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Delafiori J, Siciliano RF, de Oliveira AN, Nicolau JC, Sales GM, Dalçóquio TF, Busanello ENB, Eguti A, de Oliveira DN, Bertolin AJ, Dos Santos LA, Salsoso R, Marcondes-Braga FG, Durán N, Júnior MWP, Sabino EC, Reis LO, Fávaro WJ, Catharino RR. Comparing plasma and skin imprint metabolic profiles in COVID-19 diagnosis and severity assessment. J Mol Med (Berl) 2024; 102:183-195. [PMID: 38010437 DOI: 10.1007/s00109-023-02396-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/29/2023]
Abstract
As SARS-CoV-2 continues to produce new variants, the demand for diagnostics and a better understanding of COVID-19 remain key topics in healthcare. Skin manifestations have been widely reported in cases of COVID-19, but the mechanisms and markers of these symptoms are poorly described. In this cross-sectional study, 101 patients (64 COVID-19 positive patients and 37 controls) were enrolled between April and June 2020, during the first wave of COVID-19, in São Paulo, Brazil. Enrolled patients had skin imprints sampled non-invasively using silica plates; plasma samples were also collected. Samples were used for untargeted lipidomics/metabolomics through high-resolution mass spectrometry. We identified 558 molecular ions, with lipids comprising most of them. We found 245 plasma ions that were significant for COVID-19 diagnosis, compared to 61 from the skin imprints. Plasma samples outperformed skin imprints in distinguishing patients with COVID-19 from controls, with F1-scores of 91.9% and 84.3%, respectively. Skin imprints were excellent for assessing disease severity, exhibiting an F1-score of 93.5% when discriminating between patient hospitalization and home care statuses. Specifically, oleamide and linoleamide were the most discriminative biomarkers for identifying hospitalized patients through skin imprinting, and palmitic amides and N-acylethanolamine 18:0 were also identified as significant biomarkers. These observations underscore the importance of primary fatty acid amides and N-acylethanolamines in immunomodulatory processes and metabolic disorders. These findings confirm the potential utility of skin imprinting as a valuable non-invasive sampling method for COVID-19 screening; a method that may also be applied in the evaluation of other medical conditions. KEY MESSAGES: Skin imprints complement plasma in disease metabolomics. The annotated markers have a role in immunomodulation and metabolic diseases. Skin imprints outperformed plasma samples at assessing disease severity. Skin imprints have potential as non-invasive sampling strategy for COVID-19.
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Affiliation(s)
- Jeany Delafiori
- Innovare Biomarkers Laboratory, Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil - Rua Cinco de Junho, 350 - 13083-970 - Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Rinaldo Focaccia Siciliano
- Clinical Division of Infectious and Parasitic Diseases, University of São Paulo Medical School, São Paulo, Brazil - Av. Dr. Arnaldo, 455 - 01246-903 - Cerqueira César, São Paulo, SP, Brazil
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil - Av. Dr. Enéas de Carvalho Aguiar, 44 - 05403-900 - Cerqueira César, São Paulo, SP, Brazil
| | - Arthur Noin de Oliveira
- Innovare Biomarkers Laboratory, Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil - Rua Cinco de Junho, 350 - 13083-970 - Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - José Carlos Nicolau
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil - Av. Dr. Enéas de Carvalho Aguiar, 44 - 05403-900 - Cerqueira César, São Paulo, SP, Brazil
| | - Geovana Manzan Sales
- Innovare Biomarkers Laboratory, Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil - Rua Cinco de Junho, 350 - 13083-970 - Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Talia Falcão Dalçóquio
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil - Av. Dr. Enéas de Carvalho Aguiar, 44 - 05403-900 - Cerqueira César, São Paulo, SP, Brazil
| | - Estela Natacha Brandt Busanello
- Innovare Biomarkers Laboratory, Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil - Rua Cinco de Junho, 350 - 13083-970 - Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Adriana Eguti
- Sumaré State Hospital, Sumaré, Brazil - Av. da Amizade, 2400 - 13175-490 - Jardim Bela Vista, Sumaré, SP, Brazil
| | - Diogo Noin de Oliveira
- Innovare Biomarkers Laboratory, Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil - Rua Cinco de Junho, 350 - 13083-970 - Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Adriadne Justi Bertolin
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil - Av. Dr. Enéas de Carvalho Aguiar, 44 - 05403-900 - Cerqueira César, São Paulo, SP, Brazil
| | - Luiz Augusto Dos Santos
- Paulínia Municipal Hospital, Paulínia, Brazil - Rua Miguel Vicente Cury, 100 - 13140-000 - Nova Paulínia, Paulínia, SP, Brazil
| | - Rocío Salsoso
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil - Av. Dr. Enéas de Carvalho Aguiar, 44 - 05403-900 - Cerqueira César, São Paulo, SP, Brazil
| | - Fabiana G Marcondes-Braga
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil - Av. Dr. Enéas de Carvalho Aguiar, 44 - 05403-900 - Cerqueira César, São Paulo, SP, Brazil
| | - Nelson Durán
- Laboratory of Urogenital Carcinogenesis and Immunotherapy, University of Campinas, Campinas, Brazil - Av. Bertrand Russel, s/n - 13083-865 - Cidade Universitária Zeferino Vaz, Campina, SP, Brazil
| | | | - Ester Cerdeira Sabino
- Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil - Avenida Dr. Enéas Carvalho de Aguiar, 470 - 05403-000 - Cerqueira César, São Paulo, SP, Brazil
| | - Leonardo Oliveira Reis
- UroScience Laboratory, University of Campinas, Campinas, Brazil - Rua Tessália Vieira de Camargo, 126 - 13083-887 - Cidade, Universitária Zeferino Vaz, Campinas, SP, Brazil
- Center for Life Sciences, Pontifical Catholic University of Campinas, PUC-Campinas, Brazil - Av. John Boyd Dunlop, s/n - 13060-904 - Jd. Ipaussurama, Campinas, SP, Brazil
| | - Wagner José Fávaro
- Laboratory of Urogenital Carcinogenesis and Immunotherapy, University of Campinas, Campinas, Brazil - Av. Bertrand Russel, s/n - 13083-865 - Cidade Universitária Zeferino Vaz, Campina, SP, Brazil
| | - Rodrigo Ramos Catharino
- Innovare Biomarkers Laboratory, Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, Brazil - Rua Cinco de Junho, 350 - 13083-970 - Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil.
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Ghosh A, Sanyal A, Mitra P, Dey T, Acharjee A, Pattnaik R, Nesa L. Transmission mechanism and clinical manifestations of SARS-CoV-2. DIAGNOSIS AND ANALYSIS OF COVID-19 USING ARTIFICIAL INTELLIGENCE AND MACHINE LEARNING-BASED TECHNIQUES 2024:65-96. [DOI: 10.1016/b978-0-323-95374-0.00006-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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Russotto Y, Micali C, Marino A, Ceccarelli M, Caci G, Rullo E, Nunnari G. COVID‑19 infection and severe autoimmune haemolytic anaemia: A case report and review of the literature. WORLD ACADEMY OF SCIENCES JOURNAL 2023; 5:31. [DOI: 10.3892/wasj.2023.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Affiliation(s)
- Ylenia Russotto
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ‘Gaetano Martino’ Hospital, University of Messina, I‑98100 Messina, Italy
| | - Cristina Micali
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ‘Gaetano Martino’ Hospital, University of Messina, I‑98100 Messina, Italy
| | - Andrea Marino
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ARNAS Garibaldi Nesima Hospital, University of Catania, I‑95123 Catania, Italy
| | - Manuela Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ‘Gaetano Martino’ Hospital, University of Messina, I‑98100 Messina, Italy
| | - Grazia Caci
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ‘Gaetano Martino’ Hospital, University of Messina, I‑98100 Messina, Italy
| | - Emmanuele Rullo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ‘Gaetano Martino’ Hospital, University of Messina, I‑98100 Messina, Italy
| | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, ‘Gaetano Martino’ Hospital, University of Messina, I‑98100 Messina, Italy
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Zhang J, Luo D, Kang M, Li B, Su S. Clinical characteristics and short-term outcomes of acute pancreatitis among patients with COVID-19. Eur J Med Res 2023; 28:283. [PMID: 37582798 PMCID: PMC10428649 DOI: 10.1186/s40001-023-01252-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/29/2023] [Indexed: 08/17/2023] Open
Abstract
OBJECTIVE The existing literature on the combination of acute pancreatitis (AP) and COVID-19 is scarce. The objective of our study is to compare the clinical outcomes and occurrence of long COVID syndrome in AP patients with and without COVID-19, while investigating the potential impact of COVID-19 on the severity, mortality rate, and long COVID syndrome in these patients. METHODS This retrospective, observational study was conducted at a single center. It included patients aged 18 years and above who were diagnosed with AP during the pandemic. Patients were categorized into two groups based on the results of RT-qPCR testing: the SARS-CoV-2-positive group and the SARS-CoV-2-negative group. The study aimed to compare the severity of AP, mortality rate, and occurrence of long COVID syndrome between these two groups. RESULT A retrospective review was conducted on 122 patients diagnosed with acute pancreatitis between December 1, 2022, and January 31, 2023. Out of these patients, 100 were included in the study. The analysis revealed no significant differences in mortality rate, severity, and sequelae between AP patients with COVID-19 and those without COVID-19 (p > 0.005). However, a statistically significant difference was observed in the occurrence of long COVID syndrome, specifically in the presence of cough (p = 0.04). CONCLUSION This study demonstrates that the presence of COVID-19 in patients with pancreatitis does not lead to an increase in the mortality and severity rate of pancreatitis.
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Affiliation(s)
- Jinchang Zhang
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - De Luo
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Maoji Kang
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Bo Li
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Song Su
- Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
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Li J, Wen W, Mu Z, Du X, Han X. Prevalence of cutaneous manifestations in COVID-19: A meta-analysis. J Dermatol 2023; 50:622-636. [PMID: 36540031 PMCID: PMC9878074 DOI: 10.1111/1346-8138.16672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/31/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022]
Abstract
The global epidemic of coronavirus disease 2019 (COVID-19) endangers more and more people. Many studies on cutaneous manifestations related to COVID-19 have emerged, but their prevalence has varied widely. The objective of this study was to conduct a meta-analysis estimating the prevalence of skin manifestations in COVID-19. Four databases PubMed, Web of Science, CBM, and CNKI were searched, and the results were screened by two reviewers. A random-effects model was used to evaluate the overall prevalence. Heterogeneity was assessed by I2 . Further subgroup analyses were conducted by region, sample size, sex, age, and severity of COVID-19. A funnel plot and Egger's test were performed to assess publication bias. The pooled prevalence of cutaneous manifestation of 61 089 patients in 33 studies was 5.6% (95% confidence intervals [CI] = 0.040-0.076, I2 = 98.3%). Severity of COVID-19 was probably the source of heterogeneity. Studies with sample size <200 report higher prevalence estimates (10.2%). The prevalence of detailed types was as follows: maculopapular rash 2%, livedoid lesions 1.4%, petechial lesions 1.1%, urticaria 0.8%, pernio-like lesions 0.5%, vesicular lesions 0.3%. Petechial lesions and livedoid lesions contain a higher proportion of severe patients than other skin manifestations. The prevalence rates of pernio-like lesions, urticaria and petechial lesions vary greatly in different regions.
