RESUMO
We aimed to determine the characteristics of coronavirus disease 2019 (COVID-2019) among the Iranian population. In this study, we collected and analysed the demographics, laboratory findings and outcomes of patients with COVID-19 who were admitted to Masih Daneshvari Hospital in Tehran, Iran between 20 February 2020 and 2 April 2020. Among 1061 patients, 692 (65.2%) were male and the median age was 55 years (interquartile range (IQR), 44-66 years). Totally, 129 (12.2%) patients died during hospitalization in the ward or intensive care unit. From the remaining 932 individuals, 46 (5.0%) were admitted to the intensive care unit and 886 (95.0%) were hospitalized in the ward. Those patients who died were significantly older than those hospitalized in the ward (p < 0.001). The median absolute number of lymphocytes was 1.2 × 103/µL (IQR 0.9 × 103 to 1.6 × 103/µL) and 708 (66.7%) patients had lymphopenia (absolute lymphocyte count <1500/µL). Among the laboratory tests, D-dimer, serum ferritin and albumin had the strongest correlations with mortality (r = 0.455, r = 0.412, r = -0.406, respectively; p < 0.001 for each one). In conclusion, laboratory findings could provide useful information with regard to the management of individuals with COVID-19.
RESUMO
BACKGROUND: The similar clinical and computed tomography (CT) characteristics of cryptogenic organising pneumonia (COP) and chronic eosinophilic pneumonia (CEP) make precise diagnosis challenging. OBJECTIVES: To help differentiate between COP and CEP using high-resolution CT (HRCT). DESIGN: Clinical data and HRCT images of COP and CEP patients referred to Masih Daneshvari Hospital, Tehran, Iran, from 2007 to 2015 were reviewed. Diagnosis of COP or CEP was confirmed using open lung biopsy or a combination of transbronchial biopsy, bronchoalveolar lavage fluid (BALF) analysis, peripheral eosinophilia and a favourable response to corticosteroids. RESULTS: Ground-glass opacity, a dominant ground-glass pattern, upper-lobe pneumonia, increased thickness of bronchial walls and a mosaic pattern in the lungs were more frequent in CEP. Lower-lobe pneumonia, subpleural reticulation, a dominant consolidation pattern, nodules and masses, non-septal linear opacities, bronchial dilation and a reverse halo sign were more frequent in COP. History of asthma, wheezing and peripheral eosinophilia was significantly more common in CEP than in COP. CONCLUSION: Distinguishing between CEP and COP based on HRCT alone is not always possible. However, in many cases, especially if the correct diagnosis cannot be established by other means, certain HRCT features can be very helpful.
Assuntos
Corticosteroides/uso terapêutico , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Eosinofilia Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Biópsia , Líquido da Lavagem Broncoalveolar , Doença Crônica , Estudos Transversais , Pneumonia em Organização Criptogênica/tratamento farmacológico , Diagnóstico Diferencial , Feminino , Humanos , Irã (Geográfico) , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Eosinofilia Pulmonar/tratamento farmacológico , Resultado do TratamentoRESUMO
Pulmonary complications are not infrequent after heart transplantation. Kaposi sarcoma is a vascular tumor that can involve the skin as well as visceral organs. We describe a case of visceral and cutaneous Kaposi sarcoma that presented with diffuse bilateral pulmonary infiltration and breathlessness 6 month after heart transplantation. Following modulation of the immunosuppressive regimen and addition of chemotherapy, the patient had an excellent response and has had an uneventful 1-year follow-up.