Archives of Clinical Infectious Diseases
Volume:18 Issue: 3, Jun 2023

 Drug-resistant (DR) pulmonary tuberculosis (TB) is often associated with morbidity and mortality compared to drug-susceptible (DS) pulmonary TB. The infectiveness and pathological destruction of DR TB and DS TB strains are still controversial.

 This study aimed to compare the severity of lung damage between new cases of DR and DS pulmonary TB.

 This was an analytical observational study with a retrospective cross-sectional design. The sample was selected from the medical records of eligible TB patients treated at RSUD Dr. Soetomo, Surabaya (Indonesia) from January 2018 to November 2022. The severity of lung damage was assessed based on the chest X-ray.

 A total of 319 patients, consisting of 132 new cases of DR pulmonary TB and 187 new cases of DS pulmonary TB, were recruited. The patients had a mean age of 43.64 years old, and 59.5% of them were male. The most common comorbidity was diabetes mellitus. The severity of DR pulmonary tuberculosis is higher in the mild-moderate category (51.5%), while the severity of DS pulmonary tuberculosis is higher in the severe category (77%).

 There was a difference in lung damage on chest X-ray between new cases of DR and DS pulmonary TB. The severity of DR pulmonary TB was higher in mild-moderate category, while the severity of DS pulmonary TB was higher in severe category.

 The Gam-COVID-Vac (Sputnik V) COVID-19 vaccine is one of the approved vaccines which has been used in Iran.

 In the present retrospective study, we evaluated the short-term efficacy and side effects of the Sputnik V vaccine against COVID-19 in Iranian healthcare providers.

 Healthcare workers referred to Firoozgar Hospital affiliated with the Iran University of Medical Sciences, Tehran, Iran, between March 2021 and December 2021 were assessed. Humoral immunity was evaluated against S-RBD IgG of SARS-CoV2 after Sputnik V vaccination at three phases, including days 60 (phase I), 120 (phase II), and 210 (phase III) by an anti-S RBD IgG ELISA kit. Vaccine recipients were divided into two groups based on the history of SARS-CoV2 infection. The vaccine side effects were obtained from each participant after the first and second doses.

 A total of 65 vaccine recipients (41.5% male (27/65)) with a mean age of 35 ± 8.5 years were enrolled, of whom 41.5% had a history of COVID-19 infection. The SARS-CoV-2 IgG levels were significantly higher in vaccine recipients compared to those without a history of COVID-19 infection a month (4 vs. 6.6), three months (4.5 vs. 7.2), and six months (3.8 vs. 5.9) after vaccination (P = 0.001). Our study had 18 patients (27.7%) with vaccination breakthroughs.

 Sputnik V seems to induce high antibody levels after the second dose; however, protective antibodies declined six months after the second dose. A booster dose is highly recommended for at-risk individuals.

 There is little information about prognostic factors in patients with COVID-19. One of the aspects of SARS-CoV-2 involvement is the sudden loss of smell, called anosmia.

 This study assessed the association between COVID-19 severity and olfactory disturbance.

 This cohort study was performed at Taleghani Hospital of Iran from March 2021 to March 2022. Patients with a definitive diagnosis of COVID-19, according to a positive PCR test or chest CT scan, entered the study. Data on demographic information, past medical history, severity of COVID-19, olfactory disturbance at the time of hospitalization, and the course of the disease were gathered. Data were analyzed using Stata version 14 software.

 A total of 390 patients entered the study. According to the multiple logistic regression analysis, patients with severe and critical COVID-19 were less likely to develop olfactory disturbance (OR = 0.5, P-value = 0.035, 95%CI = 0.2-0.9). Also, obesity was a statistically significant negative predictor of developing olfactory disturbance in patients with COVID-19 (OR = 0.4, P-value = 0.043, 95%CI = 0.1 – 0.9). Diabetes mellitus was a statistically significant positive predictor of developing olfactory disturbance (OR = 3.3, P-value = 0.029, 95%CI = 1.1 – 9.9).

 Patients with severe and critical COVID-19 were less likely to develop anosmia. These patients had lower serum cytokines and presented with milder disease. The severity of olfactory disturbance could be a prognostic factor in COVID-19. It is important to closely monitor patients who exhibit mild olfactory disturbance because they are at risk of more severe COVID-19.

 Because it is still not possible to accurately determine whether the injected vaccines affect the disease incidence and mortality or not in the newly diagnosed strains, the present study aimed to investigate the effect of injected coronavirus disease 2019 (COVID-19) vaccines on the mortality rate among liver transplant patients infected with COVID-19 in Mashhad, Iran.

 This prospective cross-sectional study was conducted on liver transplant patients with moderate to severe COVID-19 referred to Montaseriyeh Hospital, Mashhad, Iran, from December 2021 to March 2022. The relationship between mortality due to Omicron strain was assessed with various variables.

