Positive Polymerase Chain Reaction Test Research Articles

Results of Routine Antenatal Screening for Cytomegalovirus at a Tertiary Center.

Cytomegalovirus (CMV) is the most common viral infection. In this study, we discussed the results of pregnant women who underwent antenatal CMV screening in a tertiary center and the value of CMV antenatal screening. For this retrospective study, the data of pregnant patients with antenatal CMV screening test results between 2019 and 2022 were obtained from hospital records. CMV immunoglobulin M (IgM), CMV IgG, anti-IgG avidity test results, amniocentesis, CMV polymerase chain reaction (PCR), and the outcome of the babies were recorded. A total of 31,912 CMV IgM and 26,969 CMV IgG tests were performed. CMV IgG seropositivity was observed in 78.99% of pregnant women, and 0.09% of the pregnant women were confirmed to have a positive CMV IgM test result. Pregnant women with positive IgM accompanying low avidity were referred to perinatology clinics for detailed ultrasonography and amniocentesis. Only 3 of the 44 pregnant women who underwent amniocentesis were confirmed to have positive CMV PCR testing. CMV screening should be preserved for pregnant women with ultrasonographic findings at high risk of congenital CMV infection.

Severe cardiac AL amyloidosis in an elderly patient with multiple SARS-CoV-2 reinfection: a case report

Introduction. The relationship between systemic amyloidosis and coronavirus disease 2019 (COVID-19) has not been sufficiently studied to date. This paper presents a case of the persistence of COVID-19 markers in an elderly patient with systemic amyloidosis.Brief description. A 74-year-old patient with heart failure with preserved ejection fraction and type 2 diabetes was repeatedly hospitalized due to decompensated heart failure. Based on the data of protein electrophoresis with immunotyping, biopsy of subcutaneous fat and bone marrow, echocardiographic data, the patient was diagnosed with systemic AL amyloidosis with cardiac involvement. During hospitalizations in April, August and December 2020, positive polymerase chain reaction test for SARS-CoV-2 were obtained, while there were no clinical manifestations of infection for a long time and adequate antibody production.Conclusion. A case report demonstrates multiple SARS-CoV-2 reinfection in a severe comorbid elderly patient, as an unfavorable prognostic factor.

Course and clinical severity of the SARS-CoV-2 Omicron variant infection in Tianjin, China.

There is limited information describing the course and severity of illness in subjects infected by the severe acute respiratory syndrome coronavirus 2 Omicron variant, especially in children. In this population-based cohort study, subjects with Omicron variant infection during the outbreak between January 8 and February 12, 2022 in Tianjin, China were included (n = 429). The main outcomes were the distribution of asymptomatic, mild, moderate, and severe patients, and clinical courses including the interval from positive polymerase chain reaction (PCR) test to the onset, aggravation or relief of symptoms, and the interval of reversing positive PCR-test into negative, and length of hospital stay. Of the 429 subjects (113 [26.3%] children; 239 [55.7%] female; median age, 36 years [interquartile range 15.0 to 55.0 years]), the proportion (95% CI) of symptomatic subjects on admission was 95.6% (93.2%, 97.2%), including 60.4% (55.7%, 64.9%) mild, 35.0% (30.6%, 39.6%) moderate, and 0.2% (0.0%, 1.3%) severe. Compared with adults, children had lower proportion of moderate Covid-19 (8.8% vs 44.3%). On discharge, 45.9% (41.3%, 50.7%) and 42.2% (37.6%, 46.9%) of the subjects were diagnosed as having experienced mild and moderate Covid-19. The median (interquartile range) length of hospital stay was 14.0 (12.0, 15.0) days. The median interval of reversing positive PCR-test into negative was 12.0 (10.0, 13.0) days. Symptomatic and moderate Covid-19 in Omicron infections was common in adults and children, recovery from Omicron infections took around 2 weeks of time. The severe acute respiratory syndrome coronavirus 2 Omicron infection in this study was not as mild as previously suggested.

