Table 2 Characteristics and disease progression of patients with P. vivax malaria who developed respiratory complications
From: Are respiratory complications of Plasmodium vivax malaria an underestimated problem?
Id | Sex/age | Symptoms (days) | Symptoms in the previous days | Signs and symptoms at hospital presentation | Concomitant conditions/comorbidities | First malaria/number of previous episodes | Treatment previous to hospital admission/time (days) | Antimal. | Positive TBS (admission)/parasitaemia (crosses) | Respiratory complications before or after treatment initiation |
|---|---|---|---|---|---|---|---|---|---|---|
1 | M, 39 | 7 | VOM (with blood), FEV, DIR | FEV, JAU, sDYS, TBC | G6PDd | No, 10 | No | CQ + PQ | No, 0 | After |
2 | F, 19 | 3 | sHEA, FEV, CHI, VOM, ABDp, DYS | DHY, PAL, TBC | Pregnancy (22 weeks) | No, NA | No | CQ | Yes, ++ | After |
3 | M, 58 | 10 | FEV, CHI, dCOU, MIA, DYS | HPM, PAL, sDYS, JAU, FEV, TBC | G6PDd | NA | No | CQ | Yes, +++ | Before |
4 | F, 50 | 6 | FEV, CHI, HEA, ART, ABDp, DYS, dCOU | sDYS, PAL | G6PDd | No, 1 | No | CQ + PQ | Yes, + | Before |
5 | M, 26 | 5 | FEV, MIA, DYS, INS, CHP, ANO | FEV, TBC | HIV (bad adherence) + drug abuse | NA | No | CQ + PQ | No, 0 | After |
6 | F, 9mo | 6 | FEV, CHI, CON, productive COU | DHY, PAL, DYS | Lactating | No, 1 | No | CQ + PQ | Yes, ++ | Before |
7 | M, 55 | 9 | FEV, CHI, COU, DYS, ANO | Patient was admitted to the hospital sedated and in use of IMV. He presented PAL, DHY, TBC and generalized oedema. Patient was diagnosed with a concomitant Streptococcus pneumoniae (tracheal aspirate) | NA | Yes, NA | Artes. | Yes, ++ | After | |
8 | M, 23 | 21 | FEV, CHI, MIA, VOM, HEA, ABDp, PRO, DYS | JAU, TBC | None | No, 2 | Yes, 3 | CQ/Artes. | Yes, ++ | After |
9 | M, 5mo | 2 | FEV, DYS, HYP | PAL, sDYS, TBC | Lactating | No, 5 | No | CQ | Yes, ++ | Before |
10 | M, 46 | 3 | CHP, COU, HEA, DYS | PAL, JAU, TBC | diabetes mellitus type 2 | NA | Yes, NA | CQ + PQ | No, 0 | After |
11 | F, 25 | 1 | FEV, HEA, MIA, DIZ | Patient was diagnosed with vivax malaria before hospital presentation and treated with CQ + PQ + IV fluids (saline). She developed acute pulmonary oedema and was transferred to the hospital using furosemide + ATM. At admission: PAL, TBC and DYS. Patient otherwise fine, with no comorbidities | Yes | Yes, 4 | CQ + PQ | No, 0 | After | |
12 | F, 47 | 1 | EPI, FEV, JAU | Patient was diagnosed with vivax malaria before hospital presentation and treated with CQ (3 days) and PQ afterwards (incomplete—5 days). In the fifth day of PQ she developed sDYS, DIR, AST, dry COU and JAU. She than presented to hospital. Patient otherwise fine, with no comorbidities | NA | Yes, 8 | CQ + PQ | Yes, ++ | After | |
13 | M, 43 | 4 | COU, DYS, NAU | DYS, PAL, FEV, TBC | None | No, 1 | No | CQ + PQ | Yes, ++ | Before |
14 | M, 25 | 7 | FEV, VOM, HEA | JAU, TBC | None | NA | Yes, 3 | CQ + PQ | Yes, + | After |
15 | F, 31 | 10 | FEV, ABDp | PAL, DHY, HYP, TBC | None | No, 1 | No | CQ + PQ | Yes, +++ | After |
16 | M, 7mo | 2 | FEV, DYS | PAL, TBC | Lactating | No, 1 | No | CQ + PQ | Yes, ++ | Before |
17 | F, 12 | 6 | HEA, CHI, DIZ, NAU, VOM, DYS | DYS, DHY, FEV, TBC | None | Yes, – | No | CQ + PQ | Yes, +++ | Before |