 In general, 97 liver transplant recipients were entered into the present study. Vaccine failure was reported in 43.5% of liver recipients. About 30% of the patients had not received any COVID-19 vaccination, and 2.9%, 40%, and 27.1% had received one, two, and three dosages of COVID-19 vaccination, respectively. Infection with COVID-19 was the cause of mortality in 11.3% of patients. No significant relationship was reported between mortality and the consumption of immunosuppressive agents (P > 0.05). Multiple linear regression showed that the number of received vaccine dosages was predictive of mortality due to infection with the Omicron variant in liver recipients (β = 0.13; P < 0.005).

 It was found that mortality due to COVID-19 vaccination was higher among the patients with fewer COVID-19 vaccination dosages and, consequently, could be related to vaccine-induced immunity in liver transplant recipients. However, due to the high vaccine failure rate, it seems that neutralizing antibody activity against Omicron variants is high.

 This is a clinical evaluation of patients with the incident, acute, or related cutaneous manifestations associated with coronavirus disease 2019 (COVID-19) and/or vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

 We aimed to propose a classification of dermatological manifestations related to either COVID-19 or vaccination against SARS-CoV-2.

 In an observational descriptive study, a classification of cutaneous manifestations is proposed based on groups of etiological hypotheses, which came from a systematic characterization and record of the observed skin lesions of patients who were evaluated personally and via teleconsultation from July 2020 to July 2022 in two reference dermatology services located in the state of Mato Grosso, Brazil.

 A total of 108 patients were included. Eighty-six patients (79.6%) had incident, acute, or COVID-19-related skin manifestations, 15 (13.9%) had dermatological lesions exclusively after vaccination against SARS-CoV-2, and seven (6.5%) %) had cutaneous manifestations related to both COVID-19 and the vaccine. A total of 143 different dermatological manifestations were diagnosed, for which different etiological hypotheses were established based on the clinical and evolutionary characteristics of the lesion, the use of concomitant medications, and the temporal link with COVID-19 and/or the vaccine against SARS-CoV-2. The observed skin manifestations were classified as peri-infectious and post-infectious immune-inflammatory reactions related to COVID-19 (62.2%); exacerbation, by COVID-19, of pre-existing skin diseases in the patient (4.2%); skin manifestations resulting from the socio-sanitary context of the pandemic (2.1%); adverse drug reactions from the treatment of COVID-19 (14%); and adverse skin reactions from SARS-CoV-2 vaccines (17.5%).

 The proposed clinical classification may assist physicians who are faced with dermatological lesions associated with COVID-19 or after active immunization against SARS-CoV-2.

 More than 87% of patients with COVID-19 have at least one resistant symptom after recovery, and bullous disease may be as a one of these resistant conditions.

 This bicentric cross-sectional study examined hospitalised patients with confirmed COVID-19 and pulmonary bullous disease from July 2021 to February 2022 in two hospitals. A radiologist reviewed all patients' chest CT scans for the presence of bullae or cysts.

 In this study, 34 COVID-19 patients with lung bullae were identified. The majority of bullae were small or medium-sized and located in the left or right lung, with 20.6% being bilateral. Most patients had a single bulla. The mortality rate was 29.4%, with an average survival time of 13 days for deceased patients. Increased age, smoking, respiratory comorbidities, intubation, and bilateral bullae were associated with lower survival time. However, no significant association was found between survival time and sex, size, or number of bullae. Findings provide important insights into the clinical implications of COVID-19 and lung bullae.

 Recognizing the coexistence of COVID-19 and pulmonary bullous disease is crucial as bilateral bullae were associated with lower survival time. Further research is needed to determine the relationship between COVID-19 and lung bullae.

 Although post-vaccination headaches have been reported following COVID-19 (Coronavirus Disease 2019) immunization, the specific effect of such vaccination on chronic migraine (CM) management utilizing botulinum toxin remains unexplored. This case series highlights the experiences of five CM patients who, despite initially responding well to abobotulinum toxin type A (BTX-A) treatment, experienced increased headache frequency post-COVID-19 vaccination. These findings suggest the potential implications of COVID-19 vaccination on the efficacy of CM management strategies.

 This case series highlights five female patients diagnosed with CM, aged 31 - 50 years, with varying past medical histories and concurrent medications, whose number of headache days increased following COVID-19 vaccination (with either Sinopharm or AstraZeneca). All patients were undergoing an ongoing clinical trial at Sina Hospital in Tehran, Iran, receiving BTX-A treatment according to a standard protocol. Routine neurological examinations and brain MRIs (magnetic resonance imaging) were performed, and they were asked to complete monthly headache diaries detailing the frequency and intensity of headaches and abortive medications used.

 Based on the observed outcomes, the authors hypothesize that COVID-19 vaccination within the initial month of botulinum toxin administration could attenuate its efficacy in managing CM. Patients should be made aware of this possibility. Consequently, it is recommended that physicians might consider rescheduling the administration of BTX-A for CM management based on their clinical judgment.