Abstract Objective: To study the impact of age and the interval between disease diagnosis and death on the organotropism of SARS-CoV-2. Method: Patients underwent post-mortem biopsies from lungs, Waldeyer ring, heart, liver, kidneys and bone marrow between 2020–2021. SARS-CoV-2 organotropism was mapped by using molecular RT-PCR analyses for SARS-CoV2 targeting the Envelope gene (E), the RNA Polymerase Gene (RdRp), and the Nucleocapsid gene (N). Statistical and linear regression analysis was performed to study the impact of age and illness duration in SARS-CoV-2 organotropism. Results: We performed 158 postmortem biopsies in 21 patients, with a mean age of 76 years old. The mean interval between the diagnosis of the infection to the death was 23 days. The RNA of the SARS-CoV-2 was detected in 100% of lung biopsies, 76%–82% of Waldeyer’s ring biopsies, 55% of heart biopsies, 40% of kidney biopsies, 33% of liver and 25% of bone marrow biopsies. Patients who died before the day 9, presented extensive visceral dissemination of SARS-CoV-2 RNA. Most of the patients older than 80 years (90%) presented visceral dissemination of SARS-CoV-2 RNA, while among younger patients, only 3/11 patients presented visceral dissemination of the virus. The relationship between “age” and “illness duration” and multitropism of the virus was statistically significant (p< 0.001). Conclusion: Disease interval and age were factors that were significantly associated with RT-PCR positive results in multiple organs. Critical COVID-19 patients have multiorganic viral dissemination in early stages. In the critical older patients, multiorganic viral dissemination is the rule. Level of evidence: 4. Case Series.

Resumo Introdução: Em 2006 e 2009, relatamos os níveis de danos teciduais agudos e crônicos após cordectomia associados ao uso de microeletrodos com energia de alta frequência. Em 2010, passamos a usar radiofrequência em vez de eletrogeradores de alta frequência. Objetivo: Avaliar a lesão tecidual aguda na laringe após cordectomia com microeletrodos acoplados a um gerador de radiofrequência. Método: Foram estudados 22 pacientes com carcinoma espinocelular glótico no estágio T1. Os pacientes foram divididos aleatoriamente nos dois modos de operação: corte ou coagulação (11 pacientes em cada modo). A força do estudo é que não há estudos anteriores sobre o efeito da radiofrequência nas cordas vocais humanas. Resultados: O dano tecidual foi mais leve quando os microeletrodos foram acoplados a um gerador de 4 MHz que opera no modo de corte. Assim, ao usar microeletrodos e radiofrequência, recomendamos que o modo de corte seja usado para a incisão epitelial e o modo de coagulação para tratar estroma e músculo e para a hemostasia final. Conclusão: O uso de microeletrodos e radiofrequência na cirurgia laríngea transoral produziu dano tecidual leve e oferece uma excelente opção ao uso de energia de alta frequência.

Abstract Introduction: In 2006 and 2009, we reported the levels of acute and chronic tissue damage after cordectomy associated with use of the microlectrodes using high frequency energy. In 2010, we shifted to radiofrequency rather than high frequency electrogenerators. Objective: The aim of this study is to evaluate acute tissue damage in the larynx after cordectomy using microelectrodes coupled to a radiofrequencygenerator. Methods: We studied 22 patients with a stage T1 glottic squamous cell carcinoma. The patients were randomly assigned to the two operating mode: cutting or coagulation (11 patients each mode). The strength of the study is that there are no previous studies on the effect of radiofrequency in human vocal cord. Results: Tissue damage was milder when microelectrodes were coupled to a 4 MHz generator operating in the cutting mode. Thus, when using microelectrodes and radiofrequency, we recommend that the cutting mode be used for epithelial incision and the coagulation mode to treat the stroma and muscle and for final hemostasis. Conclusion: Microelectrodes and radiofrequency in transoral laryngeal surgery produced mild tissue damage and offer an excellent alternative to the use of high frequency energy.

Abstract Introduction Because of the many HIV-related malignancies, the diagnosis and treatment of lymphoma in patients infected with human immunodeficiency virus are challenging. Objective Here, we review current knowledge of the pathogenesis, epidemiology, symptomatology, diagnosis, and treatment of head and neck lymphomas in HIV patients from a clinical perspective. Data Synthesis Although Hodgkin’s lymphoma is not an AIDS-defining neoplasm, its prevalence is ten times higher in HIV patients than in the general population. NHL is the second most common malignancy in HIV patients, after Kaposi’s sarcoma. In this group of patients, NHL is characterized by rapid progression, frequent extranodal involvement, and a poor outcome. HIV-related salivary gland disease is a benign condition that shares some features with lymphomas and is considered in their differential diagnosis. Conclusion The otolaryngologist may be the first clinician to diagnose head and neck lymphomas. The increasing survival of HIV patients implies clinical and epidemiological changes in the behavior of this disease. Early diagnosis is important to improve the prognosis and avoid the propagation of HIV infection.