INTRODUCTION Infections due to COVID-19 can lead to life threatening pneumonia. Accompanying severe disease are more prominent pulmonary changes on Computed Tomography (CT) scan of the chest. The goal of this study was to describe pulmonary CT changes during acute COVID-19 and at follow up and whether the extent of changes correlate with severity of illness, demographics or other risk factors. MATERIALS AND METHODS Included in this study are all individuals that had confirmed COVID-19 and came for a follow up CT of the chest at Landspitali from May to September 2020. Information regarding medical history was obtained retrospectively from medical charts. All CT scans were reviewed using an international staging system to evaluate the extent of lung changes. RESULTS Eighty-five patients with a mean age of 59 years were included in the study. Sixty patients (71%) were hospitalized during the acute phase and 18 (21%) were admitted to the ICU. During the acute phase more pronounced lung involvement was seen in males and patients admitted to the ICU. At follow-up females had less lung involvement but there was a significant relationship between a higher CT score and age, ICU admissions and days in the ICU. Full recovery was seen at follow-up CT in 31% of patients (median 68,5 days between acute and follow-up imaging). CONCLUSION Patients with severe COVID-19 have more pronounced lung involvement on CT than patients with milder disease during the acute phase and follow-up. Older patients and males are at greater risk of acute and persistent COVID-19 related lung changes.

IntroductionConsidering the pulmonary burden caused by acute COVID-19, questions remain of respiratory consequences after recovery. The aim of the study was to describe respiratory function of COVID-19 pneumonia survivors at mid-term follow-up (median 68 days) and assess whether impairments were predicted by acute illness severity or residual CT abnormalities.MethodsResidents of Iceland that had COVID-19 and oxygen saturation ≤94% from 28 February 2020 to 30 April 2021 were offered a clinical follow-up visit with an interview, a 6 min walk test (6MWT), spirometry with gas exchange measurement and chest CT. The results of these examinations were described, grouped by the level of care during acute illness. The associations of disease severity and CT abnormalities at follow-up with subjective dyspnoea, 6MWT results and lung function test results were estimated with regression analyses.ResultsOf 190 eligible patients, 164 (86%) participated in the study. Of those, 32 had never been admitted to hospital, 103 were admitted to hospital without intensive care and 29 had required intensive care. At a follow-up, need for intensive care during acute illness was associated with shorter walking distance on 6MWT, lower oxygen saturation and lower DLCO. Imaging abnormalities at follow-up were observed for most participants (74%) and the magnitude of these changes was associated with decrements in 6MWT distance, oxygen saturation, forced vital capacity and DLCO.ConclusionsThe findings show that impaired exercise capacity and lung physiology at follow-up were primarily observed for patients with COVID-19 pneumonia that required intensive care treatment and/or had persistent imaging abnormalities.

The common femoral artery is a widely used for access in endovascular interventions. Various complications, such as hematoma, pseudoaneurysm and AV-fistula (AVF), can arise from arterial punctures with estimated prevalence between 1-10%. AVF is a rare complication with prevalence <1%. AVF can cause a hemodynamic change in the form of a arteriovenous shunt (AV-shunt). AV-shunts in the groin are usually small and asymptomatic but tend to be symptomatic with larger and persistent AVFs which can present with leg claudication or high outpute heart failure.

Cardiac lipomas are very rare benign tumors of the heart. They are usually asymptomatic and are often an incidental finding on cardiac imaging. This case report involves an 82-year-old female with a history of diabetes admitted because of poor glycemic control. An echocardiogram requested because of arrhythmias and heart failure revealed a tumor in the right atrium. Computed tomographic and ultrasound appearances were consistent with a lipoma and demonstrated a large mass in the right atrium, causing a significant stenosis of the superior vena cava but no clinical symptoms or signs of superior vena cava syndrome

Hraust 69 ára kona var flutt með sjúkrabíl á Landspítalann vegna skyndilegs höfuðverkjar. Ekki var lýst brottfallseinkennum nema óskýru tali/þvoglumaelgi. Við komu á bráðamóttöku 50 mínútum frá upphafi einkenna var meðvitund skert en konan svaraði ákalli og sársaukaáreiti og hreyfði alla útlimi samkvaemt fyrirmaelum (GCS 9). Taugaskoðun sýndi misvíð sjáöldur sem svöruðu ljósáreiti, Babinski-teikn var neikvaett og lífsmörk stabíl.Bráð tölvusneiðmynd af heila var eðlileg. Tölvusneiðmynd af heilaaeðum sést á mynd 1. Á tölvusneiðmyndarbekknum vaknaði sjúklingurinn, var fulláttaður og skýr (GCS15). Ítarlegri taugaskoðun sýndi truflun á augnhreyfingum (intranuclear opthalmoplegia, INO), annars var skoðun eðlileg. Vegna útlits á aeðamynd var sjúklingurinn lagður inn á hágaeslustaeði taugalaekningadeildar. Um 15 mínútum síðar (tveimur klukkustundum eftir upphaf einkenna) versnuðu einkenni skyndilega með auknu rugli og hratt minnkandi meðvitund. Örstuttu síðar haetti hún að bregðast við áreiti (GCS 3).Konan var heilsuhraust, tók Valsartan/HCT við háþrýstingi. Hún var að koma úr löngu flugi nóttina áður en einkenni byrjuðu.Hver er líkleg greining og naestu skref í meðferð?