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1.
BMJ Case Rep ; 15(11)2022 Nov 22.
Статья в английский | MEDLINE | ID: covidwho-2137567

Реферат

A previously healthy Japanese woman in her 20s was admitted to our hospital with a 2-week history of fever (39.0°C) and a 1-week history of painful cervical lymphadenopathy. The day before fever onset, she had received her first Pfizer-BioNTech SARS-CoV-2 vaccine in her left arm. She had previously been treated with empirical antibiotics with no improvement. Physical examination revealed painful lymphadenopathy in both posterior cervical regions. CT showed symmetrical lymphadenopathies in the neck, supraclavicular, axillary and inguinal regions as well as hepatosplenomegaly. We suspected lymphoma and performed a lymph node biopsy in the right inguinal region, which revealed necrotising histiocytic lymphadenitis. The patient was, therefore, diagnosed with Kikuchi-Fujimoto disease (KFD). She improved after the corticosteroid therapy. This report highlights the importance of including KFD as a differential diagnosis of lymphadenopathy after SARS-CoV-2 vaccination. Additionally, lymph node biopsy is helpful for diagnosing KFD because it rules out other entities.


Тема - темы
COVID-19 , Histiocytic Necrotizing Lymphadenitis , Lymphadenopathy , Female , Humans , Histiocytic Necrotizing Lymphadenitis/diagnosis , Histiocytic Necrotizing Lymphadenitis/etiology , Histiocytic Necrotizing Lymphadenitis/pathology , COVID-19 Vaccines/adverse effects , SARS-CoV-2 , COVID-19/prevention & control , Lymphadenopathy/etiology , Vaccination/adverse effects , Fever/etiology , Pain/complications
2.
J Med Case Rep ; 16(1): 432, 2022 Nov 09.
Статья в английский | MEDLINE | ID: covidwho-2116292

Реферат

BACKGROUND: Coronavirus disease 2019 has changed the pattern of some diseases in the world, especially in pediatrics. Despite data suggesting that the pediatric population is less affected by coronavirus disease-19 infection, new concerns have been raised owing to reported cases with hyperinflammatory conditions such as Kawasaki disease. CASE PRESENTATION: We report herein the case of a pediatric patient diagnosed and treated for classic Kawasaki disease in the setting of confirmed coronavirus disease 2019 infection. She was an 8-year-old, previously healthy, and fully immunized Iranian girl who initially presented to the pediatric emergency department with 5 days of intermittent fever, followed by abdominal pain, nausea, and vomiting. She was admitted for fever and abdominal pain to the surgery service of Akbar Hospital with suspected appendicitis. CONCLUSIONS: This case report may serve as a useful reference to other clinicians caring for pediatric patients affected by coronavirus disease 2019 infection. Standard therapeutic interventions for Kawasaki disease must be performed to prevent critical coronary aneurysm-related complications in the coronavirus disease 2019 era.


Тема - темы
COVID-19 , Coronary Aneurysm , Mucocutaneous Lymph Node Syndrome , Female , Child , Humans , COVID-19/complications , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Iran , Coronary Aneurysm/diagnostic imaging , Coronary Aneurysm/etiology , Fever/etiology , Abdominal Pain/etiology , Systemic Inflammatory Response Syndrome
3.
Medicine (Baltimore) ; 101(45): e31361, 2022 Nov 11.
Статья в английский | MEDLINE | ID: covidwho-2115854

Реферат

RATIONALE: Paxlovid has shown the potential decreasing the hospitalization rate of mild or moderate coronavirus disease 2019 (COVID-19) and death in few of clinical trials, and is expected to the most promising medicine targeting Severe Acute Respiratory Syndrome Coronavirus 2 (SRAS-COV-2). However, there are no enough evidences to show it effectiveness for all patients with SARS-COV-2, especially among elderly patients and newest Omicron variant. PATIENT CONCERNS AND DIAGNOSIS: A 79 year's old female patient was admitted to hospital because of the moderate COVID-19 caused by the Omicron variant BA2.0. He presented the initial syndromes including Xerostomia, cough and fever. Chest computed tomography (CT) scanning at admission showed the exudation lesions on lung. The laboratory examination revealed that there are increased C-reactive protein (CRP), Ferritin and erythrocytesedimentationrate (ESR) and decreased white blood cells. INTERVENTIONS: The oral Paxlovid (Nirmatrelvir/Ritonavir) was administrated on second day after admission. OUTCOMES: The syndromes of Xerostomia, cough and fever was improved on third day after use of Paxlovid. The levels of CRP, ESR and counts of white blood cells returned the normal after three days of admission. The chest CT scanned on the third and sixth day after Paxlovid used showed the absorption of lesions. The examination of SARS-COVS viral nucleic acid turned negative at fifth day of admission. LESSONS: As a result, we would consider that Paxlovid is a suitable oral drug for elderly patients with SARS-COV2 even Omicron variant, it's benefit to improve patient's symptom and signs and can prevents COVID-19 with the high-risk factors from severe disease, although it didn't shorten the time for viral nucleic acid to turn negative.


