RESUMO
Se presenta el caso de un paciente varón de 19 años que desarrolla una poliartritis simétrica distal que se diagnosticó como artritis reactiva atípica por infección por SARS-CoV-2 tras descartar otras causas de artritis.(AU)
We present the case of a 19-year-old male patient who developed symmetrical distal polyarthritis which was diagnosed as a reactive atypical arthritis caused by SARS-COV-2 infection after dismissing other causes of arthritis.(AU)
Assuntos
Humanos , Masculino , Adulto Jovem , Artrite Reativa , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Infecções por Coronavirus/epidemiologia , Betacoronavirus , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Anamnese , Artrite , Reumatologia , Doenças Autoimunes , Doenças ReumáticasRESUMO
We present the case of a 19-year-old male patient who developed symmetrical distal polyarthritis which was diagnosed as a reactive atypical arthritis caused by SARS-COV-2 infection after dismissing other causes of arthritis.
Assuntos
Artrite Reativa , COVID-19 , Adulto , Artrite Reativa/diagnóstico , Artrite Reativa/etiologia , COVID-19/complicações , Humanos , Masculino , SARS-CoV-2 , Adulto JovemRESUMO
We present the case of a 19-year-old male patient who developed symmetrical distal polyarthritis which was diagnosed as a reactive atypical arthritis caused by SARS-COV-2 infection after dismissing other causes of arthritis.
RESUMO
Tocilizumab (TCZ) has been administered in SARS-CoV-2 pneumonia but the factors associated with mortality before and after treatment remain unclear. Cox regression models were used to estimate the predictors of time to death in a cohort of hospitalized patients with COVID-19 receiving TCZ. In addition, the mean differences between discharged and deceased patients in laboratory parameters measured before and 3, 6 and 9 days after TCZ administration were estimated with weighted generalized estimation equations. The variables associated with time to death were immunosuppression (Hazard Ratio-HR 3.15; 95% confidence interval-CI 1.17, 8.51), diabetes mellitus (HR 2.63; 95% CI 1.23-5.64), age (HR 1.05; 95% CI 1.02-1.09), days since diagnosis until TCZ administration (HR 1.05, 95% CI 1.00-1.09), and platelets (HR 0.27; 95% CI: 0.11, 0.69). In the post-TCZ analysis and compared to discharged patients, deceased patients had more lactate dehydrogenase (p = 0.013), troponin I (p = 0.013), C-reactive protein (p = 0.013), neutrophils (p = 0.024), and fewer platelets (p = 0.013) and lymphocytes (p = 0.013) as well as a lower average PaO2/FiO2 ratio. In conclusion, in COVID-19 diagnosed patients receiving TCZ, early treatment decreased the risk of death, while age, some comorbidities and baseline lower platelet counts increased that risk. After TCZ administration, lower platelet levels were again associated with mortality, together with other laboratory parameters.
