Alveolar Interstitial Pneumonia Research Articles

Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital

BackgroundDelirium incidence and clinical correlates in coronavirus disease-19 (COVID-19) pneumonia are still poorly investigated.AimTo describe the epidemiology of delirium in patients hospitalized for suspect COVID-19 pneumonia during the pandemic peak in an academic hospital of Northern Italy, identify its clinical correlations and evaluate the association with mortality.MethodsThe clinical records of 852 patients admitted for suspect COVID-19 pneumonia, defined as respiratory symptoms or fever or certain history of contact with COVID-19 patients, plus chest CT imaging compatible with alveolar-interstitial pneumonia, were retrospectively analyzed. Delirium was defined after careful revision of daily clinical reports in accordance with the Confusion Assessment Method criteria. Data on age, clinical presentation, comorbidities, drugs, baseline lab tests and outcome were collected. The factors associated with delirium, and the association of delirium with mortality, were evaluated through binary logistic regression models.ResultsNinety-four patients (11%) developed delirium during stay. They were older (median age 82, interquartile range, IQR 78–89, vs 75, IQR 63–84, p < 0.001), had more neuropsychiatric comorbidities and worse respiratory exchanges at baseline. At multivariate models, delirium was independently and positively associated with age [odds ratio (OR) 1.093, 95% confidence interval (CI) 1.046–1.143, p < 0.001], use of antipsychotic drugs (OR 4.529, 95% CI 1.204–17.027, p = 0.025), serum urea and lactate-dehydrogenase at admission. Despite a higher mortality in patients with delirium (57% vs 30%), this association was not independent of age and respiratory parameters.ConclusionsDelirium represents a common complication of COVID-19 and a marker of severe disease course, especially in older patients with neuropsychiatric comorbidity.

Características clínico-epidemiológicas de la infección respiratoria aguda (ira) por Virus Sincitial Respiratorio (VSR) en niños menores de dos años: admitidos en el hospital Infantil Dr. Robert Reid Cabral (HIRRC), enero-diciembre 2006

Antecedentes: El VSR es el principal responsable de bronquiolitis y neumonía intersticial en los primeros 2 años de vida y se asocia a complicaciones bacterianas e incremento de hospitalizaciones por infecciones respiratorias.Los casos ocurren usualmente en otoño e invierno, en República Dominicana se desconoce el comportamiento clínico y epidemiológico de la IRA causada por VRS. Objetivos: Determinar las características clínicas y epidemiológicas de los casos de IRA por VRS en niños menores de 2 años durante el periodo de estudio.Objetivo: Determinar las características clínicas y epidemiológicas de los casos de IRA por VRS en niños menores de 2 años durante el período de estudio.Métodos: Estudio prospectivo, descriptivo y observacional donde se estudiaron todos los niños de 0 a 24 meses ingresados con diagnóstico de bronquiolitis durante el período de estudio y radiografías de tórax reportadas como bronquiolitis o neumonía alveolo-intersticial, que fueron confirmadas por la prueba Binax Now® VRS.Resultados: De 114 niños de 0-24 meses de edad y de ambos sexos, admitidos con diagnóstico de bronquiolitis en el HIRRC durante el período de estudio, en 54 casos (48%) se confirmó el VRS a través de la prueba Binax Now®VRS, 62% correspondió al sexo masculino, el 76% a los menores de 4 meses; tos y dificultad respiratoria fueron las manifestaciones clínicas más frecuentes, con 52 casos (94.5%), seguidas por sibilancias, con 46 (83.6%) y retracción subcostal, con 41 (74.5%); la radiografía de tórax reportó bronquiolitis en 36 casos (66.7%), neumonía alveolo-intersticial en 16 casos (29.6%), neumonía más neumotórax y bronquiolitis más atelectasia en 1 caso (1.8%), respectivamente. En el 76.3% la estadía fue menor de 4 días. La totalidad de los casos se presentaron en los meses de octubre (19 casos), noviembre (22 casos), diciembre (12 casos) y enero (1 caso); el 87% presentó anemia, hallazgo no reportado en otros estudios.Conclusión:VSR tiene comportamiento estacional; es el responsable de la mayoría (48%) de los casos de bronquiolitis y neumonía intersticial en lactantes menores; tos y dificultad respiratoria fueron las manifestaciones clínicas más frecuentes; la anemia estuvo presente en el 87% de los casos.

Dynamique de la pathologie respiratoire dans un service de pneumologie en Afrique noire dans le contexte de l’infection à VIH de 1998 à 2007

The pneumology in developing countries is practiced in a singular context: population mostly younger, endemic tuberculosis, high prevalence of HIV infection and growing pollution. The aim of this study is to present respiratory pathology evolution in hospitalization of pneumology department in black Africa. Our study is retrospective and descriptive. We consulted the register of hospitalization activities from January 1998 to December 2007. The age group of 20-49 years represents 78.36% of all patients. Tuberculosis (TB) remains the first affection from 1998 to 2007 with a frequency varying between 38.2% and 45.2%. The cases of pneumonia are in regression since 2001, but cases of febrile alveolar interstitial pneumonia (FAIP) increase. The pathologies bound to tobacco addiction are rare. HIV infection is associated to TB (82.86%), to pneumonia (77.22%), to FAIP (92.23%). On 832 cases of death recorded, 46.15% of deaths are assigned to TB, 15.98% to pneumonia and 14.66% to FAIP. The global lethality of the TB and the pneumonia is respectively 20.1% and 17.6%. The one of FAIP is 32.5%. Mortality attributable to TB and pneumonia decreases progressively but the one attributable to FAIP remains important. Respiratory pathology is dominated by TB, pneumonia and FAIP. These pathologies associated to HIV infection cause a strong mortality.

Respiratory syncytial virus, a rare cause of severe pneumonia following bone marrow transplantation

Mixed alveolar interstitial pneumonia is a much-feared complication in bone marrow transplant recipients because it carries a high mortality. Many cases in which an etiological agent is identified are due to fungi or cytomegalovirus; rarely, other infectious agents such as Pneumocystis carinii or (para)influenzavirus are involved. In this report we describe a patient who received intense chemotherapy followed by autologous bone marrow transplantation for relapse of testis seminoma and who developed a severe alveolar interstitial pneumonia caused by respiratory syncytial virus in the early posttransplant period. The patient fully recovered after treatment with ribavirin.