Reza Ibrahimi; Shadab Sahraian; AmirAli Moodi Ghalibaf; Mahnaz mozdorian
Abstract
Coronavirus disease 2019 (COVID-19) is a rapidly growing health concern claiming over 6 million lives as of April 2022. Some evidence revealed that pregnancy increases the risk of severe illness with Coronavirus infection. COVID-19 also complicates the pregnancy results such as the number of cesarean ...
Read More
Coronavirus disease 2019 (COVID-19) is a rapidly growing health concern claiming over 6 million lives as of April 2022. Some evidence revealed that pregnancy increases the risk of severe illness with Coronavirus infection. COVID-19 also complicates the pregnancy results such as the number of cesarean deliveries and premature births. Mitral stenosis is a structural heart disease that endangers the patient and their newborn, accompanied by serious morbidity and mortality. The present patient, 40 years old gravida 2 para 1 at 37 weeks presented to the emergency department with progressive dyspnea following fever and malaise for a week. SARS-CoV-2 testing was positive ergo appropriate treatment was administered. CT scan showed severe COVID-19 pneumonia with a severity index of 23. Due to respiratory distress, the patient was readily admitted to the intensive care unit. The patient was supported with non-invasive ventilation. Nevertheless, NIV was insufficient with signs of respiratory fatigue so the patient was intubated. Despite the subsidence of fever and stable clinical condition patient remained tachycardic which promoted us to perform echocardiography revealing severe mitral stenosis. This report contains our experience and suggestions regarding this rare concurrence. The paucity of data is significant regarding the management of concurrent structural heart disease and COVID-19 in pregnancy. It should be emphasized that the importance of maintaining routine care and screening during the pandemic; which can be catastrophic if missed.
Alireza Sedaghat; Amene Raouf-Rahmati; Katayoun Samadi; Farida Daneshvar Mozaffari; Ahmad Nemati; Benyamin Fazli
Abstract
Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: ...
Read More
Introduction: Currently, humankind is facing a COVID-19 pandemic that has spread worldwide. This is the first study conducted during the first phase of the COVID-19 outbreak in Mashhad, Iran, to describe the clinical, therapeutic, and laboratory findings of survivor and non-survivor patients with COVID-19.Methods: This retrospective study included a total of 191 confirmed COVID-19 patients aged ≥18 who were admitted to an intensive care unit in the northeast of Iran in 2020. Clinical, therapeutic, and laboratory findings were recruited. The data were analyzed using SPSS software (version 23) through the Mann-Whitney U test, Chi-Square test, independent sample t-test, as well as a single variable and multivariable logistic regression.Results: Out of a total of 191 hospitalized patients, 137 (71.7%) survived and 54 (28.2%) expired. The mean age of non-survived patients was 17 years higher than that of survived patients (P<0.0001). Hypertension, diabetes, and coronary and pulmonary diseases were significantly related to mortality (OR: 3, 2.8, 21.4, and 5.4, respectively; P<0.05). Respiratory rate >24/min, heart rate>125/min, platelet count <100*109/L, creatinine >133 μmol/L, LDH >245 U/L, WBC count >10*109/L, lymphocyte count <0.8*109/L and D-dimer >1 μg/mL were frequently observed in non-survivor patients (P<0.05). Most of the patients had an abnormality on chest radiographs, and bilateral pulmonary infiltration was the dominant chest radiograph abnormality in these patients. Moreover, consolidation and ground-glass opacification were observed more frequently in non-survived patients (P<0.05). More than 57% of severe cases required non-invasive and invasive mechanical ventilation before they died, while it was 1% in survived cases (P<0.05).Conclusion: Older age, previous comorbidities such as diabetes, hypertension, coronary and pulmonary diseases, lymphopenia, leukocytosis, increased respiratory rate, creatinine, LDH, and D-dimer levels were related to a poor prognosis and mortality in patients with SARS-CoV-2 infection.
Behnaz Hatami; Omid Shoraka; Asef Younesi; Gelayol Bavafa; Melika Zamanian; Niloofar Nikpasand; Amirhossein Mohammadzade; Sara Naghizadeh Kashani; Anoush Azarfar; Mojtaba Yousefi Zoshk
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, ...
Read More
Multisystem inflammatory syndrome in children (MIS-C) is a novel syndrome in children following the coronavirus disease 2019 (COVID-19) pandemic, which has similar symptoms to Kawasaki disease or toxic shock syndrome. The most prevalent symptoms in MIS-C patients are fever and gastrointestinal symptoms, with substantial cardiac complications. Cardiac involvement is frequently reported in MIS-C patients and includes arrhythmia, coronary artery aneurysm and dilation, conduction abnormalities, and ventricular dysfunction. Cardiogenic or vasodilatory shock may develop in patients with severe MIS-C, necessitating inotropic support, fluid resuscitation, mechanical ventilation, and extracorporeal membrane oxygenation. Empirical therapies have attempted to reverse the inflammatory response, and steroids or intravenous immunoglobulin have all been commonly used. Most children will survive with prompt diagnosis and appropriate treatment, but since the disease's outcomes are unclear, long-term follow-ups are necessary. This narrative review summarizes the available studies regarding cardiac involvement in MIS-C cases as well as clinical considerations for cardiac examination and follow-up.