The first cases of COVID-19 were reported in Wuhan Province, in China, in December 2019, spreading rapidly around the world. The World Health Organization (WHO) declared this pandemic at the beginning of March 2020 and, at the same time, the first patient in Galați County was confirmed. Both the global and the regional epidemiological evolutions have taken place with variations in incidence, which have been graphically recorded in several “waves”. We conducted a retrospective study on cases of COVID-19 infection, hospitalized between March and June 2020 in an infectious diseases clinic from Galati, in the south-east of Romania. The present paper describes the “first-wave” regional epidemiological and clinical-biological features and the evolution of the COVID-19 pandemic. A poor outcome was related to late presentation to hospital, old age, and over six comorbid conditions including Alzheimer’s disease. The high death rate among people from long-term care institutions is the consequence of the cumulative risk factors associated with immune senescence and inflammation, while COVID-19 is more likely a contributing factor to lower life expectancy.

COVID-19 is currently a major health problem, leading to respiratory, cardiovascular and neurological complications, with additional morbidity and mortality. Spinal infections are rare, representing around 1% of all bone infections and comprising less than 2 per 10,000 of all hospitalizations in tertiary care centers. Spondylodiscitis is a complex disease, with challenging diagnosis and management. We report the case of a 45-year-old man, non-smoker hospitalized for severe COVID-19 disease with respiratory failure. Post-COVID-19, in the 8th week after discharge, he was diagnosed by magnetic resonance imaging with spondylodiscitis, but etiology was not confirmed by microbiological investigations. Antibiotics were used, considering the identification of MRSA from cultures of pleural fluid and nasal swab, but surgical intervention was not provided. Clinic, biologic and imagistic were improved, but rehabilitation and long term follow up are necessary. We concluded that spondylodiscitis with spinal abscess is a rare but severe complication post-COVID-19 disease, due to dysbalanced immune response related to the respiratory viral infection, endothelial lesions, hypercoagulation and bacterial superinfection.

The typical CT features of COVID-19 pneumonia include multifocal and bilateral ground-glass opacities with or without consolidation, found in both lungs, predominantly at peripheral, and posterior regions, bronchovascular thickening, crazy pavement appearance (ground-glass opacities with superimposed interlobular septal thickening). Atypical imagistic findings such as lung cavitation were rarely reported. In this report we describe the case of a 42 years old, healthy man with severe COVID-19 pneumonia who developed two pulmonary cavities during recovery. The pulmonary cavitations formed in the aria of the lung where patchy air space opacification was seen in early stages. There were no signs of invasive fungal or bacterial infection and the complementary investigations have ruled out other possible etiology for lung cavitation. Although the pathophysiological mechanism involved in the origin of the pulmonary cavities is not fully known, it could be closely related to diffuse alveolar damage in severe COVID-19 pneumonia.