Strain Echocardiography and Cardiac MRI Evaluation of a Symptomatic Myopericarditis after the Pfizer-BioNTech mRNA COVID-19 Vaccine (preprint)

Background: The COVID-19 pandemic and the accompanying new generation vaccines have entered our lives with many unknown effects. Method and result: This is a case report of myopericarditis diagnosed with fever and chest pain 3 days after the 2nd dose of Pfizer-BioNTech COVID-19 mRNA Vaccine in an 18-year-old man. The diagnosis was confirmed by cardiac MRI(CMR), but we presented that this diagnosis and follow-up could be made accurately with strain echocardiography(SE). Conclusion: It would be beneficial for the cardiologists who perform the primary follow-up of these patients to know that it is possible with SE to support the diagnosis and follow-up of these patients, even if CMR is not accesible.

Bacterial coinfections are really rare in Covid-19 intensive care units? (preprint)

Background: There are conflicting and limited data about nosocomial coinfections in COVID-19 case in the intensive care unit. This study aims to investigate coinfections in COVID-19 patients followed in a tertiary care reference university hospital intensive care unit. Methods: This study was conducted and analyzed retrospectively the data of coinfections of 351 COVID-19 patients in the period 28.02.2020–15.01.2021 in a tertiary care intensive care unit in a university hospital. Results: Bacterial coinfections were present in 216 of the 351 cases. One hundred and thirty of these cases were evaluated as nosocomial infections. Third day the Sequential Organ Failure Assessment Score, usage of invasive mechanical ventilation, and presence of septic shock were significantly higher in the coinfected group. The neutrophil/lymphocyte ratio, polymorphonuclear leukocyte count, procalcitonin, C reactive protein, ferritin, and blood urea nitrogen values were significantly higher in the coinfection group. In the multinomial regression analysis, the number of white blood cells (WBC) (HR: 1.063 [1.019–1.109], p: 0.005) and invasive mechanical ventilation use (HR: 3.336 [1.865–5.966], p < 0.001) were considered independent risk factors for coinfection. The rates of hospitalization on the day of arrival (p: 0.000) and the 21st day (p: 0.005), as well as total mortality (p: 0.004), were significantly higher in the coinfected group.Conclusions: Bacterial coinfections of COVID-19 patients in intensive care unit was not rare.  Mortality in coinfected patients was higher than noninfected group. Identifying the infectious agent, classifying colonizations and infections, and using the proper treatment of antibiotics is of great importance in case management of COVID-19 patients in intensive care unit.