Radiology During the COVID-19 Pandemic: Mapping Radiology Literature in 2020.

OBJECTIVES: Our aim was to assess articles published in the field of radiology, nuclear medicine, and medical imaging in 2020, analyzing the linkage of radiology-related topics with coronavirus disease 2019 (COVID-19) through literature mapping, along with a bibliometric analysis for publications. METHODS: We performed a search on Web of Science Core Collection database for articles in the field of radiology, nuclear medicine, and medical imaging published in 2020. We analyzed the included articles using VOS viewer software, where we analyzed the co-occurrence of keywords, which represents major topics discussed. Of the resulting topics, literature map created, and linkage analysis done. RESULTS: A total of 24,748 articles were published in the field of radiology, nuclear medicine, and medical imaging in 2020. We found a total of 61,267 keywords, only 78 keywords occurred more than 250 times. COVID-19 had 449 occurrences, 29 links, with a total link strength of 271. MRI was the topic most commonly appearing in 2020 radiology publications, while "computed tomography" has the highest linkage strength with COVID-19, with a linkage strength of 149, representing 54.98% of the total COVID-19 linkage strength, followed by "radiotherapy, and "deep and machine learning". The top cited paper had a total of 1,687 citations. Nine out of the 10 most cited articles discussed COVID-19 and included "COVID-19" or "coronavirus" in their title, including the top cited paper. CONCLUSION: While MRI was the topic that dominated, CT had the highest linkage strength with COVID-19 and represent the topic of top cited articles in 2020 radiology publications.

Efficacy and safety of COVID-19 vaccines: A network meta-analysis.

OBJECTIVE: Several vaccines showed a good safety profile and significant efficacy against COVID-19. Moreover, in the absence of direct head to head comparison between COVID-19 vaccines, a network meta-analysis that indirectly compares between them is needed. METHODS: Databases PubMed, CENTRAL, medRxiv, and clinicaltrials.gov were searched. Studies were included if they were placebo-controlled clinical trials and reported the safety profile and/or effectiveness of COVID-19 vaccines. The quality of the included studies was assessed using the Revised Cochrane risk-of-bias tool for randomized trials and the Revised Cochrane risk-of-bias tool for nonrandomized trials. RESULTS: Forty-nine clinical trials that included 421,173 participants and assessed 28 vaccines were included in this network meta-analysis. The network meta-analysis showed that Pfizer is the most effective in preventing COVID-19 infection whereas the Sputnik Vaccine was the most effective in preventing severe COVID-19 infection. In terms of the local and systemic side, the Sinopharm and V-01 vaccines were the safest. CONCLUSION: We found that almost all of the vaccines included in this study crossed the threshold of 50% efficacy. However, some of them did not reach the previously mentioned threshold against the B.1.351 variant while the remainder have not yet investigated vaccine efficacy against this variant. Since each vaccine has its own strong and weak points, we strongly advocate continued vaccination efforts in individualized manner that recommend the best vaccine for each group in the community which is abundantly required to save lives and to avert the emergence of future variants.

Impact of COVID-19 on abdominal organ transplantation: A bibliometric analysis.

BACKGROUND: Abdominal solid organ transplant (SOT) programs have been hit hard by the COVID-19 pandemic, which was officially declared as such on March 11, 2020. Over two years, the tightening and softening of limitations in response to the "waves" of infection and COVID-19 fluctuations have provided distinct issues for waitlisted patients, transplant recipients, and transplant organizations. METHOD: We searched Scopus using the terms "transplant" and "transplantation," and organ-related phrases like "intestin*," "liver," "kidney," "hepatic," "renal," and "pancrea*," as well as COVID-19 terms such as "COVID-19," "coronavirus," and "SARS-CoV-2." We included articles, reviews, conference papers, letters, notes, editorials, brief surveys, book chapters, and errata and studied nations, institutions, authors, journals, keywords, and articles. VOSviewer 1.6.18 and Excel were used to create tables and figures. RESULTS: We included 1,251 of 1,256 studies. Among them, 289 (23.1%), 489 (39.1%), and 473 (37.8%) papers were published in 2020, 2021, and 2022, with mean (SD) citations of 30.3 (53.3), 14.3 (26.8), and 4.79 (6.38), respectively. Compared to other abdominal organs, the field of kidney transplants had the highest number of articles describing the impact of COVID-19. The United States contributed the most articles, and the American Journal of Transplantation published the most articles. CONCLUSION: To our knowledge, this is the first bibliometric investigation of the impact of COVID-19 on SOT. This report provides an overview of the research conducted on SOT and COVID-19. There is potential for this bibliometric analysis to serve as a beneficial and practical resource for ongoing and future research.

