Human herpesvirus 8, also known as Kaposi sarcoma-associated herpesvirus (KSHV), is one of the few pathogens recognized as direct carcinogen, being involved in the pathogenesis of Kaposi sarcoma, primary effusion lymphoma and multicentric Castleman disease. KSHV is a relatively recently discovered virus, with still limited possibilities for diagnosis and treatment. Therefore, ongoing studies are trying to answer the main issues related to the management of KSHV infection and its associated diseases. This review updates the current knowledge of the KSHV infection, discussing aspects related to epidemiology, virological features, clinical manifestations, diagnosis and treatment.
Cytokine storm seems to be one of the main culprits for developing a severe form of COVID-19, IL-6 being one of its basic components. Therefore, currently, tocilizumab is widely studied as a powerful treatment in patients with severe forms of COVID-19. Our aim was to determine whether it could potentiate a favourable outcome in such patients. We conducted a retrospective observational study including all consecutive admitted patients with confirmed SARS-CoV-2 infection that received treatment with tocilizumab in the period between 01.05-23.08.2020 in "Matei Balș" National Institute for Infectious Diseases and Neurology Department of the Colentina Clinical Hospital in Bucharest, Romania. 22 patients were enrolled with a severe form of COVID-19, predominantly women, with an average age of of 61.72 ± 14.5 years. The fatality rate was 31.81%. It was observed that following tocilizumab administration, patients presented improvement in the majority of the studied parameters, statistically significant in the case of fibrinogen, C reactive protein and blood oxygen level (p < 0.05). Tocilizumab might be regarded as a valuable drug in the management of severe SARS-CoV-2 infection. Rezumat Furtuna de citokine pare a fi una dintre principalele cauze pentru dezvoltarea unei forme severe de COVID-19, IL-6 fiind una dintre componentele sale de bază. Prin urmare, în prezent, tocilizumab este studiat pe scară largă ca un tratament la pacienții cu forme severe de COVID-19. Scopul studiului a fost de a determina dacă ar putea potența un rezultat favorabil la astfel de pacienți. S-a realizat un studiu observațional retrospectiv care a inclus toți pacienții internați cu infecție confirmată de SARS-CoV-2 care au primit tratament cu tocilizumab în perioada 01.05-23.08.2020 în cadrul Institutului Național pentru Boli Infecțioase "Matei Balș" și al Departamentului de Neurologie al Spitalului Clinic Colentina din București, România. 22 de pacienți au fost înrolați cu o formă severă de COVID-19, predominant femei, cu o vârstă medie de 61,72 ± 14,5 ani. Rata mortalității a fost de 31,81%. S-a observat că, după administrarea tocilizumab, pacienții au prezentat îmbunătățiri în majoritatea parametrilor studiați, semnificativ statistic în cazul fibrinogenului, al concentrației proteinei C reactive și a l nivelului de oxigen din sânge (p < 0,05). Tocilizumab ar putea fi considerat un medicament valoros în gestionarea infecției severe cu SARS-CoV-2.
Introduction. COVID-19 is a viral infection with a variable clinical spectrum, ranging from asymptomatic carrier state to severe pneumonia. It is associated with a variety of complications, including musculoskeletal abnormalities. Whereas myalgia is a common clinical finding at these patients, only a few cases of COVID-19-associated rhabdomyolysis have been described in the literature. Case presentation. We describe the case of a 42-year old male confirmed with SARS-CoV-2 infection who presented to the emergency department with an 11-day evolution of dyspnea, cough, fatigue, myalgia and hyperchromic urine. The physical examination revealed dyspnea and an oxygen saturation of 87% while breathing ambient air, being otherwise normal. Blood tests showed neutrophilia, increased inflammatory markers, COVID-19 associated coagulopathy and elevation of muscular enzymes creatine-kinase and myoglobin. The chest computer tomography was consistent with mixed pneumonia, distributed in all pulmonary segments and the case was interpreted as a severe form of SARS-CoV-2 infection, associated with acute respiratory failure and rhabdomyolysis. Upon treatment (Enoxaparin, Aspirin, Dexamethasone, Favipiravir, oxygen administered by face mask, fluid resuscitation), his condition considerably improved, along with the laboratory findings, and he was discharged, without developing acute kidney injury or other complications related to rhabdomyolysis during his admission. Conclusion. COVID-19 patients can develop rhabdomyolysis, which can result in life-threating complications.
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