{"title":"COVID-19, that global parenthesis","authors":"D. A. Cabrera-Gaytán","doi":"10.24245/mim.v37i5.5634","DOIUrl":"https://doi.org/10.24245/mim.v37i5.5634","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46080991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: SARS-CoV-2 mainly attacks the respiratory system, but as more has become known about the virus, other organs have also been affected. As time passes, new symptoms emerge, no longer in the water phase, now in the recovery stage in what has been called long COVID or persistent COVID. Objective: To communicate one more of the symptoms of patients with long COVID- 19. Materials and Methods: A case series study was done from October 1st2020 to March 31st2021 at Neumology consultation of a private medical center at Chiapas, Mexico, including patients that had recurrently reported hair loss of unexplained cause after the SARS-CoV-2 infection. Results: Information was collected from 28 patients, 16 men and 12 women, the hair loss began one month after the infection and in 5/28 it persisted for more than 6 months. Conclusions: Having a series of cases where all have in common having been infected by SARS-CoV-2, the association is impossible, so these alterations of the hair follicle can be caused by SARS-CoV-2 and should be included to the long list of symptoms that occur in this entity.
{"title":"Telogen effluvium and alopecia areata: Associated symptoms in patients with long COVID-19","authors":"F. Guillén-Ortega","doi":"10.24245/mim.v37i5.5717","DOIUrl":"https://doi.org/10.24245/mim.v37i5.5717","url":null,"abstract":"Background: SARS-CoV-2 mainly attacks the respiratory system, but as more has become known about the virus, other organs have also been affected. As time passes, new symptoms emerge, no longer in the water phase, now in the recovery stage in what has been called long COVID or persistent COVID. Objective: To communicate one more of the symptoms of patients with long COVID- 19. Materials and Methods: A case series study was done from October 1st2020 to March 31st2021 at Neumology consultation of a private medical center at Chiapas, Mexico, including patients that had recurrently reported hair loss of unexplained cause after the SARS-CoV-2 infection. Results: Information was collected from 28 patients, 16 men and 12 women, the hair loss began one month after the infection and in 5/28 it persisted for more than 6 months. Conclusions: Having a series of cases where all have in common having been infected by SARS-CoV-2, the association is impossible, so these alterations of the hair follicle can be caused by SARS-CoV-2 and should be included to the long list of symptoms that occur in this entity.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68825847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. I. Pérez-Echavarría, M. Yáñez‐Morales, J. Camarillo-Cisneros, F. A. Ramos-Luján, M. I. Saad-Manzanera, A. E. Contreras-Pacheco, J. Solís-Valdez, S. C. González-Cristóbal, L. B. Enríquez-Sánchez
Background: Since the beginning of the pandemic caused by the SARS-CoV-2 virus, risk factors have been identified. These can lead to complications in patients with comorbidities, acute renal injury is one of the most important complications of COVID-19. Objective: To identify a possible relationship between the indicators of the patient's renal status upon admission and the outcome. Materials and Methods: An observational study (retrospective cohort) of patients (series of confirmed cases of COVID-19) who were admitted to the Hospital Central del Estado de Chihuahua, Mexico, from April 1stto October 20th, 2020. A binary logistic regression model was performed. Results: There were included 266 patients. It was found that 82% did not present acute kidney injury on admission, 11.7% were in stage AKIN I, 13.5% AKIN II and 4.5% AKIN III. Patients with COVID-19 without acute renal injury had a higher probability of hospital discharge than those who developed acute renal injury. Conclusions: Kidney injury influences the prognosis of patients with COVID-19;patients out of range of acute kidney injury based on basal serum creatinine have more probability of being discharged by clinical improvement.
