COVID-19-related end stage lung disease: two distinct phenotypes

In COVID-19 related end stage lung disease, there are two distinct phenotypes. The first phenotype is the COVID-19 related acute respiratory distress syndrome (CARDS) showing a classical histopathological pattern of fibrotic diffuse alveolar damage (DAD). The second phenotype is the post-COVID pulmonary fibrosis (PCPF), in which the diagnosis is based on the combined clinical, radiological and (if available) pathological information. Both phenotypes have different clinical features, risk factors, biomarkers and pathophysiology. The exact prognosis in these two phenotypes as well as optimal treatment needs further studies. Key messages Two different phenotypes exist for COVID-19 related pulmonary fibrosis. The CARDS phenotype has a worse prognosis compared to the PCPF phenotype, which requires longer-term follow-up and evolves without ARDS picture. The best treatment options for the two different phenotypes, such as anti-fibrotic drugs or lung transplantation, still needs to be defined in future studies

Epidural haematoma after epidural catheter removal under multiple anticoagulant therapy: report of two cases

We report two cases of epidural haematoma that probably developed after removal of the epidural catheter in patients receiving multiple anticoagulant and antiplatelet therapy. The first case is a 77-year-old male patient who underwent femoropopliteal artery bypass grafting surgery. The second case is a 77-year-old woman who underwent a semi-total replacement of the right hip, three days after she had a subtrochanteric fracture. Emergency laminectomy was performed in both patients but none experienced a full recovery