Teleophthalmology research: Where do we stand?

PURPOSE: To identify global research trends in teleophthalmology, as well as productivity and its association with Human development index (HDI). METHODS: A cross-sectional study. The main outcome measures were publication count, citation count, and publications count per million populations. Bibliographic data were derived from the Web of Science website. HDI data were derived from Human Development Report [2020]. One-way ANOVA test was used to examine the association between HDI and the outcome measures. We studied the correlation between continuous variables using Spearman's. Bibliometric analysis software's VOSviewer and Citspace were used to analyse results and creating visualizing maps. RESULTS: The results retrieved 355 publications, one-third of them have been published in the year of the COVID-19 pandemic; (2020). The USA has contributed to one-half of all publications, and just five countries have contributed to about 90% of all records. Very high HDI countries had significantly more publications count per million populations, than high (p-value = 0.0047), medium (p-value = 0.0081) or low HDI countries (p-value = 0.002). The main themes are screening programmes, reliability, photography, COVID-19, access, artificial intelligence, and cost-effectiveness. The leading countries in terms of both publications and citation count are the USA and India. In terms of publications count per million populations, the leading countries are Singapore and Australia. CONCLUSION: Most of the contribution in teleophthalmology research was confined to a small number of countries. More effort is needed to expand the global contribution. The hotspots in this field are artificial intelligence applications and COVID-19 impact.

Students' Perceptions of e-Learning in Medical Faculties in Jordan during the COVID-19 Pandemic

Objective: The purpose of this study is to evaluate the e-learning of medical specialties in Jordan at different grade levels and to investigate students' satisfaction and opinions about this teaching method. Design: retrospective cross-sectional questionnaire-based study Methods: The opinions of 415 students from various medical specialties were collected using a web-based questionnaire delivered via google forms to evaluate the quality of the education system from various aspects. Results: More than half of the students felt that e-learning was easy to use. The majority of students believe that the instructor did not cover the material completely. Most students actively emphasized the need for clinical reinforcement of what they learned, and they still highly value face-to-face traditional learning as irreplaceable. Analysis of the responses by grade level revealed statistically significant differences in responses to different questions among students. Conclusion: Even though e-learning is an effective and well-managed learning method, it cannot completely replace traditional face-to-face teaching, especially in the clinical grades of medical undergraduates, but it can be considered as a supplementary method in situations such as the previous COVID 19-related lockdown.

The prevalence of mental health outcomes among eating disorder patients during the COVID-19 pandemic: A meta-analysis.

BACKGROUND & AIMS: Patients with eating disorders (ED) are known to suffer from various psychological morbidities thus they are expected to be negatively impacted due to the COVID-19 pandemic. Our meta-analysis aims to evaluate the effect of the COVID-19 pandemic on the pooled prevalence of psychological comorbidities in ED patients. METHODS: Pubmed, Scopus, GoogleScholar, and medRxiv were searched using the keywords COVID19 and Eating Disorders and their related MeSH terms. The articles were included if they contained patients with diagnosed EDs and having evaluated their mental health disturbances during the COVID-19 pandemic. The quality of the included studies was assessed using the "assessing risk of bias in prevalence studies" tool. The heterogeneity was assessed using Cochrane Q and I2 heterogeneity statistics. RESULTS: A total of 13 articles have been included in this meta-analysis with a sample size of 3056. The pooled prevalence of ED patients who experienced worsening of ED symptoms was 57% (95%CI: 36%-76%), anxiety was 64% (95%CI: 39%-78%), and depression was 55% (95%CI: 12%-87%) during the pandemic. CONCLUSIONS: This meta-analysis provides evidence supporting an increase in the pooled prevalence of mental health disorders among patients suffering from EDs during the COVID-19 pandemic.

Dedicated COVID-19 Resource Center in Radiology Journals: Its Citation Metrics and Altmetrics Impact.