Body mass index and fitness in late adolescence and risk of cardiovascular disease, respiratory disease, and overall death after COVID-19.

Since obesity and poor fitness appear to be unfavorable for both cardiovascular health and coping with viral infections such as COVID-19, they are of specific interest in light of the increased risk of cardiovascular and respiratory events now seen after infection with SARS-CoV-2. Therefore, the aim of the present study was to investigate how body mass index (BMI) and cardiorespiratory fitness (CRF) in late adolescence are associated with the risk of cardiovascular disease (CVD), respiratory disease, and mortality after COVID-19. In this study, 1.5 million 18-year-old Swedish men with BMI and CRF measured during enlistment for military service 1968-2005 were included. Hospitalized and non-hospitalized COVID-19 cases were identified through the Patient Register or positive polymerase chain reaction tests, and age-matched with non-infected controls. CVD, respiratory disease, and mortality after COVID-19 were divided into <60days, 60-180days, >180days post-infection. Cox regression models were used. Hospitalized COVID-19 cases (n=9839), compared to controls, had >10-fold, 50 to 70-fold, and >70-fold hazards of CVD, respiratory disease, and mortality over the initial 60days post-infection with little variation across BMI or CRF categories. The elevated risks persisted at declining levels >180days. For non-hospitalized COVID-19 cases (n=181,822), there was a 4- to 7-fold increased acute mortality risk, and high CRF was associated with lower risk of post-infectious respiratory disease. The high hazards of adverse outcomes during the first two months after COVID-19 hospitalization, and across BMI and CRF categories, declined rapidly but were still elevated after six months. Adolescent CRF was associated with respiratory disease after COVID-19 without hospitalization, which gives further support to the health benefits of physical activity.

Using Active Surveillance to Identify Monoclonal Antibody Candidates Among COVID-19-Positive Veterans in the Atlanta VA Health Care System.

Strategies for optimizing identification and outreach to potential candidates for monoclonal antibody (Mab) therapy for COVID-19 are not clear. Using a centralized, active surveillance system, the Atlanta Veterans Affairs Health Care System (AVAHCS) infectious disease (ID) team identified candidates for Mab infusion and provided treatment. As part of a quality improvement project from December 28, 2020, to August 31, 2021, a clinical team consisting of ID pharmacists and physicians reviewed each outpatient with a positive COVID-19 polymerase chain reaction test daily at the AVAHCS. The clinical team used Emergency Use Authorization (EUA) criteria to determine eligibility. Eligible patients were contacted on the same day of review via telephone to confirm eligibility and obtain verbal consent. Telehealth follow-up occurred on day 1 and day 7 postinfusion to assess for adverse events. In total, 2028 patients with COVID-19 were identified; 289 patients (14%) were eligible, and 132 (46%) received Mab therapy. Similar to AVAHCS demographics, a majority of those who received Mab therapy were non-Hispanic Black patients (65%). The most common comorbidities were hypertension (59%) and diabetes (37%). The median time from symptom onset to positive COVID-19 polymerase chain reaction (PCR) test result was 6 days (range, 0-9), and the median time from positive COVID-19 PCR test result to Mab infusion was 2 days (range, 0-8). Twelve patients (9%) required hospitalization for worsening COVID-19 symptoms postinfusion. No deaths occurred. Combining laboratory surveillance and active screening led to high uptake of Mab therapy and minimized delay from symptom onset to Mab infusion, thereby optimizing outpatient treatment of COVID-19. This approach also successfully screened and treated Black patients in the AVAHCS population.

Musculoskeletal system symptoms in patients with COVID-19 and the impact of these symptoms on quality of life.

Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and also affects the musculoskeletal system. This study was conducted to investigate the musculoskeletal symptoms, type of pain and effect on quality of life in patients presenting with pain after COVID-19. This prospective, descriptive study included 97 patients aged 18 years or older who were diagnosed with COVID-19 based on a positive polymerase chain reaction test result, with or without musculoskeletal pain prior to COVID-19 infection. Patients who applied to the post-COVID-19 outpatient clinic with the complaint of pain at least 1 month and maximum 1 year after the diagnosis of COVID-19 were included. Patients' demographic characteristics and musculoskeletal examination findings were evaluated. The patients were examined, and the questionnaire forms were completed. The pain was assessed using the visual analog scale (VAS), the Douleur-Neuropathique-4 (DN-4) questionnaire, while the quality of life was assessed using the Short Form-36 (SF-36) survey. Patients were divided into groups in terms of gender, age, body mass index. Shapiro-Wilk's test, the independent samples t-test and the Mann-Whitney U test were used for statistical analyses. The mean age of the patients was 46.5 ± 13.5 years, 30 of them were male. Pain increased in patients with pre-COVID-19 arthralgia and myalgia (p< 0.001). Post-COVID-19 VAS was significantly higher than pre-COVID-19 VAS (7 ± 1.2 vs. 3.2 ± 1.9, p< 0.05). Pre-COVID-19 patients with myalgia had significantly worse SF-36 physical function, social function, pain, general health perception (p< 0.05). The mean scores of females in the SF-36 physical function, pain were significantly worse than males (p< 0.05). According to DN-4, 41 (42.3%) patients had neuropathic pain. There was moderate negative correlation between VAS, DN-4 and SF-36 (p< 0.05). Arthralgia, myalgia, and neuropathic pain, all of which negatively affect the quality of life, are often observed in the patients infected with COVID-19.

A pediatric case of exudative erythema multiforme probably associated with asymptomatic COVID-19

COVID-19 is a pandemic involving severe acute respiratory syndrome-coronavirus SARS-CoV-2, which started in China at the end of 2019 and has spread globally. Among COVID-19 patients, 17.8% are under 20 years of age. Most children infected with SARS-CoV-2 are asymptomatic or only oligosymptomatic and can easily be overlooked. We followed an 11-year-old boy showing exudative erythema multiforme, which appeared during isolation at home following a positive polymerase chain reaction (PCR) test for COVID-19. Our case, although otherwise asymptomatic, showed typical clinical and histological manifestations of the erythema multiforme-like lesions associated with COVID-19. The presence of such an asymptomatic SARS-CoV-2 carrier who developed erythema multiforme-like skin lesions provides the possibility that some undefined infectious organisms, such as SARS-CoV-2, could be the origin of exudative erythema multiforme cases without any apparent cause.

International biathlon season during the COVID-19 pandemic was based on frequent on-site PCR-testing protocol with rapid result management.

The resumption of professional sports during the COVID-19 pandemic has been described in team sports but less in individual sports. The International Biathlon Union implemented a COVID-19 concept for the 2020-2021 season aimed to mitigate the risks of transmission by rules designated for the professional biathlon environment. The "bubble" model was based on regular reverse transcript polymerase chain reaction (PCR) testing with rapid results and efficient result management protocol. The objective of this study was report incidence and transmission of SARS-CoV-2 among professional biathletes and staff undergoing frequent PCR testing and risk reduction measures during the international season 2020-2021. The efficiency of risk mitigation measures was also evaluated based on the incidence data. During the 4-month season, altogether 22,182 SARS-CoV-2 PCR tests were conducted on all individuals participating in international biathlon season (athletes, team staff and organizing committee). Ninety-six (0.4%) PCR tests were positive and 30% of the positive PCR tests were considered "persistent positive" following recovery from a recent COVID-19 infection. No transmission events were detected following contact with "persistent positive" cases during the season. A great majority of the positive PCR tests were recorded during the first days after arrival in the "bubble", often in the first entry test taken by the on-site laboratory. In conclusion, a "bubble model" based on frequent PCR testing and hygiene rules was efficient in keeping the infection rate low. The competition activity including international travel was safe, and most of the infections seemed to originate from outside of the "bubble".

