piperacillin--tazobactam-drug-combination and Coronavirus-Infections

Coronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of pneumonia. Nevertheless, it has not been reported as the cause of acute myocarditis or fulminant myocarditis.. A 63-year-old male was admitted with pneumonia and cardiac symptoms. He was genetically confirmed as having COVID-19 according to sputum testing on the day of admission. He also had elevated troponin I (Trop I) level (up to 11.37 g/L) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF) on echocardiography. The highest level of interleukin-6 was 272.40 pg/ml. Bedside chest radiographs showed typical ground-glass changes indicative of viral pneumonia. Laboratory test results for viruses that cause myocarditis were all negative. The patient conformed to the diagnostic criteria of the Chinese expert consensus statement for fulminant myocarditis. After receiving antiviral therapy and mechanical life support, Trop I was reduced to 0.10 g/L, and interleukin-6 was reduced to 7.63 pg/mL. Moreover, the LVEF of the patient gradually recovered to 68%. The patient died of aggravation of secondary infection on the 33rd day of hospitalization.. COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. This is the first report of COVID-19 complicated with fulminant myocarditis. The mechanism of cardiac pathology caused by COVID-19 needs further study.

Topics: Acute Disease; Antiviral Agents; Bacteroides Infections; Betacoronavirus; Biomarkers; Candidiasis; Coronavirus Infections; COVID-19; Drug Combinations; Echocardiography; Fatal Outcome; Humans; Interleukin-6; Lopinavir; Male; Middle Aged; Myocarditis; Pandemics; Piperacillin, Tazobactam Drug Combination; Pneumonia, Viral; Ritonavir; SARS-CoV-2; Stroke Volume; Tomography, X-Ray Computed; Troponin I

Hydroxychloroquine (HCQ) has been used for the treatment of novel coronavirus disease (COVID-19) cases. However, evidence of efficacy remains limited, and adverse events can be associated with its use. Here, we report a case of a patient with severe COVID-19 who, after being administered HCQ, exhibited a 10-fold increase in serum levels of transaminases, followed by a rapid decrease after HCQ was withdrawn. Considering the significantly increased use of HCQ during the COVID-19 pandemic, this case alerts us to the potential for HCQ to be associated with hepatotoxicity and the need to monitor liver function during HCQ therapy.

Topics: Adult; Alanine Transaminase; Aspartate Aminotransferases; Azithromycin; Betacoronavirus; Coronavirus Infections; COVID-19; Female; Humans; Hydroxychloroquine; Liver; Lung; Pandemics; Piperacillin, Tazobactam Drug Combination; Pneumonia, Viral; Respiration, Artificial; Reverse Transcriptase Polymerase Chain Reaction; SARS-CoV-2; Tomography, X-Ray Computed

A 33-year-old man presented repeatedly with severe abdominal pain and diarrhoea. Renal colic was suspected, and he was admitted for pain management. Questioning elicited an additional history of sore throat and mild, dry cough. Inflammatory markers were mildly raised (C reactive protein (CRP) 40 mg/L). Initial nasopharyngeal swabs were negative for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) by PCR. CT of the kidneys, ureters and bladder (CT KUB) was normal; however, CT of the thorax showed multifocal bilateral peripheral areas of consolidation consistent with COVID-19 infection. He developed respiratory compromise and was transferred to the intensive care unit (ICU). Sputum was positive for SARS-CoV-2 by PCR, and culture grew

Topics: Abdominal Pain; Adult; Anti-Bacterial Agents; Betacoronavirus; Coronavirus Infections; COVID-19; Critical Care; Diagnosis, Differential; Diarrhea; Humans; Lung; Male; Pandemics; Piperacillin, Tazobactam Drug Combination; Pneumonia, Viral; SARS-CoV-2; Sputum; Tomography, X-Ray Computed; Treatment Outcome; Yersinia enterocolitica