TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS最新文献

Covid-19 vaccine production and tariffs on vaccine inputs Covid-19疫苗生产和疫苗投入物关税

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-10-08 DOI: 10.30875/6bf3bdf6-en

引用次数: 0

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-10-08 DOI: 10.30875/12c628a5-en

引用次数: 2

Indicative list of trade-related bottlenecks and trade-facilitating measures on critical products to combat covid-19 抗击covid-19关键产品的贸易瓶颈和贸易便利化措施指示性清单

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-07-20 DOI: 10.30875/716a0e13-en

Devin McDaniels

引用次数: 4

Joint Indicative List of Critical COVID-19 Vaccine Inputs for Consultation 供协商的COVID-19关键疫苗投入物联合指示性清单

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-07-07 DOI: 10.30875/ba1fe3c9-en

Dayong Yu

引用次数: 1

Improving trade data for products essential to fight covid-19 改善抗击covid-19所需产品的贸易数据

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-07-01 DOI: 10.30875/cc1b9379-en

引用次数: 0

An Unusual Case of a COVID19-Associated Solitary Pulmonary Nodule 新冠肺炎相关孤立性肺结节1例

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-05-01 DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4103

A. Vaccarello, E. Charley, C. Jagadeesan, A. Talon, J. Munoz, M. Irandost, B. Varda, A. Saeed

{"title":"An Unusual Case of a COVID19-Associated Solitary Pulmonary Nodule","authors":"A. Vaccarello, E. Charley, C. Jagadeesan, A. Talon, J. Munoz, M. Irandost, B. Varda, A. Saeed","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4103","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4103","url":null,"abstract":"Introduction: Solitary pulmonary nodules (SPN) are commonplace and often incidental findings on diagnostic imaging such as computed tomography (CT) of the thorax. A SPN is defined as a single lung opacity of less than 3cm in size. They present a diagnostic dilemma as differentials are broad and range from benign to malignant. Here, we present a case of a SPN in an patient with SARS-CoV-2 infection. Case Description: A 33 year-old female with history of recreational marijuana use presented to the hospital with right-sided flank pain, dysuria, fevers, and nausea for four days. Upon presentation, she was afebrile with stable vital signs and SpO2 97% on ambient air. Physical exam was remarkable only for flank and suprapubic tenderness. A diagnosis of pyelonephritis was made and confirmed with CT of the abdomen which also detected a left lower lobe subpleural nodular consolidation. Follow-up chest CT better characterized the lesion as a 2.2 x 1.2 cm ground glass opacity (GGO) in the posterior left lower lobe without effusion, pneumothorax, or regional lymphadenopathy. Coccidioides serology was negative, however, routine COVID-19 testing found the patient to be positive for SARS-CoV-2. She underwent successful treatment for pyelonephritis and was discharged with instructions to follow up in pulmonology clinic. At follow up, she denied any interval development of respiratory symptoms. Repeat chest CT four months later showed complete resolution of the lesion and she was discharged from pulmonology clinic. Discussion: Since the advent of COVID-19, a plethora of radiologic findings have been noted in patients with known infections. Chest CT offers insight into clinical staging of diseas e and temporal evolutions of CT findings correlate with disease severity. Typical features include bilateral peripheral GGO, crazy paving pattern, airspace consolidations, traction bronchiectasis, and bronchovascular thickening. Atypical findings include mediastinal lymphadenopathy, pleural effusions, multiple small nodules, tree-in-bud, pneumothorax, and cavitation. Though not typical and seemingly underreported, a SPN may also indicate a very early infectious stage in the absence of respiratory symptoms. For our patient, Fleischner guidelines suggest a follow-up CT at 6-12 months but such a strategy would surely fail to detect development of pneumonia given the speed at which COVID-19 progresses, and possibly miss the window on early outpatient interventions and infection prevention. Instead, this case highlights the importance of shorter interval repeat chest imaging in patients with incidental SPN and SARS-CoV-2 infection as a means to monitor for resolution or progression requiring further evaluation and treatment.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84556330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The COP Out Diagnosis: A Rare Case of CMV Pneumonitis and COVID19 Organizing Pneumonia COP Out诊断:一例罕见的巨细胞病毒肺炎和covid - 19组织性肺炎

