scholarly journals Case Report: Massive Spontaneous Pneumothorax—A Rare Form of Presentation for Severe COVID-19 Pneumonia

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 82
Author(s):  
Adina Maria Marza ◽  
Alina Petrica ◽  
Florina Nicoleta Buleu ◽  
Ovidiu Alexandru Mederle
Keyword(s):  
Case Report ◽  
Spontaneous Pneumothorax ◽  
Health Workers ◽  
Viral Disease ◽  
Diagnosis And Treatment ◽  
Drain Tube ◽  
Rt Pcr ◽  
Reverse Transcription Pcr ◽  
Bilateral Lung ◽  
Pcr Test

Background and Objectives: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a viral disease that is spreading worldwide and became a pandemic. Although most of the time, the symptoms of the infection are flu like, a percentage of patients develop severe forms, along with severe complications. Many of them are known among front-line health workers, but the number of uncommon presentations and complications has increased. This case report aims to alert healthcare workers on less common forms of presentation, and to introduce this differential diagnosis in the evaluation of patients with COVID-19, given the increasing occurrence of pneumothorax in patients who are not mechanical ventilated. Case presentation: A 57-year-old female patient came to the Emergency Department (ED) by ambulance, with acute respiratory failure. She had SpO2 (peripheral O2 saturation ) = 43% on room air at home, and 86% on admission in ED after oxygen delivery (on a reservoir mask). SARS-CoV-2 infection was suspected based on symptoms that started three days ago (fever, dry cough, dyspnea, and fatigability). Blood was taken for lab tests, pharyngeal and nasal swabs for the reverse transcription–PCR (RT-PCR) test, and native computed tomography (CT) was scheduled. The thoracic CT scan showed massive right pneumothorax, partially collapsed lung, multiple bilateral lung infiltrates with a ground glass aspect and the RT-PCR test came back positive for SARS-CoV-2 infection. Despite the prompt diagnosis and treatment of pneumothorax (thoracostomy was performed and the drain tube was placed), the patient died after a long hospitalization in the intensive care unit. Conclusion: Secondary spontaneous pneumothorax (SSP), as a complication in severe forms of COVID-19 pneumonia, especially in female patients without risk factors is rare, and early diagnosis and treatment are essential for increasing the survival chances of these patients.

scholarly journals Invasive mucormycosis in post COVID-19 infection: Case report with review

2021 ◽  
Vol 6 (2) ◽  
pp. 135-139
Author(s):  
Sunil V Jagtap ◽  
Swati S Jagtap ◽  
Vaidehi Nagar ◽  
Kaushiki Varshney
Keyword(s):  
Case Report ◽  
Facial Pain ◽  
Rare Case ◽  
Steroid Treatment ◽  
Rt Pcr ◽  
Histopathological Findings ◽  
Face Region ◽  
Radio Imaging ◽  
In The Beginning ◽  
Pcr Test

COVID-19 is an infection caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Now there are increased cases with super infections by mucormycosis, which were rarely reported in the beginning of the current pandemic of COVID 19. Herewith a case of 47 year-old male patient of post COVID-19 infection having severe hypoxia and was on ventilator, received steroid treatment and also known case of HIV/AIDS. Now admitted to our hospital having fever, facial pain, and swelling mid-face region. His RT-PCR test was positive. On clinical, radio imaging and on histopathological findings diagnosed as maxillary mucormycosis. We are presenting this rare case for its clinical, radio imaging, and on histopathological findings.

scholarly journals Antibodies to SARS-CoV2 detectable for less than 50 days in polymerase chain reaction confirmed COVID-19 patients

2020 ◽  
Vol 7 (9) ◽  
pp. 3378
Author(s):  
Nishant Kumar ◽  
Shibal Bhartiya ◽  
Tarundeep Singh
Keyword(s):  
Polymerase Chain Reaction ◽  
Healthcare Workers ◽  
Health Workers ◽  
Natural Infection ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Cross Sectional Survey ◽  
Polymerase Chain ◽  
Roche Diagnostics ◽  
Pcr Test

