ABSTRACT
Background: Lung involvement in COVID-19 can be quantified by chest CT scan with some triage and prognostication value. Optimizing initial triage of patients could help decrease adverse health impacts of the disease through better clinical management. At least 6 CT severity score (CTSS) systems have been proposed. We aimed to evaluate triage and prognostication performance of seven different CTSSs, including one proposed by ourselves, in hospitalized COVID-19 patients diagnosed by positive polymerase chain reaction (PCR). Result(s): After exclusion of 14 heart failure and significant preexisting pulmonary disease patients, 96 COVID-19, PCR-positive patients were included into our retrospective study, admitted from February 20, 2020, to July 22. Their mean age was 63.6 +/- 17.4 years (range 21-88, median 67). Fifty-seven (59.4%) were men, and 39 (40.6%) were women. All CTSSs showed good interrater reliability as calculated intraclass correlation coefficients (ICCs) between two radiologists were 0.764-0.837. Those CTSSs with more numerous segmentations showed the best ICCs. As judged by area under curve (AUC) for each receiver operator characteristic (ROC) curve, only three CTSSs showed acceptable AUCs (AUC = 0.7) for triage of severe/critical patients. All CTSSs showed acceptable AUCs for prognostication (AUCs = 0.76-0.79). Calculated AUCs for different CTSSs were not significantly different for triage and for prediction of severe/critical disease, but some difference was shown for prediction of critical disease. Conclusion(s): Men are probably affected more frequently than women by COVID-19. Quantification of lung disease in COVID-19 is a readily available and easy tool to be used in triage and prognostication, but we do not advocate its use in heart failure or chronic respiratory disease patients. The scoring systems with more numerous segmentations are recommended if any future imaging for comparison is contemplated. CTSS performance in triage was much lower than earlier reports, and only three CTSSs showed acceptable AUCs in this regard. CTSS performed better for prognostic purposes than for triage as all 7 CTSSs showed acceptable AUCs in both types of prognostic ROC curves. There is not much difference among performance of different CTSSs. Copyright © 2022, The Author(s).
ABSTRACT
Background: Control of the COVID-19 pandemic, its treatment, and prevention of mortality and morbidity have been the main focus of researchers over the past two years. Due to disagreement on the usefulness of different corticosteroids in the treatment of COVID-19, this work compared the efficacy of dexamethasone and methylprednisolone in the treatment outcomes of intensive critical care (ICU) patients. Methods: The present retrospective cohort study examined clinical records of 105 COVID-19 patients hospitalized in the ICUs of Firoozabadi Hospital in 2021. Clinical outcomes, including the length of hospital stay, the need for a ventilator, and mortality, were compared between patients who received either dexamethasone (DXM) or methylprednisolone (MP). Data were analyzed by SPSS V.20 software at P < 0.05 as statistical significance. Results: The mean ± SD ages of the patients in the DXM and MP groups were 58.82 ± 19.29 and 60.66 ± 14.17 years, respectively, without a statistically significant difference (P > 0.05). The mean duration of hospitalization was 8.14 ± 4.36 days in the DXM group and 6.80 ± 3.34 days in the MP group (P = 0.295). Also, 19 (33.3%) cases in the DXM group an, 19 (39.6%) in the MP group needed mechanical ventilation during hospitalization (P = 0.546). Finally, 30 (52.6%) patients in the DXM group and 27 (56.2%) in the MP group died. Conclusions: The findings indicated no significant difference in the mean duration of hospitalization, the need for a ventilator, and mortality in COVID-19 ICU patients treated with methylprednisolone or dexamethasone. There is a need to perform meta-analyses owing to conflicting results regarding the effects of different corticosteroids on the COVID-19 course. © 2022, Author(s).
ABSTRACT
Aim: The world is affected by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) pandemic. This virus has emerged as a human pathogen that can cause symptoms ranging from fever to Pneumonia, but it remains asymptomatic or mild. To better understand the virus's ongoing spread, identify those who have been infected, and track the immune response, accurate and robust immunological monitoring and SARS-CoV-2 detection assays are needed. Methods: The estimation of serology tests to assess the presence of antibodies to SARS-CoV-2 in COVID-19 patients at Asian Institute of Medical Sciences (AIMS) and Isra University & hospital. 1229 patients were selected including males and females with the age being 25 to 65 years living in the territories from 1st August to 30th November 2020. The anti-SARS-CoV-2 test was performed by an electrochemiluminescence immunoassay analyzer. Results: Out of 1229 participants 206 (17%) were positive with COVID-19, and 1023 (83%) were negative. The results further revealed that a higher percentage of positive COVID-19 were detected in males in all age groups as compared to females, and most of them are affected at age of 46-65 years male 40 (24.69%) and female 14(17.5%). Conclusion: The seroprevalence of SARS-COV-2 antibodies has increased in the old age population, which may aid in determining the true number of infected cases. Although the current study is based on a small sample of participants, the findings suggest a study with a larger population to implement stronger and targeted interventions.
ABSTRACT
Background: COVID effects different people in different ways. Acute kidney injury and variations in lipid profile are frequent complications among patients hospitalized for Covid-19. Severely infected patients with Covid-19 have higher frequency of kidney injury and hypolipidemia, resulting in higher mortality rate. Objectives: The current study was designed to explore variations in lipid profile and estimated Glomerular Filtration Rate (eGFR) in Covid-19 patients, and to evaluate the association of eGFR with lipid parameters in Covid-19 patients (confirmed cases) and healthy controls. Methodology: This comparative cross sectional study was carried out at pathology lab of MACCA Diagnostic, Multan from Oct 2020 to Jan 2021. We enrolled 225 Covid-19 patients as test group and 225 healthy subjects (negative for Covid-19) as control group. Fasting blood samples of Covid-19 and control group were collected to test lipid profile and eGFR. Estimated GFR was calculated from the value of serum creatinine, age, gender and ethnicity of all participants by applying Modification of Diet in Renal Disease (MDRD) equation.
ABSTRACT
Carbon emissions have been considered a major reason behind climate change and global warming. Various studies report that rapid urbanization and the changing demands of 21st century life have resulted in higher carbon emissions. This study aims to examine the carbon footprints in an academic building to observe the carbon dioxide (CO2) levels at crucial landmarks and offices. A sensor-based automated system was designed and implemented for the collection of CO2 concentrations at selected locations. In the final stage, a CO2 footprint map was generated to highlight the vulnerable areas of CO2 in the academic building. It was concluded that offices have higher CO2 concentrations at both intervals (morning and afternoon), followed by the laboratory, corridors, and praying area. The CO2 concentration did not exceed 500 ppm at any location. Thus, all locations other than offices had normal CO2 concentration levels. Similarly, the humidity level was also satisfactory. The average humidity level was below 50%, which is below the permissible value of 65%. The recommended range for temperature values as per ASHRAE standards is 22.5 degrees C to 25.5 degrees C, except for prayer places. It was concluded that the selected academic institute is providing a good environment to the users of the building, but that may change once the academic institute becomes fully functional after COVID-19. This study assists the stakeholders in making guidelines and necessary actions to reduce CO2 concentration in academic buildings, as it is expected to rise once the human load increases in the next academic year. The suggested approach can be used in any other country and the results will vary based on the building type, building energy type, and building ventilation design.