18 | M, 13 | 9 | FEV, CHI, MIA, NAU, VOM, HYP, ABDp | Patient was diagnosed with vivax malaria before hospital presentation. He was treated with CQ. With clinical deterioration, patient was transferred to the hospital presenting: DYS, PAL, JAU, DIR, DHY, ABDp, TBC. Patient otherwise fine, with no comorbidities | Yes, – | Yes, NA | CQ + PQ | Yes, + | After | |
19 | M, 46 | 7 | FEV, CHI | Patient presented to hospital, was diagnosed with vivax malaria and received treatment (CQ + PQ) and discharged. Two days later presented again to hospital with ABDp, dCOU, sDYS, OLI, MIA, PAL, TBC. He suffered from a spleen rupture and underwent an emergency splenectomy in another hospital. Patient with diabetes mellitus type 2 and hypertension | No, 1 | Yes, NA | CQ + PQ | Yes, ++ | After | |
20 | F, 72 | 7 | INS, PRO, NAU, VOM, DIR, DSLp, sDYS | sDYS, PAL, dURI | Diabetes mellitus type 2 | No, 2 | Yes, NA | CQ + PQ | Yes, + | After |
21 | F, 65 | 3 | ABDp, dURI, CHI, FEV, MIA, VOM, ANO | DHY, JAU, PAL, TBC | Hypertension. Patient developed ARF, DIC, SAN, SHK and coma after admission | No, 5 | Yes, 3 days | CQ + PQ/artes. (ICU) | Yes, +++ | After |
22 | F, 36 | 8 | ABDp, CHI, COU, DYS, FEV, HEA, MIA, PAL, OLI | DHY, ACO, dURI, HPM, SPM, ANO, TBC | Pregnant | No, NA | No | Artes. (adm) | Yes, +++ | Before |
23 | M, 43 | 1 | CHI, DYS, FEV, HEA, MIA, PAL, OLI, VOM | ACO, PAL. Patient developed SAN, ARF, HGL, TBC and concomitant PNM (P. aeruginosa) and sepsis (Staphylococcus aureus) in the course of hospitalization | Hypertension, diabetes mellitus type 2 | No, NA | Yes, 3 days | CQ + PQ | Yes, +++ | After |
24 | M, 75 | 3 | CHI, DYS, FEV, HEA, MIA, PAL, VOM | ACO, PAL and developed DIC, SHK, SAN, HGL, TBC. + 4 cardiopulmonary arrest episodes | Diabetes mellitus type 2 | Yes | No | Artes. (adm) | Yes, ++ | Before |
25 | M, 47 | 3 | COU, dURI, CHI, DYS, FEV | HPM, SPM, MIA, PAL, DHY, TBC | None | Yes | Yes, 5 days | CQ + PQ | Yes, +++ | After |
26 | M, 17 | 4 | ABDp, CHI, DYS, FEV, HEA, DIR, MIA, PAL, VOM | PAL, SAN (PQ induced haemolysis), ARF. Patient developed HBR, SHK | G6PDd | No, NA | Yes, 5 days | CQ + PQ | No, 0 | After |
27 | F, 41 | 7 | ABDp, COU, dURI, CHI, DYS, FEV, MIA, VOM | PAL, JAU, ANO, TBC | None | No, NA | No | CQ | Yes, +++ | After |
28 | F, 74 | 10 | dURI, CHI, FEV, MIA, OLI, VOM | DHY, JAU, ARF, SHK, TBC, | diabetes mellitus type 2 | No, NA | Yes, (started 3 days before ICU) | CQ + PQ | Yes, + | After |
29 | M, 34 | 9 | ABDp, dURI, DYS, FEV, HEA, MIA, ANO, | ACO, PAL, DHY, JAU, ARF, HBR, SAN (PQ induced haemolysis), SHK | G6PDd | Yes | Yes, 5 days | CQ + PQ | No, 0 | After |
30 | F, 25 | 4 | MIA, HEA, FEV, CHI | MIA, HEA, LMS, Dysa, RD | Myasthenia Gravis | Yes, – | No | AL; Artes. (ICU) | Yes, ++ | Before |
Id | Sex/age | Time of appearance of respiratory complications after treatment start (days) | Type of respiratory complication/concomitant WHO severe malaria sd. | Laboratory findings at admission | Hosp. stay (days) | ICU (days) | Haemod. | Use of supplem. oxygen, time (days)/ventilator support | Outcome | |
|---|---|---|---|---|---|---|---|---|---|---|
1 | M, 39 | After 2 days | RD/severe anaemia | Hb 6.77, Ht 18.61, RC 2.28, WC 32,520, Plat 81, got 28, gpt 31, alp 331, ggt 71, ldh 1580; bil 46, ure 194, cre 2.9 | 44 | Yes, 42 | No | Yes, 1/yes | Death | |