Тема - темы
COVID-19 , Xerostomia , Male , Humans , Female , Aged , SARS-CoV-2 , Cough/etiology , RNA, Viral , Fever/etiology
4.
Medwave ; 22(9): e2581, 2022 Oct 25.
Статья в английский, испанский | MEDLINE | ID: covidwho-2090780

Реферат

Introduction: In March 2020, the World Health Organization (WHO) declared a pandemic for coronavirus 19. Typical symptoms were fever, cough, asthenia, dyspnea, and muscle pain. Pulmonary and central nervous system compromise presented challenging characteristics for healthcare physicians. The objectives of this study were to identify epidemiological and clinical characteristics of SARS-COV-2 infection survivors in a region of Argentina and to determine differences between gender, age groups, year of infection, and evolution time since diagnosis. Methods: A descriptive and analytical cross-sectional observational study was carried out. A self-administered questionnaire was applied, which was available between August and December 2021. Results: Among 1868 individuals included, the mean age was 39.4 ± 13.9 years, and 72.8% were female. Arterial hypertension was the most frequent comorbidity (11.7%). The majority were outpatients (81.9%). The most frequent presentation symptoms at all ages were asthenia (83.7%), fever (54.9%), headache (60.8%), anosmia (64.8%), ageusia (53.2%), cough (54.4%) and myalgias (53.7%). For the 18 to 29 years old age group, the most prevalent presentation symptoms were: headache (69.4%), anosmia (69.1%), ageusia (60.2%), odynophagia (45%), and rhinitis/nasal congestion (46.9%). In the 30 to 64 years old age group, there was a higher prevalence of myalgias (55.8%), arthralgias (41%), and concentration/memory disorder (28.3%). Male showed higher prevalence of fever (64.9% versus 51.1%; p < 0.001) and pneumonia (23.5% versus 13.4%; p < 0.001). After 12 weeks from diagnosis, 38.1% of patients persisted with asthenia, 23.6% with anosmia/dysosmia, and 21.2% with concentration/memory disorders. Conclusions: Systemic symptoms were common to all age groups with coronavirus 19 disease; however, younger, and intermediate age groups presented a higher prevalence of central nervous system symptoms such as anosmia and cognitive disorders, respectively. Symptoms beyond 12 weeks of diagnosis reached slightly more than 10% of the participants.


Introducción: En marzo de 2020 la enfermedad por coronavirus 19 fue declarada pandemia por la Organización Mundial de la Salud. Los síntomas más comunes fueron fiebre, tos, astenia, disnea y dolor muscular. Los compromisos pulmonar y del sistema nervioso central presentaron características desafiantes para los médicos asistenciales. Los objetivos del estudio fueron conocer las características epidemiológicas y clínicas de sobrevivientes a infección por SARS-CoV-2 en una región de Argentina, y determinar las diferencias entre género, grupos etarias, año de contagio, tiempo de evolución desde el diagnóstico. Métodos: Se realizó un estudio observacional descriptivo y analítico de corte transversal. Se aplicó un cuestionario auto administrado, que estuvo disponible entre agosto y diciembre de 2021. Resultados: La media de edad fue de 39,4 ± 13,9 años, el 72,8% fueron mujeres. La comorbilidad más frecuente fue hipertensión arterial (11,7%). La mayoría de los pacientes fueron ambulatorios (81,9%). Los síntomas de presentación más frecuentes a cualquier edad, fueron astenia (83,7%), fiebre (54,9%), cefalea (60,8%), anosmia (64,8%), ageusia (53,2%), tos (54,4%) y mialgias (53,7%). Para el grupo de 18 a 29 años los síntomas de presentación más prevalentes fueron cefalea (69,4%), anosmia 69,1%), ageusia (60,2%), odinofagia (45%) y rinitis/congestión nasal (46,9%). En el grupo de 30 a 64 años se observó mayor prevalencia de mialgias (55,8%), artralgias (41%), falta de concentración/memoria (28,3%). Los hombres mostraron más prevalencia de fiebre (64,9% versus 51,1%; p < 0,001) y neumonía (23,5% versus 13,4%; p < 0,001). Luego de las 12 semanas del diagnóstico 38,1% de los pacientes persistían con astenia, 23,6% con anosmia/disosmia y 21,2% con trastornos de concentración/memoria. Conclusiones: La enfermedad por coronavirus 19 presenta un patrón de síntomas sistémicos común a todos los grupos etarios. No obstante, los grupos más jóvenes presentan más prevalencia de síntomas de afección del sistema nervioso central como la anosmia y los grupos intermedios, mayor prevalencia de trastornos cognitivos. Los síntomas más allá de las 12 semanas del diagnóstico alcanzaron a algo más del 10% de los participantes.