{"title":"Acute kidney injury as a predictor of hospital discharge in COVID-19 patients","authors":"A. I. Pérez-Echavarría, M. Yáñez‐Morales, J. Camarillo-Cisneros, F. A. Ramos-Luján, M. I. Saad-Manzanera, A. E. Contreras-Pacheco, J. Solís-Valdez, S. C. González-Cristóbal, L. B. Enríquez-Sánchez","doi":"10.24245/mim.v37i5.5755","DOIUrl":"https://doi.org/10.24245/mim.v37i5.5755","url":null,"abstract":"Background: Since the beginning of the pandemic caused by the SARS-CoV-2 virus, risk factors have been identified. These can lead to complications in patients with comorbidities, acute renal injury is one of the most important complications of COVID-19. Objective: To identify a possible relationship between the indicators of the patient's renal status upon admission and the outcome. Materials and Methods: An observational study (retrospective cohort) of patients (series of confirmed cases of COVID-19) who were admitted to the Hospital Central del Estado de Chihuahua, Mexico, from April 1stto October 20th, 2020. A binary logistic regression model was performed. Results: There were included 266 patients. It was found that 82% did not present acute kidney injury on admission, 11.7% were in stage AKIN I, 13.5% AKIN II and 4.5% AKIN III. Patients with COVID-19 without acute renal injury had a higher probability of hospital discharge than those who developed acute renal injury. Conclusions: Kidney injury influences the prognosis of patients with COVID-19;patients out of range of acute kidney injury based on basal serum creatinine have more probability of being discharged by clinical improvement.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48298718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Cabello-Ganem, M. F. Espino-Rojas, F. Ramirez-Perea, A. López-Ávila
Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even though currently the cornerstone of research and treatment of COVID-19 patients has been the respiratory system, it is essential to consider that COVID-19 has multiple extrapulmonary manifestations, some severe enough to be fatal. For this reason this review focuses on three intimately related systems: cadiovascular, renal and hematological systems. SARS-CoV-2 enters cells through angiotensin converting enzyme 2 (ACE2), a key regulator of the renin-angiotensinaldosterone system (RAAS), which has been characterized in multiple cardiovascular and renal diseases. The hyperinflammatory state in COVID-19 leads to microvascular dysfunction, hypercoagulability, arrhythmias, and acute kidney injury. The importance of diverse multisystemic markers should be highlighted, they have been shown to be predictors of severity and highly useful in the management of patients with COVID-19 to avoid future complications related to the disease.
{"title":"Cardiovascular, hematological and renal implications of COVID-19","authors":"A. Cabello-Ganem, M. F. Espino-Rojas, F. Ramirez-Perea, A. López-Ávila","doi":"10.24245/mim.v37i5.4699","DOIUrl":"https://doi.org/10.24245/mim.v37i5.4699","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even though currently the cornerstone of research and treatment of COVID-19 patients has been the respiratory system, it is essential to consider that COVID-19 has multiple extrapulmonary manifestations, some severe enough to be fatal. For this reason this review focuses on three intimately related systems: cadiovascular, renal and hematological systems. SARS-CoV-2 enters cells through angiotensin converting enzyme 2 (ACE2), a key regulator of the renin-angiotensinaldosterone system (RAAS), which has been characterized in multiple cardiovascular and renal diseases. The hyperinflammatory state in COVID-19 leads to microvascular dysfunction, hypercoagulability, arrhythmias, and acute kidney injury. The importance of diverse multisystemic markers should be highlighted, they have been shown to be predictors of severity and highly useful in the management of patients with COVID-19 to avoid future complications related to the disease.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47261179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The evolution of pharmacological treatment of COVID-19","authors":"L. Carpio-Orantes","doi":"10.24245/mim.v37i5.4624","DOIUrl":"https://doi.org/10.24245/mim.v37i5.4624","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44165559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Roig-Marín, P. Roig-Rico, J. Calbo-Maiques, E. Chiner-Vives
BACKGROUND: SARS-CoV-2 infection can be associated with a hypercoagulable condition, which increases the prevalence of thromboembolic processes and the risk of deep vein thrombosis and pulmonary thromboembolism. CLINICAL CASE: An 82-year-old hypertensive woman admitted to the emergency department due to arthromyalgia, severe asthenia and cough, associated with minimal dyspnea on moderate efforts and an increase in the perimeter of the lower right limb of 3 days of evolution. Upon arrival at the emergency department, she presented tachycardia and tachypnea at rest. In the emergency department blood test showed a D-dimer elevation of 21,131 ng/mL. The chest X-ray showed patchy lung opacities, which was consistent with COVID-19. The CT angiography of the pulmonary arteries showed findings of bilateral pulmonary thromboembolism and COVID-19 pneumonia. A second PCR was positive for SARS-CoV-2. The patient was hospitalized for 8 days and showed improvement with the use of anticoagulant treatment, so it was decided to discharge her with home isolation. CONCLUSIONS: Recently, cases of thromboembolism are being described in patients with coronavirus infection, but pulmonary thromboembolism occurred when patient was admitted to the intensive care unit or in prolonged stays, unlike our patient who initially presented bilateral pulmonary thromboembolism, which is rare. Other cases of postpartum pulmonary embolism and after hospitalization associated with COVID-19 have been described. Therefore, in a patient with COVID-19, special attention must be paid to thromboembolic complications.
