Tag: covid complications

Outcomes of SARS-CoV-2 Reinfection

Abstract:

First infection with SARS-CoV-2 is associated with increased risk of acute and post-acute death and sequelae in the pulmonary and extrapulmonary organ systems. However, whether reinfection adds to the risk incurred after the first infection is not clear. Here we use the national health care databases of the US Department of Veterans Affairs to build a cohort of people with first infection (n = 257,427), reinfection (2 or more infections, n = 38,926), and a non-infected control group (n = 5,396,855) to estimate risks and 6-month burdens of all-cause mortality, hospitalization, and a set of pre-specified incident outcomes.

We show that compared to people with first infection, reinfection contributes additional risks of all-cause mortality, hospitalization, and adverse health outcomes in the pulmonary and several extrapulmonary organ systems (cardiovascular disorders, coagulation and hematologic disorders, diabetes, fatigue, gastrointestinal disorders, kidney disorders, mental health disorders, musculoskeletal disorders, and neurologic disorders); the risks were evident in those who were unvaccinated, had 1 shot, or 2 or more shots prior to the second infection; the risks were most pronounced in the acute phase, but persisted in the post-acute phase of reinfection, and most were still evident at 6 months after reinfection.

Compared to non-infected controls, assessment of the cumulative risks of repeated infection showed that the risk and burden increased in a graded fashion according to the number of infections. The constellation of findings show that reinfection adds non-trivial risks of all-cause mortality, hospitalization, and adverse health outcomes in the acute and post-acute phase of the reinfection. Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention.

Source: Ziyad Al-Aly, Benjamin Bowe, Yan Xie et al. Outcomes of SARS-CoV-2 Reinfection, 17 June 2022, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-1749502/v1] https://www.researchsquare.com/article/rs-1749502/v1 (Full text available as PDF file)

Cardiac tamponade – an unexpected “long COVID-19” complication

Abstract:

Introduction: Year 2020 has been a cornerstone in medical research due to the COVID-19 pandemic
outbreak. The process of understanding the condition brought to light certain organ involvement like
pulmonary or kidney damage or endocrine disbalances, while connection to other types of organ
impairment remain unclear. SARS-CoV-2 has previously been incriminated in cardiac involvement,
ranging from mild symptoms to more severe occurrences such as myocarditis, arrythmias or heart
failure, thus complicating the acute-phase management and worsening patients’ prognosis. Despite being
reported as an acute manifestation in critical COVID-19, cardiac tamponade seems to also occur as a
“long- COVID19” complication. The latter is a distinct yet unclear entity associated with remanent
fatigue or cough, but more severe sequelae like vasculitis or polyneuropathy can occur.

Case report: We report the case of a 42-year-old patient admitted in the intensive care unit for severe
respiratory and renal dysfunction one month after an initial mild episode of COVID-19. RT-PCR for
SARS-CoV-2 on admission was negative. Initial imaging through CT and heart ultrasound revealed the
presence of pericardial effusion but no signs of tamponade were initially obvious. Twelve hours later, the
patient’s state deteriorated with cardiocirculatory failure and signs of obstructive shock. Agents
responsible for severe acute respiratory infection (SARI) such as influenza A and B, adenovirus,
Bordetella pertussis, Mycoplasma pneumoniae, coxsackie virus, Chlamydia pneumoniae or parainfluenza
viruses were ruled out. Surprisingly, RT-PCR testing for SARS-CoV-2 came back positive, although the
initial test was negative. Repeated imaging confirmed massive circumferential pericardial effusion for
which emergency pericardiocentesis was performed. Fluid was an exudate and histopathology reported
chronic inflammation. RT-PCR testing for Mycoplasma tuberculosis in the pericardial tissue came back
negative.

Conclusions: The case is to our knowledge among the first to report cardiac tamponade one month
after mild COVID-19 infection. The aim of this case report is to raise awareness in the medical
community on the possibility of severe complications targeting major organs in the long-COVID-19
phase.

Source: Cobilinschi, Cristian; Melente, Oana Maria; Bologa, Cristina; Cotae, Ana-Maria; Constantinescu, Laura; et al. Cardiac tamponade – an unexpected “long COVID-19” complication. Germs; Bucharest Vol. 12, Iss. 1, (Mar 2022): 112-117. https://www.proquest.com/openview/4b836e7b0259b3a7fe1c40199f4b9c4c/1?pq-origsite=gscholar&cbl=2032454 (Full text)