ABSTRACT
In the COVID-19 pandemic, the overlap of clinical features between other viral infections makes a reliable diagnosis difficult in the initial stage of illness. We describe a confirmed case of CCHF in Tehran Province during this year, who was first misdiagnosed as COVID-19 infection.
ABSTRACT
Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are common hypertension medications. We aimed to investigate the association between treatment with ACEIs/ARBs and disease severity and mortality in patients with hypertension hospitalized for coronavirus disease 2019 (COVID-19). Methods: Information from the medical records of 180 hospitalized patients diagnosed with COVID-19 infection admitted in 2020 to Loghman Hakim Hospital, Tehran, Iran, was collected. Clinical histories, drug therapies, radiological findings, hospital courses, and outcomes were analyzed in all the patients. The demographic and clinical characteristics of the patients were also analyzed, and the percentage of patients with hypertension taking ACEIs/ARBs was compared between survivors and nonsurvivors. Results: The study population consisted of 180 patients at mean±SD age of 67.76±18.72 years. Hypertension was reported in 72 patients (40.0%). Patients with hypertension were older than those without it (mean±SD age =72.35±12.09 y). Among those with hypertension, death occurred in 33 patients (45.8%), of whom 60.6% were men. Fifty-three patients (73.6%) with hypertension were on ACEIs/ARBs. The ACEIs/ARBs group had a significantly lower mortality rate than the non-ACEIs/ARBs group (37.7% vs 68.4%; OR: 0.192; 95% CI: 0.05-0.68; P=0.011). Conclusion: This single-center study found no harmful effects associated with ACEIs/ARBs treatment. Patients on ACEIs/ARBs had a lower rate of mortality and disease severity than the non-ACEIs/ARBs group. Our study supports the current guideline to continue ACEIs/ARBs in patients with hypertension.
ABSTRACT
Coronavirus disease (COVID-19) is associated with thrombosis formation in various vessels, including those in the abdomen. In this case report, we present a COVID-19 infected patient who had developed abdominal discomfort. The patient underwent magnetic resonance imaging, which showed signs of thrombosis formation in the superior mesenteric vein (SMV). After conservative treatment failed, the patient was considered for vascular intervention. The SMV clot underwent thrombolysis via the infusion of reteplase (dose 6 mg stat, followed by 1 mg every hour) through a 5F perfusion Cather (Cragg-McNamara, 20 cm). Control venography showed near-complete recanalization. The patient was discharged with oral anticoagulants. Our case report is one of the first incidents of successful vascular intervention in SMV thrombosis in the setting of COVID-19.