Comparison of the computed tomography COVID-19 pneumonia severity scores in vaccinated and unvaccinated individuals without comorbidities

Aims: The aim of this study to investigate the effect of vaccines on pneumonia severity by comparing the computed tomography pneumonia scores of vaccinated and unvaccinated individuals with COVID-19 without known comorbidities. Methods: Between January 2020 and January 2022. A total of 270 patients, 133 vaccinated and 137 unvaccinated, with positive polymerase chain reaction test and without any significant co-morbidity were included in the study. Computed tomography pneumonia scores, demographic characteristics, and vaccination information were evaluated through the hospital’s electronic registry system. Results: Mean pneumonia scores of individuals vaccinated for 1 dose were higher than individuals vaccinated for 2 or more doses. The shortest duration of infection after vaccination was determined in the group with 1 dose of vaccine, and the longest in the group with 2 doses of vaccine. There was no significant difference between mean pneumonia scores of vaccinated and unvaccinated individuals (P &gt; 0.05). Pneumonia scores were found to be significantly lower in individuals over 70 years of age in vaccinated compared to unvaccinated individuals. A statistically significant positive correlation was found between the age of the patients and the pneumonia scores (Rho = 0.293). Conclusion: There is no significant difference in the pneumonia scores of vaccinated and unvaccinated Covid 19 pneumonia patients without comorbidities, except for patients over 70 years of age. There is a significant correlation between pneumonia score and age.

Prevalence, Risk Factors, Prognosis, and Management of Pericardial Effusion in COVID-19.

Background: There is limited data in the literature about the clinical importance and prognosis of pericardial effusion (PE) in patients discharged after recovering from COVID-19, but large-scale studies have yet to be available. This study investigated the prevalence, risk factors, prognosis, late clinical outcomes, and management of PE in COVID-19. Materials and Methods: Between August 2020 and March 2021, 15,689 patients were followed up in our pandemic hospital due to COVID-19. Patients with positive polymerase chain reaction (PCR) test results and PE associated with COVID-19 in computed tomography (CT) were included in the study. The patients were divided into three groups according to PE size (mild, moderate, and large). Transthoracic echocardiography (TTE) records, laboratory data, clinical outcomes, and medical treatments of patients discharged from the hospital were retrospectively reviewed. Results: According to the PE size (mild, moderate, large) of 256 patients with PE at admission or discharge, the mean age was 62.17 ± 16.34, 69.12 ± 12.52, and 72.44 ± 15.26, respectively. The mean follow-up period of the patients was 25.2 ± 5.12 months. Of the patients in the study population, 53.5% were in the mild group, 30.4% in the moderate group, and 16.1% in the large group. PE became chronic in a total of 178 (69.6%) patients at the end of the mean three months, and chronicity increased as PE size increased. Despite the different anti-inflammatory treatments for PE in the acute phase, similar chronicity was observed. In addition, as the PE size increased, the patients' frequency of hospitalization, complications, and mortality rates showed statistical significance between the groups. Conclusions: The clinical prognosis of patients presenting with PE was quite poor; as PE in size increased, cardiac and noncardiac events and mortality rates were significantly higher. Patients with large PE associated with COVID-19 at discharge should be monitored at close intervals due to the chronicity of PE and the increased risk of tamponade.

Gallstone Ileus; the Radiographic Findings in an Elderly Patient: A Case Report

Since the beginning of the COVID-19 pandemic in December 2019, Ivermectin has been proposed as an alternative for prophylaxis and treatment of COVID-19 infection despite the lack of evidence and clinical trials recommending its use. In this study, we report the case of a 52-year old Filipino male with newly diagnosed diabetes mellitus who developed a subacute history of fever, cough and generalized weakness, causing him to self-medicate with supratherapeutic doses of Ivermectin and thereafter subsequently developed decrease in sensorium, restlessness and complex visual hallucinations. Significant laboratory examinations showed hyperglycemia, mild hyponatremia, positive SARS-CoV2 reverse transcriptase polymerase chain reaction test and bilateral pneumonia on chest radiograph. He was subsequently started on antibiotics, high flow nasal cannula and given two doses of activated charcoal. During the first 24 hours of hospital admission, there was significant improvement in the patient’s sensorium with resolution of restlessness and visual hallucinations. During the rest of the hospitalization, his respiratory symptoms had improved and he was subsequently discharged. Clinical outcome in our patient after administration of activated charcoal and completion of antibiotics showed an overall improvement in symptoms and without any neurologic sequelae.

