RESUMEN
Background: The main aim of this study was to assess the efficacy of advanced respiratory support (ARS) for acute respiratory failure in do-not-attempt cardiopulmonary resuscitation order (DNACPR) COVID-19 patients. Methods: In this single-center study, the impact of different types of ARS modality, PaO2/FiO2 (PF) ratio, clinical frailty score (CFS) and 4C score on mortality was evaluated. Results: There was no significant difference in age, type of ARS modality, PF ratio and 4C scores between those who died and those who survived. Overall survival rates/hospital discharge of patients still requiring ARS at 5 and 7 days post admission were 20 and 17%, respectively. Conclusion: Our study showed that ARS can be a useful tool in frail, elderly and high-risk COVID-19 patients irrespective of high 4C mortality score.
Asunto(s)
COVID-19 , Fragilidad , Insuficiencia Respiratoria , COVID-19/mortalidad , COVID-19/terapia , Humanos , Insuficiencia Respiratoria/terapia , Órdenes de ResucitaciónRESUMEN
Aim: COVID-19 is a known risk factor for pulmonary embolism (PE). In this retrospective, multicenter study, we aimed to determine an optimal D-dimer cutoff to predict PE in hospitalized patients with COVID-19. Materials & methods: A total of 193 patients underwent computerized tomographic pulmonary angiography imaging and were classified into PE positive and negative groups. Physiological, radiological and biochemical parameters were compared and receiver operator curve analysis was conducted to determine a predictive D-dimer threshold. Results: An optimal D-dimer cutoff of 2494 ng/ml was selected (Youden index: 0.906), giving a sensitivity of 100% (95% CI: 100-100) and specificity of 90.62% (95% CI: 90.5-90.8) for predicting PE. Conclusion: We propose that in the absence of other clinical signs, a D-dimer threshold of 2495 ng/ml could be used with high sensitivity and specificity to predict PE in hospitalized patients with COVID-19.
Asunto(s)
COVID-19/epidemiología , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Pulmón , Embolia Pulmonar , Anciano , Inglaterra/epidemiología , Femenino , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Persona de Mediana Edad , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/epidemiología , Estudios Retrospectivos , Sensibilidad y EspecificidadRESUMEN
We present a rare and unusual case of 22-year-old man who was on infliximab therapy for his uncontrolled ulcerative colitis. Infliximab was stopped as he didn't get any benefit from it and he ended up having subtotal colectomy and ileostomy. He presented with shortness of breath and eosinophilia and underwent a number of investigations and finally a diagnosis of chronic eosinophilia secondary to infliximab was made.