Exploring the Relationship of Comorbidities, Smoking Status, HRCT Findings With COVID-19 Disease Severity and Outcomes

INTRODUCTION

Coronavirus disease 2019 (COVID-19) is a serious illness that can affect multiple organs including the lungs. The COVID-mortality risk is attributed to the quick transmission of the virus, the severity of disease, and preclinical risk factors, such as the presence of comorbidities. High-resolution computed tomography (HRCT) can predict disease severity in COVID-19 patients.

METHODOLOGY

This was a retrospective cohort study in which data were obtained from COVID centers at tertiary care hospitals in Azad Jammu and Kashmir. Details of clinical characteristics and HRCT findings along with details of smoking and comorbid history were obtained.

RESULTS

Fever at hospital admission, HRCT findings, and having a partner predicted disease severity showed a significant p-value of <0.05. Old age and living in a combined household were associated with severe outcomes (p<0.05). Symptoms of shortness of breath (SOB) on hospital admission could predict the need for ICU admission in COVID-19 patients.

CONCLUSION

HRCT has a good predictive value for disease severity in patients with COVID-19, and old age is a risk factor. Although, limited associations were established in the analysis, in this study hyperlipidemia and hypertension significantly affected the course of disease. Further studies should be done to explore the relationship.

Ipsilateral axillary lymphadenopathy after COVID-19 vaccination in a young female; a case report and literature review

It has been two years since vaccination for COVID-19 was launched worldwide. In Pakistan, the vaccination started in the beginning of 2020. Since then several side effects were reported after vaccination, including soreness of the arm, fever, chills, malaise and diarrhoea. Axillary lymphadenopathy has been found to be associated with several conditions that include autoimmune disorders, infections, malignancy and some idiopathic causes. We present a rare case of a 30 y old female with recent recovery from COVID-19, who developed ipsilateral axillary lymphadenopathy after 15 days of Sinovac vaccination. Ultrasonography was done to confirm the diagnosis and its spread towards breast and cervical region. This case report discusses some key points and recommendations regarding unilateral axillary lymphadenopathy after COVID-19 vaccination. Key words: COVID-19; Lymphadenopathy; vaccination; Pakistan Citation: Butt MN, Perveen W, Malik S, Raja SK, Feroz R, Asif R. Ipsilateral axillary lymphadenopathy after COVID-19 vaccination in a young female; a case report and literature review. Anaesth. pain intensive care 2022;26(6):815−818. DOI: 10.35975/apic.v26i6.2066

Probing the structure of the nicotinic acetylcholine receptor ion channel with the uncharged photoactivable compound -3H-diazofluorene

The uncharged photoactivable probe 2-[3H]diazofluorene ([3H]DAF) was used to examine structural changes in the Torpedo californica nicotinic acetylcholine receptor (AChR) ion channel induced by agonists. Photoincorporation of [3H]DAF into the AChR consisted of the following two components: a nonspecific component consistent with incorporation into residues situated at the lipid-protein interface, and a specific component, inhibitable by noncompetitive antagonists and localized to the M2 hydrophobic segments of AChR subunits. The nonspecific [3H]DAF incorporation was characterized in the M4 segment of each AChR subunit. The observed distribution and periodicity of labeled residues reinforce the conclusion that the M4 segments are organized as transmembrane alpha-helices with a common "face" of each helix in contact with lipid. Within the M2 segments, in the absence of agonist [3H]DAF specifically labeled homologous residues betaVal-261 and deltaVal-269, with incorporation into deltaVal-269 at a 5-fold greater efficiency than into betaVal-261. This observation, coupled with the lack of detectable incorporation into alpha-M2 including the homologous alphaVal-255, indicates that within the resting channel [3H]DAF is bound with its photoreactive diazo group oriented toward deltaVal-269. In the presence of agonist, there is an approximately 90% reduction in the labeling of betaVal-261 and deltaVal-269 accompanied by specific incorporation into residues (betaLeu-257, betaAla-258, deltaSer-262, and deltaLeu-265) situated 1 or 2 turns of an alpha-helix closer to the cytoplasmic end of the M2 segments. The results provide a further characterization of agonist-induced rearrangements of the M2 (ion channel) domain of the AChR.