zithromax and Pulmonary-Edema

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and mainly affects the lungs. Sarcoidosis is an autoinflammatory disease characterized by the diffusion of granulomas in the lungs and other organs. Here, we discuss how the two diseases might involve some common mechanistic cellular pathways around the regulation of autophagy.

Topics: Angiotensin-Converting Enzyme Inhibitors; Autophagy; Azithromycin; Betacoronavirus; Chloroquine; Coronavirus Infections; COVID-19; Host-Pathogen Interactions; Humans; Isoniazid; Lung; Pandemics; Pneumonia, Viral; Pulmonary Edema; Rifampin; Sarcoidosis; SARS-CoV-2; Severe Acute Respiratory Syndrome; Severity of Illness Index

There are limited data on cardiovascular complications of coronavirus disease 2019 in pregnancy, and there are only a few case reports on coronavirus disease 2019 related cardiomyopathy in pregnancy. Differentiation between postpartum cardiomyopathy and coronavirus disease 2019 related cardiomyopathy in pregnant women who develop severe acute respiratory syndrome coronavirus-2 infection during peripartum could be challenging. Here, we present a case of possible coronavirus disease 2019 related cardiomyopathy in a pregnant patient, followed by a discussion of potential differential diagnosis.. In this case report, we present the case of a young pregnant Iranian woman who developed heart failure with pulmonary edema after cesarean section. She was treated because of low left ventricular ejection fraction and impression of postpartum cardiomyopathy, and her severe dyspnea improved by intravenous furosemide. On day 3, she exhibited no orthopnea or leg edema, but she was complaining of severe and dry cough. Further evaluation showed severe acute respiratory syndrome coronavirus-2 infection.. The possibility of severe acute respiratory syndrome coronavirus-2 infection should be considered in any pregnant woman who develops cardiomyopathy and pulmonary edema.

Topics: Adult; Anti-Bacterial Agents; Antiviral Agents; Azithromycin; Cardiomyopathies; Cesarean Section; Cough; COVID-19; Diagnosis, Differential; Diuretics; Dyspnea; Echocardiography; Electrocardiography; Female; Furosemide; Heart Failure; Humans; Immunoglobulins, Intravenous; Immunologic Factors; Interferon-beta; Lung; Pre-Eclampsia; Pregnancy; Puerperal Disorders; Pulmonary Edema; SARS-CoV-2; Stroke Volume; Tomography, X-Ray Computed

To evaluate the risk of developing pulmonary edema in women exposed to nifedipine, magnesium sulfate (MgSO4), or both in a preterm setting.. We carried out a retrospective case-control study at a large tertiary care center from 2007 to 2012. Cases of pulmonary edema were age, and gestational age matched to controls at a ratio of 1 case to 4 controls. Logistic regression analysis was used to estimate the effect of nifedipine and/or MgSO4 on the development of pulmonary edema while controlling for predetermined confounding variables. Stepwise logistic regression analysis was used to evaluate additional risk factors of pulmonary edema.. A total of 150 charts were reviewed (28 cases and 122 controls). Nifedipine did not increase the odds of developing pulmonary edema [adjusted odds ratio (OR)=1.22 (confidence interval (CI) 0.50, 3.01), P=0.67], whereas exposure to MgSO4, or both MgSO4 and nifedipine, significantly increased the risk of developing pulmonary edema [adjusted OR=3.91 (CI 1.44, 10.65), P=0.008 and adjusted OR=4.75 (CI 1.15, 19.71), P=0.032, respectively]. In the stratified analysis, this association persisted even in nonpreeclamptic women [nifedipine: adjusted OR=0.91 (CI 0.33, 2.52), P=0.852; MgSO4: adjusted OR=3.51 (CI 1.26, 9.76), P=0.016; both: adjusted OR=3.39 (0.76, 15.07), P=0.108]. Other independent risk factors for pulmonary edema were multi-fetal pregnancy, azithromycin, and erythromycin administration.. MgSO4 treatment is strongly associated with the development of pulmonary edema when used either as a tocolytic agent or for seizure prophylaxis. In light of the availability of safer alternatives, MgSO4 should be used for tocolysis only in cases whereby the benefits clearly outweigh the risks.

Topics: Adult; Azithromycin; Case-Control Studies; Drug Synergism; Erythromycin; Female; Humans; Infant, Newborn; Logistic Models; Magnesium Sulfate; Nifedipine; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Premature Birth; Pulmonary Edema; Retrospective Studies; Risk Factors; Tocolysis; Tocolytic Agents; Young Adult

14-membered ring macrolides have been reported to have anti-inflammatory effects and to decrease neutrophil infiltration into the airways in chronic lower respiratory tract diseases. This study investigated the potential inhibitory effects of macrolide antibiotics on bleomycin-induced acute lung injury. Four drugs were studied: two 14-membered ring macrolides, clarithromycin (CAM) and roxithromycin (RXM); a 15-membered ring macrolide, azithromycin (AZM); and a 16-membered ring macrolide, josamycin (JM). Their effects were compared with macrolide untreated, pretreated, and post-treated groups. An acute lung injury was inhibited by pretreatment with CAM or RXM, which significantly ameliorated the bleomycin-induced increases in the total cell and neutrophil counts in bronchoalveolar lavage (BAL) fluids and the wet lung weight. The pretreatment with CAM or RXM also suppressed inflammatory cell infiltration and interstitial lung edema in the histopathological study. These inhibitory effects were associated with a decreased KC concentration in the BAL fluid and a decreased number of apoptotic cells in the lungs. Posttreatment with CAM or RXM had no marked inhibitory effects. Pretreatment with AZM was much less effective, and JM showed no inhibitory effects. These findings suggest that 14-membered ring macrolides have different effects on inflammatory lung disease than 15- and 16-membered ring macrolides and may be therapeutic agents for acute lung injury and pulmonary fibrosis.

Topics: Animals; Anti-Bacterial Agents; Antibiotics, Antineoplastic; Apoptosis; Azithromycin; Bleomycin; Bronchoalveolar Lavage Fluid; Chemokine CXCL1; Chemokines, CXC; Chemotactic Factors; Clarithromycin; Disease Models, Animal; Dose-Response Relationship, Drug; Growth Substances; In Situ Nick-End Labeling; Intercellular Signaling Peptides and Proteins; Josamycin; Lung; Male; Mice; Mice, Inbred ICR; Pulmonary Edema; Respiratory Distress Syndrome; Roxithromycin; Time Factors; Treatment Outcome