BACKGROUND: Since the emergence of coronavirus disease 2019 (COVID-19), several journals have established a dedicated resource center for all the articles published on COVID-19. Our study compared the altmetric impact captured by articles published in journals having a COVID-19 resource center. METHODS: We used the Web of Science database to assess radiology journals publishing the most common articles on COVID-19. We used the dimensions database to assess citations received and altmetric attention score for each article. For each article, we extracted several citations received and altmetric attention scores. To account for the variation in strength and exposure between included journals, we adopted a normalization strategy and regression analysis in our statistical analysis. RESULTS: A total of 494 articles were included in the current assessment, including 334 (67.6%) articles published in journals with the dedicated COVID-19 resource center, including European radiology, American Journal of Roentgenology, Radiology, and Journal of the American college of radiology, while European Journal of Nuclear Medicine and Molecular Imaging, Academic Radiology did not have COVID-19 resource center. Journals with COVID-19 resource center had a mean normalized altmetric attention score of 0.38 higher (95% CI 0.25 to 0.50; p< 0.001) and a mean normalized citation count of 6.73 higher (95% CI 3.99 to 9.48; p< 0.001) than those without COVID-19 resource center. CONCLUSION: Radiology journals that provided COVID-19 articles in a dedicated resource center within its homepage had greater attention and higher citation for their COVID-19 articles than journals that did not have such a dedicated resource center.

Impact of a Single-Day Lockdown on COVID-19: An Interrupted Time Series Analysis.

This study evaluated a special form of lockdown that was applied in Jordan: one day of lockdown every week, which was applied on consecutive weekend days (i.e., Friday in Jordan, for 24 hours). We tried to assess the impact of this form of lockdown on the daily number of positive coronavirus disease 2019 (COVID-19) cases, using interrupted time series analysis. We included the period of March 5 to April 17, 2021, as the period affected by the Friday lockdown, which was applied to seven consecutive Fridays with a total of 168 hours. We used R version 4.0.5 (R Foundation for Statistical Computing, Vienna, Austria) for our analysis. We used Poisson model regression analysis, where the number of positive cases was used as the outcome variable, while the total number of tests, time, and lockdown were used as the predictor variables. We further performed quasi-Poisson regression analysis to confirm the first model. On Poisson model regression analysis, it was found that there was an evidence of an increase in the number of positive COVID-19 cases following the intervention of Friday lockdown, with a p value of <0.001 (relative risk, 1.569; 95% confidence interval, 1.549-1.590). On using quasi-Poisson regression, similar results were found with a wider confidence interval. We concluded that a single weekend day lockdown led to an increase in the number of daily cases of COVID-19. Therefore, we recommend authorities to adhere to evidence-based measures or to the WHO recommendations in the dealing with this pandemic.

Assessment of COVID-19-related meta-analysis reporting quality.

BACKGROUND: Meta-analysis of high-quality primary articles represents the top-quality evidence in medical literature. In this project, our aim was to assess the number and quality of COVID-related meta-analysis published since the beginning of the COVID-19 pandemic. METHODS: The search included the period from January 1, 2020, when the beginning of primary articles on COVID-19, till October 31, 2020. We screened a total of 793 studies. We excluded non-meta-analytic non-COVID-19-related studies. We obtained different characteristics, and we determined the quality of reporting using the AMSTAR tool, an 11-items tool that assesses the content validity and methodological quality of systematic reviews and meta-analysis. RESULTS: A total of 538 studies were included in our assessment. The first meta-analysis included was published in March, while the last one was on the 31st of October. Upon comparing the mean AMSTAR score for meta-analysis published during each month, we found a significant difference (p < 0.001, F = 4.139), where the mean score almost steadily increased since March. CONCLUSION: The urge to publish during the COVID-19 period or any other surge in publishing should not be at the expense of quality.

Proton Pump Inhibitors: Current Use and the Risk of Coronavirus Infectious Disease 2019 Development and its Related Mortality. Meta-analysis.

