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1.
J Infect Public Health ; 15(6): 689-702, 2022 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-35643053

RESUMO

Hospitalized patients with coronavirus disease 2019 (COVID-19), particularly those admitted to the intensive care unit (ICU) are at high risk of morbidity and mortality. Several observational studies have described hemostatic derangements and thrombotic complications in patients with COVID-19. The aim of this review article is to summarize the current evidence on pathologic findings, pathophysiology, coagulation and hemostatic abnormalities, D-dimer's role in prognostication epidemiology and risk factors of thrombotic complications, and the role of prophylactic and therapeutic anticoagulation in patients with COVID-19. While existing evidence is limited in quality, COVID-19 appears to increase micro-and macro-vascular thrombosis rates in hospitalized and critically ill patients, which may contribute to the burden of disease. D-dimer can be used for risk stratification of hospitalized patients, but its role to guide anticoagulation therapy remains unclear. Evidence of higher quality is needed to address the role of therapeutic anticoagulation or high-intensity venous thromboembolism prophylaxis in COVID-19 patients. TAKE-HOME POINTS.

3.
Echo Res Pract ; 9(1): 1, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35659315

RESUMO

BACKGROUND: Patients with prosthetic heart valves (PHV) require long-term follow-up, usually within a physiologist led heart valve surveillance clinic. These clinics are well established providing safe and effective patient care. The disruption of the COVID-19 pandemic on services has increased wait times thus we undertook a service evaluation to better understand the patients currently within the service and PHV related complications. METHODS: A clinical service evaluation of the heart valve surveillance clinic was undertaken to assess patient demographics, rates of complications and patient outcomes in patients who had undergone a PHV intervention at our institute between 2010 and 2020. RESULTS: A total of 294 patients (mean age at time of PHV intervention: 71 ± 12 years, 68.7% male) were included in this service evaluation. Follow-up was 5.9 ± 2.7 years (range: 10 years). 37.1% underwent baseline transthoracic echo (TTE) assessment and 83% underwent annual TTE follow-up. Significant valve related complications were reported in 20 (6.8%) patients. Complications included a change in patient functional status secondary to significant PHV regurgitation (0.3%) or stenosis (0.3%), PHV thrombosis (0.3%) or infective endocarditis (3.7%). Significant valve related complications resulted in ten hospital admission (3.4%), two re-do interventions (0.6%), and four deaths (1.3%). CONCLUSIONS: This service evaluation highlights the large number of patients requiring ongoing surveillance. Only a small proportion of patients develop significant PHV related complications resulting in a low incidence of re-do interventions and deaths.

4.
Egypt Heart J ; 74(1): 48, 2022 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-35662385

RESUMO

BACKGROUND: Cases of COVID-19 presenting after elective cardiac surgery are rare. Published literature suggests that such cases have a high morbidity and mortality rate. Here, we report a case of COVID-19 presenting after an elective, isolated off-pump coronary artery bypass (OPCAB). CASE PRESENTATION: A 65-year-old obese, hypertensive, hypothyroid lady, with moderate left ventricular dysfunction, presenting with unstable angina, tested negative for COVID-19 at admission, having undergone thrombolysis for a recent inferior wall myocardial infarction, at an outside centre, and coronary angiography revealing left main triple vessel disease, developed signs and symptoms of COVID-19, four days after OPCAB. She was diagnosed with moderate COVID-19 infection. Subsequent contact tracing revealed that her husband was suffering from mild COVID-19 infection and was managed in home isolation. Isolation and early supportive management with moist oxygen, steroids, intravenous antibiotics, zinc and vitamin C helped the patient recover. She was followed up at one month, six months, one year and at eighteen months and has been doing well. CONCLUSIONS: A strong clinical suspicion and repeat testing for COVID-19 is required as the diagnosis may often be missed with COVID-19 mimicking the signs and symptoms of post-cardiotomy syndrome. Preferentially dealing with such cases off-pump, thereby avoiding cardio pulmonary bypass-related complications, may improve outcomes. Isolation and early supportive management help. Adequate follow-up is required in all such cases as cardiovascular complications are common, alongside known long-term sequelae, like anxiety, depression, cardio-respiratory complications, venous thromboembolism and even postural orthostatic tachycardia syndrome.

