The impact of lymphoid memory cells in different ages of COVID-19 patients

Coronaviruses are highly pathogenic and transmissible viruses. The SARS-CoV-2 virus that emerged in December 2019 is increasingly recognized as a serious, worldwide public health concern. Respiratory infections and the hyper-inflammatory response induced by SARS-CoV-2 play a key role in disease severity and death in infected COVID-19 patients. However, much uncertainty still exists about the pathogenesis and various effects of COVID-19 on immune system. It seems that memory T cells can reduce the severity of COVID-19 infection by inducing a protective immune response. Memory T cells along with protective antibodies are the main defenses and also protective barrier against recurrent COVID-19 infection. The role of Memory T cells varies in different ages and the severity of COVID-19 infection varies between children, adults and the elderly. Furthermore, the aim of this review is to evaluate the role of memory cells in mild, moderate and severe infected COVID-19 patients with different ages.

Omphalopagus conjoined twins separation during coronavirus disease-19 pandemic era: A case report

Introduction and importance

Conjoined twin is a rare congenital anomaly characterized by a fusion of certain anatomical structures. Coronavirus-19 (COVID-19) is a new emerging infectious respiratory disease affecting worldwide and potentially leads to acute respiratory distress (ARDS) in children. COVID-19 has reconstructed the healthcare system, including surgical care and decision-making.

Case presentation

Herein we describe a surgical separation of 2.5 months old omphalopagus conjoined twins, with one of them (Baby A) presenting COVID-19-associated respiratory distress, as well as the challenges faced during the preparation and the execution of the complex surgical procedure.

Clinical discussion

Baby A underwent antiviral therapy, oxygen supplementation, and ventilation in the ICU, while baby B remained stable and confirmed negative for SARS-CoV-2. The separation surgery was conducted after baby A had become clinically stable. Defect closure and reconstruction were accomplished. At one week follow-up, Baby A died of lung infection, while baby B remained well after one year.

Conclusion

The complexity of surgical separation requires careful planning by a multidisciplinary team. Surgical separation of conjoined twins during the pandemic era has not been reported much in the literature, more reports are required to provide further insight.

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Omphalopagus conjoined twins separation surgery is an intricate procedure that requires a multidisciplinary team

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The separation surgery of conjoined twins during the COVID-19 pandemic necessitate a unique surgical preparation and disciplined health protocols.

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The ideal timing of separation surgery of conjoined twins in the COVID-19 pandemic era remains controversial, factors that may play a role in the decision making include the age, weight, general clinical condition, and the complexity of fusion identified

SARS-CoV-2-related outcomes after surgical procedures on SARS-CoV-2-positive patients in a large, urban, safety net medical center

Background

Beginning on March 16, 2020, nonurgent scheduled operations at a large, urban, safety net medical center were canceled. The purpose of this study was to determine complications associated with severe acute respiratory syndrome coronavirus 2 infection for all operations done from March 16 to June 30, 2020.

Study Design

This study was a single-institution, retrospective observational analysis of data for all surgical procedures and all severe acute respiratory syndrome coronavirus 2 tests done in the medical center from March 16 to June 30, 2020. The charts of all severe acute respiratory syndrome coronavirus 2–positive patients who had a surgical procedure during the study time period were retrospectively reviewed to assess the outcomes.

Results

Of 2,208 operations during that time, 29 (1.3%) patients were severe acute respiratory syndrome coronavirus 2–positive and were asymptomatic at the time of their operations. Twenty-four (82.7%) of the 29 required urgent or emergent procedures. The median time between availability of test results and operations for these patients was 0.63 + 1.94 days. With median follow-up of 89 days, none of the 29 patients died from severe acute respiratory syndrome coronavirus 2–related causes, and none developed clinically evident thromboembolism or required reintubation secondary to severe acute respiratory syndrome coronavirus 2–related pneumonia.

Conclusion

By operating on carefully screened, asymptomatic severe acute respiratory syndrome coronavirus 2–positive patients, it was possible to eliminate major complications and mortality due to severe acute respiratory syndrome coronavirus 2 infection.

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Most SARS-CoV-2 surgical patients underwent urgent or emergent operations.

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Screening SARS-CoV-2 surgical patients may reduce complications of the virus.

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Providers should weigh the risks and benefits of delaying surgery in these patients.

Acute Cor Pulmonale in COVID-19-Related ARDS: Improvement With Almitrine Infusion

Coronavirus disease-19 (COVID-19)-related severe acute respiratory distress syndrome can lead to acute cor pulmonale. We report a case of acute cor pulmonale secondary to severe COVID-19 acute respiratory distress syndrome diagnosed with transesophageal echocardiography. Almitrine infusion allowed rapid enhancement of right ventricular function as well as improvement in oxygenation. (Level of Difficulty: Intermediate.)

Can COVID 19 present like appendicitis?

Coronavirus disease -19 is a novel pandemic contagious respiratory infection that frequently presents with fever and dry cough. However, it can present with other rare symptoms. As this disease is a new disease, the full picture of the disease presentation is not yet clear, and it might present with symptoms and signs of other common diseases. Here, we report a 40 year old female who presented with acute onset nausea, vomiting, loss of appetite and vague abdominal pain as a clinical picture of appendicitis, but her CT abdomen image showed normal appendix, bilateral patchy peripheral lung basal consolidation, and ground-glass attenuation, so she was tested for coronavirus disease-19, which was positive.