COVID-19 in 28-Week Triplets Caused by Intrauterine Transmission of SARS-CoV-2—Case Report

Since the beginning of the COVID-19 pandemic, in-utero transmission of SARS-CoV-2 remains a rarity and only very few cases have been proven across the world. Here we depict the clinical, laboratory and radiologic findings of preterm triplets born at 28 6/7 weeks to a mother who contracted COVID-19 just 1 week before delivery. The triplets showed SARS-CoV-2 positivity right after birth, developed significant leukopenia and early-onset pulmonary interstitial emphysema. The most severely affected triplet I required 10 days of high-frequency oscillatory ventilation due to failure of conventional invasive ventilation, and circulatory support for 4 days. Despite a severe clinical course in two triplets (triplet I and II), clinical management without experimental, targeted antiviral drugs was successful. At discharge home, the triplets showed no signs of neurologic or pulmonary sequelae. Placental immunohistology with SARS-CoV-2 N-protein localized strongly to syncytiotrophoblast cells and, to a lesser extent, to fetal Hofbauer cells, proving intrauterine virus transmission. We discuss the role of maternal viremia as a potential risk factor for vertical transmission. To the best of our knowledge, our report presents the earliest unequivocally confirmed prenatal virus transmission in long-term surviving children, i.e., at the beginning of the third trimester.

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The role of long-term mechanical circulatory support in patients with advanced heart failure

Netherlands Heart Journal ◽

10.1007/s12471-020-01449-3 ◽

2020 ◽

Vol 28 (S1) ◽

pp. 115-121

Author(s):

S. E. A. Felix ◽

N. de Jonge ◽

K. Caliskan ◽

O. Birim ◽

K. Damman ◽

...

Keyword(s):

Heart Failure ◽

Mechanical Circulatory Support ◽

Advanced Heart Failure ◽

Circulatory Support

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Role of long-term mechanical circulatory support in patients with advanced heart failure

Internal Medicine Journal ◽

10.1111/imj.12817 ◽

2016 ◽

Vol 46 (5) ◽

pp. 530-540 ◽

Cited By ~ 4

Author(s):

M. B. Stokes ◽

P. Bergin ◽

D. McGiffin

Keyword(s):

Heart Failure ◽

Mechanical Circulatory Support ◽

Advanced Heart Failure ◽

Circulatory Support

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Alterations in B Cell and Follicular T-Helper Cell Subsets in Patients with Acute COVID-19 and COVID-19 Convalescents

Current Issues in Molecular Biology ◽

10.3390/cimb44010014 ◽

2021 ◽

Vol 44 (1) ◽

pp. 194-205

Author(s):

Igor V. Kudryavtsev ◽

Natalia A. Arsentieva ◽

Oleg K. Batsunov ◽

Zoia R. Korobova ◽

Irina V. Khamitova ◽

...

Keyword(s):

B Cells ◽

B Cell ◽

Humoral Immunity ◽

N Protein ◽

Follicular Helper ◽

Healthy Donors ◽

Specific Igg ◽

Sparse Methods

Background. Humoral immunity requires interaction between B cell and T follicular helper cells (Tfh) to produce effective immune response, but the data regarding a role of B cells and Tfh in SARS-CoV-2 defense are still sparse. Methods. Blood samples from patients with acute COVID-19 (n = 64), convalescents patients who had specific IgG to SARS-CoV-2 N-protein (n = 55), and healthy donors with no detectable antibodies to any SARS-CoV-2 proteins (HC, n = 44) were analyses by multicolor flow cytometry. Results. Patients with acute COVID-19 showed decreased levels of memory B cells subsets and increased proportion plasma cell precursors compared to HC and COVID-19 convalescent patients, whereas for the latter the elevated numbers of virgin naïve, Bm2′ and “Bm3+Bm4” was found if compared with HC. During acute COVID-19 CXCR3+CCR6− Tfh1-like cells were decreased and the levels of CXCR3–CCR6+ Tfh17-like were increased then in HC and convalescent patients. Finally, COVID-19 convalescent patients had increased levels of Tfh2-, Tfh17- and DP Tfh-like cells while comparing their amount with HC. Conclusions. Our data indicate that COVID-19 can impact the humoral immunity in the long-term.