Background: A seroprevalence study for COVID-19 antibodies was conducted amongst health workers in Mumbai, India, in June 2020.Methods: Healthcare workers (n=801) underwent a cross sectional survey through electrochemiluminescence immunoassay (Roche diagnostics’ Elecsys anti-SARS-CoV-2 assay, Roche diagnostics, Rotkreuz, Switzerland).Results: Of the 801 healthcare workers, 62 who had been previously diagnosed with a real time-polymerase chain reaction (RT-PCR) proven SARS-CoV-2 infection, 45 (73.6%) were found to be seronegative during the study. The duration between the positive RT-PCR test and the serological testing ranged from 15 to 49 days for 34 (54.8%), and was >50 days in 28 subjects. Up to 28 days after a positive PCR test, 90% of the subjects were found to be seropositive, but this reduced to less than half over the next two weeks (38.5% between 29 and 42 days).Conclusions: Our findings are in agreement with previous reports that demonstrate a peak antibody formation after 3 weeks, and also an early antibody decay that is almost exponential. This may also have a significant effect on the protection vaccines are able to provide considering that a natural infection has such a transient antibody response. 

Identification of SARS-CoV-2 RNA in the conjunctival swab of an Italian pediatric patient affected with COVID-19: A case report

2020 ◽  
pp. 112067212097782
Author(s):  
Luciano Quaranta ◽  
Francesca Rovida ◽  
Ivano Riva ◽  
Carlo Bruttini ◽  
Ilaria Brambilla ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Pediatric Patient ◽  
Ocular Involvement ◽  
Case Description ◽  
Rt Pcr ◽  
Reverse Transcription Pcr ◽  
Ocular Symptoms ◽  
Pediatric Clinic ◽  
Conjunctival Swab

Introduction: To report a case of identification of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) RNA in ocular specimen in a pediatric patient affected with Coronavirus disease 2019 (COVID-19) with no signs of ocular involvement. Case description: A 11-year old male patient with confirmed COVID-19 infection was hospitalized at the Pediatric Clinic Clinic of the IRCCS Foundation and Hospital San Matteo, Pavia, Italy. Three days after hospital admission, because of the patient complaining very mild ocular symptoms, an ophthalmological evaluation was performed. No signs related to conjunctivitis or keratitis were found but a conjunctival swab was collected as well, based on patient’s medical history. The specific SARS-CoV-2 reverse transcription PCR (RT-PCR) was performed, unearthing the presence of viral RNA from the swab. On day 25 from hospitalization, the conjunctival swab was repeated, giving negative result. Conclusions: This is the first report of the identification of SARS-CoV-2 RNA in ocular specimen in a pediatric patient without signs of ocular involvement. However, despite the transmission through tears is theoretically possible, it is still unclear whether this could be considered as an important route for the spread of SARS-CoV-2.

SARS-CoV-2 transmission among health care workers in Iran: an urgent need for early identification and management

2021 ◽  
Vol 21 ◽  
Author(s):  
Mohammad Reza Abdolsalehi ◽  
Shima Mahmoudi ◽  
Reza Shervin Badv ◽  
Babak Pourakbari ◽  
Keyvan Mirnia ◽  
...  
Keyword(s):  
Service Providers ◽  
Health Workers ◽  
Medical Center ◽  
Gastrointestinal Symptoms ◽  
Hospital Staff ◽  
X Rays ◽  
Prevention Measures ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Pcr Test