{"title":"Bilateral pulmonary thromboembolism as the initial presentation of SARS-CoV-2 infection","authors":"N. Roig-Marín, P. Roig-Rico, J. Calbo-Maiques, E. Chiner-Vives","doi":"10.24245/mim.v37i4.4918","DOIUrl":"https://doi.org/10.24245/mim.v37i4.4918","url":null,"abstract":"BACKGROUND: SARS-CoV-2 infection can be associated with a hypercoagulable condition, which increases the prevalence of thromboembolic processes and the risk of deep vein thrombosis and pulmonary thromboembolism. CLINICAL CASE: An 82-year-old hypertensive woman admitted to the emergency department due to arthromyalgia, severe asthenia and cough, associated with minimal dyspnea on moderate efforts and an increase in the perimeter of the lower right limb of 3 days of evolution. Upon arrival at the emergency department, she presented tachycardia and tachypnea at rest. In the emergency department blood test showed a D-dimer elevation of 21,131 ng/mL. The chest X-ray showed patchy lung opacities, which was consistent with COVID-19. The CT angiography of the pulmonary arteries showed findings of bilateral pulmonary thromboembolism and COVID-19 pneumonia. A second PCR was positive for SARS-CoV-2. The patient was hospitalized for 8 days and showed improvement with the use of anticoagulant treatment, so it was decided to discharge her with home isolation. CONCLUSIONS: Recently, cases of thromboembolism are being described in patients with coronavirus infection, but pulmonary thromboembolism occurred when patient was admitted to the intensive care unit or in prolonged stays, unlike our patient who initially presented bilateral pulmonary thromboembolism, which is rare. Other cases of postpartum pulmonary embolism and after hospitalization associated with COVID-19 have been described. Therefore, in a patient with COVID-19, special attention must be paid to thromboembolic complications.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46078613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: The current COVID-19 pandemic modifies current immunosuppressive treatment guidelines against several nephrological diseases. CLINICAL CASE: A 69-year-old female patient. Her current condition began with a nonspecific clinical picture of asthenia, adynamia, abdominal pain, nausea, and emesis. Upon admission to the service, serum sodium of 111 was found and correction of hydro-electrolytic imbalance was performed. Serum creatinine of 4.41 was found with an estimated glomerular filtration rate of 9.6 mL/min/1.73m2, in addition to hemoglobin anemia of 6.3 mg/dL. A TNK catheter was inserted in the operating room. While in the peritoneal dialysis unit, patient regained kidney function with a filtration rate of 20 mL/min. Patient was then readmitted to the internal medicine floor, where anemia and persistent hypercalcemia stood out. After being evaluated by the Hematology service, final diagnosis was multiple myeloma. Shortly before starting treatment, patient started exhibiting fever, cough, and headache. Chest tomography provided data suggestive of COVID-19. CONCLUSIONS: The clinical manifestations of multiple myeloma and chronic kidney disease are very varied, so the diagnostic approach is very important to avoid wrong diagnoses.
{"title":"Multiple myeloma and COVID-19","authors":"M. Á. M. J. L. López-Lievanos, M. Albarrán-Moreno","doi":"10.24245/mim.v37i3.4795","DOIUrl":"https://doi.org/10.24245/mim.v37i3.4795","url":null,"abstract":"BACKGROUND: The current COVID-19 pandemic modifies current immunosuppressive treatment guidelines against several nephrological diseases. CLINICAL CASE: A 69-year-old female patient. Her current condition began with a nonspecific clinical picture of asthenia, adynamia, abdominal pain, nausea, and emesis. Upon admission to the service, serum sodium of 111 was found and correction of hydro-electrolytic imbalance was performed. Serum creatinine of 4.41 was found with an estimated glomerular filtration rate of 9.6 mL/min/1.73m2, in addition to hemoglobin anemia of 6.3 mg/dL. A TNK catheter was inserted in the operating room. While in the peritoneal dialysis unit, patient regained kidney function with a filtration rate of 20 mL/min. Patient was then readmitted to the internal medicine floor, where anemia and persistent hypercalcemia stood out. After being evaluated by the Hematology service, final diagnosis was multiple myeloma. Shortly before starting treatment, patient started exhibiting fever, cough, and headache. Chest tomography provided data suggestive of COVID-19. CONCLUSIONS: The clinical manifestations of multiple myeloma and chronic kidney disease are very varied, so the diagnostic approach is very important to avoid wrong diagnoses.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43816249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Polo-Martínez, J. Montiel-Mejía, V. Batista-Castellar, Neyder Contreras-Puentes, Giancarlos Conde-Cardona