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Venous Thromboembolism: Role of the Clinical Laboratory in Diagnosis and Management

The Journal of Applied Laboratory Medicine ◽

10.1373/jalm.2017.025734 ◽

2019 ◽

Vol 3 (5) ◽

pp. 870-882 ◽

Cited By ~ 6

Author(s):

Rugvedita S Parakh ◽

Daniel E Sabath

Keyword(s):

Venous Thromboembolism ◽

Clinical Laboratory ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Outpatient Basis ◽

Risk Patients ◽

Cardiovascular Illness ◽

Newer Anticoagulants

Abstract Background Venous thromboembolism (VTE) is the third most common cause of cardiovascular illness and is projected to double in incidence by 2050. It is a spectrum of disease that includes deep venous thrombosis (DVT) and pulmonary embolism (PE). In February 2016, the American College of Chest Physicians provided updated management guidelines for DVT and PE to address some of the unresolved questions from the previous version and to provide recommendations related to newer anticoagulants. Content Here we review current concepts for screening, diagnosis, thromboprophylaxis, and management of DVT and PE. We also describe the management of VTE in acute, long-term, and extended phases of treatment. Thrombophilia testing is rarely necessary and should be used judiciously; the laboratory can serve an important role in preventing unnecessary testing. The direct oral anticoagulants are as effective as conventional treatment and are preferred agents except in the case of cancer. The initial management of PE should be based on risk stratification including the use of D-dimer testing. Thrombolysis is used in cases of hemodynamically unstable PE and not for low-risk patients who can be treated on an outpatient basis. Summary This review is intended to provide readers with updated guidelines for screening, testing, prophylaxis, and management from various organizations.

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The role of long-term mechanical circulatory support in the treatment of end-stage heart failure

Kardiologia Polska ◽

10.5603/kp.a2019.0027 ◽

2019 ◽

pp. 331-340

Author(s):

Lech Paluszkiewicz ◽

Tomasz Kukulski ◽

Michał Zembala ◽

Jan Gummert ◽

Michiel Morshuis

Keyword(s):

Heart Failure ◽

Mechanical Circulatory Support ◽

Circulatory Support ◽

End Stage Heart Failure ◽

End Stage

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Intensive care unit management of percutaneous mechanical circulatory supported patients: the role of imaging

European Heart Journal Supplements ◽

10.1093/eurheartj/suab003 ◽

2021 ◽

Vol 23 (Supplement_A) ◽

pp. A15-A22

Author(s):

Andrea Montisci ◽

Letizia F Bertoldi ◽

Susanna Price ◽

Christian Hassager ◽

Jacob Møller ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Circulatory Support ◽

Cardiac Complications ◽

Correct Identification ◽

Unit Management ◽

Echocardiographic Assessment ◽

Left And Right

Abstract The clinical management of patients on Impella support requires multimodality monitoring and imaging. Upon intensive care unit admission, echocardiography is essential to ensure correct pump positioning/guide repositioning, to monitor acute myocardial infarction/device-related cardiac complications and to evaluate baseline left and right ventricular function. Over time, the echocardiographic assessment of myocardial viability has become an essential target for guiding mechanical circulatory support escalation and long-term strategies. The recognition and grading of any valvular dysfunction and damage in Impella patients are challenging, as the device interferes with the colour Doppler signal, and the loading conditions of the left ventricle are modified by the pump. Valvular disease in such patients is often secondary, and correct identification is pivotal for future therapeutic strategies. The emerging use of newer techniques, including speckle-tracking echocardiography, is of increasing interest in the imaging of critically ill patients.

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