scholarly journals Puerperal Infections Complicated by COVID-19 Co-Infection: Two Independent Case Reports with Need for Intensive Care

2021 ◽  
pp. 1-3
Author(s):  
Janis Kinkel ◽  
Janis Kinkel ◽  
Thomas Rduch ◽  
Katharina Putora ◽  
Christian R. Kahlert ◽  
...  
Keyword(s):  
Intensive Care ◽  
Myocardial Injury ◽  
Case Reports ◽  
Fetal Lung ◽  
Hemodynamic Instability ◽  
Tertiary Hospital ◽  
Intrauterine Fetal Death ◽  
Lung Maturation ◽  
Acute Myocardial Injury ◽  
Independent Case

Introduction: The current SARS-CoV-2 pandemic affects all medical fields. In obstetrics, the focus is on the effects on pregnancy and fetuses. Here we present two cases of parturient women that demonstrate the high risk of postpartum SARS-CoV-2 co-infections. Materials and Methods: Patients` data were obtained from their medical records after confirmation of written informed consent. Literature review was conducted across PubMed. Case Report: i) A 33-year-old Caucasian Gravida II, Para I was transferred to our tertiary hospital at 23+1 weeks of pregnancy with previous preterm premature rupture of membranes (PPROM) at 17+5 weeks of gestation. During antenatal corticosteroid therapy for fetal lung maturation with 24+0 weeks, intrauterine fetal death was diagnosed in the course of amniotic infection. Due to progressive hemodynamic instability and confirmed SARS-CoV-2 co-infection, our patient had to be treated with catecholamines for 24 hours and stayed at the intensive care unit (ICU) for 72 hours. An acute myocardial injury occurred during septic shock. Immediate intensive care prevented permanent damage. ii) A 27-year-old Caucasian Gravida III, Para III was admitted to our tertiary hospital, 11 days after her third caesarean section. After circulatory collapse at home, the patient arrived with signs of hemorrhagic shock. Emergency curettage was performed, and because of cardiopulmonary worsening pulmonary embolism was suspected. Computed tomography revealed typical signs of COVID-19 pneumonia. Our patient was treated by nasal oxygen in the ICU for 24 hours. Similar to the first patient, acute myocardial injury occurred without any lasting harm. Conclusion: Our two cases show rapid and worse clinical courses in parturient women with SARS-CoV-2 co-infection. Rapid diagnosis and availability of intensive care were crucial for the prevention of long-term harm. In peri- and postpartum situations of acute clinical worsening, exclusion of SARS-CoV-2 co-infection is an important diagnostic step.

scholarly journals Association of Thrombocytopenia and Mortality in Critically ill Children Admitted to PICU in Tertiary Hospital In Biratnagar

2019 ◽  
Vol 4 (1) ◽  
pp. 649-653 ◽  
Author(s):  
Vijay Kumar Sah ◽  
Arun Giri ◽  
Milan KC ◽  
Niraj Niraula
Keyword(s):  
Intensive Care ◽  
Platelet Count ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Hemodynamic Instability ◽  
Tertiary Hospital ◽  
Critically Ill Children ◽  
Bleeding Tendency ◽  
Time Of Admission

Introduction: Thrombocytopenia is a clinical condition characterized by decrease in number of platelets below the normal range. It is associated with bleeding tendency, hemodynamic instability, impaired inflammatory process and thus affecting host defence mechanism. There has been only few studies published till date in pediatric intensive care units suggesting thrombocytopenia is associated with increased mortality. Objectives: To determine the prevalence of thrombocytopenia in the critically ill children and its relationship with mortality in Pediatric intensive care unit (PICU) admitted children. Methodology: A prospective observational study was performed over a period of 12 months on 102 critically ill children admitted in PICU who fulfilled the criteria. Two patients left the study due to financial problems and as outcome could not be assessed on them, they were excluded from the study. Platelet count was noted at the time of admission and consecutively for the initial four days at PICU. Thrombocytopenia was defined as platelet count less than 150/nL. Mortality in PICU was recorded as primary outcome. Results: The prevalence of thrombocytopenia during consecutive 4 days was 34% (n=34) and at the time of admission in PICU was 16% (n=16) among 100 children analysed in the study. The mortality in the PICU was 27% (n=27). Mortality among thrombocytopenic children was 61.7% (n=21) as compared to 7.6% (n=5) in non-thrombocytopenic children (p=<0.001). Mortality was 18 times more for those who were thrombocytopenic at the time of admission as compared to those who subsequently developed thrombocytopenia during course of stay in PICU. Conclusion: Thrombocytopenia has significant association with increased mortality. Thrombocytopenic children at the time of admission have more likelihood of mortality than nonthrombocytopenic children in intensive care units.

scholarly journals Characterization and outcomes of acute myocardial injury in COVID-19 intensive care patients

Infection ◽  
2021 ◽  
Author(s):  
Vincent Labbé ◽  
Stephane Ederhy ◽  
Nathanael Lapidus ◽  
Joe-Elie Salem ◽  
Antoine Trinh-Duc ◽  
...  
Keyword(s):  
Intensive Care ◽  
Myocardial Injury ◽  
Intensive Care Patients ◽  
Acute Myocardial Injury