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Affiliation(s)
- Jingmin Li
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
| | - Weijing Wen
- Department of Emergency Medical CenterFirst Affiliated Hospital of Shanxi Medical UniversityShanxiChina
| | - Zhenzhen Mu
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
| | - Xuefei Du
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
| | - Xiuping Han
- Department of Dermatology, Shengjing HospitalChina Medical UniversityShenyangChina
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Parsa SM, Norozpour F, Elsheikh AH, Kabeel AE. Solar desalination/purification (solar stills, humidification-dehumidification, solar disinfection) in high altitude during COVID19: Insights of gastrointestinal manifestations and systems' mechanism. JOURNAL OF HAZARDOUS MATERIALS ADVANCES 2023; 10:100259. [PMID: 36816517 PMCID: PMC9927827 DOI: 10.1016/j.hazadv.2023.100259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
From the starting of the pandemic different transmission routes of the pathogen was brought into the spotlight by researchers from different disciplines. This matter in high-altitudes was more boosted as the main parameters were not exactly realized. In this review we are about to highlight the possibility of consuming contaminated water generated form solar water desalination/disinfection systems in highlands. Three systems including solar still, solar disinfection (which experimented by the authors in 2019 in high altitude) and humidification-dehumidification were consider in this context. Ascribe to the risks of pathogens transmission in solar desalination/disinfection systems where the water resources are heavily polluted in every corner of the world, highlighting the risk of consuming water in high-altitude where there are many other parameters associated with spread of pathogen is of great importance. As it was reported, reliability of solar desalination and solar water disinfections systems against contaminated water by the novel coronavirus remained on the question because the virus can be transmitted by vapor in solar stills due to tiny particle size (60-140 nm) and would not be killed by solar disinfections due to low-temperature of operation <40 °C while for HDH contamination of both water and air by sars-cov-2 could be a concern. Although the SARS-CoV-2 is not a waterborne pathogen, its capability to replicate in stomach and infection of gastrointestinal glandular suggested the potential of transmission via fecal-oral. Eventually, it was concluded that using solar-based water treatment as drinking water in high altitude regions should be cautiously consider and recommendations and considerations are presented. Importantly, this critical review not only about the ongoing pandemic, but it aims is to highlight the importance of produced drinking water by systems for future epidemic/pandemic to prevent spread and entering a pathogen particularly in high-altitude regions via a new routes.
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Affiliation(s)
- Seyed Masoud Parsa
- Centre for Technology in Water and Wastewater, School of Civil and Environmental Engineering, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Fatemeh Norozpour
- Department of Environmental Engineering, Faculty of Marine Science and Technology, Islamic Azad University, North Tehran Branch, Tehran, Iran
| | - Ammar H Elsheikh
- Department of Production Engineering and Mechanical Design, Tanta University, Tanta, Egypt
| | - A E Kabeel
- Mechanical Power Engineering Department, Faculty of Engineering, Tanta University, Tanta, Egypt
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De Vito A, Colpani A, Trunfio M, Fiore V, Moi G, Fois M, Leoni N, Ruiu S, Babudieri S, Calcagno A, Madeddu G. Living with HIV and Getting Vaccinated: A Narrative Review. Vaccines (Basel) 2023; 11:896. [PMID: 37243000 PMCID: PMC10220625 DOI: 10.3390/vaccines11050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/21/2023] [Accepted: 04/23/2023] [Indexed: 05/28/2023] Open
Abstract
After 40 years of its appearance, human immunodeficiency virus (HIV) infection remains a leading public health challenge worldwide. Since the introduction of antiretroviral treatment (ART), HIV infection has become a chronic condition, and people living with HIV could have life expectancies close to those of the general population. People with HIV often have an increased risk of infection or experience more severe morbidity following exposure to vaccine-preventable diseases. Nowadays, several vaccines are available against bacteria and viruses. However, national and international vaccination guidelines for people with HIV are heterogeneous, and not every vaccine is included. For these reasons, we aimed to perform a narrative review about the vaccinations available for adults living with HIV, reporting the most updated studies performed for each vaccine among this population. We performed a comprehensive literature search through electronic databases (Pubmed-MEDLINE and Embase) and search engines (Google Scholar). We included English peer-reviewed publications (articles and reviews) on HIV and vaccination. Despite widespread use and guideline recommendations, few vaccine trials have been conducted in people with HIV. In addition, not all vaccines are recommended for people with HIV, especially for those with low CD4 cells count. Clinicians should carefully collect the history of vaccinations and patients' acceptance and preferences and regularly check the presence of antibodies for vaccine-preventable pathogens.
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Affiliation(s)
- Andrea De Vito
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Agnese Colpani
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Mattia Trunfio
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, 10149 Torino, Italy
| | - Vito Fiore
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Giulia Moi
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Marco Fois
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Nicola Leoni
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Stefano Ruiu
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Sergio Babudieri
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, 10149 Torino, Italy
| | - Giordano Madeddu
- Unit of Infectious Diseases, Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy; (A.C.); (G.M.)
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Marzano AV, Moltrasio C, Genovese G, De Andrea M, Caneparo V, Vezzoli P, Morotti D, Sena P, Venturini M, Battocchio S, Caputo V, Rizzo N, Maronese CA, Venegoni L, Boggio FL, Rongioletti F, Calzavara-Pinton P, Berti E. SARS-CoV-2 Detection by Digital Polymerase Chain Reaction and Immunohistochemistry in Skin Biopsies from 52 Patients with Different COVID-19-Associated Cutaneous Phenotypes. Dermatology 2023; 239:584-591. [PMID: 37075721 DOI: 10.1159/000530746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND COronaVIrus Disease 19 (COVID-19) is associated with a wide spectrum of skin manifestations, but SARS-CoV-2 RNA in lesional skin has been demonstrated only in few cases. OBJECTIVE The objective of this study was to demonstrate SARS-CoV-2 presence in skin samples from patients with different COVID-19-related cutaneous phenotypes. METHODS Demographic and clinical data from 52 patients with COVID-19-associated cutaneous manifestations were collected. Immunohistochemistry and digital PCR (dPCR) were performed in all skin samples. RNA in situ hybridization (ISH) was used to confirm the presence of SARS-CoV-2 RNA. RESULTS Twenty out of 52 (38%) patients presented SARS-CoV-2 positivity in the skin. Among these, 10/52 (19%) patients tested positive for spike protein on immunohistochemistry, five of whom had also positive testing on dPCR. Of the latter, one tested positive both for ISH and ACE-2 on immunohistochemistry while another one tested positive for nucleocapsid protein. Twelve patients showed positivity only for nucleocapsid protein on immunohistochemistry. CONCLUSIONS SARS-CoV-2 was detected only in 38% of patients, without any association with a specific cutaneous phenotype, suggesting that the pathophysiology of cutaneous lesions mostly depends on the activation of the immune system. The combination of spike and nucleocapsid immunohistochemistry has higher diagnostic yield than dPCR. Skin persistence of SARS-CoV-2 may depend on timing of skin lesions, viral load, and immune response.
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Affiliation(s)
- Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco De Andrea
- Department of Public Health and Pediatrics, University of Turin, Medical School, Turin, Italy
- CAAD Center for Translational Research on Autoimmune and Allergic Disease, Novara Medical School, Novara, Italy
| | - Valeria Caneparo
- CAAD Center for Translational Research on Autoimmune and Allergic Disease, Novara Medical School, Novara, Italy
| | - Pamela Vezzoli
- Dermatology Unit ASST, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Denise Morotti
- Pathology Unit and Medical Genetics Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Paolo Sena
- Dermatology Unit ASST, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marina Venturini
- Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | | | - Valentina Caputo
- Unit of Pathology, Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Nathalie Rizzo
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Luigia Venegoni
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Francesca Laura Boggio
- Division of Pathology, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Franco Rongioletti
- Department of Medical Sciences and Public Health, Dermatology Clinic, University of Cagliari, Cagliari, Italy
- Vita-Salute University and Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele, Milan, Italy
| | | | - Emilio Berti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Figueiredo ERL, Affonso MVDG, Jacomel RJ, Gomes FDC, Gonçalves NV, Miranda CDSC, da Silva MCF, da Silva-Júnior AF, de Melo-Neto JS. COVID-19 in the Eastern Brazilian Amazon: Incidence, Clinical Management, and Mortality by Social Determinants of Health, Symptomatology, and Comorbidities in the Xingu Health Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4639. [PMID: 36901646 PMCID: PMC10002208 DOI: 10.3390/ijerph20054639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 06/18/2023]
Abstract
This study aims to investigate the relationship between social determinants of health (SDH), incidence, and mortality to verify which sociodemographic factors, symptoms, and comorbidities predict clinical management; second, this study aims to conduct a survival analysis of individuals with COVID-19 in the Xingu Health Region. Consequently, this study adopted an ecological framework, employing secondary data of COVID-19-positive individuals from the Xingu Health Region, Pará State, Brazil. The data were obtained through the database of the State of Pará Public Health Secretary (SESPA) for the period from March 2020 to March 2021. The incidence and mortality were higher in Vitória do Xingu and Altamira. Municipalities with a higher percentage of citizens with health insurance and higher public health expenditure showed a higher incidence and mortality. A higher gross domestic product was associated with a higher incidence. Females were found to be associated with better clinical management. To live in Altamira was a risk factor for intensive care unit admission. The symptoms and comorbidities that predicted worse clinical management were dyspnea, fever, emesis, chills, diabetes, cardiac and renal diseases, obesity, and neurological diseases. There were higher incidence, mortality, and lower survival rates among the elderly. Thus, it can be concluded that SDH indicators, symptomatology, and comorbidities have implications for the incidence, mortality, and clinical management of COVID-19 in the Xingu Health Region of eastern Amazonia, Brazil.
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Affiliation(s)
| | | | | | - Fabiana de Campos Gomes
- Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, Brazil
| | - Nelson Veiga Gonçalves
- Laboratory of Epidemiology and Geoprocessing of Amazon, University of the state of Pará (UEPA), Belem 66050-540, Brazil
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Danarti R, Limantara NV, Rini DLU, Budiarso A, Febriana SA, Soebono H. Cutaneous Manifestation in COVID-19: A Lesson Over 2 Years Into the Pandemic. Clin Med Res 2023; 21:36-45. [PMID: 37130789 PMCID: PMC10153677 DOI: 10.3121/cmr.2023.1598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/26/2020] [Accepted: 02/21/2023] [Indexed: 05/04/2023]
Abstract
Cutaneous manifestations related to Coronavirus Disease-19 (COVID-19) have been reported over 2 years since the pandemic began. This research aimed to review articles published in English that describe cutaneous manifestations related to COVID-19/SARS-CoV-2. A data search for case reports, original studies, and review articles from the onset of the current COVID-19 pandemic to December 31, 2022, was performed using PUBMED, Cochrane Library, ResearchGate, and Google search engines. Keywords were "coronavirus", "novel coronavirus 2019", "COVID-19", "SARS-CoV-2", and "2019-nCoV" in combination with "cutaneous", "skin" and "dermatology" The extracted data included authors, region, sex, age, number of participants with skin signs, cutaneous signs, its location, symptoms, extracutaneous/associated symptoms, suspected or confirmed status for COVID-19, timeline, and healing duration. Six authors independently reviewed the abstracts and full-texts to identify publications providing these details concerning cutaneous manifestations related to COVID-19. A total of 139 publications with full text (122 case reports, 10 case series, and 7 review articles) that reported cutaneous manifestations were identified, and reviewed from 5 continents. The most common cutaneous manifestations of COVID-19 were maculopapular, followed by chilblain-like lesion, urticarial, livedoid/necrotic, vesicular, and other/non-descript rashes/skin lesions. After 2 years into the COVID-19 pandemic, we can conclude that there is no pathognomonic cutaneous manifestation of COVID-19, since it can be also found in other viral infections.
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Affiliation(s)
- Retno Danarti
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Gedung Radiopoetro lantai 3, Jalan Farmako Sekip, Yogyakarta 55281 Indonesia
| | - Nikko Vanda Limantara
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Gedung Radiopoetro lantai 3, Jalan Farmako Sekip, Yogyakarta 55281 Indonesia
| | - Dionisia Lintang Unggul Rini
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Gedung Radiopoetro lantai 3, Jalan Farmako Sekip, Yogyakarta 55281 Indonesia
| | - Aries Budiarso
- Setjonegoro District Hospital, Jalan Setjonegoro No. 1, Wonosobo 56311 Indonesia
| | - Sri Awalia Febriana
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Gedung Radiopoetro lantai 3, Jalan Farmako Sekip, Yogyakarta 55281 Indonesia
| | - Hardyanto Soebono
- Department of Dermatology and Venereology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Gedung Radiopoetro lantai 3, Jalan Farmako Sekip, Yogyakarta 55281 Indonesia
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11
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Shoupe D. Reproductive Effects of COVID-19: A Journey Through COVID-19 Pathogenesis. HANDBOOK OF GYNECOLOGY 2023:103-109. [DOI: 10.1007/978-3-031-14881-1_97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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12
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De Vito A, Colpani A, Saderi L, Puci M, Zauli B, Fiore V, Fois M, Meloni MC, Bitti A, Di Castri C, Maida I, Babudieri S, Sotgiu G, Madeddu G. Impact of Early SARS-CoV-2 Antiviral Therapy on Disease Progression. Viruses 2022; 15:71. [PMID: 36680111 PMCID: PMC9865563 DOI: 10.3390/v15010071] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Since the start of the SARS-CoV-2 pandemic, several treatments have been proposed to prevent the progression of the disease. Currently, three antiviral (molnupiravir, nirmaltrevir/r, remdesivir) and two monoclonal antibodies (casirivimab/imdevimab and sotrovimab) are available in Italy. Therefore, we aimed to evaluate the presence of risk factors associated with disease progression. We conducted a retrospective cohort study, including all patients with a confirmed diagnosis of SARS-CoV-2 evaluated between 01/01/2022 ad 10/05/2022 by our Unit of Infectious Diseases in Sassari. We defined disease progression as the necessity of starting O2 therapy. According to AIFA (Italian Medicines Agency) indications, preventive treatment was prescribed in patients with recent symptoms onset (≤five days), no need for oxygen supplementation, and risk factors for disease progression. Subgroup differences in quantitative variables were evaluated using Student's t-test. Pearson chi-square or Fisher's exact tests were used to assess differences for qualitative variables. Multivariate logistic regression modelling was performed to determine factors associated with progression. A two-tailed p-value less than 0.05 was considered statistically significant. All statistical analyses were performed with STATA version 17 (StataCorp, College Station, TX, USA). We included 1145 people with SARS-CoV-2 diagnosis, of which 336 (29.3%) developed severe disease with oxygen supplementation. In multivariate logistic regression analysis, age, dementia, haematologic tumors, heart failure, dyspnoea or fever at first evaluation, having ground glass opacities or consolidation at the first CT scan, and bacteria coinfection were associated with an increased risk of disease progression. Vaccination (at least two doses) and early treatment with antiviral or monoclonal antibodies were associated with a lower risk of disease progression. In conclusion, our study showed that vaccination and early treatment with antiviral and/or monoclonal antibodies significantly reduce the risk of disease progression.