Тема - темы
Ageusia , COVID-19 , Humans , Male , Female , Adult , Middle Aged , Adolescent , Young Adult , COVID-19/complications , COVID-19/epidemiology , Ageusia/diagnosis , Ageusia/epidemiology , Anosmia , SARS-CoV-2 , Cough/epidemiology , Cough/etiology , Cross-Sectional Studies , Asthenia , Fever/epidemiology , Fever/etiology , Headache/epidemiology , Headache/etiology , Survivors
5.
Korean J Radiol ; 21(4): 501-504, 2020 04.
Статья в английский | MEDLINE | ID: covidwho-2089760

Реферат

From December 2019, Coronavirus disease 2019 (COVID-19) pneumonia (formerly known as the 2019 novel Coronavirus [2019-nCoV]) broke out in Wuhan, China. In this study, we present serial CT findings in a 40-year-old female patient with COVID-19 pneumonia who presented with the symptoms of fever, chest tightness, and fatigue. She was diagnosed with COVID-19 infection confirmed by real-time reverse-transcriptase-polymerase chain reaction. CT showed rapidly progressing peripheral consolidations and ground-glass opacities in both lungs. After treatment, the lesions were shown to be almost absorbed leaving the fibrous lesions.


Тема - темы
Coronavirus Infections/diagnostic imaging , Pneumonia, Viral/diagnostic imaging , Adult , COVID-19 , Female , Fever/etiology , Humans , Lung/diagnostic imaging , Tomography, X-Ray Computed
6.
J Int Med Res ; 50(10): 3000605221127518, 2022 Oct.
Статья в английский | MEDLINE | ID: covidwho-2064524

Реферат

OBJECTIVE: Using a prospective observational design, we assessed adverse events (AEs) after COVID-19 vaccination in Japanese patients. METHODS: Two doses of the mRNA-1273 (SPIKEVAX®) or BNT162b2 (COMIRNATY®) vaccine were administered to participants aged 12 to 18 years, and AEs after each dose were recorded for 14 days. Data on the duration and nature (local vs. systemic) of AEs were collected using a questionnaire. Sex-based differences in AE frequency were also analyzed. RESULTS: After the first and second doses, 152 and 135 vaccinees were enrolled, respectively. After the first dose, fever (>37.1°C) occurred in 38.9% of males and 50.0% of females, whereas local pain occurred in 89.8% and 97.7% of males and females, respectively (only SPIKEVAX® was used as the first dose). After the second dose, fever (>37.1°C) occurred in 77.8% and 82.6% of males vaccinated with COMIRNATY® and SPIKEVAX®, respectively, and 82.6% of females (all received SPIKEVAX®). The local pain rates in these groups were 80.6%, 76.3%, and 100%, respectively. After the second dose, local pain, fever (>38.1°C) and headache were significantly more common in female participants, and the median symptom duration was 3 days. CONCLUSIONS: AEs were more frequent after the second dose and in females.


Тема - темы
COVID-19 Vaccines , COVID-19 , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Fever/epidemiology , Fever/etiology , Humans , Japan/epidemiology , Male , Pain/etiology , RNA, Messenger , mRNA Vaccines
7.
Medicine (Baltimore) ; 101(40): e30953, 2022 Oct 07.
Статья в английский | MEDLINE | ID: covidwho-2063076

Реферат

RATIONALE: Adult-onset Still disease (AOSD) is a systemic autoinflammatory illness of unknown cause. Its manifestations comprise fever; arthritis or arthralgia; and skin rash with high inflammatory markers and ferritin levels. Coronavirus disease 2019 (COVID-19) shares several clinical features and laboratory markers of AOSD: making it challenging to differentiate between the 2 conditions. PATIENT CONCERNS: A 29-year-old woman presented with fever, skin rash, and polyarthritis 4 weeks before admission. Two weeks after illness onset, she had an infection with symptoms similar to those of COVID-19. She observed that her symptoms worsened, and new symptoms appeared including headache; vomiting; diarrhea; and loss of taste and smell. The patient tested positive for severe acute respiratory syndrome coronavirus 2 using polymerase chain reaction. DIAGNOSIS: The patient was diagnosed with AOSD complicated with COVID-19 after exclusion of other possible causes of her illness, such as infections, malignancy, or underlying rheumatological disease. INTERVENTIONS: The patient was administered corticosteroids and methotrexate. The patient responded quickly, particularly to corticosteroids. OUTCOMES: This is the second reported case of COVID-19 in a patient with AOSD. She experienced COVID-19 shortly after having AOSD, indicating that those with AOSD might have a higher risk of COVID-19 infection. Furthermore, she developed the most prevalent COVID-19 symptoms. However, distinguishing most of these symptoms from AOSD manifestations was difficult. LESSONS: Early diagnosis and differentiation between AOSD and COVID-19 and prompt initiation of treatment are required.


