Infected Cavitations, Bullae and Interstitial Lung Disease in a COVID-19 Patient in Lima, Peru

A 48-year-old Peruvian man was diagnosed with COVID-19 in December 2020. His infection resolved and he was discharged from hospital after 14 days. However, 1 week later he presented with haemoptysis, malaise, pleuritic pain, infected cavitations, bullae, extensive interstitial lung disease and pneumomediastinum. He recovered after antibiotic treatment and was discharged after 8 days. His symptoms may have been due alveolar rupture due to persistent cough during and after diffuse inflammation of the lung parenchyma caused by COVID-19 infection.

The Incidence of Bordetella Pertussis Infections in Jahrom City, Southern Iran

Background: Bordetella Pertussis, known as the causative agent of whooping cough, is one of the leading causes of recurrent persistent cough at all ages, even in vaccinated individuals. Methods: A total number of 110 patients coughing for at least two weeks who were admitted to clinical centers in Jahrom, Iran, were included in this cross-sectional study. For this purpose, blood samples were collected from these individuals at two stages, i.e., at the beginning of the study and on the 21st day. Afterward, anti-pertussis toxin (PT) immunoglobulin G (IgG) was measured in serum samples via the enzyme-linked immunosorbent assay (ELISA). The given cases were further evaluated in terms of age, gender, occupation, place of living, and family size.Results: Out of 110 patients recruited in this study, 77 cases were female (70%). Also, only seven patients were shown to be serologically positive (6.4%). Moreover, no significant association was observed between pertussis incidence rate and the study variables, namely, age, gender, occupation, residency area (urban or rural), and family size (p>0.05).Conclusions: This study aimed to emphasize pertussis occurrence in individuals who merely present persistent cough without typical symptoms. This requires the physicians to conduct more precise assessments along with more rapid diagnostic methods.

Pneumorrhachis: An uncommon radiological entity

Pneumorrhachis (PR) is a rare and interesting phenomenon, in which air is present within the spinal canal. The aetiologies are varied, broadly grouped as traumatic, non-traumatic or iatrogenic. Pneumorrhachis secondary to spontaneous pneumomediastinum (SPM) and barotrauma of the lungs is uncommon and even rarer within the paediatric group. This report describes a paediatric patient presenting with a persistent cough who developed a SPM and subsequent PR.

MENCEGAH PENULARAN TB PARU DI MASA PANDEMI COVID-19 BAGI PENGUNJUNG PUSKESMAS LEGOK, TANGERANG, BANTEN

Background: Tuberculosis (TB) is an infectious disease caused by TB bacteria (Mycobacterium Tuberculosis), where most of the TB bacteria attack the lungs, but can also affect other body organs. Based on data from WHO in 2020 in Southeast Asia, Tuberculosis sufferers are estimated to reach 4.3 million and around 632,000 people died from this disease. The estimated number of tuberculosis cases in Indonesia in 2020 is 845,000 cases with the number of deaths caused by this disease as many as 13,947 cases. In Tangerang district there were 6,089/100,000 new tuberculosis cases detected. The symptoms such as a persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody, weight loss, night sweats, high temperature, tiredness and fatigue, loss of appetite, swellings in the neck.The purpose of this devotional activity is to increase the knowledge of tuberculosis and the way to prevent for the community in the working area of Legok Health Center.This method of devotion is done by collecting data through pre-tests before extension activities and workshops and then post test after activities. The data obtained is processed statistically. Counseling is an extension on tuberculosis prevention efforts and workshops on how to ethically cough and the use of good and correct masks to the community in the work area of Legok Health Center.Results data processing results from pre-test, post-test and education about TB prevention efforts obtained post-test values >70 in 95% of respondents with an average value of 85.5. The results of cough ethics workshops and the use of masks 100% participants can be accompanied by the distribution of masks.Conclusion after counseling and workshops there is an increase in knowledge and ability to perform cough ethics and the use of masks that are good and correct. This effort can be done continuously so that the goal of reducing the incidence of tuberculosis can be achieved.Latar belakang tuberkulosis (TB) merupakan penyakit menular yang disebabkan oleh kuman TB (Mycobacterium Tuberculosis), dimana sebagian besar kuman TB menyerang paru-paru, tetapi dapat juga mengenai organ tubuh lainnya. Berdasarkan data WHO tahun 2020 di Asia Tenggara penderita tuberkulosis diperkirakan mencapai 4,3 juta dan sekitar 632.000 orang meninggal diakibatkan penyakit ini. Estimasi kasus tuberkulosis di Indonesia pada tahun 2020 sebanyak 845.000 kasus dengan jumlah kematian yang diakibatkan oleh penyakit ini sebanyak 13.947 kasus. Pada kabupaten Tangerang terdapat 6.089/100.000 kasus tuberkulosis baru yang terdeteksi. Penyakit ini menimbulkan berbagai gejala seperti: Batuk >3 minggu terkadang bercampur darah, penurunan berat badan, berkeringat malam hari, demam dan mengigil, lemas, penurunan nafsu makan, pembengkakn di sekitar leher.Tujuan dari kegiatan pengabdian ini untuk meningkatkan penegtahuan tentang tuberkulosis dan cara-cara pencegahannya di wilayah kerja Puskesmas Legok.Metode pengabdian ini dilakukan dengan pengumpulan data melalui pre test saat sebelum kegiatan penyuluhan dan workshop kemudian post test setelah kegiatan. Data yang diperoleh diolah secara statistik. Penyuluhan yang dilakukan adalah penyuluhan tentang upaya pencegahan tuberkulosis dan workshop cara etikda batuk serta penggunaan masker yang baik dan benar kepada masyarakat di wilayah kerja Puskesmas Legok.Hasil pengolahan data dari pre-test, post-test dan edukasi mengenai upaya pencegahan TB diperoleh nilai post-test nilainya >70 pada 95% responden dengan nilai rerata 85,5. Hasil workshop etika batuk dan penggunaan masker 100% peserta dapat disertai dengan pembagian masker. Kesimpulan setelah dilakukan penyuluhan dan workshop terjadi peningkatan pengetahuan dan kemampuan melakukan etika batuk dan penggunaan masker yang baik dan benar. Upaya ini dapat dilakukan secara berkesinambungan agar tujuan menurunkan angka kejadian tuberkulosis dapat dicapai.

