Chronic conventional disease-modifying anti-rheumatic drugs masking severe SARS-CoV-2 manifestations in an elderly rheumatic patient

In early 2020 a new beta-corona virus (SARS-CoV-2) spread all over the world, and with a high incidence in Europe, especially in Italy [1,2]. SARS-CoV-2 infection may lead to a wide range of clinical presentations, from an asymptomatic form to a severe acute respiratory syndrome [3]. The symptoms more frequently observed were fever, chills, myalgia or fatigue, followed by a dry cough and dyspnea 3-7 days later. The age and the presence of chronic comorbidities (hypertension, cardiovascular disease, diabetes, chronic lung, kidney or cerebrovascular disease or malignancy) have been considered as the major risk factors for acute respiratory distress syndrome (ARDS) and the need for intensive care in COVID-19 patients [4].
Source: Journal of Infection - Category: Infectious Diseases Authors: Tags: Letter to the Editor Source Type: research

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Publication date: Available online 4 July 2020Source: Respiratory Medicine Case ReportsAuthor(s): Fahad Faqihi, Abdulrahman Alharthy, AlFateh Noor, Ahmed Balshi, Abdullah Balahmar, Dimitrios Karakitsos
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research
Authors: Ambrosino P, Di Minno A, Maniscalco M, Di Minno MND Abstract The rapidly increasing number of studies on the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) indicate that this viral agent can cause the coronavirus disease 2019 (COVID-19), a syndrome with a wide spectrum of clinical presentations, ranging from a mild disease with flu-like symptoms to a life-threatening condition that requires specialized management at Intensive Care Units (ICU). Critical patients with COVID-19 have a high risk of thromboembolic complications, as expressed by a Padua prediction score always ≥4. Moreover...
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
Conclusion and Relevance: In this single-center case series from New Delhi, out of 82 patients of SARI, 32 patients were confirmed NCIP, with a COVID-19 positivity of 39%. 75% of NCIP presented in severe pneumonia and 37.5% required ICU care. The case fatality rate was 28%. PMID: 32602676 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Abstract The novel severe acute respiratory syndrome coronavirus 2 is the causative agent of coronavirus disease 2019, a new human infectious disease. While fever, cough, and respiratory distress are typical first symptoms, a fraction of those affected present instead with neurological symptoms suggestive of central nervous system compromise. This review summarizes the potential contribution of coronavirus disease 2019 to hemorrhagic stroke in the elderly and proposes possible mechanisms. Reports show that the most affected patients have underlying chronic diseases such as hypertension and diabetes, which are two ...
Source: Aging - Category: Biomedical Science Authors: Tags: Aging (Albany NY) Source Type: research
AbstractObjectivesThe primary objective is to determine the efficacy of a single dose of ivermectin, administered to low risk, non-severe COVID-19 patients in the first 48 hours after symptom onset to reduce the proportion of patients with detectable SARS-CoV-2 RNA by Polymerase Chain Reaction (PCR) test from nasopharyngeal swab at day 7 post-treatment.The secondary objectives are:To assess the efficacy of ivermectin to reduce the SARS-CoV-2 viral load in the nasopharyngeal swab at day 7 post treatment.To assess the efficacy of ivermectin to improve symptom progression in treated patients.To assess the proportion of seroco...
Source: Trials - Category: Research Source Type: clinical trials
CONCLUSIONS: SARS-Cov-2 has emerged as a worldwide threat, currently affecting 170 countries and territories across the globe. There is still much to be understood regarding SARS-CoV-2 about its virology, epidemiology and clinical management strategies; this knowledge will be essential to both manage the current pandemic and to conceive comprehensive measures to prevent such outbreaks in the future. PMID: 32495923 [PubMed - in process]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
A 50 year-old man with controlled hypertension and type II diabetes presented after one week of dyspnea and cough with a blood O2 saturation of 90%. A Reverse Transcriptase-Polymerase Chain Reaction assay on a nasopharyngeal swab specimen confirmed severe acute respiratory syndrome coronavirus 2, and a diagnosis of coronavirus disease 2019 (COVID-19) pneumonia. On initial neurologic examination, the patient was alert and fully oriented with fluent speech and no focal deficits. On the second hospital day and while on 2L of supplemental O2 through nasal cannula, blood O2 saturation dropped to 70% and he was intubated.
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research
AbstractThe COVID-19 pandemic is a significant global event in the history of infectious diseases. The SARS-CoV-2 appears to have originated from bats but is now easily transmissible among humans, primarily through droplet or direct contact. Clinical features of COVID-19 include high fever, cough, and fatigue which may progress to ARDS. Respiratory failure can occur rapidly after this. The primary laboratory findings include lymphopenia and eosinopenia. Elevated D-dimer, procalcitonin, and CRP levels may correlate with disease severity. Imaging findings include ground-glass opacities and patchy consolidation on CT scan. Mo...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
An 84-year-old woman with a diameter of 10  mm irregular subsolid nodule in the right middle lobe on computed tomography (CT) images of the chest (Figure 1, A1) was confirmed to have T1b N0 M0 lung adenocarcinoma after thoracoscopic right middle lobectomy on January 14. She had 20-year history of hypertension and diabetes and her pulmonary function testing was normal before surgery. This patient complained of cough, expectoration, and dyspnea the next day but no any signs of pneumonia displayed on her chest CT images (Figure 1, A2).
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Case Report Source Type: research
One of the worst symptoms of any plague is uncertainty—who it will strike, when it will end, why it began. Merely understanding a pandemic does not stop it, but an informed public can help curb its impact and slow its spread. It can also provide a certain ease of mind in a decidedly uneasy time. Here are some of the most frequently asked questions about the COVID-19 pandemic from TIME’s readers, along with the best and most current answers science can provide. A note about our sourcing: While there are many, many studies underway investigating COVID-19 and SARS-CoV-19, the novel coronavirus that causes the illn...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Explainer Source Type: news
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