Background Kidney disease accompanying coronavirus disease 2019 (COVID-19) is not well understood, and information about the presentation of acute kidney injury (AKI), its risk factors, and outcomes is scarce, particularly in Bahrain and the Gulf region. In this study, we aimed to determine the rate of AKI among patients hospitalized with COVID-19 pneumonia at a tertiary hospital in Bahrain and to describe the various aspects of AKI in these patients, including its relationship with respiratory failure and in-hospital mortality. Methods This retrospective observational cohort study of patients admitted with COVID-19 pneumonia from April 1 to May 31, 2020, excluded those aged less than 18 years, those with end-stage renal disease, and those with renal transplants. Clinical and laboratory patient data were collected. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria were used to define AKI. Results The mean age across the 73 included patients was approximately 54 years; about 60% were men, and nearly 58% were Bahraini nationals. Of the patients, 39.7% (29) developed AKI during hospitalization, out of which 11.0% reached stage 1, 15.1% reached stage 2, and 13.7% reached stage 3. Of all patients, seven (9.6%) required hemodialysis. Chronic kidney disease conferred an increased risk for AKI (P = 0.003) as did critical COVID-19 status (P < 0.001) and the necessity for mechanical ventilation or intensive care admission (P < 0.001 for both). Additionally, AKI was significantly associated with a lower PaO 2 /FiO 2 (partial pressure of arterial oxygen/percentage of inspired oxygen) ratio (P < 0.001) and a greater number of medications for COVID-19 pneumonia (P = 0.003). Finally, in-hospital death tolls were remarkably higher in patients with AKI (P < 0.001). No association was found between AKI and each of the following therapies: angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, tocilizumab, and convalescent plasma. Conclusions The rate of AKI in patients hospitalized with COVID-19 pneumonia at our institution is relatively high and is strongly associated with disease severity, respiratory failure, and in-hospital mortality. Awareness of kidney disease in COVID-19 patients is crucial and of vital importance.

During herpes zoster infection, immunocompromised hosts are especially vulnerable to complications, which include visceral organ involvement. Voiding dysfunction secondary to herpes zoster infection is an uncommon clinical presentation and has numerous enigmatic mechanisms. This case of herpes-zoster-associated voiding dysfunction occurred in a patient with nephrotic syndrome treated with immunosuppressives (prednisolone and mycophenolate mofetil). The patient presented with acute urinary retention and extensive lumbosacral herpetic infection. He responded positively to treatment and completely recovered following a 14-day course of intravenous acyclovir and intermittent self-catheterization (two to three times daily) for four weeks.

Vaccine-induced thrombotic thrombocytopenia is a life-threatening prothrombotic syndrome that has been associated with two adenoviral vector-based coronavirus disease 2019 (COVID-19) vaccines. Although it remains a rare disorder with relatively low incidence, awareness of this condition is crucial given the ongoing vaccination programs of millions around the world. In this case series, we report four cases of vaccine-induced thrombotic thrombocytopenia, diagnosed at Queen Alexandra Hospital, Portsmouth, United Kingdom. We also review the mechanism of this syndrome, its clinical presentation, diagnosis, and course of treatment with emphasis on the role of therapeutic plasma exchange.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a novel coronavirus that has spread rapidly, resulting in a worldwide pandemic. Even though end-stage renal disease (ESRD) patients are particularly susceptible to COVID-19 infection and can develop severe to critical disease, there are limited studies and case reports about COVID-19 in ESRD patients. We report a case of a 63-year-old gentleman with ESRD on regular hemodialysis. We describe the clinical presentation of this patient, the diagnostic process, the laboratory and imaging investigations, as well as the course of treatment. He positively responded to a 14-day course of Lopinavir-Ritonavir, Ribavirin, Azithromycin, and Hydroxychloroquine.

Acute appendicitis is a rare but important complication in children with leukemia. It can be difficult to diagnose, and it has a complicated disease course, especially in patients receiving chemotherapy. Awareness of these complications is critical, particularly in cases where surgical intervention is required. We report a child with T-cell acute lymphoblastic leukemia and chemotherapy-induced neutropenia who presented with acute appendicitis. He was successfully treated with broad-spectrum empiric antibiotics and a delayed laparoscopic appendectomy.