Introduction: By increasing the rate of COVID-19, particularly in developing countries such as Iran, high numbers of frontline service providers, including doctors and nurses, die and makes frontline healthcare workers (HCWs) more vulnerable to the psychological disorders, fear and anxiety of secondary transmission to others, especially their family members. In this study, we aimed to report the incidence of COVID-19 infection among HCWs in an Iranian referral pediatrics hospital between April 2020 and July 2020. Material and Methods: In this retrospective cross-sectional study, HCWs and hospital staff working at Children's Medical Center, Tehran, Iran with positive SARS-CoV-2 RT-PCR test results were evaluated between April 2020 and July 2020. Results: Sixty-one out of the 1085 personnel (5.6%) including 14 pediatricians (23%), 24 nurses (39%), 9 paramedics (15%), and 14 HCWs without direct patient contact (23%) had a nasopharyngeal specimen positive SARS-CoV-2 RT-PCR test. The mean age was 39.8±10.6 years. Eleven cases (18%) had underlying diseases such as hypertension and asthma. The most common symptoms were fatigue (67%, n=41), dry cough (61%, n=37), fever (52%, n=32), headache (46%, n=28), dyspnea (43%, n=24), anosmia (28%, n=17), chills (26%, n=16), sore throat (26%, n=16), gastrointestinal symptoms (23%, n=14), and productive cough (3%, n=2). Eleven cases (18%) showed lung involvement in their chest X-rays and/or CT scans. Eighteen cases (29.5%) had lymphopenia, and 20 individuals (33%) had a high level of C-reactive protein. Conclusion: In conclusion, in the early phase of the COVID-19 outbreak, a substantial proportion of HCWs with fever, respiratory, and other prevalent symptoms including fatigue and headache were infected with SARS-CoV-2. Therefore, implementation of infection prevention measures, isolation of confirmed HCWs, disinfection of the environment, and regular COVID-19 prevention training for HCWs are strongly recommended for the wellbeing of health workers and minimizing the spread of infection.

scholarly journals Coronavirus Disease 2019 (COVID-19) Candidate Chest CT Features: A Systematic Review of Extracted Imaging Features from 7571 Individuals

2020 ◽  
Author(s):  
Javad Zahiri ◽  
Mohammad Hossein Afsharinia ◽  
Zhaleh Hekmati ◽  
Mohsen Khodarahmi ◽  
Shahrzad Hekmati ◽  
...  
Keyword(s):  
False Negative ◽  
Ct Imaging ◽  
Response To Therapy ◽  
Imaging Features ◽  
Lung Involvement ◽  
Test Results ◽  
Rt Pcr ◽  
Pubmed Database ◽  
Bilateral Lung ◽  
Pcr Test

AbstractSince the outbreak of Coronavirus Disease 2019 (COVID-19) causing novel coronavirus (2019-nCoV)-infected pneumonia (NCIP), over 45 million affected cases have been reported worldwide. Many patients with COVID-19 have involvement of their respiratory system. According to studies in the radiology literature, chest computed tomography (CT) is recommended in suspected cases for initial detection, evaluating the disease progression and monitoring the response to therapy. The aim of this article is to review the most frequently reported imaging features in COVID-19 patients in order to provide a reliable insight into expected CT imaging manifestations in patients with positive reverse-transcription polymerase chain reaction (RT-PCR) test results, and also for the initial detection of patients with suspicious clinical presentation whose RT-PCR test results are false negative. A total of 60 out of 173 initial COVID-19 studies, comprising 7571 individuals, were identified by searching PubMed database for articles published between the months of January and June 2020. The data of these studies were related to patients from China, Japan, Italy, USA, Iran and Singapore. Among 40 reported features, presence of ground glass opacities (GGO), consolidation, bilateral lung involvement and peripheral distribution are the most frequently observed ones, reported in 100%, 91.7%, 85%, and 83.3% of articles, respectively. In a similar way, we extracted CT imaging studies of similar pulmonary syndromes outbreaks caused by other strains of coronavirus family: Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). For MERS and SARS, 2 out of 21 and 5 out of 153 initially retrieved studies had CT findings, respectively. Herein, we have indicated the most common coronavirus family related and COVID-19 specific features. Presence of GGO, consolidation, bilateral lung involvement and peripheral distribution were the features reported in at least 83% of COVID-19 articles, while air bronchogram, multi-lobe involvement and linear opacity were the three potential COVID-19 specific CT imaging findings. This is necessary to recognize the most promising imaging features for diagnosis and follow-up of patients with COVID-19. Furthermore, we identified co-existed CT imaging features.