Тема - темы
Arthritis , COVID-19 , Exanthema , Still's Disease, Adult-Onset , Adrenal Cortex Hormones/therapeutic use , Adult , Arthritis/diagnosis , Biomarkers , COVID-19/complications , COVID-19/diagnosis , Exanthema/drug therapy , Female , Ferritins , Fever/etiology , Humans , Methotrexate/therapeutic use , Still's Disease, Adult-Onset/complications , Still's Disease, Adult-Onset/diagnosis , Still's Disease, Adult-Onset/drug therapy
8.
Acta Med Indones ; 54(3): 419-427, 2022 Jul.
Статья в английский | MEDLINE | ID: covidwho-2045695

Реферат

BACKGROUND: COVID-19 is an infection caused by SARS-COV 2.For screening the patient, Rapid antigen for COVID-19 is used with a high diagnostic value. However, there are still some cases of false-negative even with clinical symptoms suggesting COVID-19. Undetected COVID-19 patients certainly will increase  transmission. A simple and practical diagnostic model, using determining factors, is required to guide physicians through a quicker decision making process, especially when deciding the need for the isolation rooms for patients with COVID-like symptoms. METHODS: This study is a cross-sectional study. The study was conducted at CiptoMangunkusumo Hospital, Jakarta.History of contact with COVID-19, clinical symptoms, laboratory examination, and chest radiograph data were taken from medical records. Bivariate and multivariate analyses were conducted to assess the effect sizes of patient factors on the diagnostic results.ROCcurve and Hosmer-Lemeshow calibration was used to make the scoring. RESULTS: There were 187 patients with the majority of subjects in the age group < 60 years old. The selected variables in this scoring systemwere contact history,fever/history of fever, dyspnea with respiratory rate >20 breaths/minute, leucocyte ≤ 10.000 cells/mLand typical chest radiography. The area under the curve for this model was 0,777 (CI95% (0,706-0,847), P<0,001). The probability was 82% with a cut-off point ≥ 4. CONCLUSION: Determinant models based on the combination of contact history, presence or history of fever, dyspnea, leucocyte count ≤ 10.000 cells/mL and typical chest radiography provides good accuracy to aid physicians in managing isolation room needs for patients with suspected COVID-19.


Тема - темы
COVID-19 , COVID-19/diagnostic imaging , COVID-19 Testing , Cross-Sectional Studies , Dyspnea/complications , Fever/etiology , Humans , Middle Aged , Radiography , SARS-CoV-2
9.
BMC Pediatr ; 22(1): 550, 2022 09 15.
Статья в английский | MEDLINE | ID: covidwho-2029697

Реферат

BACKGROUND: The first Covid-19 pandemic affected the epidemiology of several diseases. A general reduction in the emergency department (ED) accesses was observed during this period, both in adult and pediatric contexts. METHODS: This retrospective study was conducted on the behalf of the Italian Society of Pediatric Nephrology (SINePe) in 17 Italian pediatric EDs in March and April 2020, comparing them with data from the same periods in 2018 and 2019. The total number of pediatric (age 0-18 years) ED visits, the number of febrile urinary tract infection (UTI) diagnoses, and clinical and laboratory parameters were retrospectively collected. RESULTS: The total number of febrile UTI diagnoses was 339 (73 in 2020, 140 in 2019, and 126 in 2018). During the first Covid-19 pandemic, the total number of ED visits decreased by 75.1%, the total number of febrile UTI diagnoses by 45.1%, with an increase in the UTI diagnosis rate (+ 121.7%). The data collected revealed an increased rate of patients with two or more days of fever before admission (p = 0.02), a significant increase in hospitalization rate (+ 17.5%, p = 0.008) and also in values of C reactive protein (CRP) (p = 0.006). In 2020, intravenous antibiotics use was significantly higher than in 2018 and 2019 (+ 15%, p = 0.025). Urine cultures showed higher Pseudomonas aeruginosa and Enterococcus faecalis percentages and lower rates of Escherichia coli (p = 0.02). CONCLUSIONS: The first wave of the Covid-19 pandemic had an essential impact on managing febrile UTIs in the ED, causing an absolute reduction of cases referring to the ED but with higher clinical severity. Children with febrile UTI were more severely ill than the previous two years, probably due to delayed access caused by the fear of potential hospital-acquired Sars-Cov-2 infection. The possible increase in consequent kidney scarring in this population should be considered.


Тема - темы
COVID-19 , Urinary Tract Infections , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , C-Reactive Protein , COVID-19/epidemiology , Child , Child, Preschool , Disease Outbreaks , Emergency Service, Hospital , Escherichia coli , Fever/drug therapy , Fever/epidemiology , Fever/etiology , Humans , Infant , Infant, Newborn , Pandemics , Retrospective Studies , SARS-CoV-2 , Urinary Tract Infections/diagnosis
10.
Am J Trop Med Hyg ; 107(5): 1074-1082, 2022 Nov 14.
Статья в английский | MEDLINE | ID: covidwho-2024897

Реферат

Subacute thyroiditis (SAT), potentially caused by severe acute respiratory syndrome coronavirus 2 infection, has been reported as a complication of COVID-19 since 2020. The clinical characteristics and outcomes of SAT after COVID-19 remain incompletely defined. Therefore, we aimed to collect and survey case reports of SAT after COVID-19. We performed a systematic search of PubMed/MEDLINE, Web of Science, and Google Scholar. The keywords and MeSH terms used for the searches were "subacute thyroiditis" and "COVID-19." A total of 38 patients from 26 case reports, case series, and letters on SAT associated with COVID-19 were included and analyzed. The most frequent SAT symptom was neck pain (27 cases), followed by fever (22 cases). Of the 25 cases with information on the duration between onset of COVID-19 symptoms and onset of SAT symptoms, the shortest was simultaneous occurrence, and the longest was 4 months. In most cases, patients developed SAT at several days or weeks after the onset of COVID-19. All patients with SAT recovered with no severe complications or sequelae. Clinicians should be aware of the possibility of SAT development in patients with neck pain and fever following COVID-19. Further research is necessary to determine the relationship between SAT and COVID-19.


