Lung cyst is an atypical computed tomography (CT) thorax finding in COVID-19 pneumonia. Cyst in COVID-19 may result independent of mechanical ventilation. The cyst may rupture causing pneumomediastinum or pneumothorax or may get secondarily infected resulting in an adverse outcome in patients. Here, we describe the clinical characteristics and outcomes of 19 patients with COVID-19 pneumonia with lung cysts detected in CT thorax. A total of 17 (89%) of our patients survived uneventfully and 2 died due to complications unrelated to the cysts.

BACKGROUND The Covid-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a public health challenge being faced by the world currently. International and national responses to combat the Covid-19 pandemic have been very prompt with the setting up of dedicated Covid-19 hospitals. In the state of Odisha, situated in the eastern part of India, Kalinga Institute of Medical Sciences (KIMS), set up the first dedicated Covid hospital of the state. This study intends to chronicle the clinical profile, radiological presentations, laboratory findings, and clinical outcome of patients admitted to the KIMS Covid hospital. METHODS A retrospective analysis of the clinical and laboratory data of patients admitted with Covid-19 diagnosis at the dedicated Covid-19 hospital from 5th April 2020 to 4th June 2020 was done. RESULTS A total number of 272 Covid-19 cases were included in this study. Majority of the patients were males (83.57 %) and most of the patients (79.04 %) were asymptomatic. The mortality rate was 1.9 %. Fever (18.38 %), cough (17.27 %), dyspnoea (16.91 %) and myalgia (14.7 %) were the major symptoms observed. Severity was mild in 78.94 % cases. Delayed viral clearance was seen in 13 % cases. The typical features of novel SARS-CoV-2 infection was seen in 12 - 13 % cases in computed tomography (CT) images of thorax. c-reactive protein (CRP) was raised as a biomarker of inflammation. Of the 5 deaths encountered, 2 had diabetes mellitus, 2 were hypertensive and 1 had chronic obstructive pulmonary disease (COPD). CONCLUSIONS Covid-19 may have a delayed viral clearance beyond two weeks. A discordance between CT images and the clinical condition may also be observed. Diabetes, hypertension, and high blood CRP levels were significantly associated with mortality. KEYWORDS Covid-19, SARS-CoV-2, Clinical Profile, Radiological Findings, Comorbidities, Fatality

Background: Most of the acute exacerbations of chronic obstructive pulmonary disease (COPD) are due to infections, mostly due to bacteria and viruses. There is a need to study the outcome of microbe-induced airway inflammation.Materials and methods: It is an observational follow-up study from the pulmonary medicine department of Kalinga Institute of Medical Sciences with the participation of the Regional Medical Research Center, Bhubaneswar, from October 2018 to February 2022. Patients who were admitted with acute exacerbation of COPD and treated as per GOLD (Global Initiative for Chronic Obstructive Lung Disease) 2021 guidelines were included in the study. Those patients in the severe category, who had clinically recovered, had undergone pulmonary physiotherapy, were on prescribed medications and home oxygen therapy after discharge, were followed up every three months by telephone calls. Any exacerbation, clinical stability, or mortality information was recorded.Results: Out of 197 cases, the majority were elderly, males, smokers, and belonged to urban areas; in total, 102 (51.8%) microbes were isolated as etiological agents of infective exacerbation in which 19.79% were viruses and 23.35% were bacteria, while coinfection was found in 8.62% cases. Among the viruses, rhinovirus, influenza virus, and respiratory syncytial virus were the major isolates. Among the bacteria, mostly gram-negative organisms such as Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa were isolated. Readmission was more among patients with coinfection.Conclusion: Acute exacerbation of COPD was mostly seen in males in the age group of 61-80 years. Rhinovirus and influenza A virus were the two most common viral isolates, and among the bacterial isolates, Acinetobacter baumannii and Klebsiella pneumoniae were predominantly detected. Poor clinical outcomes were noticed more among the coinfection group.