OBJECTIVE: To describe the clinical characteristics of patients with COVID-19 and an atypical variety of Kawasaki disease with systemic inflammatory processes in children, and their diagnostic and therapeutic procedures. METHODOLOGY: Narrative literature review, from consultation of the databases of PubMed, Science Direct and Google academic. The following keywords (MeSH) were used for the search: “COVID-19”, “Kawasaki Disease”, “SARS-CoV-2”, “multisystem inflammatory syndrome”. Original articles and clinical case reports were included. RESULTS: Fifty-two articles were found, of which 27 were selected that met the inclusion criteria for analysis. CONCLUSIONS: With the clinical manifestations associated with COVID-19 appeared atypical multisystemic inflammatory pictures and Kawasaki disease establishes an urgency of precise and prospective data of this syndrome that manages to differentiate, in its totality, Kawasaki disease or, in its absence, to define it as a variant of the same one. Physicians caring for patients with COVID-19 should be aware of the diagnostic criteria of the new syndrome and be vigilant, especially in countries with consistent case numbers where the majority of complicated patients may be seen following SARS-CoV-2 infection. In addition, these research updates imply an even deeper perspective for pathophysiological study, treatment indication and conceptualization of the clinical basis for its understanding.
{"title":"COVID-19, Kawasaki disease and multisystem inflammatory syndrome: A conceptualization from the main reports","authors":"M. Polo-Martínez, J. Montiel-Mejía, V. Batista-Castellar, Neyder Contreras-Puentes, Giancarlos Conde-Cardona","doi":"10.24245/mim.v37i3.4617","DOIUrl":"https://doi.org/10.24245/mim.v37i3.4617","url":null,"abstract":"OBJECTIVE: To describe the clinical characteristics of patients with COVID-19 and an atypical variety of Kawasaki disease with systemic inflammatory processes in children, and their diagnostic and therapeutic procedures. METHODOLOGY: Narrative literature review, from consultation of the databases of PubMed, Science Direct and Google academic. The following keywords (MeSH) were used for the search: “COVID-19”, “Kawasaki Disease”, “SARS-CoV-2”, “multisystem inflammatory syndrome”. Original articles and clinical case reports were included. RESULTS: Fifty-two articles were found, of which 27 were selected that met the inclusion criteria for analysis. CONCLUSIONS: With the clinical manifestations associated with COVID-19 appeared atypical multisystemic inflammatory pictures and Kawasaki disease establishes an urgency of precise and prospective data of this syndrome that manages to differentiate, in its totality, Kawasaki disease or, in its absence, to define it as a variant of the same one. Physicians caring for patients with COVID-19 should be aware of the diagnostic criteria of the new syndrome and be vigilant, especially in countries with consistent case numbers where the majority of complicated patients may be seen following SARS-CoV-2 infection. In addition, these research updates imply an even deeper perspective for pathophysiological study, treatment indication and conceptualization of the clinical basis for its understanding.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48753258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mexico has the highest death rate of health professionals in the world after contracting COVID-19, as well as has obligations and responsibilities in accordance with the corpus iuris of human rights in the care of the pandemic, in particular those at the forefront of solving the problem, providing them with all the appropriate means to face their responsibility and the good exercise of the medical profession.
{"title":"Obligations of the Mexican state in response to COVID-19","authors":"A. A. Herrera-Fragoso","doi":"10.24245/mim.v37i3.5280","DOIUrl":"https://doi.org/10.24245/mim.v37i3.5280","url":null,"abstract":"Mexico has the highest death rate of health professionals in the world after contracting COVID-19, as well as has obligations and responsibilities in accordance with the corpus iuris of human rights in the care of the pandemic, in particular those at the forefront of solving the problem, providing them with all the appropriate means to face their responsibility and the good exercise of the medical profession.","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45064561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Numerical observations to the study Frequency of anosmia and dysgeusia in patients hospitalized with SARS-CoV-2","authors":"D. A. Cabrera-Gaytán","doi":"10.24245/mim.v37i3.5389","DOIUrl":"https://doi.org/10.24245/mim.v37i3.5389","url":null,"abstract":"","PeriodicalId":35750,"journal":{"name":"Medicina Interna de Mexico","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68825788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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