Georgiana Alexandra Lacatusu

In the HIV/AIDS Regional Center from Iasi, Romania, over 1440 patients are closely followed-up. A small percent <1% (12 patients) of cases are represented by adolescences between 14 and 18 years old. The majority of those (10 cases) are adherent and compliant with the treatment. None of the patients is a drug abuser and one patient acquired the infection through vertical transmission. The COVID-19 pandemic, paradoxically, increased the adherence and compliance to treatment, mainly because it seems that the HIV infected adolescent acknowledge the fact that good health can shield them from an unknown enemy. In these pandemic times, they experienced anxiety and depression, but they kept a closer contact through telemedicine with their physician, and most importantly, they required a sustained session, also through telemedicine, with the psychologist. The red thread of their discussion was focused on their fear, insecurities, and lack of control and the fact that they experienced the feeling of abandonment caused by the absence of interpersonal interaction with their support group.

The novel coronavirus infection has been, and still is, a pressing medical problem with a catastrophic effect, not only from a medical point of view, but also from an economic and social one. The cutaneous manifestations of the disease have a diverse morphology and can signal the presence of the infection. The present article reports the case of a 77‑year‑old male patient admitted at The Sf. Parascheva Clinical Hospital of Infectious Diseases in Iasi (Romania) after testing positive for SARS CoV‑2 infection. Initially, the patient presented a pruriginous generalized maculopapular‑erythematous eruption with a tendency towards confluence, peri‑oro‑nasal meliceric crusts and desquamation of the skin on the third anterosuperior and posterior thorax, scalp and forehead, which was accompanied by low back pain, headache and orbital pain. The suspicion of Stevens‑Johnson syndrome (SJS) was raised, and treatment was given according to the recommendation of the hospital dermatologist. This association raises multiple questions regarding whether SJS is a cutaneous manifestation of COVID‑19 or if there was a concomitance between the viral infection and the immune reaction. The combination of SJS and COVID‑19 can have a fatal outcome if not recognized and promptly treated. To our knowledge, this is the first case of SJS in a patient diagnosed with SARS CoV‑2 infection in Romania.

Looking back into history, infectious diseases played an important role in human history being responsible, in terms of pathologies, for more deaths than any other disease. Considering that infectious diseases have a high rate of transmissibility, with an acute debut and sometimes with a fast evolution to exitus, the impact of the news on families of the departed patient diagnosed with an infectious disease can come as a shock. Processing the unexpected death of a family member needs not only the implication of the physician but also the counseling of a specialized psychologist which can help the families through all stages of loss and grief.