Methanol poisoning during the COVID-19 pandemic in Iran: A retrospective cross-sectional study of clinical, laboratory, and brain imaging characteristics and outcomes.

Objective: To evaluate the frequency and significance of brain imaging findings in methanol poisoning patients and to propose a criterion for prioritizing brain imaging. Methods: We retrospectively reviewed the data of 306 patients (286 men and 34 women, mean age 32.10 ± 9.9 years) with confirmed methanol poisoning who were admitted to two hospitals in Iran during the COVID-19 pandemic. We analyzed their demographic, clinical, laboratory, and brain imaging data. Results: The main brain computed tomography (CT) scan findings were hypodensity in the putamen (11.1%), cerebellar nuclei (8.2%), diffuse cerebral edema (7.5%), and intracranial hemorrhage (ICH; 1.6%). These findings were associated with blood pH, Glasgow Coma Scale (GCS), renal failure, bicarbonate, oxygen, carbon dioxide, potassium, and glucose levels (p < 0.05). Poor prognosis was related to blindness, opium addiction, chronic alcohol use, hyperglycemia, and abnormal CT scans (p < 0.001 for all). The most predictive brain imaging findings for poor prognosis were hypodensity in the cerebellar nuclei, diffuse cerebral edema, and ICH. Conclusion: Brain imaging can provide valuable information for the diagnosis and management of methanol poisoning patients. We suggest that patients with severe acidosis, low GCS, low pH, low oxygen saturation, and high glucose levels should undergo brain CT scan as a priority.

Association between Fok1 and TaqI polymorphisms of vitamin D receptor gene with the severity of stenosis and calcification in carotid bulb in patients with ischemic stroke.

BACKGROUND AND AIMS: There have been plenty of reports regarding the association between Vitamin D (Vit D) and carotid atherosclerosis and stroke. We aimed to assess the association between FokI and TaqI polymorphisms of vitamin D receptor (VDR) gene and the severity of carotid bulb stenosis and the incidence of carotid bulb calcification in patients with ischemic stroke. METHODS: This prospective study conducted at Shiraz University of Medical Sciences between February 2020 and August 2020. All consecutive patients with ischemic stroke with more than 50% carotid bulb stenosis in color doppler sonography underwent cervical CT angiography (CTA). Demographics, risk factors of ischemic stroke, serum calcium, phosphate, creatinine, serum 25-hydroxyvitamin D (Vit D) level were investigated by High-Performance Liquid Chromatography (HPLC) method. The severity of stenosis and presence of calcification in carotid bulb ipsilateral was studied in CTA to ischemic stroke. VDR genotypes of FokI and TaqI polymorphisms were determined by the Restriction FragmentLength Polymorphism (RFLP) method. RESULTS: A total of 122 patients were recruited in this study (mean age: 59.1, 66.4% males, 17.2% with carotid artery stenosis of 70-99%. 57% with carotid bulb calcification). There was a significant association between calcification of carotid bulb with FokI CC polymorphisms of VDR gene (P value = 0.037). There was no significant relationship between the severity of carotid bulb stenosis and Fok1 and TaqI polymorphisms of vitamin D receptor gene and their alleles. CONCLUSIONS: There may be a biological association between the FokI VDR gene and carotid bulb calcification.

Clinical, laboratory, and chest CT features of severe versus non-severe pediatric patients with COVID-19 infection among different age groups.

BACKGROUND: This study was performed with the intention of comparing the clinical, laboratory, and chest computed tomography (CT) findings between severe and non-severe patients as well as between different age groups composed of pediatric patients with confirmed COVID-19. METHOD: This study was carried out on a total of 53 confirmed COVID-19 pediatric patients who were hospitalized in Namazi and Ali Asghar Hospitals, Shiraz, Iran. The patients were divided into two severe (n = 27) and non-severe (n = 28) groups as well as into other three groups in terms of their age: aged less than two years, aged 3-12 years and 13-17 years. It should be noted that CT scans, laboratory, and clinical features were taken from all patients at the admission time. Abnormal chest CT in COVID-19 pneumonia was found to show one of the following findings: ground-glass opacities (GGO), bilateral involvement, peripheral and diffuse distribution. RESULT: Fever (79.2%) and dry cough (75.5%) were the most common clinical symptoms. Severe COVID-19 patients showed lymphocytosis, while the non-severe ones did not (P = 0.03). C-reactive protein (CRP) was shown to be significantly lower in patients aged less than two years than those aged 3-12 and 13-17 years (P = 0.01). It was shown also that O2 saturation experienced a significant increase as did patients' age (P = 0.01). Severe patients had significantly higher CT abnormalities than non-severe patients (48.0% compared to 17.9%, respectively) (P = 0.02). CONCLUSION: Lymphocytosis and abnormal CT findings are among the factors most associated with COVID-19 severity. It was, moreover, showed that the severity of COVID-19, O2 saturation, and respiratory distress were improved as the age of confirmed COVID-19 pediatric patients increased.

A First Case of Acute Cerebellitis Associated with Coronavirus Disease (COVID-19): a Case Report and Literature Review.

Novel coronavirus (severe acute respiratory syndrome-coronavirus-2: SARS-CoV-2), which originated from Wuhan, China, has spread to the other countries in a short period of time. We report a 47-year-old male who was admitted to our hospital due to suffering from progressive vertigo and ataxia for 7 days prior to the admission. Neurological examination revealed cerebellar dysfunction, and brain magnetic resonance imaging (MRI) depicted edema of the cerebellar hemisphere associated with leptomeningeal enhancement. Cerebrospinal fluid (CSF) analysis showed mild lymphocytic pleocytosis, elevated protein, and lactate dehydrogenase. SARS-CoV-2 RNA was detected in the oropharyngeal/nasopharyngeal and CSF specimens. As a result, treatment with lopinavir/ritonavir was initiated, and patient symptoms and signs improved significantly during the course of hospitalization. To the best of our knowledge, this is the first case of acute cerebellitis associated with COVID-19 disease which is reported in the literature so far.