Abstract 16918: COVID-19 Associated Acute Myocardial Injury With Prolonged Troponin Elevation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ly Tran ◽  
Charlie Ervin ◽  
Mathew J Thomas ◽  
David Moore ◽  
Rahul Sampath ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cardiac Catheterization ◽  
Myocardial Injury ◽  
Troponin I ◽  
Case Reports ◽  
Left Ventricular ◽  
Left Shoulder ◽  
Troponin Elevation ◽  
First Case ◽  
Acute Myocardial Injury

Introduction: Acute myocardial injury in the setting of COVID-19 has been well described and is associated with higher mortality. Hypothesis: Myocarditis has been reported as a rare cause of myocardial injury in at least seven recent case reports. Methods: A 70-year-old man with coronary artery disease status post bypass surgery with recent hospitalization for left shoulder septic arthritis with MSSA bacteremia was readmitted 10 days later with a positive PCR test for SARS-CoV-2 at a local nursing facility. His symptoms were dyspnea, chest pain, fever, nausea, and diarrhea. Previous hospitalization he underwent evaluation for chest pain with cardiac catheterization revealing ejection fraction (EF) of 45% and patency of all three grafts. Results: Laboratory investigation showed elevated markers of myocardial injury with high sensitivity troponin I (hs-TnI) of 17,643 ng/L and B-type natriuretic peptide of 2,627 pg/mL, elevated C-Reactive Protein, D-dimer, and sedimentation rate. Chest X-ray showed hazy opacity in the infrahilar right lung. ECG notable for a first degree AV block with no ST-segment elevation. Transthoracic echocardiogram (TTE) showed an EF of 20% with global left ventricular dysfunction with hypokinesis of the right ventricle. No evidence of pericardial effusion. Blood cultures were negative. Management of heart failure led to clinical improvement. Over the next three months, Hs-TnI level stayed elevated at 11,339 ng/L for four weeks and trended down to 6,791 ng/L. The patient was seropositive for COVID-19 IgG eight weeks after the diagnosis of COVID-19 was made. Conclusions: We report the first case of COVID-19 related myocardial injury with prolonged and extreme troponin elevation. Recent favorable cardiac catheterization further supports immune mediated myocarditis over ischemic cardiomyopathy. Unfortunately, no endomyocardial biopsy has been performed.

Effect of prenatal isoxsuprine on pulmonary oxygen toxicity in the newborn rat

1980 ◽  
Vol 48 (3) ◽  
pp. 505-510 ◽  
Author(s):  
L. Frank ◽  
J. Summerville ◽  
D. Massaro
Keyword(s):  
Enzyme Activities ◽  
Oxygen Toxicity ◽  
Fetal Lung ◽  
Antioxidant Enzyme Activities ◽  
Newborn Rats ◽  
Lung Maturation ◽  
Lung Weight ◽  
Pregnant Rats ◽  
Rat Pups ◽  
Hyperoxic Exposure

Isoxsuprine, a beta-sympathomimetic agent used clinically to delay premature parturition and to possibly accelerate fetal lung maturation, was administered to pregnant rats at 48 and 24 h prior to delivery. Newborn rats were placed in 96-98% O2 (or room air) to determine if the prenatal isoxsuprine treatment compromised their tolerance to prolonged hyperoxic exposure. (Exogenous catecholamines are known to exacerbate O2 toxicity in adult animals). Survival of the isoxsuprine-treated pups in O2 (52%) was no different than for control neonates exposed to hyperoxia for 7 days (57%) (P = 0.22). Body weight, lung weight, lung protein, and DNA content of the newborns were also not altered by the prenatal isoxsuprine treatment. Lung antioxidant enzyme activities for superoxide dismutase, catalase, and glutathione peroxidase were the same at birth in the isoxsuprine-treated and control rat pups, and the enzyme activities increased in response to hyperoxic exposure in each group to an equivalent degree. Thus, in utero treatment with isoxsuprine had no apparent adverse effect on newborn rats exposed to a prolonged O2 challenge.

Chronic kidney disease, pregnancy and haemodialysis: Case reports from a single centre in Kenya and literature review

2021 ◽  
pp. 1753495X2098540
Author(s):  
Samuel K Kabinga ◽  
Jackline Otieno ◽  
John Ngige ◽  
Seth O Mcligeyo
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Case Reports ◽  
Tertiary Hospital ◽  
Reproductive Age ◽  
Review Of Literature ◽  
Single Centre ◽  
End Stage Kidney Disease ◽  
Women Of Reproductive Age ◽  
End Stage

Chronic kidney disease (CKD) and end stage kidney disease are prevalent even in women of reproductive age. These are known to reduce fertility and successful pregnancy. There are chances of conception even in advanced CKD, though laden with complications. We present two cases of women who conceived in advanced CKD and are on haemodialysis in a tertiary hospital in Kenya and review of literature.

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