Management of Anesthesia in Pre-Eclamptic Patients with Covid 19 Infection

Background: Pregnant women with immunological and cardiopulmonary system abnormalities may experience more severe symptoms from respiratory virus infections. Objectives: The aim of this study was to assess the management of anesthesia in pre eclamptic patients with covid 19 infection. Methods: This cross-sectional descriptive study was carried out in the Department of Anaesthesia, Uttara Adhunik Medical College Hospital, during October 2020 to September 2021. A total of 50 pregnant women with pre-eclampsia and had positive polymerase chain reaction (PCR) test for COVID-19 with nasopharyngeal swabs were included in the study irrespective of age and patients who were not willing to participate were and who were clinically suspected (such as a clinical situation or travel history) but tested negative for COVID-19 excluded from this study. Statistical analyses of the results were be obtained by using window based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-22), where required. Results: The mean age of the patients was 26± 2.0 years. 36% patients were within 26-31 weeks of gestational age, 40% patients were within 32-36 weeks of gestational age, 20% patients were within 37-42 weeks of gestational age, and only 4% had more than 42 weeks of gestational age. About 60% patients had mild pre-eclampsia and 40% had severe pre-eclampsia. 98% patients had given spinal anesthesia and 2% had given epidural type of anesthesia. The indication for caesarian section was 50% for severe pre-eclampsia, 25% for uterine rupture in pre-eclampsia and 25% for previous caesarean section. The mean Hemoglobin was 12.17 ± 1.70, mean Aspartate aminotransferase was 28.05 ± 21.11, mean Alanine aminotransferase, was 17.06 ± 12.98, mean Creatine was 0.68 ± 0.71, mean C-reactive protein was 2.10 ± 2.33 and mean D-Dimer was 3.00 ± 2.26. About 60% of the patients were fit to discharge within 4 days and 40% within 5 days. Conclusion: Preeclampsia as one of pregnancy related complications is a notable burden of adverse health. Regional anaesthesia is not considered to be prohibited by the diagnosis of COVID-19 alone. In conclusion, COVID-19-infected pregnant women should be managed by specialised teams in a multidisciplinary facility, and all medical personnel involved in the caesarean section should be careful to use Level-3 PPE equipment. Due to the increased risk of infection and morbidity in general anaesthesia in pregnant women with COVID-19, regional anaesthesia becomes more prevalent. We also noted that there is no umbilical chord transmission from mother to child.

Frequency of Positive Polymerase Chain Reaction (PCR) Testing for Borrelia burgdorferi on Whole Blood Samples That Tested Positive for Babesia microti by PCR from an Endemic Area for Both Infections in New York State.

Because both Babesia microti and Borrelia burgdorferi can be transmitted by the bite of a single coinfected Ixodes scapularis tick, an attempt was made to determine the frequency with which whole blood samples that tested positive for B. microti infection by polymerase chain reaction (PCR) would also test positive by PCR for B. burgdorferi infection. Over a 7-year period from 2013 to 2019, 119 different patients tested positive for B. microti infection by PCR on at least one blood sample. Among the 118 patients with a positive B. microti PCR blood sample that could also be tested by a qualitative PCR for B. burgdorferi, only one patient tested positive (0.85%, 95% CI 0.02 to 4.6%). Routine PCR testing of every B. microti PCR-positive blood specimen to detect B. burgdorferi coinfection appears to have a low yield, even in a highly endemic geographic area for both of these infections.

General Hospitalization and Intensive Care Unit-Related Factors of COVID-19 Patients in Northeastern Colombia: Baseline Characteristics of a Cohort Study.

