Hyperacute multi-organ thromboembolic storm in COVID-19: a case report
We report a 66-year-old female patient with post-mortem diagnosis of COVID-19 who presented progressive livedo racemosa, acute renal failure and myocardial injury, as well as an absence of respiratory symptoms. Transthoracic echocardiography showed severe spontaneous echo contrast in the right cardiac chambers and right-sided cardiac overload presumed to result from pulmonary microvascular thrombosis or embolism.d-dimer levels were increased. The patient developed an acute ischemic stroke and died 2 days following presentation despite therapeutic anticoagulation. Her predominantly thromboembolic presentation supports the concept of coronavirus infection of endothelial cells and hypercoagulability, or COVID-19 endotheliitis. The case we report highlights that COVID-19-associated hyperacute mul ti-organ thromboembolic storm may precede or present disproportionately to respiratory involvement.
Publication date: September 2020Source: American Heart Journal, Volume 227Author(s): Payam Dehghani, Laura J. Davidson, Cindy L. Grines, Keshav Nayak, Jacqueline Saw, Prashant Kaul, Akshay Bagai, Ross Garberich, Christian Schmidt, Hung Q. Ly, Jay Giri, Perwaiz Meraj, Binita Shah, Santiago Garcia, Scott Sharkey, David A. Wood, Frederick G. Welt, Ehtisham Mahmud, Timothy D. Henry
Ikaros zinc finger 1 (IKZF1 or Ikaros) is a hematopoietic zinc finger DNA-binding transcription factor that acts as a critical regulator of lymphocyte and myeloid differentiation. Loss-of-function germline heterozygous mutations in IKZF1 affecting DNA-binding were described as causative of 2 distinct primary immunodeficiency (PID)/inborn error of immunity diseases. Mutations acting by haploinsufficiency present with a common variable immune deficiency-like phenotype mainly characterized by increased susceptibility to infections. Mutations acting in a dominant negative fashion present with a combined immunodeficiency phenot...
Authors: Kim S, Jin HJ, Kim SR PMID: 32638569 [PubMed]
We report this consensus to support allergists and clinical immunologists to make optimal decisions under the urgent situation in Asia. PMID: 32638559 [PubMed]
Conclusions: As policymakers face the very difficult question of the necessity and effectiveness of social distancing across the U.S., counties where the policies have been imposed have effectively increased social distancing and have seen slowing the spread of COVID-19. These results might help policymakers to make the public understand the risks and benefits of the lockdown. PMID: 32636878 [PubMed]
Once the Covid-19 pandemic began in late February, the hospital has had 471 patient Covid-19 cases and 73 employees become infected with the illness. It has tested 8,453 people to date.