Long COVID Complicated by Fatal Cytomegalovirus and Aspergillus Infection of the Lungs: An Autopsy Case Report.

After the acute phase of COVID-19, some patients develop long COVID. This term is used for a variety of conditions with a complex, yet not fully elucidated etiology, likely including the prolonged persistence of the virus in the organism and progression to lung fibrosis. We present a unique autopsy case of a patient with severe COVID-19 with prolonged viral persistence who developed interstitial lung fibrosis complicated by a fatal combination of cytomegalovirus and Aspergillus infection. SARS-CoV-2 virus was detected at autopsy in the lungs more than two months after the acute infection, although tests from the nasopharynx were negative. Immune dysregulation after COVID-19 and the administration of corticoid therapy created favorable conditions for the cytomegalovirus and Aspergillus infection that were uncovered at autopsy. These pathogens may represent a risk for opportunistic infections, complicating not only the acute coronavirus infection but also long COVID, as was documented in the presented case.

Nutrition and immune system: the size of the thymus as an indicator of the newborn's nutrition status.

SUMMARY: The thymus is a central lymphatic organ reaching its largest size after the delivery. Its size is significantly affected by endogenous and exogenous negative factors. In our research, we investigated the relationship between the size of the thymus determined by sonography and anthropometric parameters as well as indexes demonstrating the nutritional status. The examined group consisted of 212 full-term newborns, all of which passed an anthropometric examination during the first five days after delivery (birth weight and length, mid-arm and head circumference). The following nutritional status indexes were calculated from estimated anthropometric dimensions: Quételet's index, Rohrer's index, birth weight-to-length ratio and mid-arm-to-head circumference ratio. The size of the thymus was assessed by sonography and expressed as the multiple of transversal width of the cranial thymus part and sagittal area of the major thymus lobe (so-called 'Thymic Index'). The Thymic Index showed a positive correlation with the majority of indicators of the newborn's nutritional status, but all of these correlations are low (Spearman correlation coefficients 0.228-0.409). The correlation of the size of thymus with the birth weight or birth weight-to-length ratio was stronger than the correlation with the Quételet's index or mid-arm circumference. The size of the thymus reflects the newborn's nutritional status assumed by anthropometry and can represent one of the "barometers of nutrition". Normal nutrition in the prenatal period plays a relatively critical role in the development of the immune system.

Assessment of the thymic morphometry using ultrasound in full-term newborns.

PURPOSE: The size of thymus is variable and depends on age of the individual. Thymus undergoes its maximum development at the time of birth, when it also has the greatest relative weight. The aim of our study was to compare the two ways of expressing the size of the newborns' thymus, the Thymus index and estimated volume of thymus. METHODS: The examined group consisted of 212 full-term newborns from Slovakia, Europe. We estimated the length, width and thickness of the left and right lobes. We used these data to calculate the approximate volume of the thymus. We also expressed size of the thymus as a multiple of the transverse diameter of the cranial part of the thymus and the sagittal area of the larger lobe of the thymus, the so-called Thymus index. Bilateral differences in thymus lobes' sizes, as well as the thymus' sizes between sexes and among the newborns of different types of birth were also analysed. RESULTS: Our results show that (1) the left thymus lobe is longer and thicker than the right lobe; (2) the Thymus index and the estimated volume of the thymus have a strong significant and positive correlation; (3) boys reach significantly higher values of the Thymus index than girls; and (4) when comparing the differences in the thymus size between the newborns born in two different ways (spontaneous and operatively), no significant difference was discovered. CONCLUSION: Ultrasound examination is safe, effective and suitable for simple assessment of the thymus size, which has a great variability in children. In other hand, the use of the Thymus index in everyday clinical practice is limited due to different mean values in a number of studies.

Association among size of thymus, anthropometric dimensions and number of lymphocytes in peripheral blood in newborns from Slovakia.

AIMS: Thymus is the central lymphatic organ in humans with important endocrine function that is involved in maturation of immunocompetent T-lymphocytes. In our study we investigated the relationship among thymus size and the anthropometric dimensions as well as between thymus size and the number of lymphocytes in peripheral blood in full-term newborns. METHODS: The examined group consisted of 212 full-term newborns from the region of Southern Slovakia. We examined birth weight, birth body length, head circumference and chest circumference. Thymus size was estimated by ultrasonography and it was expressed as Thymic Index. The number of lymphocytes in peripheral blood was determined from the number of total leukocytes and from the leukogram. RESULTS: We have found a statistically significant positive correlation among thymus size and the body dimensions of newborns. The highest correlation with thymus size was found for birth weight (r = 0.409; P < 0.001) followed by birth body length (r = 0.368; P < 0.001), head circumference (r = 0.365; P < 0.001) and chest circumference (r = 0.340; P < 0.001). We have proven also a statistically significant positive correlation between the number of lymphocytes in peripheral blood and thymus size (r = 0.208; P = 0.039). CONCLUSION: Our results confirmed the findings of other authors about a close relationship of Thymic Index and basic body parameters in newborns.