2 | F, 19 | After 3 days | ARDS | Hb 7.84, Ht 21.86, RC 2.62, WC 14,590, Plat 91, got 10, gpt 5, ure 24, cre 0.6 | 16 | Yes, 4 | No | Yes, 3/yes | Discharged | |
3 | M, 58 | – | RD/severe thrombocytopaenia | Hb 11.82, Ht 34.12, RC 4.03, WC 9980, Plat 41, got 58, gpt 99, alp 575, ggt 326, ldh 1030, bil 3.49, ure 37, cre 1 | 4 | No, – | No | No, – | Discharged | |
4 | F, 50 | – | RD at rest/lung crackles/intermittent dry cough | Hb 10.1, Ht 29.24, RC 3.24, WC 10,880, Plat 256, got 120, gpt 204, alp 425, ggt 416, bil 2.36, ure 28, cre 0.8 | 5 | No, – | No | No, – | Discharged | |
5 | M, 26 | Day 1 of hospitalization | RD/severe thrombocytopaenia | Hb 13.4, Ht 38.5, RC 4.3, WC 2500, Plat 13, got 59, gpt 25, ldh 751, ure 21, cre 1 | 4 | No, – | No | No, – | Discharged | |
6 | F, 9mo | Day 1 of hospitalization | RD/cerebral manifestations (repeated convulsions) | Hb 8.08, Ht 25.15, RC 3.78, WC 10,820, Plat 146 | 7 | No, – | No | Yes, 9/no | Discharged | |
7 | M, 55 | NA | ARDS | Hb 8.28, Ht 24.34, RC 2.73, WC 5770, Plat 103, got 74, ggt 140, ldh 656, ure 31, cre 0.6 | 10 | Yes, 9 | Yes | Yes, 8/yes | Death | |
8 | M, 23 | Day 1 | RD/cerebral manifestations, severe thrombocytopaenia | Hb 9.83, Ht 27.98, RC 3.49, WC 740, Plat 6, got 49, gpt 27, alp 182, ggt 131, ldh 610, bil 5,61, ure 69, cre 1.2 | 8 | Yes, 5 | No | NA | Discharged | |
9 | M, 5mo | – | RD and nasal flaring/severe thrombocytopaenia | Hb 11.92, Ht 35.54, RC 4.61, WC 6660, Plat 4, got 37, gpt 27, alp 543, ggt 14, ldh 883, bil 0.3, ure 29, cre 0.5 | 6 | No, – | No | Yes, 4/no | Discharged | |
10 | M, 46 | Day 1 of hospitalization | PE | Hb 12.61, Ht 37.88, RC 4.21, WC 7140, Plat 75, got 132, gpt 104, alp 751, ggt 347, ldh 912, bil 4.7, ure 18, cre 0.7 | 4 | No, – | No | No, – | Discharged | |
11 | F, 25 | Same day of treatment start | CHP, DYS and PE | Hb 9.78, Ht 28.83, RC 3.41, WC 6070, Plat70, got 24, gpt 42, alp 283, ldh 1199, bil 0.47, ure 17, cre 1 | 3 | No, – | No | No, – | Discharged | |
12 | F, 47 | After 8 days | PE | Hb 9.45, Ht 29.19, RC 3.52, WC 11,500, Plat 506, got 50, gpt 71, alp 485, ggt 192, ldh 584, bil 0.9, ure 25, cre 0.9 | 4 | No, – | No | No, – | Discharged | |
13 | M, 43 | – | RD/severe thrombocytopaenia | Hb 10.43, Ht 31.03, RC 3.61, WC 5300, Plat 33, got 60, gpt 66, bil 0.4, ure 43, cre 1.3 | 3 | No, – | No | Yes, 2/no | Discharged | |
14 | M, 25 | After 2 days | RD+ absence of breath sounds on auscultation/severe thrombocytopaenia | Hb 11.39, Ht 34.35, RC 3,82, WC 6220, Plat 48, got 13, gpt 41, alp 206, ggt 90, ure 23, cre 1 | 6 | No, – | No | No, – | Discharged | |
15 | F, 31 | After 4 days | Severe RD+ central and limb cyanosis | Hb 10.09, Ht 29.15, RC 3.5, WC 6300, Plat 51, got 18, gpt 14, alp 211, ggt 124, ldh 393, bil 2.1, ure 11, cre 0.7 | 7 | No, – | No | Yes, 7/yes | Discharged | |
16 | M, 7mo | Arrived with respiratory deterioration | RD+ crackles at lung auscultation/severe thrombocytopaenia | Hb 8.79, Ht 26.03, RC 3.74, WC 9540, Plat 31, got 52, gpt 15, alp 64, ldh 885, bil 0.5, ure 12, cre 0.2 | 11 | No, – | No | No, – | Discharged | |
17 | F, 12 | Arrived with respiratory deterioration | RD/severe thrombocytopaenia | Hb 9.78, Ht 30.29, RC 3.88, WC 3340, Plat 30, got 51, gpt 38, alp 605, ldh 901, bil 3.6, ure 25, cre 0.7 | 6 | No, – | No | No, – | Discharged | |
