Introduction: The SARS-CoV-19 pandemic swept through the east coast of the United States of America, with initial presentation in March, a peak in early April, and diminishment of the first wave through June of 2020.  Much of the presentation was poorly understood when infected individuals initially appeared in the hospital emergency rooms.  Presenting symptoms of fever and cough, while initially best recognized as a high likelihood for the coronavirus, were not the only presentations. What became clear, especially as the cases waxed in May and June, was that there is a significant vascular element involved as the chief complaint, often without the usual fever or cough.

Methods: Under an IRB approved protocol the medical records of our safety-net, inner-city institutions, (three hospitals under one main administration, 680 beds expanded to 820 beds, 48 ICU beds expanded to 80), were reviewed with individual patient data anonymized from Mar 19 – Aug 7, 2020. Patients with vascular pathology were studied in relationship to venous, arterial, and renal disease with correlation of presenting symptoms, predisposing medical conditions, interventions performed during hospitalization, and ultimate outcomes, including disposition, (death, rehabilitation, or discharge home). Additional data regarding limb salvage, renal function, and cardiac status were compared with a similar time period from the year prior.

Results: The time period from Mar 19, 2020 to there were 8,479 patients confirmed positive for SARS-CoV-19 and an additional 159 persons under investigation (PUI) treated at our institution. There were 830 expiration (mortality 9.6%).  There were 243 deep venous thrombosis diagnosed  and 48 pulmonary embolisms in this cohort, with 82 isolated to the right iliofemoral system, compared with 115 DVT’s during the year prior, of which only 18 acute DVT’s, 10 PE’s, and no isolated right iliofemoral DVTs. Eight patients were admitted with isolated and unprovoked extremity occlusions, (one arm).  There were 97 temporary lines place for rapid and profound renal failure, (average BUN over 180 mg/dl), with exchanges to larger bore hemodialysis catheters required in nearly all patients to avoid thrombosis during continuous renal ultrafiltration.

Conclusion: It has been well documented that inner-city areas with increased percentages of lower income, Black, Hispanic, and persons of color had higher mortality rates. There was a significant risk of DVT/PE in infected patients with nearly pathognomonic presentation when isolated to the right iliofemoral system. Perhaps related, the profound uremia requires larger bore catheters to avoid repeated line occlusions. Finally, later presentation of isolated arterial limb occlusion without underlying disease or other symptoms may be seen during the second wave of SARS-CoV-19 infection.

Introduction: Studies about placental tissue provide abundance of information about pregnancy course and pathological processes responsible for complications during pregnancy. Cytodiagnostics is a method which helps to estimate the condition of an organ by observing its cells on cytosmear. Placenta is a unique organ, composed of tissue which belongs to the two different organisms and has many complex functions.
Aim: To compare cytological and histological findings of the human term placenta and determine the most appropriate method for preparing cytosmears.
Materials and methods: Material used in this study represented five segments of five placentas. Placentas had normal morphological characteristics and were obtained after the elective cesarean section, done in term under sterile conditions. The cytosmears and histological preparations were made of placental segments. Smears were made by impression-method, towage-method and method with cytobrush. For histological preparations, the tissue was fixated, dehydrated, moulded and cut on the microtome. Smears and preparations were stained with Giemsa stain and H&E.
Results: On cytosmears, decidual, amniotic, trophoblastic, blood cells, chorionic villi and syncytial knots were found. There were no fibrinoids nor microcalcifications found on cytosmears, which existed on corresponding histological preparations. The number of all types of granulocytes was regular on every cytosmear/ histological preparation pair.
Conclusion: All elements, which may be indicators of some placental diseases, can be seen on cytosmears, except fibrinoid. The method with cytobrush, among applied ones, provides the best quality cytosmear so that histological findings could be completed with cytological ones.