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Affiliation(s)
- Andrea De Vito
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Agnese Colpani
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Laura Saderi
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Mariangela Puci
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Beatrice Zauli
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Vito Fiore
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Marco Fois
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Maria Chiara Meloni
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Alessandra Bitti
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Cosimo Di Castri
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Ivana Maida
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Sergio Babudieri
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giordano Madeddu
- Unit of Infectious Disease, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
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13
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Boeriu A, Roman A, Dobru D, Stoian M, Voidăzan S, Fofiu C. The Impact of Clostridioides Difficile Infection in Hospitalized Patients: What Changed during the Pandemic? Diagnostics (Basel) 2022; 12:3196. [PMID: 36553203 PMCID: PMC9778033 DOI: 10.3390/diagnostics12123196] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/03/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: Clostridioides difficile (C. difficile) and SARS-CoV-2 coronavirus represent significant health threats. Our study focused on the impact of concurrent infections on patient outcomes against the backdrop of changes imposed by the pandemic. (2) Materials and methods. We performed a retrospective analysis and included patients diagnosed with CDI who were admitted in our hospital before and during the pandemic. We compared patient exposure to risk factors for CDI in both groups and patient negative outcomes: need for ICU care, prolonged hospitalization, organ failure, toxic megacolon, and death. (3) Results. Overall, 188 patients were included, of which 100 had CDI (the pre-pandemic group), and 88 patients presented both CDI and COVID-19 (the pandemic group). Patients in the pandemic group were significantly older, with a higher Charlson Comorbidity Index (CCI) and a greater exposure to antibiotics and corticosteroids, and were more likely to develop organ dysfunction, to require ICU care and have prolonged hospitalization. The severity of COVID-19, leukocytosis and increased D-dimer levels were indicators of poor prognosis in the pandemic group. Higher CCI scores and leukocytosis increased the risk for negative outcomes in CDI alone patients. (4) Conclusions. The study highlights the negative impact of associated infections on patient outcome. The severity of COVID-19 directly influences the prognosis of patients with concurrent infections.
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Affiliation(s)
- Alina Boeriu
- Gastroenterology Department, University of Medicine Pharmacy, Sciences, and Technology “George Emil Palade” Targu Mures, 540142 Targu Mures, Romania
- Gastroenterology Department, Mureș County Clinical Hospital, 540103 Targu Mures, Romania
| | - Adina Roman
- Gastroenterology Department, University of Medicine Pharmacy, Sciences, and Technology “George Emil Palade” Targu Mures, 540142 Targu Mures, Romania
- Gastroenterology Department, Mureș County Clinical Hospital, 540103 Targu Mures, Romania
| | - Daniela Dobru
- Gastroenterology Department, University of Medicine Pharmacy, Sciences, and Technology “George Emil Palade” Targu Mures, 540142 Targu Mures, Romania
- Gastroenterology Department, Mureș County Clinical Hospital, 540103 Targu Mures, Romania
| | - Mircea Stoian
- Intensive Care Unit Department, University of Medicine Pharmacy, Sciences, and Technology “George Emil Palade” Targu Mures, 540142 Targu Mures, Romania
- Intensive Care Unit Department, Mureș County Clinical Hospital, 540103 Targu Mures, Romania
| | - Septimiu Voidăzan
- Epidemiology Department, University of Medicine Pharmacy, Sciences, and Technology “George Emil Palade” Targu Mures, 540142 Targu Mures, Romania
| | - Crina Fofiu
- Gastroenterology Department, University of Medicine Pharmacy, Sciences, and Technology “George Emil Palade” Targu Mures, 540142 Targu Mures, Romania
- Internal Medicine Department, Bistrița County Hospital, 420094 Bistrița, Romania
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14
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Russotto Y, Micali C, Calabrese V, Nunnari G, Rullo E, Semproni C. Delirium during COVID‑19: A report of eight cases and a review of the literature. WORLD ACADEMY OF SCIENCES JOURNAL 2022; 5:1. [DOI: 10.3892/wasj.2022.178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Affiliation(s)
- Ylenia Russotto
- Unit of Infectious Diseases, University of Messina, I-98124 Messina, Italy
| | - Cristina Micali
- Unit of Infectious Diseases, University of Messina, I-98124 Messina, Italy
| | - Vincenzo Calabrese
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, I-98124 Messina, Italy
| | - Giuseppe Nunnari
- Unit of Infectious Diseases, University of Messina, I-98124 Messina, Italy
| | - Emmanuele Rullo
- Unit of Infectious Diseases, University of Messina, I-98124 Messina, Italy
| | - Camilla Semproni
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, I-98124 Messina, Italy
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15
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Garibaldi BT, Chisolm MS, Berkenblit GV, Feller-Kopman D, Stephens RS, Stewart RW, Wright SM. Review of the published literature to characterise clinical excellence in COVID-19 care. Postgrad Med J 2022; 98:880-886. [PMID: 37063034 DOI: 10.1136/postgradmedj-2021-140002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 11/04/2022]
Abstract
COVID-19 continues to be a major source of global morbidity and mortality. It abruptly stressed healthcare systems early in 2020 and the pressures continue. Devastating hardships have been endured by individuals, families and communities; the losses will be felt for years to come. As healthcare professionals and organisations stepped up to respond to the overwhelming number of cases, it is understandable that the focus has been primarily on coping with the quantity of the demand. During a pandemic, it is not surprising that few papers have drawn attention to the quality of the care delivered to those afflicted with illness. Despite the challenges, clinicians caring for patients with COVID-19 have risen to the occasion. This manuscript highlights aspirational examples from the published literature of thoughtful and superb care of patients with COVID-19 using an established framework for clinical excellence (formulated by the Miller-Coulson Academy of Clinical Excellence).
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Affiliation(s)
- Brian T Garibaldi
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Margaret S Chisolm
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gail V Berkenblit
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Feller-Kopman
- Section of Pulmonary and Critical Care Medicine, Dartmouth-Hitchcock Medical Center, Hancock, New Hampshire, USA
| | - R Scott Stephens
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rosalyn W Stewart
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Scott M Wright
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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16
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Sonkar C, Hase V, Banerjee D, Kumar A, Kumar R, Jha HC. Post COVID-19 complications, adjunct therapy explored, and steroidal after effects. CAN J CHEM 2022; 100:459-474. [DOI: 10.1139/cjc-2021-0247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Abstract
For COVID-19 survivors, defeating the virus is just the beginning of a long road to recovery. The inducibility and catastrophic effects of the virus are distributed across multiple organs. The induction of cytokine storms in COVID-19 patients is due to the interaction of the SARS-CoV-2 virus and the host receptor, leading to various immunopathological consequences that may eventually lead to death. So far, COVID-19 has affected tons of people across the world, but there is still no effective treatment. Patients facing complications of COVID-19 after recovery have shown extensive clinical symptoms similar to that of patients recovering from previously circulating coronaviruses. Previous knowledge and literature have opened up ways to treat this disease and manage post-COVID-19 complications, which pose a severe challenge to the health system globally and may exacerbate the fragmentation of diseases. The use of steroids as a treatment has resulted in various health problems and side-effects in COVID-19 patients. This review discusses various post-COVID-19 complications observed and adjunctive therapies used along with common COVID-19 treatment and spotlights their side effects and consequences. This review provides the latest literature on COVID-19, which emphasizes the subsequent complications in various organs, side effects of drugs, and alternative regimens used to treat COVID-19.
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Affiliation(s)
- Charu Sonkar
- Department of Biosciences and Biomedical Engineering (BSBE), Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
| | - Vaishnavi Hase
- School of Biotechnology and Bioinformatics, D.Y. Patil Deemed to be University, Navi Mumbai 400614, India
| | - Durba Banerjee
- School of Biotechnology (SOB), Gautam Buddha University (Delhi NCR), Yamuna Expressway, Gautam Buddha Nagar, Greater Noida, Uttar Pradesh 201312, India
| | - Awanish Kumar
- Department of Biotechnology, National Institute of Technology, Raipur 492010, India
| | - Rajesh Kumar
- Department of Physics, Indian Institute of Technology, Indore 453552, India
| | - Hem Chandra Jha
- Department of Biosciences and Biomedical Engineering (BSBE), Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore 453552, India
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17
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Molaee H, Emadi SN, M Imunya JMN, Davoudi-Monfared E, Mohammed A, Razavi Z. Chilblain or perniosis-like skin lesions in children during the COVID-19 pandemic: A systematic review of articles. Dermatol Ther 2022; 35:e15298. [PMID: 34981615 DOI: 10.1111/dth.15298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/24/2021] [Accepted: 12/31/2021] [Indexed: 11/27/2022]
Abstract
COVID toes or chilblain-like skin lesions represent a widespread and specific skin presentation mostly in the feet that may be attributed to COVID-19 infection. They may last for several months. We conducted this study to investigate chilblain-like lesions in children during the COVID-19 pandemic, any predisposition, location, clinical course, and prognosis. We searched Google Scholar, Scopus, and Medline (PubMed) databases using the following keywords: "Coronavirus" OR "COVID-19" AND "Chilblains" OR "Pernio" OR "Perniosis" OR "Children" OR "Cutaneous" OR "skin." The inclusion criteria were: (a) Studies that described the specific vascular skin lesion. (b) Studies that included patients aged >1 month till 18 years. (c) Case reports, case series, retrospective or prospective cohort studies, case-control studies. A total of 28 articles were included. The total number of children with chiblain-like lesions (CLL) was 433. The mean age of children presenting CLL during the COVID-19 pandemic was estimated as 12.58 ± 2.15. Of note, 53.6% of them were male. The nasopharyngeal SARS-CoV-2 RT-PCR test and anti-SARS-CoV-2 antibodies were mostly negative for the virus. In conclusion, it is crucial to be familiar with various presentations of COVID-19 infection and their clinical significance to approach the earliest diagnosis, immediate treatment, estimate the prognosis, and finally isolate the patients to prevent spreading. Chilblain-like lesions as a possible cutaneous presentation of COVID-19 in children may last several months with the indolent course.