scholarly journals Shedding of Viable Virus in Asymptomatic SARS-CoV-2 Carriers

mSphere ◽  
2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Takayuki Murata ◽  
Aki Sakurai ◽  
Masahiro Suzuki ◽  
Satoshi Komoto ◽  
Tomihiko Ide ◽  
...  
Keyword(s):  
Reverse Transcription ◽  
Potential Role ◽  
Nonstructural Protein ◽  
Rt Pcr ◽  
Asymptomatic Carriers ◽  
Reverse Transcription Pcr ◽  
The Impact ◽  
Crossing Point ◽  
Pcr Test

ABSTRACT Information regarding the infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic carriers is scarce. In order to determine the duration of infectivity and its correlation with reverse transcription-PCR (RT-PCR) results and time since initial positive PCR test in this population, we evaluated SARS-CoV-2 cell infectivity in nasopharyngeal samples longitudinally obtained from asymptomatic carriers who disembarked from a cruise ship during a COVID-19 outbreak. Of 166 nasopharyngeal samples collected from 39 asymptomatic carriers every 48 h until two consecutive negative PCR test results were obtained, SARS-CoV-2 was successfully isolated from 9 PCR-positive samples which were obtained from 7 persons (18%; 7/39). Viable viruses were isolated predominantly within 7 days after the initial positive PCR test, except for one person who shed viable virus until day 15. The median crossing point (Cp) value of RT-PCR of culture-positive samples was 24.6 (interquartile range [IQR], 20.4 to 25.8; range, 17.9 to 30.3), and Cp values were significantly associated with isolation of viable virus (odds ratio, 0.496; 95% confidence interval [CI], 0.329 to 0.747; P value, 0.001), which was consistent with existing data for symptomatic patients. Genome sequence analysis of SARS-CoV-2 samples consecutively obtained from a person who shed viable virus for 15 days identified the emergence of two novel single nucleotide variants (C8626T transition and C18452T transition) in the sample collected on day 15, with the latter corresponding to an amino acid substitution in nonstructural protein 14. The impact of these mutations on prolonged viable-virus shedding is unclear. These findings underscore the potential role of asymptomatic carriers in transmission. IMPORTANCE A growing number of studies suggest the potential role of asymptomatic SARS-CoV-2 carriers as a major driver of the COVID-19 pandemic; however, virological assessment of asymptomatic infection has largely been limited to reverse transcription-PCR (RT-PCR), which can be persistently positive without necessarily indicating the presence of viable virus (e.g., replication-competent virus). Here, we evaluated the infectivity of asymptomatic SARS-CoV-2 carriers by detecting SARS-CoV-2-induced cytopathic effects on Vero cells using longitudinally obtained nasopharyngeal samples from asymptomatic carriers. We show that asymptomatic carriers can shed viable virus until 7 days after the initial positive PCR test, with one outlier shedding until day 15. The crossing point (Cp) value of RT-PCR was the leading predictive factor for virus viability. These findings provide additional insights into the role of asymptomatic carriers as a source of transmission and highlight the importance of universal source control measures, along with isolation policy for asymptomatic carriers.

scholarly journals A case report of COVID-19 with false negative RT-PCR test: necessity of chest CT

2020 ◽  
Vol 38 (5) ◽  
pp. 409-410 ◽  
Author(s):  
Hao Feng ◽  
Yujian Liu ◽  
Minli Lv ◽  
Jianquan Zhong
Keyword(s):  
Case Report ◽  
False Negative ◽  
Chest Ct ◽  
Rt Pcr ◽  
Pcr Test

scholarly journals Sensitivity of RT-PCR testing of upper respiratory tract samples for SARS-CoV-2 in hospitalised patients: a retrospective cohort study