Objective This study aims to describe demographic and clinical characteristics and the factors associated with the risk of COVID-19 general hospitalization and intensive care unit (ICU) care of patients who consulted in a third-level hospital in Santander, Colombia. Methods We used baseline data from an ambidirectional cohort study. We included all patients with positive real-time polymerase chain reaction (PCR) tests for COVID-19 who came to the emergency room (ER) for respiratory symptoms related to COVID-19. Information regarding patients' baseline characteristics and symptoms was collected through telephone interviews and review of medical records. Vital signs were extracted from medical records as well. Results We enrolled 3,030 patients, predominantly men, with a median age of 60(interquartile range (IQR): 44-73). Symptoms of the acute phase varied between men and women. Men presented with more respiratory symptoms, and women had general symptoms. Hypertension, obesity, and diabetes were common risk factors for hospital admission. Antibiotic consumption may also play a role in hospital admission. Conclusions Male sex, older age,hypertension, obesity, prior thrombotic events, and self-medicated antibiotics were associated with general hospitalization. Hypertension, obesity, diabetes, and cancer were associated with ICU admission. The Charlson comorbidity index (CCI) is a powerful tool for evaluate the impact of pre-existing health conditions on COVID-19 hospital admission. We highlight the importance of these findings as possible predictors in our region.

Risk of autoimmune diseases following COVID-19 and the potential protective effect from vaccination: a population-based cohort study

Case reports suggest that SARS-CoV-2 infection could lead to immune dysregulation and trigger autoimmunity while COVID-19 vaccination is effective against severe COVID-19 outcomes. We aim to examine the association between COVID-19 and development of autoimmune diseases (ADs), and the potential protective effect of COVID-19 vaccination on such an association. A retrospective cohort study was conducted in Hong Kong between 1 April 2020 and 15 November 2022. COVID-19 was confirmed by positive polymerase chain reaction or rapid antigen test. Cox proportional hazard regression with inverse probability of treatment weighting was applied to estimate the risk of incident ADs following COVID-19. COVID-19 vaccinated population was compared against COVID-19 unvaccinated population to examine the protective effect of COVID-19 vaccination on new ADs. The study included 1,028,721 COVID-19 and 3,168,467 non-COVID individuals. Compared with non-COVID controls, patients with COVID-19 presented an increased risk of developing pernicious anaemia [adjusted Hazard Ratio (aHR): 1.72; 95% Confidence Interval (CI): 1.12-2.64]; spondyloarthritis [aHR: 1.32 (95% CI: 1.03-1.69)]; rheumatoid arthritis [aHR: 1.29 (95% CI: 1.09-1.54)]; other autoimmune arthritis [aHR: 1.43 (95% CI: 1.33-1.54)]; psoriasis [aHR: 1.42 (95% CI: 1.13-1.78)]; pemphigoid [aHR: 2.39 (95% CI: 1.83-3.11)]; Graves' disease [aHR: 1.30 (95% CI: 1.10-1.54)]; anti-phospholipid antibody syndrome [aHR: 2.12 (95% CI: 1.47-3.05)]; immune mediated thrombocytopenia [aHR: 2.1 (95% CI: 1.82-2.43)]; multiple sclerosis [aHR: 2.66 (95% CI: 1.17-6.05)]; vasculitis [aHR: 1.46 (95% CI: 1.04-2.04)]. Among COVID-19 patients, completion of two doses of COVID-19 vaccine shows a decreased risk of pemphigoid, Graves' disease, anti-phospholipid antibody syndrome, immune-mediated thrombocytopenia, systemic lupus erythematosus and other autoimmune arthritis. Our findings suggested that COVID-19 is associated with an increased risk of developing various ADs and the risk could be attenuated by COVID-19 vaccination. Future studies investigating pathology and mechanisms would be valuable to interpreting our findings. Supported by RGC Collaborative Research Fund (C7154-20GF).

