Curēus
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Objective Post-operative infection after cardiac surgery causes prolonged hospital stay and increased mortality. In patients with diabetes, peri-operative and pre-operative glycemic control have been associated with increased risk of post-operative infection. Saudi Arabia is the 7th highest country in the world for the prevalence of diabetes. ⋯ Conclusion The majority of our patients presented with sub-optimal long-term glycemic control which we linked to poor stress glycemic control perioperatively. Patients with post-operative infections had higher mean peri-operative blood glucose. With the high incidence of diabetes in Saudi Arabia we have demonstrated the importance of good pre-operative assessment which allows tighter peri-operative glycemic control to reduce post-operative morbidity.
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Objective The study was conducted with the objective of describing High-resolution computed tomography (HRCT) chest findings of clinically suspected COVID-19 patients having a negative real-time polymerase chain reaction (RT-PCR) assay as well as prevalence and distribution of the HRCT chest manifestations consistent with the diagnosis of COVID-19 pneumonia. Methods This descriptive cross-sectional study was conducted prospectively on a total of 48 patients with high clinical suspicion for COVID-19 and a negative RT-PCR assay that was presented to the Diagnostic Radiology Department of Capital Hospital, Islamabad from July 2020 to December 2020. These patients were included via non-probability consecutive sampling, had a positive history of contact with a known COVID-19 patient and/or any two of the following signs and symptoms; fever, cough, malaise, body aches, arthralgia, new-onset loss of taste and smell, and dyspnea or oxygen saturation less than 85%. ⋯ Subpleural atelectatic bands were seen in 18 (47.36%) of these, bronchovascular markings were prominent in 15 (39.47%), and reverse halo sign was positive in nine (23.68%) cases. Out of the rest of the cases, three were diagnosed as interstitial lung disease, two as chronic lung disease, and one as active pulmonary tuberculosis. Conclusion The majority of clinically suspected cases for COVID-19 showed hallmark findings on non-contrast HRCT chest scans in keeping with coronavirus disease regardless of a negative RT-PCR assay.
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A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as coronavirus disease 2019 (COVID-19), emerged in Wuhan, China, and rapidly spread across the world. Today, we present an interesting case of a patient with no prior history of pulmonary disease who was diagnosed with COVID-19, recovered after a prolonged hospital course, and was diagnosed with pulmonary fibrosis requiring oxygen therapy thereafter. ⋯ His oxygen requirements have decreased, and repeat computed tomography (CT) scanning has demonstrated improvement in the extent of his pulmonary fibrosis. This case highlights the possibility of pulmonary fibrosis being a major complication among COVID-19 survivors and the importance of using pirfenidone in the management of such cases.
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Background and objective The coronavirus disease 2019 (COVID-19) pandemic has become a global healthcare emergency. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has a wide range of clinical manifestations ranging from subclinical infection to multi-organ failure. In addition to the respiratory system, COVID-19 also adversely affects the kidneys. ⋯ AKI was found to have a significant association with severe COVID-19 disease, with a pooled OR of 8.45 (95% CI: 5.56-12.56; p<0.00001; I2=0%). AKI was associated with significantly higher mortality in patients with COVID-19 with an OR of 13.52 (95% CI: 5.43-33.67; p<0.00001; I2=88%). Conclusion AKI manifests as a common COVID-19 complication, and COVID-19 patients with AKI generally have poor outcomes in terms of disease severity and mortality.
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Coronavirus disease 2019 (COVID-19) resulted in a worldwide pandemic that at the time of this writing has caused over 400,000 deaths within the United States. During the pandemic surge in New York City, NY, a number of military Medical Corps (MC) and Nurse Corps (NC) providers were mobilized in direct support of critical care capabilities through expansion intensive care units. In the course of the deployment, high rates of neurological-related manifestations associated with COVID-19 infection were directly observed by our military provider teams which will be described and supporting literature highlighted. ⋯ Cerebral vascular injuries documented included strokes, iatrogenic intraparenchymal hemorrhage, hypoxia-related changes and sequelae, as well as acquired diseases secondary to delayed treatment of other primary neurologic disease states. Hypercoagulable and inflammatory markers (d-dimer, C-reactive protein, etc) were commonly elevated, and anticoagulation became a key factor in disease treatment and to help mitigate the downstream neurologic sequelae associated with this disease. Here we present these initial findings to lay the groundwork for more robust clinical studies moving forward.