2020 ◽  
Vol 5 ◽  
pp. 254
Author(s):  
Thomas C. Williams ◽  
Elizabeth Wastnedge ◽  
Gina McAllister ◽  
Ramya Bhatia ◽  
Kate Cuschieri ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Clinical Diagnosis ◽  
Gold Standard ◽  
Upper Respiratory Tract ◽  
Rt Pcr ◽  
Reverse Transcription Pcr ◽  
Hospitalised Patients ◽  
Increased Sensitivity ◽  
Upper Respiratory ◽  
Pcr Test

Background: This study aimed to determine the sensitivity and specificity of reverse transcription PCR (RT-PCR) testing of upper respiratory tract (URT) samples from hospitalised patients with coronavirus disease 2019 (COVID-19), compared to the gold standard of a clinical diagnosis. Methods: All URT RT-PCR testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in NHS Lothian, Scotland, United Kingdom between the 7th of February and 19th April 2020 (inclusive) was reviewed, and hospitalised patients were identified. All URT RT-PCR tests were analysed for each patient to determine the sequence of negative and positive results. For those who were tested twice or more but never received a positive result, case records were reviewed, and a clinical diagnosis of COVID-19 allocated based on clinical features, discharge diagnosis, and radiology and haematology results. For those who had a negative RT-PCR test but a clinical diagnosis of COVID-19, respiratory samples were retested using a multiplex respiratory panel, a second SARS-CoV-2 RT-PCR assay, and a human RNase P control. Results: Compared to the gold standard of a clinical diagnosis of COVID-19, the sensitivity of a single upper respiratory tract RT-PCR for COVID-19 was 82.2% (95% confidence interval 79.0-85.1%).   The sensitivity of two upper respiratory tract RT-PCR tests increased sensitivity to 90.6% (CI 88.0-92.7%). A further 2.2% and 0.9% of patients who received a clinical diagnosis of COVID-19 were positive on a third and fourth test; this may be an underestimate of the value of further testing as the majority of patients 93.0% (2999/3226) only had one or two URT RT-PCR tests. Conclusions: The sensitivity of a single RT-PCR test of URT samples in hospitalised patients is 82.2%. Sensitivity increases to 90.6% when patients are tested twice.  A proportion of cases with clinically defined COVID-19 never test positive on URT RT-PCR despite repeat testing.

scholarly journals The long-quarantined case of COVID-19 with prolonged viral shedding and intermittent fever for more than 70 days

2021 ◽  
Vol 16 (2) ◽  
pp. 79-84
Author(s):  
Eijiro Yamada ◽  
Emi Ishida ◽  
Yasuyo Nakajima ◽  
Kazuhiko Horiguchi ◽  
Shunichi Matsumoto ◽  
...  
Keyword(s):  
Japanese Woman ◽  
Pcr Analysis ◽  
Rt Pcr ◽  
Intermittent Fever ◽  
Laboratory Findings ◽  
Inflammatory Reactions ◽  
Mild Disease ◽  
Viral Shedding ◽  
Reverse Transcription Pcr ◽  
Pcr Test

A 79-year old Japanese woman was diagnosed with coronavirus disease (COVID-19), caused by SARS coronavirus 2 (SARS-CoV-2), based on a positive reverse transcription-PCR (RT-PCR) test result. Chest computed tomography revealed mild interstitial pneumonia. She had intermittent persistent inflammatory reactions with fever. Laboratory findings and RT-PCR test results showed SARS-CoV-2 positivity for more than 70 days. To the best of our knowledge, this relatively mild case has the longest duration of viral shedding recorded, as confirmed by RT-PCR analysis. This case demonstrates that the viral shedding in COVID-19 can be prolonged, even in mild disease, and highlights the difficulties in distinguishing viral shedding from SARS-CoV-2 infectivity.

Sign in / Sign up

Export Citation Format

Share Document