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Affiliation(s)
- Hamideh Molaee
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Naser Emadi
- Skin Research Center of Razi and Imam Khomeini Hospital, Research Center for War-affected People, Tehran University of Medical Sciences and the Iranian Red Crescent Society, Tehran, Iran
| | | | - Esmat Davoudi-Monfared
- Health Management Research Center, Department of Community Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Asha Mohammed
- Public Health Department, The Kenya Red Cross Society, Nairobi, Kenya
| | - Zahra Razavi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Coronavirus Disease 2019 and Acute Hemorrhagic Edema of Infancy. Case Rep Infect Dis 2022; 2022:7610402. [PMID: 35127185 PMCID: PMC8812376 DOI: 10.1155/2022/7610402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background Acute hemorrhagic edema of infancy (AHEI) is a small-vessel leukocytoclastic vasculitis, presented with low-grade fever and edema in the face and upper and lower limbs, as well as purpuric/ecchymotic lesions in these regions. AHEI was also reported after viral infections, including herpes simplex virus, rotavirus, and adenovirus. Case Presentation. Herein, we reported a case of a 20-month-old boy presented with low-grade fever. Additionally, mild cough and progressive purpuric/ecchymotic lesions were observed in some independent regions and extremity swelling. Laboratory testing showed leukopenia, lymphopenia, and the elevation of both C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Thereafter, the result of the reverse-transcriptase polymerase chain reaction (RT-PCR) test on the obtained specimen samples, including nasopharyngeal swab for COVID-19, was positive. The patient was treated with supportive care, and two weeks later, the serology test for COVID-19 resulted positive. Conclusion We should think about children infected with COVID-19, particularly those with skin manifestations.
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Shirazi FM, Mirzaei R, Nakhaee S, Nejatian A, Ghafari S, Mehrpour O. Repurposing the drug, ivermectin, in COVID-19: toxicological points of view. Eur J Med Res 2022; 27:21. [PMID: 35123559 PMCID: PMC8817475 DOI: 10.1186/s40001-022-00645-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/23/2022] [Indexed: 12/15/2022] Open
Abstract
The global COVID-19 pandemic has affected the world's population by causing changes in behavior, such as social distancing, masking, restricting people's movement, and evaluating existing medication as potential therapies. Many pre-existing medications such as tocilizumab, ivermectin, colchicine, interferon, and steroids have been evaluated for being repurposed to use for the treatment of COVID-19. None of these agents have been effective except for steroids and, to a lesser degree, tocilizumab. Ivermectin has been one of the suggested repurposed medications which exhibit an in vitro inhibitory activity on SARS-CoV-2 replication. The most recommended dose of ivermectin for the treatment of COVID-19 is 150-200 µg/kg twice daily. As ivermectin adoption for COVID-19 increased, the Food and Drug Administration (FDA) issued a warning on its use during the pandemic. However, the drug remains of interest to clinicians and has shown some promise in observational studies. This narrative reviews the toxicological profile and some potential therapeutic effects of ivermectin. Based on the current dose recommendation, ivermectin appears to be safe with minimum side effects. However, serious questions remain about the effectiveness of this drug in the treatment of patients with COVID-19.
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Affiliation(s)
- Farshad M Shirazi
- Arizona Poison & Drug Information Center, College of Pharmacy and University of Arizona College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Roya Mirzaei
- Faculty of Pharmacy and Pharmaceutical Sciences, Islamic Azad University, Tehran Medical Sciences University (IAUTMU), Tehran, Iran
- Venom and Biotherapeutic Molecules Lab., Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, 13169-43551, Tehran, Iran
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Amir Nejatian
- Department of Civil Eng., Sharif University of Technology, Tehran, Iran
| | - Shokouh Ghafari
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Omid Mehrpour
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
- Data Science Institute, Southern Methodist University, Dallas, TX, USA.
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20
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Tatsi EB, Dellis C, Petridou E, Banou K, Zachariadou L, Syriopoulou V, Michos A. SARS-CoV-2 seroepidemiological study in healthcare workers and discordant results using seven different diagnostic methods. Infection 2022; 50:251-256. [PMID: 34224078 PMCID: PMC8256773 DOI: 10.1007/s15010-021-01653-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/25/2021] [Indexed: 12/14/2022]
Abstract
The aim of the study was to access the SARS-CoV-2 antibody seroprevalence in healthcare workers (HCWs) of a tertiary pediatric hospital after the first wave of the pandemic and to compare the results among seven commercially available antibody detection assays, including chemiluminescence (CMIA), electroluminescence (ECLIA), Εnzyme-Linked Immunosorbent Assay (ELISA), and rapid immunochromatography (RIC). SARS-CoV-2 antibody detection was performed in serum samples of 1216 HCWs, using a reference CMIA assay and 8/1216 (0.66%) were detected positive. Positive serum samples were further tested with other assays; however, only one sample was positive by all tests. The rest 7 cases were negative with ECLIA and ELISA and gave discordant results with RIC test. Six months later, new serum samples of seropositive HCWs were analyzed with the same 7 tests, with inconsistent results again. Identification of reliable SARS-CoV-2 antibody tests is important to determine the actual number of past infections, the duration of antibodies, and guide public health decisions.
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Affiliation(s)
- Elizabeth-Barbara Tatsi
- First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, Athens, 11527, Greece.
| | - Charilaos Dellis
- First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, Athens, 11527, Greece
| | - Evangelia Petridou
- Department of Microbiology, "Aghia Sophia" Children's Hospital, Athens, 11527, Greece
| | - Kirkira Banou
- Department of Microbiology, "Aghia Sophia" Children's Hospital, Athens, 11527, Greece
| | - Levantia Zachariadou
- Department of Microbiology, "Aghia Sophia" Children's Hospital, Athens, 11527, Greece
| | - Vassiliki Syriopoulou
- First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, Athens, 11527, Greece
| | - Athanasios Michos
- First Department of Pediatrics, Infectious Diseases and Chemotherapy Research Laboratory, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou, Athens, 11527, Greece
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21
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Durand M, Thibault P, Lévesque S, Brault A, Carignan A, Valiquette L, Martin P, Labbé S. Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its first variants in fourplex real-time quantitative reverse transcription-PCR assays. MICROBIAL CELL (GRAZ, AUSTRIA) 2022; 9:1-20. [PMID: 35083313 PMCID: PMC8717086 DOI: 10.15698/mic2022.01.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022]
Abstract
The early diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is required to identify and isolate contagious patients to prevent further transmission of SARS-CoV-2. In this study, we present a multitarget real-time TaqMan reverse transcription PCR (rRT-PCR) assay for the quantitative detection of SARS-CoV-2 and some of its circulating variants harboring mutations that give the virus a selective advantage. Seven different primer-probe sets that included probes containing locked nucleic acid (LNA) nucleotides were designed to amplify specific wild-type and mutant sequences in Orf1ab, Envelope (E), Spike (S), and Nucleocapsid (N) genes. Furthermore, a newly developed primer-probe set targeted human β2-microglobulin (B2M) as a highly sensitive internal control for RT efficacy. All singleplex and fourplex assays detected ≤ 14 copies/reaction of quantified synthetic RNA transcripts, with a linear amplification range of nine logarithmic orders. Primer-probe sets for detection of SARS-CoV-2 exhibited no false-positive amplifications with other common respiratory pathogens, including human coronaviruses NL63, 229E, OC43, and HKU-1. Fourplex assays were evaluated using 160 clinical samples positive for SARS-CoV-2. Results showed that SARS-CoV-2 viral RNA was detected in all samples, including viral strains harboring mutations in the Spike coding sequence that became dominant in the pandemic. Given the emergence of SARS-CoV-2 variants and their rapid spread in some populations, fourplex rRT-PCR assay containing four primer-probe sets represents a reliable approach to allow quicker detection of circulating relevant variants in a single reaction.
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Affiliation(s)
- Mathieu Durand
- Plateforme RNomique et de Génomique Fonctionnelle, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Philippe Thibault
- Plateforme RNomique et de Génomique Fonctionnelle, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Simon Lévesque
- Département de Microbiologie et d'Infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Laboratoire de Microbiologie, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Estrie, Centre Hospitalier Universitaire de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Ariane Brault
- Département de Biochimie et de Génomique Fonctionnelle, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Alex Carignan
- Département de Microbiologie et d'Infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Louis Valiquette
- Département de Microbiologie et d'Infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Philippe Martin
- Département de Microbiologie et d'Infectiologie, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Simon Labbé
- Département de Biochimie et de Génomique Fonctionnelle, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
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22
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Sanghai N, Tranmer GK. COVID-Toe - The Silent Symptom: Raising Awareness among Health Care Professionals and Community. Curr Mol Med 2022; 22:563-566. [PMID: 34645373 DOI: 10.2174/1566524021666211013121116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/10/2021] [Accepted: 08/26/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Nitesh Sanghai
- College of Pharmacy, Rady Faculty of Health Science, University of Manitoba, Winnipeg, MB R3E 0T5, Canada
| | - Geoffrey K Tranmer
- College of Pharmacy, Rady Faculty of Health Science, University of Manitoba, Winnipeg, MB R3E 0T5, Canada
- Department of Chemistry, Faculty of Science, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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Cerrato F, Esposito M, Drusiani A, Moi I, Franciosi E, Assueri N, Campalastri R, Fioritti A. Locking out the virus: management of a SARS-CoV-2 outbreak in an Italian prison. Int J Prison Health 2021; 17:258-266. [PMID: 34323430 DOI: 10.1108/ijph-12-2020-0100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE In this paper, the authors present insights and findings drawn from the authors' experiences of containing a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in a large prison in northern Italy.Within penitentiaries, close-quarter living is ripe terrain for outbreaks of disease among detainees and staff. If left unchecked, these outbreaks can easily spill over the prison walls to threaten the general public. Moreover, these risks are heightened by preexisting environmental conditions, especially overcrowding. It is thus paramount to establish effective protocols for prevention, early detection and outbreak management. The purpose of this article is to document a strategy that been at least partially successful in reducing the damage that could potentially be caused by a sustained SARS-CoV-2 outbreak within a correctional facility. DESIGN/METHODOLOGY/APPROACH The authors conducted a retrospective analysis on patients' and health-care workers' medical records to obtain demographic and clinical information. Descriptive data analysis was then carried out. FINDINGS In total, the authors tested 453 people with oropharyngeal swabs from March 15, 2020, to June 30, 2020. Of these people, 58 were positive and 395 were negative, with a prevalence of 12.8%.Of the 453 patients, 60 were health workers: 24 tested positive for SARS-CoV2 ribonucleic acid (RNA); 18 developed symptoms; and three needed hospitalization.Among patients in detention, 34 resulted positive for SARS-CoV-2 RNA. Two were hospitalized and later died. Both had severe preexisting conditions; they were aged 76 and 59 years old, respectively. ORIGINALITY/VALUE In this study, the authors describe the design and effective implementation of prevention and containment measures against SARS-CoV-2 within the walls of a correctional facility. The authors describe how they rapidly created clean confinement sections to isolate cases in an environment designed for security at the expense of virus containment and how educational efforts have played a vital role in their strategy.
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Affiliation(s)
- Ferdinando Cerrato
- Department of Mental Health and Substane Abuse, AUSL Bologna, Bologna, Italy
| | - Michele Esposito
- DATER - Department of Nursing and Health Professions, AUSL Bologna, Bologna, Italy
| | - Agnese Drusiani
- DATER - Department of Nursing and Health Professions, AUSL Bologna, Bologna, Italy
| | - Iuri Moi
- DATER - Department of Nursing and Health Professions, AUSL Bologna, Bologna, Italy
| | - Eugenia Franciosi
- DATER - Department of Nursing and Health Professions, AUSL Bologna, Bologna, Italy
| | - Nadialina Assueri
- DATER - Department of Nursing and Health Professions, AUSL Bologna, Bologna, Italy
| | | | - Angelo Fioritti
- Department of Mental Health and Substane Abuse, AUSL Bologna, Bologna, Italy
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Multisystem Inflammatory Syndrome with Features of Atypical Kawasaki Disease during the COVID-19 Pandemic. Case Rep Pediatr 2021; 2021:9950588. [PMID: 34642609 PMCID: PMC8502244 DOI: 10.1155/2021/9950588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background Although Kawasaki disease (KD) is the most common self-limited systemic vasculitis in pediatrics, the exact etiology of the disease, its association with other diseases, and pathogens is still unknown. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating KD during the COVID-19 pandemic. Here, we present a case of an atypical case of KD presenting as multisystem inflammatory syndrome (MIS) during the COVID-19 pandemic. Case Presentation. The patient is a 7-year-old girl who developed fever (39°C) and erythematous multiform rash on the abdomen and along with erythema and edema on the extremities. Laboratory evaluation revealed neutrophilia and lymphopenia along with elevated C-reactive protein, erythrocyte sedimentation rate, troponin, lactate dehydrogenase, ferritin, and D-dimer. Although the patient did not fulfill the KD criteria, based on approved guidelines and approaches regarding atypical KD and multisystem inflammatory syndrome in children (MIS-C) during the COVID-19 pandemic, intravenous immunoglobulin along with aspirin was administered for the patients. The patient's symptoms resolved with an uneventful postdischarge course. Conclusion Early diagnosis and treatment of patients meeting full or partial criteria for KD are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.