5.
Respir Med Case Rep ; 38: 101676, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35663110

RESUMO

The progression of secondary pulmonary damage in SARS-COV-2 infection, associated with interstitial damage, inflammation and alveolar consolidation and eventually resulted in the development of pulmonary fibrosis (PF), remains one of the key clinical dilemmas for the treatment of patients in intensive care units (ICU). Currently, there is no standardized algorithm for PF prevention and timely management, although few studies have discussed the use of antifibrotic agents in COVID-19 patients. One of the treatment options for patients with interstitial PF, when irresponsive to the given corticosteroid therapy, is the administration of cytostatic agents, in particular, cyclophosphamide. Cyclophosphamide is one of the well-studied drugs in the cytostatic group, which effectiveness in inhibiting systemic inflammation suggests its ability to reduce the progression of the secondary lung damage, interstitial abnormalities and PF caused by the so-called "cytokine storm". The presented case reports provide data on the use of cyclophosphamide (Сy) in the management of severe respiratory failure in COVID-19 patients stationed in ICU. We describe three clinical cases characterized by different types of respiratory support, including extracorporeal membrane oxygenation.

6.
Ann Med Surg (Lond) ; 78: 103888, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35663120

RESUMO

Introduction: COVID 19 is a new virus appeared in the late of 2019, and spread widely through the world, causing respiratory symptoms and sometimes could cause digestive manifestations. Case presentation: We reported a case of a 72 years old women presented with a complaint of dry cough, dyspnea and swollen abdomen, which she diagnosed with COVID19 and her medical history showed type 2 diabetes mellitus and acute kidney injury one month prior to her presentation. CT-abdomen showed Ascites and slightly hepatomegaly then we performed prednisolone antibiotics medication. After a week the Ascites decreased and her condition was good and stable. Discussion: Few similar cases have been reported in the literature as case reports, but our article reports the first case report from Syria, which may increase the clinical awareness towards rare complications of COVID19 infection among Syrian clinical doctors, especially pulmonologists. Conclusion: The peritoneal effusion consider as s rare digestive manifestation of COVID19 that Clinical doctors should take aware off.

7.
Ann Med Surg (Lond) ; 78: 103897, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35663122

RESUMO

Introduction: Vero Cell, AstraZeneca, Janssen, mRNA-1273 (Moderna), and Pfizer COVID-19 vaccines have been authorized for emergency use in Nepal. These vacines have been linked to some adverse effects, including fever, myalgia, and headache. Furthermore Bell's Palsy a rare adverse effect was also reported to be associated with the use of mRNA-1273 (Moderna) vaccine in some patients. Case presentation: In this case report we present a 17-year-old female who acquired Bell's Palsy following the administration of mRNA-1273 (Moderna) COVID-19 vaccination. Discussion: The possible etiology of BP that has been suggested is infection by reactivated viruses, such as the varicella-zoster virus (VZV), herpes simplex virus type 1 (HSV-1), human herpesvirus 6, and the Usutu virus, [1] the most accepted hypothesis is the one with reactivation of latent Herpes Simplex Virus type 1 in the geniculate ganglia of the facial nerves, an autoimmune mechanism through the mimicry of host molecules by the antigens of the vaccines. Conclusion: Though the extent of association between the mRNA vaccination and the development of Bell's Palsy has yet to be confirmed, this example highlights the need to closely monitor side effects and repercussions after receiving a new vaccine.

8.
Cureus ; 14(5): e24699, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35663660

RESUMO

Several cases of myocarditis and pericarditis have been reported after mRNA COVID-19 vaccination. Interestingly, most cases were seen in male adolescents and young adults, commonly after 3-4 days of the second dose of mRNA vaccine. The vaccine contains the viral spike glycoprotein in the nucleoside-modified mRNA of the coronavirus that activates the proinflammatory cascades and immunological pathways, which can cause myocarditis and pericarditis. Here we report a case of a middle-aged Caucasian male who presented with progressive dyspnea, fever, and chills seven days after the second dose of the COVID-19 vaccine. He was found to have pericarditis with massive hemorrhagic pericardial effusion, large bilateral pleural effusions, circulatory shock, and cardiac arrhythmia. The patient required pericardiocentesis and thoracentesis and was discharged home on antiarrhythmic and anti-inflammatory therapy. Our case report describes a correlation between mRNA COVID-19 vaccine and pericarditis, suggesting the importance of pharmacovigilance and reporting of adverse outcomes and encourages a high index of clinical suspicion in physicians to facilitate early diagnosis and interventions.