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-05-01 DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4084

J. Khosa, I. C. Jun, K. Wei

{"title":"The COP Out Diagnosis: A Rare Case of CMV Pneumonitis and COVID19 Organizing Pneumonia","authors":"J. Khosa, I. C. Jun, K. Wei","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4084","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4084","url":null,"abstract":"Introduction: Cytomegalovirus (CMV) pneumonitis is well known as a life-threatening condition in immunocompromised risk groups and has been implicated in the development of cryptogenic organizing pneumonia (COP). We present a unique case of CMV pneumonitis confounded by COP related to a recent SARS-Coronavirus 19 (COVID19) infection. It is important for clinicians to recognize underlying red herrings or potential anchoring bias in the differential of COVID19 sequelae including secondary opportunistic infections. Description: A fifty-five year old gentleman presented with fevers, cough, dyspnea, and myalgias for nine days which progressed to acute hypoxemic respiratory failure. Computed tomography (CT) of the chest showed diffuse ground glass airspace disease with hilar lymphadenopathy and left lower basal consolidation (Figure 1). Diagnostic differentials considered included community acquired pneumonia and COVID19 bronchopneumonia. Empiric antibiotics, Anakinra, and systemic steroids were started. Initial microbiologic studies were negative for bacterial, fungal or viral etiologies, as were serologic testing for autoimmune diseases. COVID19 nucleic acid amplification probes were negative on five separate swabs. The patient failed to clinically improve and ultimately was referred for surgical lung biopsy. The biopsy revealed intranuclear viral inclusions and findings of chronic fibrosing interstitial organizing pneumonia with CMV pneumonitis. Serum CMV polymerase chain reaction (PCR) showed a viral load of 2,520 IU/mL and COVID-19 specific serum IgG was later found to be positive. The patient was treated with therapeutic dose of ganciclovir for two weeks and given a longer steroid course for the organizing pneumonia. After a prolonged hospital stay, the patient was discharged home with tapered prednisone and supplemental oxygen. Discussion: The coexistence of COVID19 and CMV pneumonitis has reported to date in one other case to our knowledge (1,3). We hypothesize that COVID19 infection as evidenced by positive IgG could have served as the inciting event leading to the development of organizing pneumonia. Systemic steroids can induce a relative immunosuppressed state which predisposes to opportunistic infections like CMV pneumonitis. Alternatively, CMV can reactivate in critically ill patients (2). Of note, this case demonstrates the perils of confounding diagnoses and anchoring bias as our patient likely failed to respond clinically to systemic steroid therapy for COP while secondarily infected with CMV. This case highlights the need to consider other possible confounders in the diagnostic differential for COVID19 sequalae when patients are not responding adequately to empiric treatment and to evaluate more histopathologic or post-mortem examinations of COVID19 patients.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84756573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relapse Versus Reinfection: A Case of Recurrence of COVID-19 Infection During Pregnancy 复发与再感染:1例妊娠期COVID-19感染复发

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-05-01 DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4100

