Background: Echocardiography is generally used in our daily practice to detect cardiovascular complications in COVID-19 patients and for etiological research in the case of worsened clinical status. Many echocardiographic parameters have been the subject of investigation in previous studies on COVID-19. Recently, the right ventricle early inflow-outflow (RVEIO) index has been identified as a possible and indirect marker of the severity of tricuspid regurgitation and right ventricular dysfunction in pulmonary embolism. In this study, we aimed to investigate the relationship between the severity of pneumonia in COVID-19 patients and the RVEIO index.Methods: A total of 54 patients diagnosed with COVID-19 pneumonia were enrolled in this study. Our study population was separated into two groups as severe pneumonia and nonsevere pneumonia based on computed tomography imaging.Results: Saturation O 2 , C-reactive protein, D-dimer, deceleration time, tricuspid annular plane systolic excursion, tricuspid lateral annular systolic velocity, and RVEIO index values were found to be significantly different between severe and nonsevere pneumonia groups. The result of the multivariate logistic regression test revealed that saturation O2, D-dimer, Sm, and RVEIO index were the independent predictive parameters for severe pneumonia. Receiver operating characteristic curve analysis demonstrated that RVEIO index >4.2 predicted severe pneumonia with 77% sensitivity and 79% specificity.
Conclusion:The RVEIO index can be used as a bedside, noninvasive, easily accessible, and useful marker to identify the COVID-19 patient group with widespread pneumonia and, therefore high risk of complications, morbidity, and mortality.
Wegener granülomatozu (WG), üst ve alt solunum yollarının nekrotizan granülomatöz vaskülitine ilişkin klinik-patolojik belirtileri, glomerülonefrit ve küçük damar vasküliti ile karakterize multisistemik tutulum yapan bir hastalıktır. Ateş, eritrosit sedimantasyon hız yüksekliği, halsizlik bulguları ile başvurup, progresif böbrek yetmezliği saptanan, geniş spektrumlu antibiyotik tedavisine rağmen pulmoner lezyonlarda progresyon gözlenen 68 yaşında bayan hasta, böbrek biyopsisi sonrasında WG tanısı almıştır. İkinci olgumuz ise; ilk semptomu işitme kaybı olan 31 yaşında erkek hasta 2 aydır tekrarlayan üst solunum yolu enfeksiyon atakları ve son 1 haftadır devam eden ateş, halsizlik yakınması ile başvurdu. c-ANCA pozitifliği saptanan her iki olguyu enfeksiyon kliniği ile baş-vurmuş olup daha sonra Wegener tanısı alması nedeniyle sunmayı uygun bulduk.
Anahtar Sözcükler: Wegener granülomatozis, c-ANCA, pnömoni, ateş.Wegener Granülomatozu (WG) etyolojisi bilinmeyen, küçük ve orta boy damarları tutan, sıklıkla üst ve alt hava yollarının nekrotizan granulomatöz iltihabı ile karakterize sistemik bir vaskülittir (1,2).Wegener's granulomatosis (WG) is a necrotizing granulomatous vasculitic disease that particularly involves the upper and lower respiratory tract and kidneys. A 68-year-old female patient was admitted to the hospital, a high erythrocyte sedimentation rate, fever, and progressive renal failure. Progression was observed in the patient's pulmonary infiltrations in spıte of wide-spectrum antibiotherapy. The renal biopsy revealed Wegener's granulomatosis. The second case, whose the first symptom was hearing loss, was a 31-year-old male patient who was admitted to the hospital with recurrent episodes of upper respiratory tract infection for two months and with symptoms of fever, and malaise for one week. The WG case with multiple organ involvement in which c-ANCA was determined positive and responded to treatment is discussed in this case presentation
A foreign 72-year-old man who had diabetes mellitus and hypertension was admitted to the emergency room with severe chest pain and dyspnea. Physical examination upon arrival was found to be unremarkable, with a pulse rate of 70 beats/minute and a blood pressure of 115/75 mm Hg. Initial 12-lead electrocardiogram revealed sinus rhythm with minimal ST segment elevations in leads DII, DIII, aVF, and V4-V6, without reciprocal ST segment changes. Inferior wall motion abnormalities were detected in emergency bedside two-dimensional transthoracic echocardiographic examination. The echocardiogram revealed constrictive physiology of the mitral and tricuspid valves and pericardial thickening in the atrioventricular (AV) groove. The early diastolic velocity of the lateral mitral annulus and that of the septal annulus was not reduced in tissue Doppler imaging. The patient was referred to emergency coronary angiography with the diagnosis of acute coronary syndrome. Coronary angiography (Fig. 1a, b) showed coronary artery disease (three-vessel disease) and massive calcification along the AV groove. Reconstructed images of cardiac computed tomography (Fig. 2a, b) demonstrated massive, ring-shaped calcification along the AV groove causing strangulation of the heart. The patient underwent an extensive pericardial resection and coronary artery by-pass graft surgery. A 61-year-old woman with a history of diabetes mellitus, hypertension, and chronic renal impairment was admitted with complaints of fever and inadequate hemodialysis. She had been undergoing catheter-based hemodialysis 3 times a week for 6 months. Chest X-ray revealed that the tip of the catheter was Massive, ring-shaped pericardial calcification of atrioventricular groove Successful management of complications after inappropriate positioning of a hemodialysis catheter
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