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Meis-Pinheiro U, Lopez-Segui F, Walsh S, Ussi A, Santaeugenia S, Garcia-Navarro JA, San-Jose A, Andreu AL, Campins M, Almirante B. Clinical characteristics of COVID-19 in older adults. A retrospective study in long-term nursing homes in Catalonia. PLoS One 2021; 16:e0255141. [PMID: 34297774 PMCID: PMC8301631 DOI: 10.1371/journal.pone.0255141] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/09/2021] [Indexed: 01/12/2023] Open
Abstract
The natural history of COVID-19 and predictors of mortality in older adults need to be investigated to inform clinical operations and healthcare policy planning. A retrospective study took place in 80 long-term nursing homes in Catalonia, Spain collecting data from March 1st to May 31st, 2020. Demographic and clinical data from 2,092 RT-PCR confirmed cases of SARS-CoV-2 infection were registered, including structural characteristics of the facilities. Descriptive statistics to describe the demographic, clinical, and molecular characteristics of our sample were prepared, both overall and by their symptomatology was performed and an analysis of statistically significant bivariate differences and constructions of a logistic regression model were carried out to assess the relationship between variables. The incidence of the infection was 28%. 71% of the residents showed symptoms. Five major symptoms included: fever, dyspnea, dry cough, asthenia and diarrhea. Fever and dyspnea were by far the most frequent (50% and 28%, respectively). The presentation was predominantly acute and symptomatology persisted from days to weeks (mean 9.1 days, SD = 10,9). 16% of residents had confirmed pneumonia and 22% required hospitalization. The accumulated mortality rate was 21.75% (86% concentrated during the first 28 days at onset). A multivariate logistic regression analysis showed a positive predictive value for mortality for some variables such as age, pneumonia, fever, dyspnea, stupor refusal to oral intake and dementia (p<0.01 for all variables). Results suggest that density in the nursing homes did not account for differences in the incidence of the infection within the facilities. This study provides insights into the natural history of the disease in older adults with high dependency living in long-term nursing homes during the first pandemic wave of March-May 2020 in the region of Catalonia, and suggests that some comorbidities and symptoms have a strong predictive value for mortality.
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Affiliation(s)
| | | | - Sandra Walsh
- Institut de Biologia Evolutiva (UPF-CSIC), Universitat Pompeu Fabra, Barcelona, Spain
| | - Anton Ussi
- European Infrastructure for Translational Medicine, EATRIS, Amsterdam, Netherlands
| | - Sebastia Santaeugenia
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic–University of Vic-Central University of Catalonia (UVIC-UCC), Vic, Spain
- Chronic Care Program, Ministry of Health, Generalitat de Catalunya, Barcelona, Spain
| | | | - Antonio San-Jose
- Geriatric Unit, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - Antoni L. Andreu
- Associació Catalana de Recursos Assistencials, ACRA, Barcelona, Spain
- European Infrastructure for Translational Medicine, EATRIS, Amsterdam, Netherlands
| | - Magda Campins
- Preventive Medicine and Epidemiology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain
| | - Benito Almirante
- Infectious Diseases Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain
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Mazzitelli M, Dastoli S, Mignogna C, Bennardo L, Lio E, Pelle MC, Trecarichi EM, Pereira BI, Nisticò SP, Torti C. Histopathology and immunophenotyping of late onset cutaneous manifestations of COVID-19 in elderly patients: Three case reports. World J Clin Cases 2021; 9:5744-5751. [PMID: 34307634 PMCID: PMC8281404 DOI: 10.12998/wjcc.v9.i20.5744] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/12/2021] [Accepted: 05/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Several cutaneous manifestations such as urticarial rash, erythematous patches and chilblain-like lesions have been described in young adults with coronavirus disease 2019 (COVID-19) and are present in up to 20% patients, but few reports exist describing histopathological and immunophenotypic characteristics of dermatological lesions in older patients. Our aim was to characterize skin lesions in elderly patients during late stages of COVID-19 from clinical, histological and immunophenotypic perspectives.
CASE SUMMARY Three patients, admitted for COVID-19, and who developed cutaneous manifestations underwent skin biopsies. Immunophenotypic analysis for CD20, CD3, CD4 and CD8 was performed on skin biopsies to assess immune cell infiltrates. CD1a was used as a marker of Langerhans cells, and CD31 as a marker of endothelial cells. In the three study patients, cutaneous manifestations were evident in the late-stage of COVID-19 (mean time from the first positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) swab to rash onset was 35 d). Skin biopsies showed a similar pattern of T lymphocyte infiltration in all patients. Indeed, a chronic dermatitis with perivascular lymphocytic infiltrate was observed with predominance of CD3+ T-cell (CD3+).
CONCLUSION Our study confirms previous reports. Histological and immunophenotypic patterns in our patients confirm results described in the two previous reported experiences. This pattern is similar to what is found in some lympho-proliferative disorders. Therefore, since these findings are non-specific, SARS-CoV-2 infection should be suspected.
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Affiliation(s)
- Maria Mazzitelli
- Department of Medical and Surgical Sciences, Infectious and Tropical Disease Unit, Magna Graecia University, Catanzaro 88100, Italy
| | - Stefano Dastoli
- Department of Health Sciences, Magna Graecia Università of Catanzaro, Catanzaro 88100, Italy
| | - Chiara Mignogna
- Interdipartimental Service Center, Pathology Unit, Pugliese Ciaccio Hospital, Catanzaro 88100, Italy
| | - Luigi Bennardo
- Department of Health Sciences, Magna Graecia University, Catanzaro 88100, Italy
| | - Elena Lio
- Department of Medical and Surgical Sciences, Infectious and Tropical Disease Unit, Magna Graecia University, Catanzaro 88100, Italy
| | - Maria Chiara Pelle
- Department of Medical and Surgical Sciences, Magna Graecia Università of Catanzaro, Catanzaro 88100, Italy
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, Infectious and Tropical Disease Unit, Magna Graecia University, Catanzaro 88100, Italy
| | - Branca Isabel Pereira
- HIV/GUM Directorate, Chelsea and Westminster Hospital Foundation Trust, London SW109NH, United Kingdom
| | - Steven Paul Nisticò
- Department of Health Sciences, Magna Graecia Università of Catanzaro, Catanzaro 88100, Italy
| | - Carlo Torti
- Department of Medical and Surgical Sciences, Infectious and Tropical Disease Unit, Magna Graecia University, Catanzaro 88100, Italy
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Farooq A, Alam F, Saeed A, Butt F, Khaliq MA, Malik A, Chaudhry M, Abdullah M. Multisystem Inflammatory Syndrome in Children and Adolescents (MIS-C) under the Setting of COVID-19: A Review of Clinical Presentation, Workup and Management. Infect Dis (Lond) 2021; 14:11786337211026642. [PMID: 34220204 PMCID: PMC8221672 DOI: 10.1177/11786337211026642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/30/2021] [Indexed: 12/29/2022] Open
Abstract
Earlier in its course, SARS-CoV-2 was primarily identified to cause an acute respiratory illness in adults, the elderly and immunocompromised, while children were known to be afflicted with milder symptoms. However, since mid-April of 2020, latent effects of the virus have begun emerging in children and adolescents, which is characterised by a multisystem hyperinflammatory state; thus, the term Multisystem Inflammatory Syndrome in Children (MIS-C) was introduced by the WHO and CDC. The syndrome manifests itself approximately 4 weeks after COVID-19 infection, with symptoms mimicking Kawasaki Disease and Kawasaki Disease Shock Syndrome. Demographically, MIS-C peaks in children aged 5 to 14 years, with clusters in Europe, North and Latin America seen, later followed by Asia. Although the exact pathophysiology behind the syndrome is unknown, recent studies have proposed a post-infectious immune aetiology, which explains the increased levels of immunoglobulins seen in affected patients. Patient presentation includes, but is not limited to, persistent fever, rash, gastrointestinal symptoms and cardiac complications including myocarditis. These patients also have raised inflammatory markers including C reactive protein, ferritin and interleukin-6. In poorly controlled patients, the syndrome can lead to multiorgan failure and death. The mainstay of treatment includes the use of intravenous immunoglobulins, steroids, immune modulators and aspirin. Adjunct therapy includes the use of low molecular weight heparin or warfarin for long term anticoagulation. Currently very little is known about the syndrome, highlighting the need for awareness amongst healthcare workers and parents. Moreover, with increased cases of COVID-19 as a result of the second wave, it is essential to keep MIS-C in mind when attending patients with a past history of COVID-19 exposure or infection. Additionally, once these patients have been identified and treated, strict follow-up must be done in order carry out long term studies, and to identify possible sequelae and complications.
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Affiliation(s)
- Ayesha Farooq
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Fatima Alam
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Asma Saeed
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Farooq Butt
- Sialkot Medical College Pvt Ltd, Sialkot, PK-PB Punjab, Pakistan
| | - Muhammad Azeem Khaliq
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
| | - Ayesha Malik
- Hameed Latif Hospital, Lahore, Lahore, PK-PB Punjab, Pakistan
| | | | - Mohammad Abdullah
- CMH Lahore Medical College and Institute of Dentistry, Lahore, PK-PB, Punjab, Pakistan
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28
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Bai B, Xu Z, Hu Y, Qu M, Cheng J, Luo S, Yao Z, Gao H, Ma Y, Gao R, Hou J, Xin S, Mao P. Patient hematology during hospitalization for viral pneumonia caused by SARS-CoV-2 and non-SARS-CoV-2 agents: a retrospective study. Eur J Med Res 2021; 26:45. [PMID: 33990223 PMCID: PMC8120019 DOI: 10.1186/s40001-021-00515-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/30/2021] [Indexed: 02/07/2023] Open
Abstract
Background Hematological comparison of coronavirus disease (COVID-19) and other viral pneumonias can provide insights into COVID-19 treatment. Methods In this retrospective case–control single-center study, we compared the data of 126 patients with viral pneumonia during different outbreaks [severe acute respiratory syndrome (SARS) in 2003, influenza A (H1N1) in 2009, human adenovirus type 7 in 2018, and COVID-19 in 2020]. Results One of the COVID-19 characteristics was a continuous decline in the hemoglobin level. The neutrophil count was related to the aggravation of COVID-19 and SARS. Thrombocytopenia occurred in patients with SARS and severe COVID-19 even at the recovery stage. Lymphocytes were related to the entire course of adenovirus infection, recovery of COVID-19, and disease development of SARS. Conclusions Dynamic changes in hematological counts could provide a reference for the pathogenesis and prognosis of pneumonia caused by respiratory viruses in clinics.
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Affiliation(s)
- Bingke Bai
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Zhe Xu
- Treatment and Research Center for Infectious Diseases, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Yan Hu
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Mengmeng Qu
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Juan Cheng
- Treatment and Research Center for Infectious Diseases, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Shengdong Luo
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Zengtao Yao
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Hongyan Gao
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Yenv Ma
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Rong Gao
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Jun Hou
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Shaojie Xin
- Liver Failure Treatment and Research Center, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China
| | - Panyong Mao
- Research Center of Clinical and Translational Medicine, Fifth Medical Center of Chinese, PLA General Hospital, 100 Middle Street of 4th West Ring Road, Beijing, 100039, China.
