Arleta Kowala-Piaskowska

Introduction: In older inpatients, SARS-CoV-2 positivity does not always indicate that COVID-19 is the cause of admission. Aim: To compare clinical profiles and 180-day mortality between older adults admitted for typical COVID-19 and those with incidental SARS-CoV-2 infection. Material and methods: This retrospective cohort study included 306 hospitalized patients aged ≥60 years with SARS-CoV-2 infection. Admission phenotype was manually adjudicated as typical COVID-19 respiratory disease or incidental SARS-CoV-2 infection. Baseline characteristics, multimorbidity, CRP, IL-6, D-dimer, SpO2, and 180-day mortality were analyzed. Mortality was assessed using Kaplan–Meier curves and multivariable logistic regression. Results and discussion: The cohort included 266 typical and 40 incidental admissions. Multimorbidity was common in both groups (79.2% vs 89.7%; p = 0.122). Typical admissions had lower SpO2 and higher CRP at admission (75.2 vs 34.8 mg/L; p = 0.007), whereas incidental admissions had higher D-dimer concentrations (2.2 vs 1.1 ng/mL; p = 0.016). Crude 180-day mortality was higher in the typical COVID-19 group (42.9% vs 22.5%; p=0.014). After adjustment for age and multimorbidity, incidental phenotype was independently associated with lower mortality odds (OR = 0.40; 95% CI: 0.18–0.89; p = 0.027). Conclusions: Typical COVID-19 and incidental SARS-CoV-2 infection are distinct geriatric admission phenotypes. Typical COVID-19 admissions are associated with higher 180-day mortality, independent of baseline multimorbidity.

Introduction: Some viral pharyngitis can mimic streptococcal pharyngitis. The clinical similarity of infectious mononucleosis (IM) and streptococcal pharyngitis makes differential diagnosis based on the clinical picture alone tricky, and patients with IM may be treated empirically with antibiotics (ATBs). Aim: To assess prehospital ATB use in adult patients with IM admitted to the hospital. In addition, to compare antibiotic-treated individuals and patients not treated with ATBs using selected demographic, clinical, and laboratory parameters. Materials and methods: Medical records of patients with a laboratory-confirmed IM diagnosis (2006-2023) from one center in Poland were analyzed. Results: Out of one hundred and forty-four patients, 119 (82.6%) were treated with ATBs in the prehospital period. Many patients (n = 59) received more than one ATB. The most common choices were amoxicillin/clavulanate (46.2%), cefuroxime (27.7%), and macrolides (26.1%). One-fourth of patients had palpebral edema (more commonly in subjects treated with ATBs). The enlarged spleen was found in almost 90% of individuals with an available abdominal ultrasound assessment (113/127). A significant proportion of patients (43.1%) were given steroids (more commonly in subjects treated with ATBs). Conclusions: More severe IM in young adults is a common cause of ATB therapy. Broad-spectrum ATBs are often prescribed. Meticulous clinical evaluation supported by simple and widely available diagnostic tools could reduce the use of antimicrobials in such a patient population.

We describe an atypical case of mpox virus (MPXV) infection in a Polish patient, with a focus on clinical presentation, virological characterisation, and the phylogenetic placement of the viral isolate within the emerging C.1 lineage of Clade IIb. The report aims to contribute to a better understanding of MPXV lineage-specific disease features and viral evolution in non-endemic settings. The patient presented with numerous localised lesions and minimal systemic symptoms. Genomic analysis confirmed infection with an MPXV C.1 lineage of Clade IIb responsible for the 2022–2025 global outbreaks. Infection with C.1 lineage may lead to atypical presentations, particularly in immunocompetent individuals. Continued genomic surveillance and clade-specific clinical correlation are essential for accurate diagnosis, risk stratification, and public health response.

Introduction: Toxocariasis is the most widespread zoonotic parasitic infection, shared between humans, dogs, and wild canids. Clinical manifestations vary widely, often leading to delayed diagnosis, with allergic skin reactions and joint swelling being less common. Case Report: A 53-year-old...

The introduction of COVID-19 vaccinations has significantly altered the course of the pandemic by markedly reducing the number of severe infection cases, hospitalizations, and deaths due to COVID-19. Elderly individuals constitute a particularly vulnerable group at risk of severe disease progression, which is often related to decreased immune system effectiveness and comorbidities. Severe infection outcomes in vaccinated individuals, though substantially rarer than in the unimmunized population, can still lead to death due to underlying health conditions. This analysis aims to describe the population of elderly individuals who, despite being vaccinated, died from interstitial pneumonia complicating SARS-CoV-2 infection. Data on the infection course and co-existing diseases were obtained from the database of the Józef Struś Multispecialty City Hospital in Poznań, which was converted into a dedicated facility during the pandemic. The inclusion criteria for the analysis were being over 60 years of age on the day of hospital admission, confirmed pneumonia in radiological examination, COVID-19 infection confirmed by PCR test, and an adverse disease course resulting in death. Patients admitted to the hospital from 1 June 2021 to 31 December 2021 were analyzed. Out of all hospitalizations, only 18 individuals met the inclusion criteria. Given the small number of patients, the authors employed descriptive methods to illustrate the clinical states of the individual patients, presenting SARS-CoV-2 infection in the context of co-existing diseases that significantly affect prognosis. The qualitative analysis employed highlights the complex and multidimensional courses of severely ill COVID-19 patients more emphatically.