Persistent cough and asthma-like symptoms post COVID-19 hospitalization in children

Backgrounds: Respiratory viruses are the main triggers of asthma. Coronavirus is shown to contribute to infections of the respiratory tract that can lead to prolong cough and asthma. Objectives: Present study aimed to determine the risk of developing Persistent cough and asthma-like symptoms in hospitalized children due to COVID-19. Methods: This prospective study was carried out in a tertiary referral center. During the COVID-19 pandemic, 69 hospitalized pediatric patients admitted with COVID-19 were observed from February2020 to January 2021. Clinical and laboratory data were recorded, and after discharge, patients were followed and visited for cough and asthma evaluation in one, 2 and 6 months later. Patients with asthma-like diagnosis in follow up define as asthma-like group and patients without any sign of asthma categorized as the non-asthma group. Asthma-like co-morbids and risk factors were evaluated and compared between two groups. Results: Most of the COVID-19 hospitalized patients (N=42) (58.5%) were not affected by asthma-like symptoms in follow-up. 60.9% of the COVID-19 patients were male. The asthma-like group cases had a significantly familial history of asthma (63.0%), past medical history of asthma (33.3%), and Allergic rhinitis (85.2%). Rates of signs and symptoms during hospitalization were significantly higher in patients with COVID-19 and past medical history of asthma. Conclusions: We found an asthma-like prevalence of 41.5% in the cohort of COVID-19 hospitalized children. Family history of asthma and previous history of asthma and allergic rhinitis are risk factors for asthma-like after COVID-19 hospitalization. COVID-19 presentations are more severe in the asthma-like group.

Predictive symptoms for COVID-19 in the community: REACT-1 study of over 1 million people

Background Rapid detection, isolation, and contact tracing of community COVID-19 cases are essential measures to limit the community spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to identify a parsimonious set of symptoms that jointly predict COVID-19 and investigated whether predictive symptoms differ between the B.1.1.7 (Alpha) lineage (predominating as of April 2021 in the US, UK, and elsewhere) and wild type. Methods and findings We obtained throat and nose swabs with valid SARS-CoV-2 PCR test results from 1,147,370 volunteers aged 5 years and above (6,450 positive cases) in the REal-time Assessment of Community Transmission-1 (REACT-1) study. This study involved repeated community-based random surveys of prevalence in England (study rounds 2 to 8, June 2020 to January 2021, response rates 22%–27%). Participants were asked about symptoms occurring in the week prior to testing. Viral genome sequencing was carried out for PCR-positive samples with N-gene cycle threshold value < 34 (N = 1,079) in round 8 (January 2021). In univariate analysis, all 26 surveyed symptoms were associated with PCR positivity compared with non-symptomatic people. Stability selection (1,000 penalized logistic regression models with 50% subsampling) among people reporting at least 1 symptom identified 7 symptoms as jointly and positively predictive of PCR positivity in rounds 2–7 (June to December 2020): loss or change of sense of smell, loss or change of sense of taste, fever, new persistent cough, chills, appetite loss, and muscle aches. The resulting model (rounds 2–7) predicted PCR positivity in round 8 with area under the curve (AUC) of 0.77. The same 7 symptoms were selected as jointly predictive of B.1.1.7 infection in round 8, although when comparing B.1.1.7 with wild type, new persistent cough and sore throat were more predictive of B.1.1.7 infection while loss or change of sense of smell was more predictive of the wild type. The main limitations of our study are (i) potential participation bias despite random sampling of named individuals from the National Health Service register and weighting designed to achieve a representative sample of the population of England and (ii) the necessary reliance on self-reported symptoms, which may be prone to recall bias and may therefore lead to biased estimates of symptom prevalence in England. Conclusions Where testing capacity is limited, it is important to use tests in the most efficient way possible. We identified a set of 7 symptoms that, when considered together, maximize detection of COVID-19 in the community, including infection with the B.1.1.7 lineage.