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Most read medical case studies of 2021

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Most read medical case studies of 2021

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As countries continue to administer COVID-19 vaccines, including to children and those who require a third dose, scientific research into the potential and rare side effects of injections remains a priority for many.

Medical understanding of SARS-CoV-2 and how to protect people from the disease has evolved dramatically since scientists first identified the new coronavirus in Wuhan, China, over two years ago.

While COVID-19 vaccines currently approved for use have undergone rigorous clinical trials and approval processes by governing health agencies, individual patient case reports and their outcomes after infection or COVID-19 vaccination is a key focus of early-stage research.

Among the most popular sources for cutting edge research is BMJ Case Reports, considered “the world’s largest repository of case reports”.

Not surprisingly, six of the journal’s 10 most-read case reports in 2021 were linked to adverse events following COVID-19 vaccination, and three were linked to symptoms of infection. But the largest case report concerns a COVID-19 patient who unexpectedly miraculously cured.

Here is a summary of the most widely read case studies from BMJ Case Reports, all of which are available free of charge as part of the journal’s pandemic policy.

118 DAYS ON A FAN

The most widely read 2021 case report, released in March, describes a COVID-19 patient with multiple co-morbidities who was successfully weaned from ventilation after 118 days, although his recovery was complicated by recurrent septic episodes, as well. than by the need for an advanced cardiovascular examination. renal replacement therapy and support.

“To our knowledge, this is the longest reported ventilation and intensive care / hospital stay for a surviving patient with COVID-19 and emphasizes the importance of allowing sufficient time for clinical interventions. take effect even when the prognosis appears bleak. “the doctors wrote in the case report.

A 53-year-old Lebanese man was admitted to a UK hospital with COVID-19 pneumonia after suffering from a sore throat and cough for two weeks. Her comorbidities included type 2 diabetes, hypertension, obstructive sleep apnea, and severe gastroesophageal reflux disease. By the third day of his hospital admission, he had developed hypoxia – a lack of oxygen in the tissues – and was intubated and transferred to the ICU for mechanical ventilation. He quickly developed acute kidney injury and cardiovascular collapse requiring inotropic support to alter the strength of the heart’s contractions. He also underwent a tracheostomy on day 23 of his ICU admission and began receiving ongoing renal replacement therapy on day 24. Over the next two months, doctors said he had several episodes of “significant respiratory deterioration” and pneumonia, which prolonged his need for ventilation. .

Following a “combination of steroids, optimization of antimicrobials and best supportive care,” the patient was finally able to breathe without a ventilator on day 118 and was then discharged from the intensive care unit on day 134. After spending another two months in rehabilitation (six months in total as an inpatient) he was sent home, however, doctors say he continues to be short of breath and needs mobility aids, including a wheelchair and a walker due to back pain.

PUT INTO AN ADULT FOLLOWING VACCINATION

This case study, which was published in July, describes the first reported case of multisystem inflammatory syndrome (MIS) in an adult after vaccination against COVID-19. While COVID-19 vaccines are safe and effective, adverse events after vaccination can occur, including MIS, a rare but serious immune response that occurs when different parts of the body – including, but not limited to , heart, lungs and skin – become inflamed. While MIS has been reported more frequently in children and some adults after COVID-19 infection, experts point out that the development of MIS after vaccination is very rare. According to the case study, there had been no further reports of MIS-C or MIS-A following the COVID-19 vaccination at the time of publication.

Doctors say a 44-year-old British woman was admitted to hospital after experiencing pain in her arm at the vaccine site a few days after receiving the Pfizer-BioNTech vaccine, which progressed to fever, diarrhea and abdominal pain over the next few days. She also had a red rash on her chest and swollen muscles from a buildup of fluid. According to the case report, the woman developed an “unprovoked” pulmonary embolism with acute kidney injury. After administration of an intravenous corticosteroid, the muscle swelling, rash, and acute kidney injury resolved. However, the patient needed an “extended hospital stay” for her rehabilitation.

BEEHIVES AS AN INITIAL SYMPTOM OF INFECTION

The 54-year-old woman at the center of this case study, published in March, presented to the emergency room with shortness of breath, generalized weakness and hives associated with a itching, burning sensation that gradually worsened. over the three days. before. The woman had no other symptoms such as fever, chills, cough, nausea, diarrhea, abdominal pain or sore throat. She had no known exposure to COVID-19, but tested positive for the disease upon arrival at the hospital.

The woman had a generalized rash on her arms and legs that was unusually red, raised, and consistent with a hives rash. Treatment for the rash included oral antihistamines and a topical cream, given the severity of the itching. Antiviral treatment was given intravenously once a day for five days to help relieve his shortness of breath. Within 48 hours of starting this treatment, the woman’s rash was gone and she was discharged on the fifth day of hospitalization after completing the antiviral treatment.

According to the case report, skin manifestations, or rashes, as a symptom of COVID-19 infection are “primarily described as self-limiting.” While the report notes that hives are not reported as the initial presenting symptom of COVID-19 infection, scientists say they can occur at the same time or after the onset of other more common symptoms. .

Here are the other most read case reports from BMJ case reports:

4. Guillain-Barré syndrome after COVID-19 vaccination

5. Sequential contralateral facial nerve palsies after the first and second dose of COVID-19 vaccination

6. Reactivation of herpes simplex keratitis after vaccination

7. Adult MIS in a patient who recovered from COVID-19 after vaccination

8. COVID-19 infection in tissue and debris of palatine tonsils

9. Immune Thrombocytopenic Purpura and Acute Liver Injury after COVID-19 Vaccine

10. Reactive arthritis after COVID-19


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