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SeyedAlinaghi S, Abbasian L, Solduzian M, Ayoobi Yazdi N, Jafari F, Adibimehr A, Farahani A, Salami Khaneshan A, Ebrahimi Alavijeh P, Jahani Z, Karimian E, Ahmadinejad Z, Khalili H, Seifi A, Ghiasvand F, Ghaderkhani S, Rasoolinejad M. Predictors of the prolonged recovery period in COVID-19 patients: a cross-sectional study. Eur J Med Res 2021; 26:41. [PMID: 33957992 PMCID: PMC8100933 DOI: 10.1186/s40001-021-00513-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/22/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The clinical course of COVID-19 may vary significantly. The presence of comorbidities prolongs the recovery time. The recovery in patients with mild-to-moderate symptoms might take 10 days, while in those with a critical illness or immunocompromised status could take 15 days. Considering the lack of data about predictors that could affect the recovery time, we conducted this study to identify them. METHODS This cross-sectional study was implemented in the COVID-19 clinic of a teaching and referral university hospital in Tehran. Patients with the highly suggestive symptoms who had computed tomography (CT) imaging results with typical findings of COVID-19 or positive results of reverse transcriptase-polymerase chain reaction (RT-PCR) were enrolled in the study. Inpatient and outpatient COVID-19 participants were followed up by regular visits or phone calls, and the recovery period was recorded. RESULTS A total of 478 patients were enrolled. The mean age of patients was 54.11 ± 5.65 years, and 44.2% were female. The median time to recovery was 13.5 days (IQR: 9). Although in the bivariate analysis, multiple factors, including hypertension, fever, diabetes mellitus, gender, and admission location, significantly contributed to prolonging the recovery period, in multivariate analysis, only dyspnea had a significant association with this variable (p = 0.02, the adjusted OR of 2.05; 95% CI 1.12-3.75). CONCLUSION This study supports that dyspnea is a predictor of recovery time. It seems like optimal management of the comorbidities plays the most crucial role in recovery from COVID-19.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Abbasian
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Mohammad Solduzian
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Science, Golgasht St, Tabriz, 5166414766 Iran
| | - Niloofar Ayoobi Yazdi
- Department of Radiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jafari
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Alireza Adibimehr
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Aazam Farahani
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Arezoo Salami Khaneshan
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Parvaneh Ebrahimi Alavijeh
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Zahra Jahani
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Elnaz Karimian
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Zahra Ahmadinejad
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Hossein Khalili
- Department of Clinical Pharmacy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Seifi
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Fereshteh Ghiasvand
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Sara Ghaderkhani
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
| | - Mehrnaz Rasoolinejad
- Department of Infectious Disease, Imam Khomeini Hospital, Tehran University of Medical Sciences, Blv. Keshavarz, Tehran, 1419733141 Iran
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Abstract
Italy was among the world's earliest and most affected countries by coronavirus disease 2019 (COVID-19). We report the Italian experience with the pandemic. The dermatologic community immediately reduced any type of activities to 80% to 90% of outpatient consultations, both in public hospitals and in private offices. The Italian Society of Dermatology and Sexually Transmitted Diseases and the Italian Forensic Dermatologic Society supported the dermatologic community by reporting recommendations in newsletters (vademecum) regarding the routine management of dermatologic patients either in the hospital or private setting. We have provided an overview of the skin manifestations from the pandemic, including the consequences of the misuse of safety measures. We also have evaluated the recently developed research projects on patients treated with biologics for psoriasis, atopic dermatitis, and hidradenitis suppurativa, as well as on the registries regarding various skin diseases affected by COVID-19.
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Shahbaznejad L, Rouhanizadeh H, Navaeifar MR, Hosseinzadeh F, Movahedi FS, Rezai MS. Clinical Characteristics and Outcomes of COVID-19 in Children in Northern Iran. Int J Pediatr 2021; 2021:5558287. [PMID: 34007286 PMCID: PMC8099525 DOI: 10.1155/2021/5558287] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/18/2021] [Accepted: 04/03/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Since December 2019, the coronavirus disease 2019 (COVID-19) has been spread rapidly all over the world, infecting all age groups with this novel virus. In this manuscript, we report characteristics of children with COVID-19 in Mazandaran province, northern Iran. METHOD From 12 February to 28 July 2020, medical records of 100 children diagnosed with COVID-19 admitted to the hospitals of Mazandaran province were collected. Patients' age, gender, clinical symptoms, and signs, in addition to therapeutic management and outcomes, were reported. RESULTS 57 (57%) boys and 43 girls with the mean age of 104.63 ± 79.14 months were evaluated. 20 patients (20%) were transferred to the PICU (pediatric intensive care unit), and 13 children experienced a severe form of the disease, pediatric inflammatory multisystem syndrome (PIMS). The mean duration of hospitalization was 5.3 ± 4.7 days. Fever (81%), respiratory (79%), gastrointestinal (47%), and neurologic complaints (29%) were experienced by the patients in addition to skin rash (14%). Sixty-two patients needed supplemental oxygen, and 6 of them underwent endotracheal intubation. Leukopenia was reported in 7, anemia in 24, and thrombocytopenia in 12 patients. 4 patients with underlying diseases including chronic renal failure, Down syndrome with cerebral palsy, and morbid obesity died. CONCLUSION COVID-19 can cause symptoms in children in two stages. In the first week, upper and lower respiratory symptoms can occur which has lower severity and prevalence compared to adults. But after 2-3 weeks following infection, symptoms of MIS-C or multisystem involvement can occur and COVID-19 should be considered. The most common indication for admission is fever, rash, and respiratory problems.
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Affiliation(s)
- Leila Shahbaznejad
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Rouhanizadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Navaeifar
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fatemeh Hosseinzadeh
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Faeze Sadat Movahedi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Sadegh Rezai
- Pediatric Infectious Diseases Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
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Behera P, Patro BK, Singh AK, Chandanshive PD, S. R. R, Pradhan SK, Pentapati SSK, Batmanabane G, Mohapatra PR, Padhy BM, Bal SK, Singh SR, Mohanty RR. Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study. PLoS One 2021; 16:e0247163. [PMID: 33592050 PMCID: PMC7886121 DOI: 10.1371/journal.pone.0247163] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/02/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Ivermectin is one among several potential drugs explored for its therapeutic and preventive role in SARS-CoV-2 infection. The study was aimed to explore the association between ivermectin prophylaxis and the development of SARS-CoV-2 infection among healthcare workers. METHODS A hospital-based matched case-control study was conducted among healthcare workers of AIIMS Bhubaneswar, India, from September to October 2020. Profession, gender, age and date of diagnosis were matched for 186 case-control pairs. Cases and controls were healthcare workers who tested positive and negative, respectively, for COVID-19 by RT-PCR. Exposure was defined as the intake of ivermectin and/or hydroxychloroquine and/or vitamin-C and/or other prophylaxis for COVID-19. Data collection and entry was done in Epicollect5, and analysis was performed using STATA version 13. Conditional logistic regression models were used to describe the associated factors for SARS-CoV-2 infection. RESULTS Ivermectin prophylaxis was taken by 76 controls and 41 cases. Two-dose ivermectin prophylaxis (AOR 0.27, 95% CI, 0.15-0.51) was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Those involved in physical activity (AOR 3.06 95% CI, 1.18-7.93) for more than an hour/day were more likely to contract SARS-CoV-2 infection. Type of household, COVID duty, single-dose ivermectin prophylaxis, vitamin-C prophylaxis and hydroxychloroquine prophylaxis were not associated with SARS-CoV-2 infection. CONCLUSION Two-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Chemoprophylaxis has relevance in the containment of pandemic.
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Affiliation(s)
- Priyamadhaba Behera
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Binod Kumar Patro
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Arvind Kumar Singh
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Pradnya Dilip Chandanshive
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Ravikumar S. R.
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Somen Kumar Pradhan
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Siva Santosh Kumar Pentapati
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | | | - Prasanta Raghab Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Biswa Mohan Padhy
- Department of Pharmacology, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Shakti Kumar Bal
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Sudipta Ranjan Singh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
| | - Rashmi Ranjan Mohanty
- Department of General Medicine, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
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Zhan X, Chen Z, Hu H, Yang Y, Wu K, Cheng Z, Liu B. Dandelion and focal crazy paving signs: the lung CT based predictors for evaluation of the severity of coronavirus disease. Curr Med Res Opin 2021; 37:219-224. [PMID: 33136449 PMCID: PMC7711729 DOI: 10.1080/03007995.2020.1846173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/25/2020] [Accepted: 11/01/2020] [Indexed: 01/12/2023]
Abstract
PURPOSE To describe the radiological features of coronavirus disease 19 (COVID-19) and to explore the significant signs that indicate severity of disease. MATERIALS AND METHODS We collected data retrospectively of 180 cases of COVID-19, from 15 January 2020 to 31 March 2020, from both the Wuhan Zhongnan and Beijing Ditan Hospitals, including 103 cases of mild and 77 cases of severe pneumonia. All patients had their first chest computed tomography scan within five days of symptom onset. The dandelion sign was defined by a focal ground glass opacity (GGO) with a central thickening of the airway wall, and the focal crazy paving sign was defined by a focal GGO with thickening of the interlobular septa. RESULTS Consolidation presented in only 4.9% (5/103) of the mild pneumonia cases, which was significantly lower than that in severe pneumonia cases (70.1% 54/77), p < .001). Multifocal distribution and pure GGOs were observed more frequently in severe cases of pneumonia (p < .05). The dandelion sign was present in 86.4% (89/103) of the mild pneumonia cases, significantly more frequent than those with severe pneumonia (13.0% [10/77], p < .001). The focal crazy paving sign presented in 65.0% (67/103) of the mild pneumonia cases and was significantly more frequent than in severe cases (23.4% [18/77], p < .001). The hospital stay duration of the mild pneumonia group (13.6 ± 7.2 days) was significantly shorter than the severe pneumonia group (26.6 ± 11.7 days, p < .001). CONCLUSIONS Consolidation, pure GGO and multifocal distribution on a CT scan were associated with severe COVID-19. The dandelion and focal crazy paving signs indicate mild COVID-19.
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Affiliation(s)
- Xi Zhan
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Huijuan Hu
- Radiology Department, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yibin Yang
- Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Kaisong Wu
- Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Zhenshun Cheng
- Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China
| | - Bing Liu
- Department of Pulmonary and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
- Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China
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Ni YN, Wang T, Liang BM, Liang ZA. The independent factors associated with oxygen therapy in COVID-19 patients under 65 years old. PLoS One 2021; 16:e0245690. [PMID: 33481912 PMCID: PMC7822310 DOI: 10.1371/journal.pone.0245690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/05/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The number of hospitalized young coronavirus disease 2019 (COVID-19) patients has increased significantly. However, specific data about COVID-19 patients under 65 years old who are admitted to the hospital are scarce. METHODS The COVID-19 patients under 65 years old who were admitted to the hospital in Sichuan Province, Renmin Hospital of Wuhan University, and Wuhan Red Cross Hospital were included in this study. Demographic information, laboratory data and clinical treatment courses were extracted from electronic medical records. Risk factors associated with oxygen therapy were explored. RESULTS Eight hundred thirty-three COVID-19 patients under 65 years old were included. Of the included patients, 29.4% had one or more comorbidities. Oxygen therapy was required in 63.1% of these patients, and the mortality was 2.9% among the oxygen therapy patients. Fever (odds ratio [OR] 2.072, 95% confidence interval [CI] 1.312-3.271, p = 0.002), dyspnea (OR 2.522, 95% CI 1.213-5.243, p = 0.013), chest distress (OR 2.278, 95% CI 1.160-4.473, p = 0.017), elevated respiratory rate (OR 1.114, 95% CI 1.010-1.228, p = 0.031), and decreased albumin (OR 0.932, 95% CI 0.880-0.987, p = 0.016) and globulin levels (OR 0.929, 95% 0.881-0.980, p = 0.007) were independent factors related to oxygen therapy. CONCLUSIONS Oxygen therapy is highly required in COVID-19 patients under 65 years old who are admitted to the hospital, but the success rate is high. Respiratory failure-related symptoms, elevated respiratory rate, low albumin and globulin levels, and fever at admission are independent risk factors related to the requirement of oxygen.
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Affiliation(s)
- Yue-Nan Ni
- Department of Respiratory and Critical Care, West China School of Medicine and West China Hospital, Sichuan University, Chengdu, China
| | - Ting Wang
- Department of Respiratory and Critical Care, West China School of Medicine and West China Hospital, Sichuan University, Chengdu, China
| | - Bin-miao Liang
- Department of Respiratory and Critical Care, West China School of Medicine and West China Hospital, Sichuan University, Chengdu, China
| | - Zong-An Liang
- Department of Respiratory and Critical Care, West China School of Medicine and West China Hospital, Sichuan University, Chengdu, China
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Chilblain-Like Lesions during COVID-19 Pandemic: The State of the Art. Life (Basel) 2021; 11:life11010023. [PMID: 33401712 PMCID: PMC7823415 DOI: 10.3390/life11010023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/27/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023] Open
Abstract
SARS-CoV-2 infection has spread all over the world in the last year, causing millions of COVID-19 cases among humans with a large variability of symptoms and signs, including those on the skin. Among these, a contemporary cluster of chilblain-like lesions with no certain relationship with the infection has been reported. The aim of this paper is to delineate a profile of chilblain-like lesions and to establish the state-of-the-art knowledge about this new phenomenon.