Тема - темы
COVID-19 , Thyroiditis, Subacute , Humans , COVID-19/complications , Neck Pain/etiology , Thyroiditis, Subacute/complications , Thyroiditis, Subacute/diagnosis , Fever/etiology
11.
N Engl J Med ; 387(8): 679-691, 2022 08 25.
Статья в английский | MEDLINE | ID: covidwho-2016969

Реферат

BACKGROUND: Before April 2022, monkeypox virus infection in humans was seldom reported outside African regions where it is endemic. Currently, cases are occurring worldwide. Transmission, risk factors, clinical presentation, and outcomes of infection are poorly defined. METHODS: We formed an international collaborative group of clinicians who contributed to an international case series to describe the presentation, clinical course, and outcomes of polymerase-chain-reaction-confirmed monkeypox virus infections. RESULTS: We report 528 infections diagnosed between April 27 and June 24, 2022, at 43 sites in 16 countries. Overall, 98% of the persons with infection were gay or bisexual men, 75% were White, and 41% had human immunodeficiency virus infection; the median age was 38 years. Transmission was suspected to have occurred through sexual activity in 95% of the persons with infection. In this case series, 95% of the persons presented with a rash (with 64% having ≤10 lesions), 73% had anogenital lesions, and 41% had mucosal lesions (with 54 having a single genital lesion). Common systemic features preceding the rash included fever (62%), lethargy (41%), myalgia (31%), and headache (27%); lymphadenopathy was also common (reported in 56%). Concomitant sexually transmitted infections were reported in 109 of 377 persons (29%) who were tested. Among the 23 persons with a clear exposure history, the median incubation period was 7 days (range, 3 to 20). Monkeypox virus DNA was detected in 29 of the 32 persons in whom seminal fluid was analyzed. Antiviral treatment was given to 5% of the persons overall, and 70 (13%) were hospitalized; the reasons for hospitalization were pain management, mostly for severe anorectal pain (21 persons); soft-tissue superinfection (18); pharyngitis limiting oral intake (5); eye lesions (2); acute kidney injury (2); myocarditis (2); and infection-control purposes (13). No deaths were reported. CONCLUSIONS: In this case series, monkeypox manifested with a variety of dermatologic and systemic clinical findings. The simultaneous identification of cases outside areas where monkeypox has traditionally been endemic highlights the need for rapid identification and diagnosis of cases to contain further community spread.


Тема - темы
Global Health , Monkeypox , Adult , Exanthema/etiology , Female , Fever/etiology , Global Health/statistics & numerical data , Humans , Male , Monkeypox/epidemiology , Monkeypox/therapy , Monkeypox virus
12.
Pediatr Rheumatol Online J ; 20(1): 69, 2022 Aug 20.
Статья в английский | MEDLINE | ID: covidwho-2002198

Реферат

BACKGROUND: For children with the multisystem inflammatory syndrome(MIS-C), intravenous immunoglobulins (IVIG) with or without methylprednisolone are the most effective treatment. In this study, IVIG combined with methylprednisolone was compared to IVIG used alone in children with MIS-C. METHODS: This retrospective cohort study was carried out between April 1, 2020, and November 1, 2021. This study covered all children with MIS-C. According to whether they received IVIG alone or IVIG with methylprednisolone as an initial treatment for MIS-C, the patients were split into two groups. The IVIG dosage for the patients in group I was 2 gr/kg, whereas the IVIG dosage for the patients in group II was 2 gr/kg + 2 mg/kg/day of methylprednisolone. These two groups were contrasted in terms of the frequency of fever, length of hospital stay, and admission to the pediatric intensive care unit. RESULTS: The study comprised 91 patients who were diagnosed with MIS-C and were under the age of 18. 42 (46.2%) of these patients were in the IVIG alone group (group I), and 49 (53.8%) were in the IVIG + methylprednisolone group (group II). Patients in group II had a severe MIS-C ratio of 36.7%, which was substantially greater than the rate of severe MIS-C patients in group I (9.5%) (p 0.01). When compared to group I (9.5%), the rate of hypotension was considerably higher in group II (30.6%) (p = 0.014). Additionally, patients in group II had considerably higher mean serum levels of C-reactive protein. The incidence of fever recurrence was 26.5% in group II and 33.3% in group I, however the difference was not statistically significant (p > 0.05). CONCLUSIONS: The choice of treatment for patients with MIS-C should be based on an individual evaluation. In MIS-C children with hypotension and/or with an indication for a pediatric intensive care unit, a combination of IVIG and methylprednisolone may be administered. For the treatment modalities of children with MIS-C, however, randomized double-blind studies are necessary.