B. J. Abuhalimeh, D. Dumford

{"title":"Relapse Versus Reinfection: A Case of Recurrence of COVID-19 Infection During Pregnancy","authors":"B. J. Abuhalimeh, D. Dumford","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4100","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4100","url":null,"abstract":"Introduction The world has been experiencing a novel COVID-19 pandemic since December 2019. Since that time there has been rapid spread and considerable mortality and morbidity. The immunology of COVID-19 is still being determined in the general population as well as select groups such as pregnant females whose immune response may be altered. Here we present a case of questionable relapse vs reinfection of COVID-19 in a pregnant health care worker. Case description A 32 year old female healthcare worker, with no significant past medical history developed slight shortness of breath and loss of taste and smell soon after she discovered about her first pregnancy. She subsequently tested positive for COVID-19 in April 2020. At that time she was at six weeks gestation. She never developed a fever, cough, GI symptoms, malaise, muscle fatigue or sore throat. Because her symptoms were mild and stable, and she never required oxygen supplements, she was asked to quarantine at home, and to take the needed precautions. Telephone visits have been conducted daily to check on her clinical status and patient had access to pulse oximetry and thermostat and therefore has been keeping track of her vital signs and wellbeing. In May 2020 - one month after initial infection- she reported total clearance of her initial symptoms and she has been preparing to return to work. She however reported that she has had contact COVID-19 positive individuals. Because of that she has been retested prior to returning to work. Nasopharyngeal swab was performed and PCR was negative. Two weeks later, she reported acute onset on dyspnea on exertion, and loss of taste and smell. Nasopharyngeal swab was performed and PCR was positive. She experienced mild symptoms and was quarantined home. One month later, she reported resolution of symptoms and repeat COVID19 testing was negative. Discussion Studies have shown that post infection immunity has conferred for at least 3-6 month. Clinical course and prognosis of COVID19 in pregnancy has been found to be associated with more complications and rapid clinical deterioration. Hence, frequent ICU admissions and need for mechanical ventilation were noticed in pregnant COVID19 infected females, however, limited data is available on post infection immunity in pregnancy. Hence, it remains unknown if this presented patient has experienced relapse of an initial infection or if given her immunosuppressed state in setting of pregnancy she has re-acquired the infection.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90922562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When Coronavirus Disease 2019 (COVID-19) Pneumonia Isn't Enough: A Rare Case of Bacterial Coinfection 当2019冠状病毒病(COVID-19)肺炎还不够时:罕见的细菌合并感染病例

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-05-01 DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4093

B. Anderson, A. Nathani, S. Ghamande

{"title":"When Coronavirus Disease 2019 (COVID-19) Pneumonia Isn't Enough: A Rare Case of Bacterial Coinfection","authors":"B. Anderson, A. Nathani, S. Ghamande","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4093","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4093","url":null,"abstract":"Introduction: Atypical bacterial coinfections, including more rare organisms such as Legionella pneumophila, can complicate coronavirus disease 2019 (COVID-19) infections. Care should be taken to avoid anchoring bias and ensure all bacterial coinfections are diagnosed and treated in patients with COVID-19. CASE REPORT: A 49-year-old male with no past medical history developed abdominal pain, diarrhea and cough on April 4, 2020. He tested positive for SARS-CoV 2 on April 6th given there were several people at his work that had recently contracted coronavirus disease 2019 (COVID-19). Over the next week he developed progressive fever, cough, anosmia, ageusia and then dyspnea with exertion which prompted him to seek medical care. Shortly after admission, he became more febrile, tachycardic and hypoxic requiring oxygen supplementation via high-flow nasal cannula. His oxygen requirements continued to worsen, and he was transferred to the ICU and intubated. His procalcitonin was elevated at 8.99 and he was started on empiric broad spectrum antibiotics. Tracheal aspirate was tested via PCR and returned positive for Legionella pneumophila. He also tested positive for Legionella urinary antigen. He received hydroxychloroquine for 7 days, IV doxycycline for 10 days, ceftriaxone for 6 days and piperacillin-tazobactam for 2 days. He gradually improved and was successfully weaned off supplemental oxygen. He was discharged after a 10-day hospital stay with minimal respiratory symptoms. DISCUSSION: Among patients diagnosed with COVID-19, Legionella bacterial coinfection appears to be rare. In a systematic review published in July 2020, Rawson et al reported that only 8% (62/806) of patients diagnosed with COVID-19 were diagnosed with a bacterial pneumonia coinfection and found only one patient who had COVID-19 and Legionella. However, it has been reported that there may be an increased risk of Legionella infections during the COVID-19 pandemic due to water systems being used less often because of lockdown orders. In September 2020, De Giglio et al reported that a large Italian hospital found a significant increase in Legionella pneumophila isolates on routine water system testing in two of three wards which had been closed for over a month due to emergency reorganization. It remains important to keep Legionella bacterial co-infection on the differential when treating COVID-19 since it may require a longer treatment regimen than what is recommended for treating standard community acquired pneumonia. In addition, the pandemic response has the potential to increase the risk of legionella infections secondary to stagnant water systems in lockdowns.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79510766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Spontaneous Pneumomediastinum/Pneumothorax in Acute COVID-19 Pneumonia: A Case Report 急性COVID-19肺炎并发自发性纵隔气胸1例

TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS Pub Date : 2021-05-01 DOI: 10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4112

N. Sahu, J. Roy, E. Ernst, A. Zamir

{"title":"Spontaneous Pneumomediastinum/Pneumothorax in Acute COVID-19 Pneumonia: A Case Report","authors":"N. Sahu, J. Roy, E. Ernst, A. Zamir","doi":"10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4112","DOIUrl":"https://doi.org/10.1164/AJRCCM-CONFERENCE.2021.203.1_MEETINGABSTRACTS.A4112","url":null,"abstract":"Introduction Spontaneous pneumomediastinum, a rare condition in viral pneumonias, has been increasingly reported during the ongoing COVID-19 pandemic. Emerging literature suggests a higher incidence and mortality in COVID-19 patients with both a pneumothorax and pneumomediastinum. Early recognition and understanding of these complications are necessary to improve outcomes. We present a case of an older man initially diagnosed with mild COVID-19 symptoms who quickly progressed with increasing oxygen levels found to have a small pneumothorax and pneumomediastinum. Description A 77-year-old man with hypertension, obstructive sleep apnea on home continuous positive airway pressure (CPAP) therapy, and diagnosis of mild COVID-19 via reverse transcriptase polymerase chain reaction 1-week prior, presented to the emergency department for worsening shortness of breath. He was found to have a temperature of 101.5°F, heart rate of 103bpm, stable blood pressure, respiratory rate of 25 breaths/minute, and oxygen saturation of 70% on ambient air. He was placed on 15lpm mid-flow. Labs were significant for a white blood cell count of 14k/uL, hemoglobin 11.7g/dL, c-reactive protein 185 mg/L, pro- BNP of 637pg/mL, ferritin 802 ng/mL, lactic acid 2 mmol/L, procalcitonin of 0.84 ng/mL. He had a chest x-ray with bilateral perihilar and lower lobe infiltrates. He was started on dexamethasone, remdesivir, antibiotics, tocilizumab, and enoxaparin. His CPAP was held and continued on oxygen therapy. Discussion Pneumomediastinum, or air in the mediastinum, occurs through various etiologies categorized into secondary and spontaneous. Common secondary causes include blunt injuries by trauma, iatrogenic causes such as intubation, central lines, and chest operations, and finally, medical conditions such as interstitial lung disease, asthma, connective tissue disorders, and respiratory infections may be other causes (1). Several cases have been reported with spontaneous pneumomediastinum in patients with COVID-19, however, the exact etiology is unknown as none were placed on mechanical ventilation (2-5). One mechanism is likely due to the repetitive episodes of cough causing increased airway pressure leading to alveolar rupture in already extensively damaged alveoli and proximal gas leakage (2). Based on one autopsy report, there were findings of desquamation of pneumocytes and hyaline membrane formation indicating early acute respiratory distress syndrome (6). In another case series, barotrauma from higher PEEP (positive end-expiratory pressure) with the use of CPAP is potentially another mechanism (7). Careful consideration for these complications should occur in patients with progressive forms of COVID-19, ensuring cough suppression, use of anti-emetics, diuretics and low PEEP strategy to help mitigate this previously rare phenomenon.","PeriodicalId":23169,"journal":{"name":"TP100. TP100 UNEXPECTED COVID-19 CASE REPORTS","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79855893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0