Prevalence of Persistent Hypertension Following Delivery Complicated by Hypertensive Disorders and Related Obstetric and Laboratory Risk Factors

This study examined prevalence of persistent hypertension following delivery complicated by hypertensive disorders and related obstetric and laboratory risk factors. This prospective cohort study was conducted in a teaching medical center on 270 women with more than 20 weeks of gestation who were admitted for examination and management of high blood pressure. The patients were followed up for blood pressure in two visits at 6 and 12 weeks postpartum. After 12 weeks, women were assigned to three groups of healthy, prehypertension and persistent hypertension. Background information was reviewed to find independent factors associated with persistency of blood pressure using statistical t-test and logistic regression. In bivariate analysis, relative risk of persistent hypertension was estimated at 95% confidence interval. Of 270 patients (46.2%), 110 patients developed persistent hypertension. Among risk factors, high BMI, delivery in less than 34 weeks of pregnancy, history of preeclampsia, history of diabetes, severe preeclampsia and drug control for PIH were independently associated with persistent hypertension. Abnormal laboratory findings included thrombocytopenia, increased serum uric acid and serum creatinine and severe proteinuria associated with this disorder (P <0.05). Almost one in every two pregnant women with hypertensive disorders was prone to postpartum persistent hypertension. This risk particularly increased in maternal obesity, preterm birth due to preeclampsia and abnormal laboratory findings indicating severe preeclampsia. Therefore, more detailed follow-up of high-risk patients is recommended in puerperal visits for diagnosis and timely treatment

Late diagnosis of respiratory syncytial virus and influenza co-infection during coronavirus disease 2019 pandemic: a case report

Abstract Background Respiratory syncytial virus (RSV)-induced disease is one of the important causes of flu-like illness in older adults and can cause serious disease in those who are at high-risk medical conditions. During coronavirus disease 2019 (COVID-19) pandemic, because of overlapping symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection with other respiratory infections, diagnosing diseases based on clinical and radiological findings was challenging and could cause misdiagnosis. Case presentation An 87-year-old Persian man was admitted to the hospital due to loss of consciousness, respiratory distress, tachypnea, and oliguria. He had previously hospitalized because of cough, fever, loss of appetite, and fatigue. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test was performed which was negative; however, based on ground glass opacity on his chest computed tomography (CT) scan and being on the outbreak of COVID-19, he fulfilled case definition of COVID-19; therefore, he received protocol’s treatment (remdesivir) for COVID-19 and relatively recovered and discharged. In our center, we requested brain and chest CT scans, blood tests, and multiplex PCR. Multiplex PCR revealed co-infection of influenza virus and RSV. Although we had started pneumonia and sepsis treatment, old age, weak immune system and the delay in initiation of right antibiotic and antivirus therapy altogether led him to die. Conclusion As a takeaway lesson of this case report, it is necessary to pay attention to viruses that show similar symptoms during future specific virus pandemics, especially in patients with old age and weak immune systems