Тема - темы
Hypotension , Methylprednisolone , COVID-19/complications , Child , Fever/drug therapy , Fever/etiology , Humans , Immunoglobulins, Intravenous , Infusions, Intravenous , Methylprednisolone/adverse effects , Retrospective Studies , Systemic Inflammatory Response Syndrome
13.
Pan Afr Med J ; 42: 173, 2022.
Статья в английский | MEDLINE | ID: covidwho-1998038

Реферат

Since the global pandemic of the 2019 coronavirus disease (COVID-19), few studies have reported on the relevance of bacteria co-infection on outcome of COVID-19 patients. Little is known about the clinical presentation among pregnant women, mother-to-child transmission, and fetal outcomes. This report shows a 24-year-old nulliparous woman who was 32 weeks pregnant and was admitted to the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi Ghana with symptoms of fever (40.3°C), cough and breathlessness of two weeks duration. Her nasopharyngeal sample tested positive for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and blood culture isolated Burkholderia cepacia. She was given medications but went into pre-term labour and delivered a stillborn baby. This rare case of COVID-19 and Burkholderia cepacia co-infection emphasizes the need for a thorough assessment and appropriate treatment of patients presenting with fever and respiratory symptoms in order to mitigate poor outcome.


Тема - темы
Burkholderia cepacia , COVID-19 , Coinfection , Pregnancy Complications, Infectious , Adult , COVID-19/complications , COVID-19/diagnosis , Coinfection/diagnosis , Female , Fetal Death , Fever/etiology , Humans , Infectious Disease Transmission, Vertical , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Pregnancy Outcome , SARS-CoV-2 , Young Adult
14.
J Infect Chemother ; 28(12): 1616-1622, 2022 Dec.
Статья в английский | MEDLINE | ID: covidwho-1996363

Реферат

INTRODUCTION: We investigated the clinical characteristics, outcomes and factors related to the serious adverse events (AEs) of patients visiting the emergency department (ED) with various AEs after ChAdOx1 and mRNA COVID-19 vaccination. METHODS: Patients with AEs who visited the ED between March 2021 and September 2021 were selected from three EDs. The clinical data of these patients were collected by retrospectively reviewing medical records. Serious adverse events (AEs) were defined as any adverse medical events that led to hospital admission. RESULTS: A total of 3572 patients visited the ED with AEs; 69.6% were administered mRNA vaccines, and the median (IQR) age was 48 (31-63) years. Regarding chief complaints, chest pain/discomfort (43.7%) was most common in the mRNA vaccines group, while fever (15.8%) was more commonly presented in the ChAdOx1 group. Most patients (93.9%) were discharged from the ED. In multivariate analysis, age ≥70 years, days from vaccination to ED visit ≥8 days, fever and dyspnea as chief complaints were higher independent risk factors for serious AEs (OR 27.94, OR 2.55, OR 1.95 and OR 2.18: p < 0.001, p < 0.001, p = 0.003 and p = 0.003, respectively). CONCLUSION: Most patients who visited the ED with AEs after vaccination were discharged from the ED regardless of the type of vaccine. Emergency physicians need to differentiate serious AEs and consider factors that may require admission to the ED.


Тема - темы
COVID-19 Vaccines , COVID-19 , 2019-nCoV Vaccine mRNA-1273 , Aged , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , ChAdOx1 nCoV-19 , Emergency Service, Hospital , Fever/epidemiology , Fever/etiology , Humans , Middle Aged , RNA, Messenger , Retrospective Studies , Vaccination/adverse effects
15.
Medicina (Kaunas) ; 58(8)2022 Aug 14.
Статья в английский | MEDLINE | ID: covidwho-1987887

Реферат

Background and Objectives: Acute abdominal pain in children has been noticed to be a primary reason to seek medical attention in multisystem inflammatory disorder (MIS-C), which can prevail separately or together with acute appendicitis. Our aim was to distinguish regular appendicitis cases from MIS-C and to suggest the best clinical and laboratory criteria for it. Materials and methods: Cases of patients, admitted to the Pediatric Surgery Department over a six-month period in 2021, were retrospectively analyzed. Confirmed MIS-C or acute appendicitis cases were selected. MIS-C cases were either separate/with no found inflammation in the appendix or together with acute appendicitis. Acute appendicitis cases were either regular cases or with a positive COVID-19 test. Four groups were formed and compared: A-acute appendicitis, B-MIS-C with acute appendicitis, C-MIS-C only and D-acute appendicitis with COVID-19. Results: A total of 76 cases were overall analyzed: A-36, B-6, C-29 and D-5. The most significant differences were found in duration of disease A-1.4 days, B-4.5 days, C-4 days, D-4 days (p < 0.0001), C reactive protein (CRP) values A-19.3 mg/L B-112.5 m/L, C-143.8 mg/L and D-141 mg/L (p < 0.0001), presence of febrile fever A-13.9%, B-66.7%, C-96.6% and D-40% (p < 0.0001) and other system involvement: A 0%, B 100%, C 100% and D 20%. A combination of these factors was entered into a ROC curve and was found to have a possibility to predict MIS-C in our analyzed cases (with or without acute appendicitis) with an AUC = 0.983, p < 0.0001, sensitivity of 94.3% and specificity of 92.7% when at least three criteria were met. Conclusions: MIS-C could be suspected even when clinical data and performed tests suggest acute appendicitis especially when at least three out of four signs are present: CRP > 55.8 mg, symptoms last 3 days or longer, febrile fever is present, and any kind of other system involvement is noticed, especially with a known prior recent COVID-19 contact, infection or a positive COVID-19 antibody IgG test.


