgery, infection, etc. In the outcome: 53.4% women showed complete recovery of renal function, 11.1% developed CKD 4-5 stages, 35.5% had dialysis-dependent end-stage renal failure (ESDR). Maternal mortality was 23.9%. Perinatal mortality was 32.6%. The early start of eculizumab treatment (within 1-2 weeks from the onset of aHUS), compared with therapy start after 3 weeks, increased the chances of favorable outcome for mother in 5.33 times, and the chances for normalization of renal function in 48.7 times. Conclusion. Obstetric aHUS is characterized by the development of AKI in 100% of cases. In most patients, the obstetric aHUS occurs with the development of MOF. Timely diagnosis of aHUS and immediate treatment by eculizumab allows not only to save the life of patients, but also completely restore their health.

scholarly journals Hospital-acquired pneumonia due to Achromobacter xylosoxidans in the elderly: A single-center retrospective study in Beijing

2017 ◽  
Vol 11 (01) ◽  
pp. 10-18 ◽  
Author(s):  
Chao Liu ◽  
Jun Guo ◽  
Weifeng Yan ◽  
Yi Jin ◽  
Fei Pan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Elderly Patients ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Achromobacter Xylosoxidans ◽  
Apache Ii Score ◽  
Chronic Obstructive ◽  
Indwelling Catheter ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Introduction: Achromobacter xylosoxidans has been reported in several countries; however, hospital-acquired pneumonia (HAP) due to this organism in elderly patients in China remains rare. Methodology: HAP due to Achromobacter xylosoxidans identified at the General Hospital of the People's Liberation Army in Beijing from January 2008 to October 2011 was studied. Detailed clinical manifestations were collected. To study the clinical risk factors for the imipenem-resistant strain, patients were divided into two groups: imipenem-resistant (21 cases) and imipenem-nonresistant (20 cases). Univariate and multivariate logistic regression were used. Results: All patients were > 75 years of age, and 92.7% (38/41) were male. Nine patients died 30 days after infection. The mean acute physiology and chronic health evaluation (APACHE) II score and sequential organ failure assessment (SOFA) were 23.66 ± 7.71 and 6.93 ± 2.47, respectively. Almost all strains were resistant to aminoglycosides. However, the strains showed significant sensitivity to minocycline (MIN), piperacillin-tazobactam (PTZ), and cefoperazone-sulbactam (SCF). Compared with the imipenem-nonresistant group, more patients with imipenem-resistant infection had the following characteristics: use of an intubation, use of a proton-pump inhibitor (PPI), chronic obstructive pulmonary disease (COPD), and coronary artery disease (CHD). Among the four risk factors, COPD and CHD remained independent risk factors in the multivariate analysis. Conclusions: HAP due to Achromobacter xylosoxidans occurred in severely ill elderly patients with a long-term indwelling catheter and many underlying diseases. Effective treatment of imipenem-resistant organisms is challenging. SCF, PTZ, and MIN may be useful for imipenem-resistant Achromobacter xylosoxidans.

scholarly journals Rat bite fever due to Streptobacillus notomytis complicated by meningitis and spondylodiscitis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suchada Pongsuttiyakorn ◽  
Witchuda Kamolvit ◽  
Sunee Limsrivanichakorn ◽  
Arissa Phothisirisakulwong ◽  
Walaiporn Wangchinda
Keyword(s):  
Rheumatoid Arthritis ◽  
Polymerase Chain Reaction Amplification ◽  
Clinical Manifestations ◽  
Complete Recovery ◽  
The Elderly ◽  
Knee Joints ◽  
Rrna Gene ◽  
Tertiary Referral Center ◽  
First Case ◽  
Rat Bite Fever

Abstract Background Only three other cases of rat bite fever caused by Streptobacillus notomytis in humans have been reported since this species was identified in 2015. Data specific to the differences in clinical features and geographic distribution between S. notomytis infection and S. moniliformis infection are scarce. All previous cases of human S. notomytis infection were reported from Japan. This is the first case of S. notomytis infection reported from outside of Japan. Case presentation A 72-year-old Thai woman was admitted to Siriraj Hospital (Bangkok, Thailand)—Thailand’s largest university-based national tertiary referral center—in August 2020 with fever, myalgia, and polyarthralgia for 3 days, and gradually decreased consciousness for the past 1 day. Physical examination and laboratory investigations revealed septic arthritis of both knee joints, meningitis, and hepatitis. She was initially misdiagnosed as rheumatoid arthritis in the elderly since the initial investigations were unable to detect a causative pathogen. However, S. notomytis infection was later confirmed by polymerase chain reaction amplification of a part of the 16S rRNA gene and sequencing from synovial fluid. Her clinical course was also complicated by spondylodiscitis and epidural abscess caused by S. notomytis, which was detected from tissue biopsy. Therefore, rat bite fever in this patient manifested as meningitis, septic polyarthritis, hepatitis, and spondylodiscitis. The patient was treated with intravenous ceftriaxone then switched to oral amoxicillin with complete recovery. Conclusions The clinical manifestations of S. notomytis infection are similar to those demonstrated in S. moniliformis infection. This case also showed that arthritis caused by S. notomytis mimics rheumatoid arthritis, and that meningitis and spondylodiscitis are potential coexisting complications that can be found in S. notomytis infection.

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