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Shah S, Akhade K, Ganguly S, Nanda R, Mohapatra E, Goel AK. Cutaneous manifestations associated with COVID-19 in children: A systematic review. J Family Med Prim Care 2021; 10:93-101. [PMID: 34017709 PMCID: PMC8132763 DOI: 10.4103/jfmpc.jfmpc_1389_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/17/2020] [Accepted: 10/14/2020] [Indexed: 01/19/2023] Open
Abstract
Cutaneous manifestation of COVID 19 in children has not yet been reviewed systematically. Hence, this review gives the clinicians a future direction to be vigilant for skin presentations during pandemics. The Pubmed database used for literature search with keywords COVID 19, children, and skin in different combinations. Articles published in English with cases of age one month to 18 years were eligible. The outcome included varied aspects of cutaneous and COVID 19 infection. The authors did not register review protocol. Of 51 publications identified, 13 studies containing 149 children met the eligibility criteria. Acrally located erythematous maculopapular lesion was the most common finding in 138 children. The researcher reported Erythema multiforme, varicella like exanthem, and Kawasaki disease like presentations in the rest of the cases. The duration of the skin lesion was 1 2 weeks in 43%. Skin biopsy done in 18 patients revealed superficial and deep perivascular and peri eccrine lymphocytic infiltrate and lymphocytic vasculitis. RT PCR was positive13.8% cases. Serological markers for HSV, parvovirus B19 analyzed across various studies, were negative, except positive mycoplasma pneumonia in 2 of 20 cases tested. Clinicopathologic analysis established chilblains like lesion in 43% cases with no confirmed etiology like cold exposure, autoimmune dysfunction, drug reaction, or viral infection. The usual cephalo caudal spread of a viral exanthem was also missing. However, a low number of discussed cases was a limitation of the study. The absence of any confirmed etiology for such cutaneous manifestations, the possibility of COVID 19, should be explored and thoroughly evaluated and isolated during such a pandemic.
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Affiliation(s)
- Seema Shah
- Assistant Professor, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Kiran Akhade
- Project Coordinator, SCoE-SAM, State Centre of Excellence, Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Satyaki Ganguly
- Associate Professor, Department of Dermatology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rachita Nanda
- Additional Professor, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Eli Mohapatra
- Professor, Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Anil Kumar Goel
- Professor, Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Pavone P, Marino S, Marino L, Cacciaguerra G, Guarneri C, Nunnari G, Taibi R, Marletta L, Falsaperla R. Chilblains-like lesions and SARS-CoV-2 in children: An overview in therapeutic approach. Dermatol Ther 2021; 34:e14502. [PMID: 33141476 DOI: 10.1111/dth.14502] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/20/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022]
Abstract
SARS-CoV-2 (Severe Acute Respiratory Syndrome, Coronavirus, type 2) is the virus responsible for the global pandemic of Coronavirus disease 2019 (COVID-19) that began in China in December 2019. The variability of nasal olfactory symptoms in pediatric patients is interlinked with possible warning signs, including respiratory, gastrointestinal, ocular, or dermatological symptoms. Skin findings in patients with COVID-19 can range from petechiae to papulovesicular rashes to diffuse urticaria and can be confused with rashes of non-COVID-19 conditions. These lesions typically appear early during COVID-19 and are thought to be secondary to viral replication or circulating cytokines. Herein, we discuss two pediatric cases, presenting with skin lesions, which tested positive for SARS-CoV-2, thus, briefly reviewing current literature for similar reports and related management. Although these lesions heal spontaneously in most cases, an adequate "targeted" therapeutic approach can shorten the time and the discomfort of the skin disease.
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Affiliation(s)
- Piero Pavone
- Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, Catania, Italy
| | - Silvia Marino
- Unit of Pediatrics and Pediatric Emergency, Pediatric COVID-19 Center, AOU "Policlinico", PO "SanMarco", University of Catania, Catania, Italy
| | - Lidia Marino
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanni Cacciaguerra
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Claudio Guarneri
- University of Messina, AOU "G. Martino", COVID Hospital, Messina, Italy
| | - Giuseppe Nunnari
- University of Messina, AOU "G. Martino", COVID Hospital, Messina, Italy
| | - Rosaria Taibi
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS, CRO, Aviano, Italy
| | - Livia Marletta
- University of Messina, AOU "G. Martino", COVID Hospital, Messina, Italy
| | - Raffaele Falsaperla
- Unit of Pediatrics and Pediatric Emergency, Pediatric COVID-19 Center, AOU "Policlinico", PO "SanMarco", University of Catania, Catania, Italy
- Neonatal Intensive Care Unit [NICU], Neonatal COVID-19 Center, AOU "Policlinico", PO "San Marco, University of Catania, Catania, Italy
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Bhalla A, Suri V. Organ Involvement in COVID 19: Lung and Beyond. DELINEATING HEALTH AND HEALTH SYSTEM: MECHANISTIC INSIGHTS INTO COVID 19 COMPLICATIONS 2021:165-180. [DOI: 10.1007/978-981-16-5105-2_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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Ceccarelli M, Venanzi Rullo E, Berretta M, Cacopardo B, Pellicanò GF, Nunnari G, Guarneri C. New generation biologics for the treatment of psoriasis and psoriatic arthritis. State of the art and considerations about the risk of infection. Dermatol Ther 2020; 34:e14660. [PMID: 33301216 DOI: 10.1111/dth.14660] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 12/04/2020] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic immune-mediated disease characterized by inflammation of skin (psoriasis) or joints (psoriatic arthritis) or both, resulting from a dysregulation in particular of the T helper (Th)17 functions. There is no available cure for psoriasis, and a life-long treatment is needed to control signs and symptoms. Research interest is high around the newest biological drugs approved for the treatment of moderate to severe psoriasis and psoriatic arthritis, and especially drugs blocking the IL-23/IL-17 axis. Our aim is to review the new biological drugs for the treatment of psoriasis and their adverse effects, focusing on the risk of infections.
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Affiliation(s)
- Manuela Ceccarelli
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, Messina, Italy
| | - Emmanuele Venanzi Rullo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Massimiliano Berretta
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Bruno Cacopardo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morpho Functional Imaging, University of Messina, Messina, Italy
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COVID-19-associated coagulopathy and disseminated intravascular coagulation. Int J Hematol 2020; 113:45-57. [PMID: 33161508 PMCID: PMC7648664 DOI: 10.1007/s12185-020-03029-y] [Citation(s) in RCA: 262] [Impact Index Per Article: 52.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 10/15/2020] [Accepted: 10/22/2020] [Indexed: 01/08/2023]
Abstract
The pathology of coronavirus disease 2019 (COVID-19) is exacerbated by the progression of thrombosis, and disseminated intravascular coagulation (DIC), and cytokine storms. The most frequently reported coagulation/fibrinolytic abnormality in COVID-19 is the increase in d-dimer, and its relationship with prognosis has been discussed. However, limits exist to the utility of evaluation by d-dimer alone. In addition, since the coagulation/fibrinolytic condition sometimes fluctuates within a short period of time, regular examinations in recognition of the significance of the examination are desirable. The pathophysiology of disseminated intravascular coagulation (DIC) associated with COVID-19 is very different from that of septic DIC, and both thrombotic and hemorrhagic pathologies should be noted. COVID-19 thrombosis includes macro- and microthrombosis, with diagnosis of the latter depending on markers of coagulation and fibrinolysis. Treatment of COVID-19 is classified into antiviral treatment, cytokine storm treatment, and thrombosis treatment. Rather than providing uniform treatment, the treatment method most suitable for the severity and stage should be selected. Combination therapy with heparin and nafamostat is expected to develop in the future. Fibrinolytic therapy and adsorption therapy require further study
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Wu ZH, Yang DL. A meta-analysis of the impact of COVID-19 on liver dysfunction. Eur J Med Res 2020; 25:54. [PMID: 33148326 PMCID: PMC7609835 DOI: 10.1186/s40001-020-00454-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is leading to a worldwide pandemic. Except representative manifestation of pneumonia and acute respiratory symptoms, COVID-19 patients have also shown different levels of liver injury or liver dysfunction. The aim of our study was to explore the probable clinical severity and mortality of COVID-19 patients and their liver dysfunction. METHOD A combination of computer and manual retrieval was used to search in Medline through PubMed, EMBASE and Web of Science. Review Manager 5.3 software was used to examine the heterogeneity among the studies and to calculate the combined effect value (OR, 95CI). Subgroup analysis, sensitivity analysis, and publication bias test were also performed. RESULTS We found a significant connection between liver dysfunction and mortality of COVID-19 patients with a pooled OR of 1.98 (95% CI 1.39-2.82; P = 0.0002). There was a significant association between AST and severity of COVID-19 with a pooled OR of 4.48 (95% CI 3.24-7.21; P < 0.001), and a pooled WMD of 3.35 (95% CI, 2.07 to 4.64; P < 0.001). In addition, there was a significant difference between TBIL and severity of COVID-19, with a pooled OR of 1.91 (95% CI 1.40-2.60; P < 0.001), and with a pooled WMD of 1.18 (95% CI, 0.78 to 1.58; P < 0.001). CONCLUSION The mortality and severity of COVID-19 patients are significantly associated with liver dysfunction. The non-survivors and severe COVID-19 patients have elevated serum AST levels than the survivors and non-severe COVID-19 patients. The results of this study form a basis for better clinical liver management of patients with COVID-19.
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Affiliation(s)
- Zeng-Hong Wu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Dong-Liang Yang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is leading to a worldwide pandemic. Except representative manifestation of pneumonia and acute respiratory symptoms, COVID-19 patients have also shown different levels of liver injury or liver dysfunction. The aim of our study was to explore the probable clinical severity and mortality of COVID-19 patients and their liver dysfunction. METHOD A combination of computer and manual retrieval was used to search in Medline through PubMed, EMBASE and Web of Science. Review Manager 5.3 software was used to examine the heterogeneity among the studies and to calculate the combined effect value (OR, 95CI). Subgroup analysis, sensitivity analysis, and publication bias test were also performed. RESULTS We found a significant connection between liver dysfunction and mortality of COVID-19 patients with a pooled OR of 1.98 (95% CI 1.39-2.82; P = 0.0002). There was a significant association between AST and severity of COVID-19 with a pooled OR of 4.48 (95% CI 3.24-7.21; P < 0.001), and a pooled WMD of 3.35 (95% CI, 2.07 to 4.64; P < 0.001). In addition, there was a significant difference between TBIL and severity of COVID-19, with a pooled OR of 1.91 (95% CI 1.40-2.60; P < 0.001), and with a pooled WMD of 1.18 (95% CI, 0.78 to 1.58; P < 0.001). CONCLUSION The mortality and severity of COVID-19 patients are significantly associated with liver dysfunction. The non-survivors and severe COVID-19 patients have elevated serum AST levels than the survivors and non-severe COVID-19 patients. The results of this study form a basis for better clinical liver management of patients with COVID-19.
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Affiliation(s)
- Zeng-Hong Wu
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Dong-Liang Yang
- Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Gavriatopoulou M, Korompoki E, Fotiou D, Ntanasis-Stathopoulos I, Psaltopoulou T, Kastritis E, Terpos E, Dimopoulos MA. Organ-specific manifestations of COVID-19 infection. Clin Exp Med 2020; 20:493-506. [PMID: 32720223 PMCID: PMC7383117 DOI: 10.1007/s10238-020-00648-x] [Citation(s) in RCA: 322] [Impact Index Per Article: 64.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/15/2020] [Indexed: 02/06/2023]
Abstract
Although COVID-19 presents primarily as a lower respiratory tract infection transmitted via air droplets, increasing data suggest multiorgan involvement in patients that are infected. This systemic involvement is postulated to be mainly related to the SARS-CoV-2 virus binding on angiotensin-converting enzyme 2 (ACE2) receptors located on several different human cells. Lung involvement is the most common serious manifestation of the disease, ranging from asymptomatic disease or mild pneumonia, to severe disease associated with hypoxia, critical disease associated with shock, respiratory failure and multiorgan failure or death. Among patients with COVID-19, underlying cardiovascular comorbidities including hypertension, diabetes and especially cardiovascular disease, has been associated with adverse outcomes, whereas the emergence of cardiovascular complications, including myocardial injury, heart failure and arrhythmias, has been associated with poor survival. Gastrointestinal symptoms are also frequently encountered and may persist for several days. Haematological complications are frequent as well and have been associated with poor prognosis. Furthermore, recent studies have reported that over a third of infected patients develop a broad spectrum of neurological symptoms affecting the central nervous system, peripheral nervous system and skeletal muscles, including anosmia and ageusia. The skin, the kidneys, the liver, the endocrine organs and the eyes are also affected by the systemic COVID-19 disease. Herein, we provide a comprehensive overview of the organ-specific systemic manifestations of COVID-19.