Тема - темы
Appendicitis , COVID-19 , Acute Disease , Appendicitis/complications , Appendicitis/diagnosis , C-Reactive Protein , COVID-19/complications , COVID-19/diagnosis , Child , Fever/diagnosis , Fever/etiology , Humans , Retrospective Studies , Systemic Inflammatory Response Syndrome
16.
Am J Emerg Med ; 59: 133-140, 2022 Sep.
Статья в английский | MEDLINE | ID: covidwho-1971926

Реферат

BACKGROUND: The aim was to evaluate the epidemiological, clinical, laboratory, and radiologic data of children with SARS-CoV-2 positivity by polymerase chain reaction (PCR) together with treatment strategies and clinical outcomes and to evaluate cases of multisystem inflammatory syndrome in children (MIS-C) in this population. METHODS: This was a multicenter retrospective observational cohort study performed in the pediatric emergency departments of 19 tertiary hospitals. From March 11, 2020, to May 31, 2021, children who were diagnosed with confirmed nasopharyngeal/tracheal specimen SARS-CoV-2 PCR positivity or positivity for serum-specific antibodies against SARS-CoV-2 were included. Demographics, presence of chronic illness, symptoms, history of contact with SARS-CoV-2 PCR-positive individuals, laboratory and radiologic investigations, clinical severity, hospital admissions, and prognosis were recorded. RESULTS: A total of 8886 cases were included. While 8799 (99.0%) cases resulted in a diagnosis of SARS-CoV-2 with PCR positivity, 87 (1.0%) patients were diagnosed with MIS-C. Among SARS-CoV-2 PCR-positive patients, 51.0% were male and 8.5% had chronic illnesses. The median age was 11.6 years (IQR: 5.0-15.4) and 737 (8.4%) patients were aged <1 year. Of the patients, 15.5% were asymptomatic. The most common symptoms were fever (48.5%) and cough (30.7%) for all age groups. There was a decrease in the rate of fever as age increased (p < 0.001); the most common age group for this symptom was <1 year with the rate of 69.6%. There was known contact with a SARS-CoV-2 PCR-positive individual in 67.3% of the cases, with household contacts in 71.3% of those cases. In terms of clinical severity, 83 (0.9%) patients were in the severe-critical group. There was hospital admission in 1269 (14.4%) cases, with 106 (1.2%) of those patients being admitted to the pediatric intensive care unit (PICU). Among patients with MIS-C, 60.9% were male and the median age was 6.4 years (IQR: 3.9-10.4). Twelve (13.7%) patients presented with shock. There was hospital admission in 89.7% of these cases, with 29.9% of the patients with MIS-C being admitted to the PICU. CONCLUSION: Most SARS-CoV-2 PCR-positive patients presented with a mild clinical course. Although rare, MIS-C emerges as a serious consequence with frequent PICU admission. Further understanding of the characteristics of COVID-19 disease could provide insights and guide the development of therapeutic strategies for target groups.


Тема - темы
COVID-19 , COVID-19/complications , COVID-19/diagnosis , COVID-19/epidemiology , Child , Emergency Service, Hospital , Female , Fever/etiology , Humans , Male , Retrospective Studies , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
17.
Eur J Pediatr ; 181(9): 3549-3554, 2022 Sep.
Статья в английский | MEDLINE | ID: covidwho-1941646

Реферат

Multisystem inflammatory syndrome in children (MIS-C) is an inflammatory condition associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is characterized by fever, gastro-intestinal symptoms, cardiovascular complications, conjunctivitis, skin involvement, elevated inflammatory markers, and coagulation abnormalities. The current ongoing COVID-19 pandemic causes an increased alertness to MIS-C. In combination with the heterogeneous clinical spectrum, this could potentially lead to diagnostic blindness, misdiagnosis of MIS-C, and overtreatment with expensive IVIG treatment. This report demonstrates the challenge of accurately distinguishing MIS-C from other more common inflammatory pediatric diseases, and the need to act with caution to avoid misdiagnoses in the current pandemic. We present a case series of 11 patients suspected of MIS-C based on the current definitions. Three of them were eventually diagnosed with a different disease. CONCLUSION: Current definitions and diagnostic criteria lack specificity which potentially leads to misdiagnosis and overtreatment of MIS-C. We emphasize the need to act with caution in order to avoid MIS(-C)-taken diagnoses in the current pandemic. WHAT IS KNOWN: • A pediatric multisystem inflammatory disease associated with SARS-CoV-2 has been described (MIS-C). • There are three definitions being used for MIS-C, all including fever for at least 24 h, laboratory evidence of inflammation, clinically severe illness with multi-organ (≥ 2) involvement, and no alternative plausible diagnosis. WHAT IS NEW: • MIS-C has a heterogeneous clinical spectrum without distinctive features compared to more common childhood diseases. Current definitions and diagnostic criteria for MIS-C lack specificity which leads to misdiagnosis and overtreatment. • Amid the current excessive attention to COVID-19 and MIS-C, pediatricians should remain vigilant to avoid mistaken diagnoses.