9.
Cureus ; 14(5): e24665, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35663665

RESUMO

We report on two critically ill pediatric patients, aged 16 and 18 years, presenting with acute myopericarditis at a tertiary-care center in New Jersey, United States. Both patients had their severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations, tested negative for SARS-CoV-2, and shared only significant history of asthma. Clinical presentations were similar to acute onset chest pain that worsened with deep inspiration. One patient reported a history of vaping and escalating marijuana use several hours preceding presentation. Both patients had elevated troponin on admission and had ST-segment elevation on electrocardiogram (EKG), thus prompting admission to the pediatric intensive care unit (PICU) for cardiac monitoring. Myopericarditis has multiple etiologies and is a newly described rare complication of the SARS-CoV-2 vaccine. It can also occur as a complication of vaping and frequent marijuana drug use. Our paper highlights the importance of a detailed social and drug history in adolescents presenting with chest pain. The clinical characterization is necessary to promote better case definitions and the design of targeted interventions for this vulnerable group.

10.
Cureus ; 14(5): e24638, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35663687

RESUMO

Coronavirus disease 2019 (COVID-19) has been known to affect multiple organ systems, aside from the respiratory system. Increasing reports of post-infection neurological complications have been reported. Miller-Fisher syndrome, a rare variant of Guillain-Barré syndrome (GBS), has been reported after COVID-19 infection. We present the youngest known adult (26-year-old male) reported to have had COVID-19-associated Miller Fisher syndrome (MFS) with also the longest reported latency period (10 weeks) between infection and development of neurological symptoms (including dysphagia, horizontal diplopia, facial weakness, upper and lower extremity weakness, paresthesia). This is currently the second youngest reported case after the case of a seven-year-old child. The patient was treated with intravenous immunoglobulin and was ultimately transferred to a different facility for higher level of care. Most symptoms were resolved within four days. The patient reported resolution of neurologic symptoms with the exception of left-sided facial weakness at the one-year follow-up. As more reports of COVID-19-associated GBS and MFS appear in the future, we are likely to discover more variability than was previously known in GBS and MFS. With COVID-19 potentially affecting multiple systems, there could be increased variability to previously known conditions. Future studies may need to closely examine long-term follow-ups of patients previously diagnosed with COVID-19 as post-COVID complications become more prevalent.

11.
Cureus ; 14(5): e24654, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35663715

RESUMO

The ST-segment elevation is commonly associated with acute myocardial Infarction. However, there are other non-ischemic causes of ST-elevation. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious illness that continues to plague the world since the first case was reported in China over two years ago. As cases of the diseases become rampant, we have learned more of its complications which can include cardiac and pericardial disease. We present a case report of a young African American male who presented with chest pain six weeks after being diagnosed with SARS-Cov-2 pneumonia. Electrocardiogram (EKG) showed ST-segment changes that were initially presumed to be acute pericarditis. The patient was initially treated with colchicine. After further workup and a second opinion, ST-segment changes were thought to be likely benign early repolarization changes rather than pericarditis. Differential diagnosis of ST-segment changes on EKG in the patient with chest pain is broad. Subtle findings on EKG are important in distinguishing these differentials and should be well known and understood.

12.
Cureus ; 14(5): e24694, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35663719

RESUMO

Following coronavirus disease-2019 (COVID-19), many patients experience acute complications and long-term sequelae. Acute complications include respiratory failure, myocardial injury, and neurological complications. Respiratory and thromboembolic complications prove to be acute changes that cause detrimental long-term outcomes. A continued exploration of the COVID-19 hospital course will allow for effective management and treatment of the virus. We report the case of a 48-year-old Hispanic woman who experienced a pulmonary embolism, deep vein thrombosis in all four extremities, and a brain embolus following a COVID-19 infection in 2021. Despite hospital care and prompt treatment, she developed long-term sequelae, specifically post-intubation tracheal stenosis. The critical factor promoting this inflammatory state is the overproduction of cytokines in what is coined a "cytokine storm." The lasting complications have multiple facets that need to be explored beyond the virus itself. Treatment modalities have their own risks and side effects. Comparing effective and ineffective treatment outcomes for this patient may lead to improvements in COVID-19 management. For this reason, exploring the treatment and complications in the acute setting is necessary for the prevention of the long-term sequelae accompanying cases of COVID-19. While literature exists detailing the unique thrombotic and respiratory complications that can present as a result of COVID-19 coagulopathies, this field is continuously evolving and warrants further research.

