Coronavirus disease-2019 (COVID-19) is a type of acute viral pneumonia, which began with a sudden outbreak in Wuhan, China. Although closely related to severe acute respiratory syndrome, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), the disease excessive transmission rate distinguishes it from other viral pneumonia diseases. The pulmonary complications and infections caused by this virus, as well as the lack of specific therapeutic have caused one of the most complicated epidemics of the last century. In this review article, we attempted to discuss and describe the latest findings of immunopathogenesis, as well new and applicable treatments for coronavirus disease.

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, Severe Acute Respiratory Syndrome-Coronavi-rus-2 (SARS-CoV-2), led to the ongoing global public health crisis. Existing clinical data suggest that COVID-19 patients with acute respiratory distress syndrome (ARDS) have worse outcomes and increased risk of intensive care unit (ICU) admission. The rapid increase in the numbers of patients requiring ICU care may imply a sudden and major challenge for affected health care systems. In this narrative review, we aim to summarize current knowledge of pathophysiology, clinical and morphological characteristics of COVID-19-associated ARDS and ARDS caused by other factors (classical ARDS) as defined by Berlin criteria, and therefore to elucidate the differences, which can affect clinical management of COVID-19-as-sociated ARDS. Fully understanding the characteristics of COVID-19-associated ARDS will help identify its early progres-sion and tailor the treatment, leading to improved prognosis in severe cases and reduced mortality. The notable mechanisms of COVID-19-associated ARDS include severe pulmonary infiltration/edema and inflammation, leading to impaired alveolar homeostasis, alteration of pulmonary physiology resulting in pulmonary fibrosis, endothelial inflammation and vascular thrombosis. Despite some distinct differences between COVID-19-associated ARDS and classical ARDS as defined by Ber-lin criteria, general treatment principles, such as lung-protective ventilation and rehabilitation concepts should be applied whenever possible. At the same time, ventilatory settings for COVID-19-associated ARDS require to be adapted in individ-ual cases, depending on respiratory mechanics, recruitability and presentation timing.

INTRODUCTION: Miliary tuberculosis is due to hematogenous spread of mycobacterium tuberculosis. Clinical manifestations are nonspecific and protean, depending on the predominant site of involvement. We evaluated the clinical manifestations of 15 patients with miliary tuberculosis. METHODS: A retrospective case review. RESULTS: The diagnosis of miliary tuberculosis was based on the identification of miliary nodules on chest radiography and one of the three following criteria: 1) acid-fast bacilli smear and/or positive culture of clinical specimens (14/15) 2) histopathological identification of TB granuloma (4/15), and 3) radiological and clinical improvement after anti-tuberculosis treatment (14/15). The median age (±SD) of the patients was 52.6±19.1 years. There was an underlying disease (diabetes mellitus) in one patient. Three patients developed acute respiratory distress syndrome (ARDS), one of whom died during intensive care. DISCUSSION: ARDS caused by military TB is associated with a high fatality rate, and there remains scope for improvement in its management.