We monitored for mpox in the Poznan wastewater system from July to December 2022 and compared its occurrence with the number of hospitalizations. Our results suggest that the scale of the epidemic is underestimated, and many mpox-infected individuals are not identified by the public health authority. Article summary line Wastewater-based epidemiology can determine the scale of an epidemic and estimate the number of infected individuals not under public health authorities.

The COVID-19 pandemic requires the development of effective methods for the treatment of severe cases. We aimed to describe clinical outcomes and changes in inflammatory markers in Polish patients treated with tocilizumab. The medical charts of SARS-CoV-2-positive patients treated in the Department of Infectious Diseases between 4 March and 2 September 2020 were retrospectively analyzed. The patients who received tocilizumab according to the Polish Association of Epidemiologists and Infectiologists guidelines were selected for the study. We identified 29 individuals who received tocilizumab, out of whom 11 (37.9%) died. The individuals who died had significantly higher maximal interleukin-6 (IL-6) and lactate dehydrogenase (LDH) serum levels than survivors. After administration of tocilizumab, further increase in LDH and IL-6 was a prognostic factor for unfavorable outcomes. Among inflammatory markers, 7-day mean of IL-6 serum concentration was the best predictor of death (cut-off: ≥417 pg/mL; area under ROC curve = 0.81 [95% Confidence Interval: 0.63–0.98]). The serum concentrations of inflammatory markers before administration of tocilizumab did not predict the outcome, whereas IL-6 and LDH measurements after administration of tocilizumab seemed to be of predictive value.

W pracy omówiono znaczenie diagnostyki wirusologicznej w zakażeniach górnych dróg oddechowych. Wskazano na jej znaczenie zwłaszcza w niektórych grupach pacjentów, takich jak: biorcy przeszczepów, chorzy z upośledzonym układem odpornościowym oraz osoby hospitalizowane. Przedstawiono możliwości i ograniczenia wykorzystania techniki izolacji, metod serologicznych oraz biologii molekularnej, a także omówiono możliwe trudności przy interpretacji wyników.

Wirus Zika (ZIKV) został odkryty w 1947 roku. Pierwsze przypadki zachorowań u ludzi stwierdzono w 1952 roku, głownie w tropikalnej Afryce, Azji Południowo-Wschodniej i na wyspach Pacyfiku. Wybuch zakażeń ZIKV na wyspie Yap w Mikronezji w 2007 roku dowiódł, że choroba opuściła dotychczasowe rejony występowania. Aktualna transmisja wirusa Zika została po raz pierwszy opisana w Brazylii. ZIKV jest jednoniciowym wirusem RNA z rodzaju Flavivirus, rodziny Flaviviridae, przenoszonym na ludzi głownie poprzez ukłucie zakażonego komara z gatunku Aedes, przede wszystkim Aedes aegypti i Aedes albopictus. Do zakażenia może dojść podczas kontaktu seksualnego, transfuzji krwi oraz z matki na dziecko. Obecność ZIKV RNA wykryto we krwi, moczu, nasieniu, ślinie, płynie mózgowo-rdzeniowym, płynie owodniowym i mleku matki. Około 80% zakażonych nie wykazuje żadnych objawów infekcji, u pozostałych obserwuje się: ból głowy, wysypkę, gorączkę, jadłowstręt, biegunkę, zaparcia, bole brzucha, zawroty głowy, wymioty, zapalenie spojówek oraz bole mięśni. Potwierdzeniem zakażenia jest wykrycie obecności ZIKV RNA we krwi lub w innych płynach ustrojowych. Aktualnie nie ma dostępnych leków przeciwwirusowych przeznaczonych do terapii zakażenia wirusem Zika. Obserwowanymi powikłaniami są zespół Guillaina-Barrego oraz zapalenie opon mózgowo- rdzeniowych i mózgu. W 2015 roku Ministerstwo Zdrowia w Brazylii wskazało na możliwy związek pomiędzy zakażeniem wirusem Zika a występowaniem mikrocefalii. Rokowanie odnośnie ZIKV jest dobre. Przebycie zakażenia chroni przed ponownym zachorowaniem.