13.
Glob Pediatr Health ; 9: 2333794X221101773, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35664046

RESUMO

A preadolescent female presented to the emergency department with an acute asthma exacerbation. Chest radiograph and computed tomography scan showed extensive pneumomediastinum with a small pneumopericardium without a distinct source for this air leak. The patient was admitted for noninvasive monitoring, analgesia, and high concentration oxygen. Serial chest radiographs showed marked improvement following high concentration oxygen, and she was discharged on hospital day 3. Spontaneous pneumomediastinum and pneumopericardium are rare complications of asthma that can often be managed conservatively but should be considered on the differential for this patient population, and may be a complication of COVID-19.

14.
Cureus ; 14(4): e24629, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35664398

RESUMO

Background The Omicron variant of SARS-CoV-2 infection was seen to be more infectious but less severe in children than adults with reduced hospitalization rates. There is a paucity of data on hospitalized children with confirmed Omicron variant. Objective We describe demographic, epidemiologic, clinical, radiological, laboratory features and outcomes of children with confirmed Omicron variant of SARS-CoV-2 infection admitted to a tertiary care teaching hospital in Pune, India. Methodology Children who tested positive for SARS-CoV-2 - Omicron variant and were admitted between 1st December 2021 and 28th February 2022 were included in the study. Results Out of a total of 37 Covid-positive children admitted during the study period, 16 underwent genome sequencing of which 14 were confirmed to be Omicron variant and two were Delta variant. The age range was one month to 12 years and seven (50%) were male. Common presenting features were fever (n=13, 93%), cough (n=7, 50%), seizures (n=7, 50%) and coryza (n=5, 36%). Comorbidities noted were epilepsy (n=3, 21%) and one each with Thalassemia Major, suspected inborn error of metabolism (IEM), operated anorectal malformation with hypospadias, chronic suppurative otitis media with complications (mastoiditis and facial nerve palsy), neonatal cholestasis and intracranial bleed with dural venous sinus thrombosis. Malnutrition was noted in 42%, pallor in 10 cases (71%). Severe anaemia (n=10, 71%), elevated ferritin (n=6, 43%), positive C-Reactive Protein (n=4, 28%) and deranged D-dimer (n=11, 78%) were noted. The Neutrophil to Lymphocyte ratio (NLR) was >3.3 in five (36%) children. Four (28%) had evidence of pneumonia on the chest radiograph. Oxygen therapy was needed in nine (64%) while two children (14%) required mechanical ventilation. There were two deaths (14%) in children with multiorgan dysfunction and refractory shock. Intravenous immunoglobulin and methylprednisolone were administered to one patient respectively (14%). The median hospital stay was 10 days (Interquartile range = 8). Conclusion Hospitalized children with Omicron variant of SARS-CoV-2 who have underlying comorbidities may have severe presentations needing ICU care. Mortality rates are low with appropriate ICU care.

15.
Res Pract Thromb Haemost ; 6(4): e12730, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35664536

RESUMO

D-dimer is a fragment of crosslinked fibrin resulting from plasmin cleavage of fibrin clots and hence an indirect biomarker of the hemostatic system activation. Early in the coronavirus disease 2019 (COVID-19) pandemic, several studies described coagulation disorders in affected patients, including high D-dimer levels. Consequently, D-dimer has been widely used in not-yet-approved indications. Ruling out pulmonary embolism and deep vein thrombosis in patients with low or intermediate clinical suspicion is the main application of D-dimer. D-dimer is also used to estimate the risk of venous thromboembolism recurrence and is included in the ISTH algorithm for the diagnosis of disseminated intravascular coagulation. Finally, numerous studies identified high D-dimer levels as a biomarker of poor prognosis in hospitalized patients with COVID-19. This report focuses on validated applications of D-dimer testing in patients with and without COVID-19.

