Cardiac Tamponade, Sever Hypothyroidism and ARDS in Down syndrome with COVID-19 infection

Alkaf, Fahmi; Garni, Turki Al; Al-Harbi, Nahes; Sandokji, Hassan; Samargandy, Sondos

doi:10.37616/2212-5043.1235

Cited by 6 publications

(4 citation statements)

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“…Similar to the present case, a case of a 21-year-old patient with Down syndrome who developed acute respiratory distress syndrome with SARS-CoV-2 infection and cardiac tamponade due to pericarditis was recently reported [ 11 ]. Interestingly, this patient also had complications due to an autoimmune disease causing severe hypothyroidism with anti-thyroid antibodies.…”

Section: Discussionsupporting

confidence: 78%

COVID-19 in an Adult with Down Syndrome: Impact on Autoimmune Response

Kobayashi

Akiniwa

Yamaguchi

et al. 2022

Case Reports in Infectious Diseases

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We here report a case of COVID-19 with effusion prior to the development of pneumonia in an adult with Down syndrome. Serositis due to rheumatic disease was initially suspected because of a high titer of serum autoantibodies and leukocytopenia; however, SARS-CoV-2 infection was confirmed by reverse transcription polymerase chain reaction on admission after previous negative tests. Several cases of COVID-19 have been associated with autoimmune responses along with some cases of COVID-19 with autoimmune manifestations. Furthermore, patients with Down syndrome have a higher mortality risk from COVID-19 than the general population, and it is believed that a high sensitivity to the interferon response may contribute to the increased severity of the disease. Thus, careful attention should be paid to autoimmune manifestations due to SARS-CoV-2 infection for ensuring a proper and timely diagnosis, especially in patients with Down syndrome.

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Section: Discussionsupporting

confidence: 78%

COVID-19 in an Adult with Down Syndrome: Impact on Autoimmune Response

Kobayashi

Akiniwa

Yamaguchi

et al. 2022

Case Reports in Infectious Diseases

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“…Following the elimination of duplicates and screening of titles and abstracts, we evaluated 244 articles in full text. Among these, we found 43 eligible articles (5 RCTs, 16 cohort studies, 2 case-control studies, and 20 case reports) (Figure 1) (Salvarani et al, 2021;REMAP-CAP Investigators et al, 2021;Canziani et al, 2020;Menzella et al, 2020;Fisher et al, 2021;Campochiaro et al, 2020;Vazquez Guillamet et al, 2021;Rajendram et al, 2021;Huang et al, 2021;Galván-Román et al, 2021;Saffo et al, 2021;Somers et al, 2021;Brosnahan et al, 2021;Corominas et al, 2021;Cavalli et al, 2021;Abe et al, 2021;Patel et al, 2020;Mady et al, 2020;Bernardo et al, 2020;Morillas et al, 2020;Cascella et al, 2020;Al-Kaf et al, 2021;Eroglu et al, 2021;Kataoka et al, 2021;Kishaba et al, 2021;Leelayuwatanakul et al, 2021;McKenzie et al, 2021;Nourié et al, 2021;Ladna et al, 2021;Senegaglia et al, 2021;Thammathiwat et al, 2021;Lescure et al, 2021;Della-Torre et al, 2020;Gremese et al, 2020;Kyriazopoulou et al, 2021a;Bozzi et al, 2021;Franzetti et al, 2021;…”

Section: Search Resultsmentioning

confidence: 99%

Specific Interleukin-1 Inhibitors, Specific Interleukin-6 Inhibitors, and GM-CSF Blockades for COVID-19 (at the Edge of Sepsis): A Systematic Review

