Faculty of Medicine
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Item type:Publication, Clinical Features of a young Patient with COVID-19 presented with ARDS and severe thrombocytopenia(Via Medica, 2022-07-22); Mickovski, IvanaCase report of a 33-year-old male SARS-CoV-2 positive patient admitted to hospital because of hemopty sis, dyspnea, fever, oxygen saturation of 60%, hypoxemia, elevated C-reactive protein (CRP). The patient was not vaccinated and it was his first infection with the virus. The symptoms started 10 days before with headache, fever, and cough. Chest radiography on hospital admission detected diffuse interstitial pneu monia in both lungs. Initial CT (Computed Tomography) presented extensive lung involvement with bilateral wide areas of consolidation with air bronchogram, the non-consolidated area showing patchy ground glass infiltration. The patient was hospitalized in ICU (Intensive Care Unit), oxygen support was started immediately with non-invasive ventilation (NIV), CPAP (Continuous Positive Airway Pressure) mode, FiO2 (Fraction of inspired Oxygen) 100%, PEEP (Positive end-expiratory pressure) 8, and the saturation started to increase. Therapy consisted of parenteral antibiotic, low-molecular weight heparin (LMWH) in prophylactic doses, pulsed dose of corticosteroid (methylprednisolone), Remdesivir, tocilizumab (Actemra), albumin, protein-pump inhibitor, antipyretics, fluids, physical therapy. Microbiology results from sputum detected MRSA (methicillin-resistant Staphylococcus aureus) and therapy with Vancomycin was started according to recommendations. After three days of vancomycin therapy, the patient manifested profuse epistaxis and tamponade was necessary. Hemostasis result was normal, but severe thrombocytopenia was noticed in the blood count. Platelets and plasma were administered and the bleeding stopped. Vancomycin was replaced with Linezolid. In the next days of follow up, the platelets increased, and the corticosteroid dose was slowly reduced. During the treatment as the health status of the patient improved, the CPAP therapy was replaced with routine oxygen support, gradually lowering the oxygen flow until saturation of 94% was achieved at ambient air. The COVID-19 pandemic is still evolving and the medical fraternity is posed with a huge challenge. COVID-19 is primary a respiratory viral infection, but the virus can affect many organs and systems, presenting various signs, symptoms and outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Unusual Cause of Death in a Patient with COVID-19(Bulgarian Academy of Sciences, "Prof. Marin Drinov" Publishing House, 2021); ; ; Jasar DzengisThis is a case presentation of a patient with confirmed coronavirus disease (COVID-19) who ended his life with suicide by hanging. We are presenting the history of the disease, a clinical feature, the onset of the psychiatric symptoms and finally the pathological feature. Aims are: to perceive, in which phase of the disease occurred the psychiatric symptoms and eventually their connection with some morphological feature of the brain; to evaluate the changes of the primary disease to internal organs and finally, the ethical aspect i.e. how are these patients protected by the health care system. Results: patient committed suicide on the 12th day of the disease and around the 21st day after the infection, looking by its serum antibodies. On lungs dominated the picture of acute restrictive pulmonary disease and ARDS (acute respiratory distress syndrome) with strong inflammatory answer. A psychiatric disorder occurred with the epilog of double suicide attempt, of which the second one was successful.