16.
Vacunas ; 2022 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-35664924

RESUMO

Introduction: In December 2020, vaccination against SARS-CoV-2 started in Spain. Until March 2022, 91.1% of the target population was vaccinated. The objective of the study is to describe the characteristics of patients with SARS-CoV-2 infection, the risk of serious outcomes and their vaccination status. Material and methods: Retrospective longitudinal analytical observational study. Demographic characteristics and outcomes of COVID-19 infections and vaccination history from 01/01/2021-08/10/2021 were collected from electronic medical records and the Unified Vaccination Registry. Data analysis was performed with Excel and Stata 16. Results: 4161 COVID-19 cases were detected; of which 185 (4.5%) had received a complete vaccination schedule. The most affected age group was 80-89 years (34.1%). 1697 patients were hospitalized, of whom 78 (4.6%) had been vaccinated against SARS-CoV-2. No patient admitted to the ICU had a history of vaccination. The mean hospitalization time in unvaccinated patients was 11 days (95% CI -41.54-63.54) compared to 8.5 days (95% CI 7.04-9.96) in vaccinated patients. The relative risk of hospitalization in vaccinated patients compared to unvaccinated patients for the age group 40 to 59 years was 0.29 (95% CI 0.11-0.72) and 0.77 (95% CI 0.67-0). 0.90) for people over 60 years of age. Conclusions: The risk of hospitalization and death was lower in vaccinated patients compared to unvaccinated patients in the age groups 40-59 and older than 60 years. This finding supports current clinical evidence.


Introducción: En diciembre 2020 inició la vacunación frente al SARS-CoV-2 en España. Hasta principios de marzo 2022 el 91,1% de la población diana ha sido vacunada. El objetivo del estudio es describir las características de los pacientes con infección por SARS-CoV-2, el riesgo de desenlaces graves y el estado de vacunación. Material y métodos: Estudio observacional analítico longitudinal retrospectivo. Se recogieron características demográficas y desenlace de infecciones COVID-19 de casos confirmados y sus antecedentes de vacunación desde 01/01/2021­10/08/2021 de las historias clínicas electrónicas y del Registro Unificado de Vacunación. El análisis de datos se realizó con Excel y Stata 16. Resultados: Se detectaron 4161 casos COVID-19; 185 (4,5%) recibieron pauta de vacunación completa. El grupo de edad más afectado fue 80­89 años (34,1%). 1697 pacientes hospitalizaron, de los cuales 78 (4,6%) recibieron pauta de vacunación completa. Ningún paciente ingresado en UCI tenía antecedentes de vacunación. El tiempo medio de hospitalización en no vacunados fue de 11 días (IC95% -41,54-63,54) frente a 8,5 días (IC95% 7,04-9,96) en vacunados. El riesgo relativo de hospitalización en vacunados respecto a no vacunados para el grupo de edad de 40 a 59 años fue de 0,29 (IC95% 0,11-0,72) y de 0,77 (IC95% 0,67-0,90) para las personas de más de 60 años. Conclusiones: El riesgo de hospitalización y muerte fue menor en los pacientes vacunados en comparación con los no vacunados en los grupos de edad 40­59 y mayores de 60 años. Este hallazgo está de acuerdo con los datos de la evidencia clínica actual.

17.
Front Neurol ; 13: 882905, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35665037

RESUMO

Although SARS-CoV-2 causes a respiratory viral infection, there is a large incidence of neurological complications occurring in COVID-19 patients. These range from headaches and loss of smell to encephalitis and strokes. Little is known about the likely diverse mechanisms causing these pathologies and there is a dire need to understand how to prevent and treat them. This review explores recent research from the perspective of investigating how the immune system could play a role in neurological complications, including cytokines, blood biomarkers, immune cells, and autoantibodies. We also discuss lessons learnt from animal models. Overall, we highlight two key points that have emerged from increasing evidence: (1) SARS-CoV-2 does not invade the brain in the majority of cases and so the associated neurological complications might arise from indirect effects, such as immune activation (2) although the immune system plays a critical role in controlling the virus, its dysregulation can cause pathology.