et al. 2022

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Sepsis is a syndrome with high mortality, which seriously threatens human health. During the pandemic of coronavirus disease 2019 (COVID-19), some severe and critically ill COVID-19 patients with multiple organ dysfunction developed characteristics typical of sepsis and met the diagnostic criteria for sepsis. Timely detection of cytokine storm and appropriate regulation of inflammatory response may be significant in the prevention and treatment of sepsis. This study evaluated the efficacy and safety of specific interleukin (IL)-1 inhibitors, specific IL-6 inhibitors, and GM-CSF blockades in the treatment of COVID-19 (at the edge of sepsis) patients through systematic review and meta-analysis. Methodology: A literature search was conducted on PubMed, EMBASE, Clinical Key, Cochrane Library, CNKI, and Wanfang Database using proper keywords such as “SARS-CoV-2,” “Corona Virus Disease 2019,” “COVID-19,” “anakinra,” “tocilizumab,” “siltuximab,” “sarilumab,” “mavrilimumab,” “lenzilumab,” and related words for publications released until August 22, 2021. Other available resources were also used to identify relevant articles. The present systematic review was performed based on PRISMA protocol. Results: Based on the inclusion and exclusion criteria, 43 articles were included in the final review. The meta-analysis results showed that tocilizumab could reduce the mortality of patients with COVID-19 (at the edge of sepsis) [randomized controlled trials, RCTs: odds ratio (OR) 0.71, 95%CI: 0.52–0.97, low-certainty evidence; non-RCTs: risk ratio (RR) 0.68, 95%CI: 0.55–0.84, very low-certainty evidence) as was anakinra (non-RCTs: RR 0.47, 95%CI: 0.34–0.66, very low-certainty evidence). Sarilumab might reduce the mortality of patients with COVID-19 (at the edge of sepsis), but there was no statistical significance (OR 0.65, 95%CI: 0.36–1.2, low-certainty evidence). For safety outcomes, whether tocilizumab had an impact on serious adverse events (SAEs) was very uncertain (RCTs: OR 0.87, 95%CI: 0.38–2.0, low-certainty evidence; non-RCTs 1.18, 95%CI: 0.83–1.68, very low-certainty evidence) as was on secondary infections (RCTs: OR 0.71, 95%CI: 0.06–8.75, low-certainty evidence; non-RCTs: RR 1.15, 95%CI: 0.89–1.49, very low-certainty evidence). Conclusions: This systematic review showed that tocilizumab, sarilumab, and anakinra could reduce the mortality of people with COVID-19 (at the edge of sepsis), and tocilizumab did not significantly affect SAEs and secondary infections. The current evidence of the studies on patients treated with siltuximab, mavrilimumab, and lenzilumab is insufficient. In order to establish evidence with stronger quality, high-quality studies are needed.Systematic Review Registration: PROSPERO (https://www.crd.york.ac.uk/prospero/), identifier CRD42020226545

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“…We report a single center experience of an increased incidence of MC in the time period from the beginning of COVID-19 pandemic until present. Although several case reports of severe hypothyroidism and MC diagnosed in patients with COVID-19 have been published [12][13][14], we have identi ed only one case report of an exacerbation of hypothyroidism leading to MC during the COVID-19 lockdown [16]. To our best knowledge, this is the rst report of an increased incidence of MC in the period of COVID-19 pandemic, when access to primary care services was very limited, and in the early post-pandemic era, when longterm consequences of the lock-down are expected to manifest.…”

Section: Discussionmentioning

confidence: 99%

“…Although thyroid cells express angiotensinconverting enzyme 2 (ACE-2), the main protein that functions as a receptor to which SARS-CoV-2 binds to enter host cells, studies have shown that patients with controlled hypothyroidism and hyperthyroidism do not have a higher prevalence of COVID-19 nor do they have a worse prognosis when infected with the virus [8][9][10][11]. Nevertheless, several case reports of severe hypothyroidism and MC in patients with COVID-19 have been published [12][13][14]. Moreover, the COVID-19 pandemic affected not only the health of general population but also the functioning of healthcare systems, imposing signi cant changes in existing clinical practices.…”

Section: Introductionmentioning

confidence: 99%

Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series

Sokołowski,

Studen,

Opalinska

et al. 2024

Preprint

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Introduction: The COVID-19 pandemic was a major challenge for all health care employees, but it was also difficult for patients to gain access to health care services. Myxedema coma (MC) is an exteremely rare but potentially fatal endocrine emergency. Objectives: The aim of the study was to report an increased incidence of life-threatening myxedema coma that occurred in relation to the COVID-19 pandemic. Material and Methods: In this paper, we report a cohort of 11 patients with MC who were treated at the University Hospital in Krakow, Poland, in the period from 2015–2023. Only 1 case of MC was recorded in the period from 2015–2019, and, in the same area, 10 cases of MC were recorded after the start of COVID-19 pandemic until present. Results: Hypothyroidism was diagnosed de novo in 2 (18%) patients; the remaining patients were severely hypothyroid due to therapy non-compliance. Nine patients had primary hypothyroidism, and 2 had central hypothyroidism. Besides longstanding hypothyroidism, an additional precipitating factor for MC was identified in 4 (36%) of the patients. Due to the inaccessibility of parenteral levothyroxine, patients were treated with oral, mostly liquid, form of levothyroxine. The mortality rate in this cohort was 27.2%. In conclusion, the increase of the incidence of MC, which is a life-threatening complication of inadequately treated hypothyroidism, during the COVID-19 pandemic, when resources were limited, and in the post-pandemic era, underlines the importance of adequate communication with patients and of long term availability of primary care for patients with thyroid disease.

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Cardiac Tamponade, Sever Hypothyroidism and ARDS in Down syndrome with COVID-19 infection

Cited by 6 publications

References 0 publications

COVID-19 in an Adult with Down Syndrome: Impact on Autoimmune Response

COVID-19 in an Adult with Down Syndrome: Impact on Autoimmune Response

Specific Interleukin-1 Inhibitors, Specific Interleukin-6 Inhibitors, and GM-CSF Blockades for COVID-19 (at the Edge of Sepsis): A Systematic Review

Increased incidence of myxedema coma during the COVID-19 pandemic and in the post pandemic era: a single-center case series

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