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Affiliation(s)
- Maria Gavriatopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Eleni Korompoki
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece
- Division of Brain Sciences, Imperial College London, London, UK
| | - Despina Fotiou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Ioannis Ntanasis-Stathopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Theodora Psaltopoulou
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Evangelos Terpos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece
| | - Meletios A Dimopoulos
- Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, 80 Vas. Sofias Avenue, 11528, Athens, Greece.
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Haraszti S, Sendil S, Jensen N. Delayed Presentation of Acute Generalized Exanthematous Pustulosis Following Treatment with Cefepime in a Patient with COVID-19 without the Use of Hydroxychloroquine. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e926901. [PMID: 33097683 PMCID: PMC7592336 DOI: 10.12659/ajcr.926901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/16/2020] [Accepted: 09/09/2020] [Indexed: 12/03/2022]
Abstract
BACKGROUND Acute generalized exanthematous pustulosis (AGEP) is a rare exanthem characterized by the abrupt onset of numerous small, non-follicular, sterile pustules arising on an erythematous base. AGEP is often associated with medications; however, it has also been connected to various viral infections including cytomegalovirus, parvovirus B19, and Epstein-Barr virus. Coronavirus disease 2019 (COVID-19) has been associated with a variety of skin findings, including erythematous or patchy rash, urticaria, hives, blisters, petechiae, livedo reticularis, and even AGEP in a patient undergoing treatment with hydroxychloroquine. CASE REPORT A 78-year-old man with a past medical history of benign prostatic hyperplasia, coronary artery disease, and atrial fibrillation presented with septic shock secondary to a urinary tract infection. On day 7 of treatment with cefepime, he became febrile and developed a pustular rash and persistent hypotension without any respiratory symptoms. Subsequently, he was diagnosed with COVID-19. Skin biopsy of the rash revealed AGEP. CONCLUSIONS AGEP is an uncommon cutaneous eruption often triggered by medications and viruses. AGEP is thought to be mediated by pro-inflammatory cells and cytokines. This report describes an unusual presentation of AGEP following treatment with cefepime for a urinary tract infection in a 78-year-old man who was found to be positive for SARS-CoV-2 infection, but was not treated with hydroxychloroquine. Although AGEP has been described in association with some viral infections, it is more commonly a drug-associated dermatosis, commonly seen during treatment with antibiotics. As in this case, AGEP usually resolves after discontinuation of the offending antibiotic.
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Abou-Ismail MY, Diamond A, Kapoor S, Arafah Y, Nayak L. The hypercoagulable state in COVID-19: Incidence, pathophysiology, and management. Thromb Res 2020; 194:101-115. [PMID: 32788101 PMCID: PMC7305763 DOI: 10.1016/j.thromres.2020.06.029] [Citation(s) in RCA: 445] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023]
Abstract
The 2019 coronavirus disease (COVID-19) presents with a large variety of clinical manifestations ranging from asymptomatic carrier state to severe respiratory distress, multiple organ dysfunction and death. While it was initially considered primarily a respiratory illness, rapidly accumulating data suggests that COVID-19 results in a unique, profoundly prothrombotic milieu leading to both arterial and venous thrombosis. Consistently, elevated D-dimer level has emerged as an independent risk factor for poor outcomes, including death. Several other laboratory markers and blood counts have also been associated with poor prognosis, possibly due to their connection to thrombosis. At present, the pathophysiology underlying the hypercoagulable state is poorly understood. However, a growing body of data suggests that the initial events occur in the lung. A severe inflammatory response, originating in the alveoli, triggers a dysfunctional cascade of inflammatory thrombosis in the pulmonary vasculature, leading to a state of local coagulopathy. This is followed, in patients with more severe disease, by a generalized hypercoagulable state that results in macro- and microvascular thrombosis. Of concern, is the observation that anticoagulation may be inadequate in many circumstances, highlighting the need for alternative or additional therapies. Numerous ongoing studies investigating the pathophysiology of the COVID-19 associated coagulopathy may provide mechanistic insights that can direct appropriate interventional strategies.
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Affiliation(s)
- Mouhamed Yazan Abou-Ismail
- University Hospitals, Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University, Cleveland, OH, United States of America.
| | - Akiva Diamond
- University Hospitals, Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University, Cleveland, OH, United States of America
| | - Sargam Kapoor
- Alaska Native Medical Center, Anchorage, AK, United States of America
| | - Yasmin Arafah
- University Hospitals, Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University, Cleveland, OH, United States of America
| | - Lalitha Nayak
- University Hospitals, Cleveland Medical Center, Cleveland, OH, United States of America; Case Western Reserve University, Cleveland, OH, United States of America.
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Charitos IA, Ballini A, Bottalico L, Cantore S, Passarelli PC, Inchingolo F, D'Addona A, Santacroce L. Special features of SARS-CoV-2 in daily practice. World J Clin Cases 2020; 8:3920-3933. [PMID: 33024749 PMCID: PMC7520789 DOI: 10.12998/wjcc.v8.i18.3920] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/31/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023] Open
Abstract
The severe acute respiratory syndrome-coronavirus-2 (commonly known as SARS-CoV-2) is a novel coronavirus (designated as 2019-nCoV), which was isolated for the first time after the Chinese health authorities reported a cluster of pneumonia cases in Wuhan, China in December 2019. Optimal management of the Coronavirus Disease-2019 disease is evolving quickly and treatment guidelines, based on scientific evidence and experts' opinions with clinical experience, are constantly being updated. On January 30, 2020, the World Health Organization declared the SARS-CoV-2 outbreak as a "Public Health Emergency of International Concern". The total lack of immune protection brought about a severe spread of the contagion all over the world. For this reason, diagnostic tools, patient management and therapeutic approaches have been tested along the way, in the desperate race to break free from the widespread infection and its fatal respiratory complications. Current medical knowledge and research on severe and critical patients' management and experimental treatments are still evolving, but several protocols on minimizing risk of infection among the general population, patients and healthcare workers have been approved and diffused by International Health Authorities.
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Affiliation(s)
- Ioannis A Charitos
- Department of Emergency and Urgency, National Poisoning Centre, Riuniti University Hospital of Foggia, Foggia 71122, Italy
| | - Andrea Ballini
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University Campus "E. Quagliariello", University of Bari “Aldo Moro”, Bari 70125, Italy
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Lucrezia Bottalico
- Interdepartmental Research Center for Pre-Latin, Latin and Oriental Rights and Culture Studies (CEDICLO), University of Bari, Bari 70121, Italy
| | - Stefania Cantore
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari 70124, Italy
- Sorriso & Benessere - Ricerca e Clinica S.R.L, Bari 70129, Italy
| | - Pier Carmine Passarelli
- Department of Head, Neck and Sense Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, Section of Dental Medicine, University of Bari “Aldo Moro”, Bari 70124, Italy
| | - Antonio D'Addona
- Department of Head and Neck and Sensory Organs, Division of Oral Surgery and Implantology, Fondazione Policlinico Universitario A. Gemelli IRCCS — Università Cattolica del Sacro Cuore, Roma 00168, Italy
| | - Luigi Santacroce
- Interdepartmental Research Center for Pre-Latin, Latin and Oriental Rights and Culture Studies (CEDICLO), University of Bari, Bari 70121, Italy
- Ionian Department, Microbiology and Virology Laboratory, Policlinico University Hospital, University of Bari “Aldo Moro”, Bari 70124, Italy
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Karki S, Rawal SB, Malla S, Rayamajhi J, Thapa BB. A case report on spontaneous hemoperitoneum in COVID-19 patient. Int J Surg Case Rep 2020; 75:211-213. [PMID: 32959008 PMCID: PMC7489338 DOI: 10.1016/j.ijscr.2020.09.078] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Coronavirus disease (COVID-19) is a global a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients commonly present with respiratory tract symptoms and fever. However two third are asymptomatic and unusual presentation is evolving. This has cause management dilemma among physicians. PRESENTATION OF CASE A 35 year young otherwise healthy male presented to emergency department of this institute with fever of 103 °F, abdominal pain, and pancytopenia with progressive fall in hemoglobin level was tested positive for COVID-19. Contrast enhance computed tomography of the patient revealed hemoperitoneum with splenic infarct. He was admitted in intensive care unit and managed with supportive treatment. DISCUSSION Respiratory and gastrointestinal symptoms with hematological abnormalities like lymphopenia, thrombocytopenia are common presentation of COVID-19. Although coagulopathy and vasculitis has been a well-documented entity in patients with COIVD-19, visceral infarction leading to spontaneous hemoperitoeum was unusual and rare clinical presentation. CONCLUSION A high degree of clinical suspicion and thorough evaluation helps in the diagnosis of COVID-19 and related complications. The management of cases with unusual presentation requires judicious and careful approach.
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Affiliation(s)
- Saurab Karki
- Department of Surgery, Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal.
| | - Sushil Bahadur Rawal
- Department of Surgery, Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal.
| | - Srijan Malla
- Department of Surgery, Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal.
| | - Jyoti Rayamajhi
- Department of Surgery, Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal.
| | - Bikash Bikram Thapa
- Department of Surgery, Nepalese Army Institute of Health Sciences, College of Medicine, Kathmandu, Nepal.
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Smith R, Geary SM, Salem AK. Implications of current and future approaches to coronavirus disease 2019 testing. Future Virol 2020; 15:551-556. [PMID: 33193806 PMCID: PMC7560716 DOI: 10.2217/fvl-2020-0318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/30/2020] [Indexed: 11/21/2022]
Affiliation(s)
- Rasheid Smith
- Division of Pharmaceutics & Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA
| | - Sean M Geary
- Division of Pharmaceutics & Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA
| | - Aliasger K Salem
- Division of Pharmaceutics & Translational Therapeutics, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA
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Maniaci A, Iannella G, Vicini C, Pavone P, Nunnari G, Falsaperla R, Di Mauro P, Ferlito S, Cocuzza S. A Case of COVID-19 with Late-Onset Rash and Transient Loss of Taste and Smell in a 15-Year-Old Boy. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e925813. [PMID: 32814757 PMCID: PMC7467634 DOI: 10.12659/ajcr.925813] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 08/11/2020] [Accepted: 07/17/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic that spread from China is caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). The head and neck region can be variably affected in adult patients, and taste and smell disorders are typical manifestations. However, pediatric clinical signs are less severe, making the onset diagnosis challenging to interpret. The variability of nasal olfactory symptoms in children and adolescents is intertwined with possible warning signs, including gastrointestinal, ocular, or dermatological symptoms. We present a case involving a 15-year-old boy with clinically confirmed COVID-19 who had late-onset rash and transient taste and smell disorders. CASE REPORT The boy's clinical history revealed that a family member was positive for SARS-CoV-2. In the preceding 3 days, the boy's eating habits had changed; he perceived a metallic taste while eating and had a loss of appetite. He also had erythematous skin lesions on the lower limbs for the 2 previous days. A sore throat, nasal congestion, and a runny nose were reported on head and neck examination. A real-time polymerase chain reaction test was positive, confirming the initial diagnostic hypothesis. CONCLUSIONS SARS-CoV-2 virus infection in children and adolescents can be asymptomatic, but it can also occur with fever, dry cough, fatigue, and gastrointestinal symptoms. Due to the unique immune characteristics of pediatric and adolescent patients, the correct interpretation of the gustatory and skin symptoms associated with specific laboratory tests for SARS-CoV-2 infection can lead to the most appropriate management and supportive care.
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Affiliation(s)
- Antonino Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Catania, Italy
| | | | - Claudio Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck, and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
| | - Piero Pavone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giuseppe Nunnari
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | | | - Paola Di Mauro
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Catania, Italy
| | - Salvatore Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Catania, Italy
| | - Salvatore Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Catania, Italy
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Singh V, Luthra A, Chauhan R, Meena SC. Basic Virology and Pathophysiology of COVID-19. CLINICAL SYNOPSIS OF COVID-19 2020:5-29. [DOI: 10.1007/978-981-15-8681-1_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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