18.
Int J Nephrol ; 2022: 3773625, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35665075

RESUMO

Background: The SARS-CoV-2 virus caused the global COVID-19 pandemic, with waxing and waning course. This study was conducted to compare outcomes in the first two waves, in mechanically ventilated patients. Methods: This retrospective observational study included all mechanically ventilated COVID-19 patients above 18 years of age, between March 2020 and January 2021. Patients were grouped into first wave from March 2020 to July 2020, and second wave from August 2020 to January 2021. Outcome measures were mortality, the development of acute kidney injury (AKI), and need for renal replacement therapy (RRT). Univariate and multivariate cox regression analysis were used to delineate risk factors for the outcome measures. Results: A total of 426 patients, 285 in the first wave and 185 in the second wave, were included. The incidence of AKI was significantly lower in the second wave (72% vs. 63%; p=0.04). There was no significant difference in mortality (70% vs. 63%; p=0.16) and need for RRT (36% vs. 30%; p=0.1). Risk factors for mortality were increasing age and AKI in both waves, and chronic kidney disease (CKD) (adj. HR 1.7; 95% CI 1.02-2.68; p=0.04) in the second wave. Risk factors for AKI were CKD in both the waves, while it was diabetes (adj. HR 1.4; 95% CI 1.02-1.95; p=0.04) and increasing age in the first wave. Remdesivir (adj. HR 0.5; 95% CI 0.3-0.7; p < 0.01) decreased the risk of AKI, and convalescent plasma (adj. HR 0.5; 95% CI 0.3-0.9; p=0.02) decreased the risk of mortality in the first wave, however, such benefit was not observed in the second wave. Conclusions: Our study shows a decrease in the incidence of AKI in critically ill patients, however, the reason for this decrease is still unknown. Studies comparing the waves of the pandemic would not only help in understanding disease evolution but also to develop tailored management strategies.

19.
Front Med (Lausanne) ; 9: 879996, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35665342

RESUMO

Introduction: Gastrointestinal symptoms are common among COVID-19 patients. Although gastrointestinal involvements are mostly benign, they rarely indicate a severe pathology like intestinal ischemia. The present case series describes 21 patients with bowel ischemia, necrosis, or perforation. Methods: The present case series was conducted from April 2020 to February 2022 in the surgical wards of two Iranian hospitals. We retrospectively included adult patients with concomitant COVID-19 and intestinal ischemia. Primary outcomes were defined as the length of stay and survival. Results: Twenty-four patients with a median age of 61.5 years were included in the study. Sixteen (67%) patients were male, and 13 (54%) were without any comorbidities. Macrovascular mesenteric ischemia was not identified in 21 patients (87.5%). Gastrointestinal manifestations appeared on the median of seven days (range 2-21) after the diagnosis of COVID-19, with the most common symptom being abdominal pain. All the patients had a significantly elevated C-Reactive Protein prior to surgery, ranging from 68 to 362. D-dimer was measured in eight patients and was significantly elevated, ranging from 1,878 to over 5,000 ng/mL. One patient was managed conservatively due to a good clinical condition. Except for one patient with angioinvasive mucormycosis and one other with leukocytoclastic vasculitis, pathologic evaluation revealed general features of intestinal necrosis, including ulcer, hemorrhage, necrosis, neutrophilic infiltration (in seven patients), neutrophilic abscess (in four patients), and edema. Bowel necrosis accompanied mortality of 15 (62.5%) patients and a median of 6.5 days of hospital stay. Conclusion: Intestinal ischemia in COVID-19 patients is associated with a high mortality rate. Further research is needed to elucidate the dynamics of intestinal ischemia in the setting of COVID-19.

20.
J Surg Case Rep ; 2022(5): rjac250, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35665401

RESUMO

Intrapleural foreign body is an unusual complication. It most commonly occurs after the trauma but has been rarely seen after diagnostic or therapeutic procedures. We hereby, present an unusual occurrence of a retained guidewire after a chest drain insertion using a Seldinger technique in a patient with coronavirus disease of 2019 pneumonitis. Surgical removal of the guidewire has prevented this foreign body to cause further harm. We further discuss how to identify and prevent such a complication.

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