Тема - темы
COVID-19 , Adolescent , COVID-19/complications , COVID-19/diagnosis , Child , Fever/etiology , Humans , Pandemics , SARS-CoV-2 , Systemic Inflammatory Response Syndrome/diagnosis , Systemic Inflammatory Response Syndrome/therapy
18.
N Engl J Med ; 387(2): 168-176, 2022 07 14.
Статья в английский | MEDLINE | ID: covidwho-1931551

Тема - темы
Cough , Fever , Adolescent , Cough/etiology , Female , Fever/etiology , Humans
19.
Acta Med Indones ; 54(2): 314-315, 2022 Apr.
Статья в английский | MEDLINE | ID: covidwho-1929426

Реферат

After being declared as a pandemic on March 11, 2020 by the World Health Organization, COVID-19 has affected 497 million people worldwide as of 9 April 2022. COVID-19 is a disease with a plethora of clinical manifestations, which extends to those beyond pulmonary signs and symptoms. Studies that report on the clinical presentation of COVID-19 rarely report specifically on cases with only extrapulmonary manifestations of COVID-19. Extrapulmonary clinical presentations of COVID-19 without pulmonary signs and symptoms is rare, and in such cases, COVID-19 is rarely suspected.We herewith describe four patients with extrapulmonary manifestations of COVID-19, with positive SARS-COV-2 PCR when the test was performed for initial patient screening. The first patient is a 44-year-old female who developed painful ulcer with burning sensation at the lateral side of the tongue along with low grade fever. This symptom appeared after the initial complaints of coughing and nasal congestion subsided.  The second patient is a 37-year-old male, who complained of red eyes  with itchiness and increased tear production for 3 days before seeing an ophthalmologist. The third patient is a 44-year-old female who developed burning sensation and soreness on her throat upon swallowing with fever and chills. These symptoms appear consecutively without any respiratory complaint. The fourth patient is a previously healthy, 30-year-old female, with a normal weight and BMI, and without any comorbidity, cardiovascular risk and neither personal nor family history of cardiovascular disease. In these 4 patients, COVID-19 stomatitis, conjunctivitis, pharyngitis and COVID-19-associated atrial fibrillation was subsequently diagnosed, respectively.In the pandemic stage of COVID-19, COVID-19 screening has often been routinely performed due to the high risk of transmission. However, the decrease in the number of COVID-19 cases may prompt physicians to perform SARS-COV-2 testing based on clinical suspicion. It is imperative to consider the likelihood of COVID-19 and perform SARS-COV-2 PCR in patients with extrapulmonary complaints that have persisting complaints despite treatment.


Тема - темы
COVID-19 , Adult , COVID-19/complications , COVID-19/diagnosis , COVID-19 Testing , Female , Fever/etiology , Humans , Male , Pandemics/prevention & control , SARS-CoV-2
20.
Pediatr Rheumatol Online J ; 20(1): 46, 2022 Jul 08.
Статья в английский | MEDLINE | ID: covidwho-1928189

Реферат

OBJECTIVE: It is common knowledge among clinicians who treat PFAPA (Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis) patients that emotional stress can trigger PFAPA attacks similarly to other autoinflammatory diseases. However, it has never been proved scientifically. Our aim was to examine whether emotional stress serves as a trigger for PFAPA attacks. METHODS: Patients aged 3-12 years, with active PFAPA, from two Israeli medical centers were enrolled to this study. Patient's parents were reached via phone calls in two occasions: a stressful period related to the COVID-19 pandemic restrictions and a less stressful period. In both times they were asked to report occurrence of PFAPA attacks in the preceding 2 weeks. The relative stress levels of the two periods were validated by an emotional distress scale questionnaire. The significance level was set at 0.05. RESULTS: Mean age was 7.28 ± 2.7 for the 99 paediatric patients enrolled in the study. Scores for the mean emotional distress questionnaire were statistically significant higher in the stressful period compared to the less stressful period (35.6 ± 8.1 vs. 32.1 ±7.7, respectively, P = 0.047). In the stressful period, 41 (38.7%) reported at least one attack during the preceding 2 weeks, compared to 24 (22.6%) in the less stressful period (p = 0.017). CONCLUSION: PFAPA flares during COVID-19 outbreak are described. This study is the first to suggest that emotional stress is associated with PFAPA attacks.


Тема - темы
COVID-19 , Disease Outbreaks , Emotions , Fever , COVID-19/epidemiology , Child , Child, Preschool , Female , Fever/etiology , Humans , Israel , Male , Stress, Physiological
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