Hematological and Extra-Hematological Manifestations of Parvovirus B19 Disease

Abstract Objective Parvovirus B19 (PVB19) is a virus that can present with many hematological and extra-hematological findings. Its prognosis is relatively good in immunocompetent patients, but severe disease may develop in immunocompromised patients. We retrospectively reviewed a series of children who presented with PVB19 during a 6-year period at our institution. Methods Nine children with positive polymerase chain reaction and serological test results for PVB19 were studied. Their demographic data, atypical clinical and laboratory findings, treatment regiments, clinical course, and prognosis were noted. Results The hematological abnormalities associated with PVB19 were anemia, neutropenia, and thrombocytopenia, and the extra-hematological abnormalities were systemic lupus erythematosus-like syndrome, hemophagocytic lymphohistiocytosis, and acute kidney injury. All patients had good outcomes with no significant sequelae. Conclusion This case review suggests that clinicians should not consider PVB19 only as a cause of hematological events; they should also be alert to the possibility that it may cause extra-hematological diseases.

Abdominal Imaging Findings in Laboratory-Confirmed COVID-19 Patients: A Retrospective Observational Study.

Coronavirus disease 2019 (CO-VID-19) is known to predominantly present with respiratory symptoms; however, a significant proportion of patients present with digestive symptoms. These symptoms are often non-specific and as such prompt the treating physician to request further imaging evaluation. Understanding the abdominal imaging findings in COVID-19 and their possible associations is thus crucial to direct patient care and prevent misdiagnosis.The aim of this study was to describe abdominal imaging findings on both computed tomography (CT) and ultrasound scans in cases with positive COVID-19 polymerase chain reaction (PCR) tests performed at our institution, and also, to evaluate the reason for requesting these imaging studies, and to correlate these findings with patients' demographics. A retrospective observational study was conducted at Salmaniya Medical Complex, Bahrain, between February 2021 and March 2022. We examinedthe abdominal CT and ultrasound data for PCR-confirmed COVID-19 patients. The demographic data, reason for requesting imaging and imaging findings were gathered by reviewing the hospital's electronic health records and picture archiving and communicating system (PACS). The study included 97 patients, with the majority being male (57.7%). The most common reason for imaging was abdominal pain, as seen in over half of the patients (60.8%), followed by deranged liver enzymes (18.6%). More than 75% of imaging studies showed positive abdominal findings with the majority (19.6%) showing non-specific inflammatory findings, followed by gallbladder disease (13.4%). The CT studies were more likely to yield positive findings as compared to ultrasound, with only 7 (11.3%) CT scans yielding normal findings (χ2 = 14.65; P < 0.01). To our knowledge, the research conducted on the abdominal manifestations of COVID-19 is still limited, especially in our region. Our study showed that there are variable presentations of abdominal organ involvement in COVID-19 cases, and as such more data is required to direct choice of imaging study, protocol, and interpretation of findings to better guide patient management.

Myocardial Function in Fetuses with Congenital Cytomegalovirus Infection

Introduction: The objective of this study was to investigate myocardial deformation of left (LV) and right ventricle (RV) using 2-dimensional speckle-tracking echocardiography (2D-STE) in fetuses with and without congenital cytomegalovirus (CMV) infection. Methods: This was a prospective single-center study. Vertical transmission was defined by a positive CMV polymerase chain reaction (PCR) test on the amniotic fluid or on the neonate’s urine. Fetuses were divided into group 1 and group 2 if CMV-PCR was positive or negative, respectively. LV and RV global longitudinal strain (GLS) values were obtained and adjusted for gestational age by calculating Z-scores. Univariate analysis was carried out to compare cardiac indices between group 1 and group 2. Results: Fetuses from group 1 (n = 11) had a significantly lower LV myocardial shortening than those from group 2 (n = 32). GLS was −20.7 ± 5.2% and −26.3 ± 4.1%, respectively (p = 0.001). Similarly, GLS Z-score was lower (0.02 ± 0.72) in group 1 than in group 2 (−0.80 ± 0.59) (p = 0.001). Similarly, RV GLS Z-score was significantly impaired in group 1 compared to group 2 (−0.44 ± 1.03 vs. −1.04 ± 0.71, p = 0.041). Conclusion: Fetuses with congenital CMV showed subclinical biventricular myocardial dysfunction. Further studies are needed to confirm the potential role of 2D-STE in identifying fetuses with congenital CMV at risk of postnatal cardiovascular morbidities.

