Congenital fiber-type disproportion presenting with type II respiratory failure after delivery:A case report

BACKGROUND Congenital fiber-type disproportion(CFTD)is a form of congenital myopathy.CFTD is rare,especially when presenting in patients with critical illnesses.Here,we report a case of CFTD presenting with type II respiratory failure after delivery and provide a review of the literature on CFTD.CASE SUMMARY A 30-year-old woman was admitted to the obstetrics department of our hospital with premature rupture of the fetal membrane and with 7 h of regular contractions.After delivery,the patient experienced a refractory type II respiratory failure.Physical examination along with diagnostic procedures such as electromyography and biopsy confirmed CFTD.Use of invasive ventilator followed by intermittent use of noninvasive ventilator attenuated her symptoms.The patient recovered after ventilator-assisted respiration and was weaned off the noninvasive ventilator on the seventh day postpartum.CONCLUSION Congenital myopathy should be considered a differential diagnosis for type II respiratory failures that cannot be attributed to other diseases.

Impact of the COVID-19 pandemic on liver donation and transplantation:A review of the literature

The coronavirus disease 2019(COVID-19)pandemic has upended healthcare systems worldwide and led to an inevitable decrease in liver transplantation(LT)activity.During the first pandemic wave,administrators and clinicians were obliged to make the difficult decision of whether to suspend or continue a lifesaving procedure based on the scarce available evidence regarding the risk of transmission and mortality in immunosuppressed patients.Those centers where the activity continued or was heavily restricted were obliged to screen donors and recipients,design COVID-safe clinical pathways,and promote telehealth to prevent nosocomial transmission.Despite the ever-growing literature on COVID-19,the amount of high-quality literature on LT remains limited.This review will provide an updated view of the impact of the pandemic on LT programs worldwide.Donor and recipient screening,strategies for waitlist prioritization,and posttransplant risk of infection and mortality are discussed.Moreover,a particular focus is given to the possibility of donor-to-recipient transmission and immunosuppression management in COVID-positive recipients.

Altered gut microbiota composition in children and their caregivers infected with the SARS‑CoV‑2 Omicron variant

Background Gut microbiota alterations have been implicated in the pathogenesis of coronavirus disease 2019(COVID-19).This study aimed to explore gut microbiota changes in a prospective cohort of COVID-19 children and their asymptomatic caregivers infected with the severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2)Omicron variant.Methods A total of 186 participants,including 59 COVID-19 children,50 asymptomatic adult caregivers,52 healthy children(HC),and 25 healthy adults(HA),were recruited between 15 April and 31 May 2022.The gut microbiota composition was determined by 16S rRNA gene sequencing in fecal samples collected from the participants.Gut microbiota functional profling was performed by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States(PICRUSt)software.Results The gut microbiota analysis of beta diversity revealed that the fecal microbial community of COVID-19 children remained far distantly related to HC.The relative abundances of the phyla Actinobacteria and Firmicutes were decreased,whereas Bacteroidetes,Proteobacteria,and Verrucomicrobiota were increased in COVID-19 children.Feces from COVID-19 children exhibited notably lower abundances of the genera Blautia,Bifdobacterium,Fusicatenibacter,Streptococcus,and Romboutsia and higher abundances of the genera Prevotella,Lachnoclostridium,Escherichia-Shigella,and Bacteroides than those from HC.The enterotype distributions of COVID-19 children were characterized by a high prevalence of enterotype Bacteroides.Similar changes in gut microbiota compositions were observed in asymptomatic caregivers.Furthermore,the microbial metabolic activities of KEGG(Kyoto Encyclopedia of Genes and Genomes)and COG(cluster of orthologous groups of proteins)pathways were perturbed in feces from subjects infected with the SARS-CoV-2 Omicron variant.Conclusion Our data reveal altered gut microbiota compositions in both COVID-19 children and their asymptomatic caregivers infected with the SARS-CoV-2 Omicron variant,which further implicates the critical role of gut microbiota in COVID-19 pathogenesis.