18 | M, 13 | Arrived with respiratory deterioration | RD+ crackles at lung auscultation/severe thrombocytopaenia | Hb 10.16, Ht 32.51, RC 4.14, WC 3190, Plat 28, got 38, gpt 30, alp 364, ggt 55, ldh 632, bil 3.1, ure 41, cre 0.8 | 5 | No, – | No | No, – | Discharged | |
19 | M, 46 | After 2 days | RD/severe anaemia, acute renal failure and severe thrombocytopaenia | Hb 5.53, Ht 15.98, RC 1.71, WC 4460, Plat 22, got 24, gpt 7, alp 134, ggt 51, ldh 563, bil 1.6, ure 96, cre 3.1 | 2 | No, – | No | No, – | Discharged | |
20 | F, 72 | After 4 days | PE/impaired consciousness | Hb 10.29, Ht 31.07, RC 3.39, WC 8060, Plat 101, got 50, gpt 54, alp 987, ggt 217, bil 1, ure 17, cre 1 | 7 | Yes, 7 | No | Yes, 1/no | Discharged | |
21 | F, 65 | Arrived with respiratory complication | ARDS/acute renal failure (decreased urinary output), shock and severe thrombocytopaenia | Hb 10.4, Ht 30.9, RC 3.6, WC 1500, Plat 34, got 38, gpt 25, alp 300, ggt 359, ldh 1545, bil 12.8, ure 41, cre 1 | 13 | Yes, 13 | Yes | Yes, 13/yes | Death | |
22 | F, 36 | Arrived with respiratory complication | RD/altered consciousness and severe thrombocytopaenia | Hb 8.1, Ht 25.15, RC 2.83, WC 4800, Plat 36, got 56, gpt 68, alp 464, ggt 53, ldh 781, bil8.5, ure 31, cre 1.2 | 10 | No | No | Yes, 6/yes | Discharged | |
23 | M, 43 | Arrived with respiratory complication | ARDS/acute renal failure, hypoglycemia, altered consciousness | Hb 7.6, Ht 21.7, RC 2.64, WC 12,800, Plat 66, got 45, ggt 132, ldh 627, bil 0.7, ure 116, cre 3 | 51 | Yes, 47 | Yes | Yes, 42/yes | Discharged | |
24 | M, 75 | Arrived with respiratory complication | ARDS/severe anaemia, shock, DIC, hypoglycemia and altered consciousness | Hb 6.7, Ht 22, RC 2.5, WC 9700, Plat 79, got 94, gpt 22, ggt 36, ldh 1740, bil 0.6, ure 88, cre 2.3 | 3 | Yes, 3 | No | Yes, 3/yes | Death | |
25 | M, 47 | Arrived with respiratory complication | RD/acute renal failure (decreased urinary output) | Hb 13, Ht 39.2, RC 4.22, WC 3900, Plat 98, got 52, ggt 51, ldh 693, bil 0.3, ure 35, cre 0.8 | No | No | No | Discharged | ||
26 | M, 17 | Arrived with respiratory complication | ARDS/severe anaemia, acute renal failure and shock | Hb 5.1, Ht 13.9, RC 1.51, WC 19,600, Plat 316, got 117, gpt 29, alp 203, ggt 17, ldh 114, nil10, ure 249, cre 8 | 27 | Yes, 14 | No | Yes, 9/yes | Discharged | |
27 | F, 41 | Arrived with respiratory complication | RD/severe thrombocytopaenia | Hb 9.9, Ht 28.3, RC 3.27, WC 3700, Plat 39, got 31, gpt 48, alp 184, ggt 79, bil 1.6, ure 31, cre 1 | 8 | No | Yes | Yes, 3/yes | Discharged | |
28 | F, 74 | Arrived with respiratory complication | ARDS/shock and severe thrombocytopaenia | Hb 11.7, Ht 34.1, RC 4.64, WC 6500, Plat 45, got 35, ggt 142, ldh 1389, bil 1, ure 72, cre 1.5 | 31 | Yes, 15 | No | Yes, 10/yes | Discharged | |
29 | M, 34 | Arrived with respiratory complication | ARDS/shock and altered consciousness | Hb 6.7, Ht 18.6, RC 2.28, WC 32,500, Plat 81, got 28, ggt 71, ldh 1580, bil 26.9, ure 194, cre 3 | 1 | Yes, 1 | Yes | Yes, 1/yes | Death | |
30 | F, 25 | Arrived with respiratory complication | PE and ARDS/severe thrombocytopaenia | Hb 11.86, Ht 34.47, RC 3.27, WC 7240, Plat 30, Cre 2.1, GOT 108 | 11 | Yes, 11 | No | Yes, 8/yes | Discharged |