The effect of hemoperfusion on treatment outcomes in COVID-19 patients with respiratory failure: a prospective study

Introduction: COVID-19 emerged as a global clinical threat following an outbreak in China in late 2019. Objectives: The aim of the current study was to assess the effect of hemoperfusion in COVID-19 patients with respiratory failure. Patients and Methods: In this prospective study, a total of 98 patients over the age of 18 with the positive COVID-19 polymerase chain reaction (PCR) test were investigated. The patients were divided into two groups; a control group consisting of 47 patients who did not receive hemoperfusion, and an exposed group consisting of 51 patients who met the criteria for hemoperfusion. Various parameters including complete blood cell counts, serum bilirubin, creatinine, C-reactive protein (CRP), and interleukin 6 (IL-6) levels were evaluated in all patients. Results: The results of our study revealed a statistically significant difference in intensive care unit (ICU) admission between the two groups. Hospitalization time (19.941±1.75 versus 14.615±1.39, P=0.021) and ICU time (14.98±1.30 versus 9.62±1.15; P=0.003) were significantly higher in patients who received hemoperfusion. Regarding the mortality rate, only 36.7% of the patients survived; however, there was no significant difference observed between the two groups (P=0.34). Conclusion: In conclusion, the findings of our study indicate that hemoperfusion in COVID-19 patients with respiratory failure led to a significant increase in hospital stay and ICU stay compared to those without hemoperfusion. Further research is needed to determine the optimal timing and frequency of hemoperfusion to improve treatment outcomes in COVID-19 patients with respiratory failure.

Severe acute respiratory syndrome coronavirus 2 infection in patients with autoimmune bullous diseases in China.

Patients with autoimmune bullous diseases (AIBDs) are considered to be immunocompromised and, consequently, they may be more susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and have poorer outcomes. However, the risk and repercussions of SARS-CoV-2 infection in patients with AIBDs have not been fully understood. Therefore, we aimed to investigate the risk factors of SARS-CoV-2 infection and the impact of SARS-CoV-2 on patients with AIBDs. From December 2022 to January 2023, all patients with AIBDs who visited our clinic were enrolled in this study. Meanwhile, web-based questionnaires and telesurveys were used as supplements. Information about patients' demographics, comorbidities, SARS-CoV-2 infection, and vaccination, as well as AIBD status and treatments were collected and analyzed. The diagnosis of SARS-CoV-2 infection was based on a positive polymerase chain reaction test, and/or an antigen test, or the presence of typical symptoms in conjunction with an epidemiological history. Finally, 95 patients with AIBDs were enrolled, including 47 cases of pemphigus and 48 cases of pemphigoid cases, and 73 had symptoms consistent with coronavirus disease 2019. Common symptoms after SARS-CoV-2 infection were fever (80.8%), fatigue (75.0%), cough (71.2%), muscle/joint pain (49.3%), and sore throat (45.2%). No significant differences were found between SARS-CoV-2-infected and asymptomatic patients. Patients who had hypertension (p = 0.034), hyperlipidemia (p = 0.017), or more than two comorbidities (p = 0.011) were more likely to develop pneumonia after infection. Patients with pemphigus who did not achieve disease control (p = 0.045) or had an oral corticosteroid dose ≥15 mg/day (p = 0.024) and patients with pemphigoid with a disease duration ≥2 years (p = 0.037) were more prone to AIBDs aggravation. In conclusion, patients with AIBDs are generally susceptible to SARS-CoV-2 infection. Individuals with newly diagnosed AIBDs, uncontrolled disease, and a higher corticosteroid dose are more susceptible to disease exacerbation.