RESUMO
We report the case of a thrombotic occlusion of an extra-anatomical aortic bypass graft performed 37 years ago in a 46-year-old male with Takayasu's arteritis. He presented with uncontrolled upper body hypertension, claudication pain in both the lower limbs, and kidney dysfunction which returned to normal post-surgery. On table we found a pseudoaneurysm at the proximal anastomosis along with calcification of the capsular tissue surrounding the graft. We attempt to explain the mechanism behind the graft occlusion, along with management of this late surgical complication which has not been described in the existing literature.
RESUMO
AIMS: This study aims to find a quantitative association between the presence of co-existing diabetes mellitus (DM) and/or hypertension (HTN) with COVID-19 infection severity and mortality. METHODS: A total of 813 patients with a positive COVID-19 were included. A case-control design was used to dissect the association between DM and HTN with COVID-19 severity and mortality. RESULTS: According to MOHFW guidelines, 535 (65.7%) patients had mild, 160 (19.7%) patients had moderate, and 118 (14.5%) patients had severe disease outcomes including mortality in 52 patients. Age, Neutrophil%, and Diabetes status were significantly associated with severe COVID-19 infection. After adjusting for age, patients with diabetes were 2.46 times more likely to have severe disease (Chi-squared = 18.89, p-value<0.0001) and 2.11 times more likely to have a fatal outcome (Chi-squared = 6.04, p-value = 0.014). However, we did not find evidence for Hypertension modifying the COVID-19 outcomes in Diabetic patients. CONCLUSION: COVID-19 severity and mortality both were significantly associated with the status of DM and its risk may not be modified by the presence of HTN.