BACKGROUND: The ongoing Coronavirus Infectious Disease (COVID-19) pandemic is a global health crisis that has had a magnanimous worldwide impact on all aspects of people's lives. Several observational studies investigated the relationship between Proton Pump Inhibitors use and the risk of COVID-19 development and mortality. AIM OF THE STUDY: The aim of this meta-analysis is to investigate the association between current PPIs use and the development of COVID-19 as well as its mortality. METHODS: Pubmed, Google Scholar, ScienceDirect and medRxiv were searched until November 21, 2020 using the following keywords: proton pump inhibitors and COVID-19 as well as their related MESH terms. The studies considered in the meta-analysis were either cohort or case-control in design and adjusted for confounding factors. The quality of the studies included in this meta-analysis was assessed using the Newcastle-Ottawa Scale. In addition, a random-effects model was used to calculate the pooled Odds Ratio (ORs) and the corresponding confidence interval (95% CI). Heterogeneity was evaluated using The Cochran's Q heterogeneity test and I2 statistic. RESULTS: Six observational studies with 195,230 participants were included. In this meta-analysis, current use of PPIs increased risk of COVID-19 development (OR = 1.19; 95% CI: 0.62-2.28) and mortality (OR = 1.67; 95% CI: 1.41-1.97). CONCLUSIONS: Our meta-analysis indicates that current PPIs use significantly increased the risk of COVID-19 mortality, but it did not reach a significant threshold in regards to the risk of COVID-19 development.

Delayed Intravitreal Anti-VEGF Therapy for Patients During the COVID-19 Lockdown: An Ethical Endeavor.

PURPOSE: To assess the impact of Jordanian's Corona Virus Disease (COVID-19) lockdown on visual acuity and macular thickness in patients with macular edema receiving intravitreal injections, and to assess the ethical endeavor of lockdown among serious sight threatening conditions. PATIENTS AND METHODS: This retrospective observational study included patients planned for intravitreal injections who did not complete the planned course before the lockdown (ie, before 20th of March 2020). Data included demographics, indication for the intravitreal injection, corrected distance visual acuity (CDVA), and central macular thickness on Optical Coherence Tomography (OCT) before and after the lockdown. RESULTS: One-hundred and sixty-six eyes of 125 patients were studied, 68 (54.4%) patients were males, and the mean (± standard deviation, SD) age was 64.79 (±9.41) years. Mean (±SD) duration of delay in the planned injection was 60.97 (±24.35) days. The change in visual acuity was statistically significant for patients with diabetic macular edema (p= 0.045 improvement), patients with central retinal vein thrombosis (CRVO) (p= 0.05 deterioration), and patients with age-related macular degeneration (AMD) (p= 0.005 deterioration). Of interest, delay of more than 2 months and the previous need for 3 or more injections were significant poor prognostic factors for visual outcome for patients with diabetic macular edema (p=0.027 and 0.045). CONCLUSION: The impact of delay in the scheduled intravitreal injections resulted in variable outcomes depending on the indication. Triaging the urgency of patients should be based on the indication to support the equity principle of bioethics, where those in need are prioritized against others, depending on potential adverse outcome.

A meta-analysis: The mortality and severity of COVID-19 among patients with mental disorders.

Several observational studies investigated the relationship between pre-diagnosis with mental disorders and COVID-19 outcomes. Thus, we have decided to conduct this meta-analysis to explore this relationship. We complied to the PRISMA guidelines in conducting this meta-analysis. PubMed, ScienceDirect, Google Scholar and medRxiv were searched until the 15th of February, 2021. We used the Random effect model in Meta XL, version 5.3 to pool the included studies. Statistical heterogeneity was assessed using Cochran's Q heterogeneity test and I². This meta-analysis included 634,338 COVID-19 patients from 16 studies. Our findings revealed that pre-diagnosis with mental disorders increased the risk of COVID-19 mortality and severity. This increase in the risk of COVID-19 mortality and severity remained significant in the model that only included the studies that adjusted for confounding variables. Furthermore, higher mortality was noticed in the included studies among schizophrenia, schizotypal and delusional disorders patients compared to mood disorders patients. In this meta-analysis we provided two models which both reported a significant increase in the risk of  COVID-19 severity and mortality among patients with mental disorders, and with the upcoming COVID-19 vaccines, we recommend to give this category the priority in the vaccination campaigns along with medical health providers and elderly.

Assessment of final-year medical students' performance in diagnosing critical findings on chest X-ray.

PURPOSE: Due to the recently emerging shortage in medical staff during the novel corona virus pandemic, several countries have rushed their undergraduate medical students into the emergency department. The accuracy of diagnosing critical findings on X-rays by senior medical students is not well assessed. In this study, we aim to assess the knowledge and accuracy of undergraduate final-year medical students in diagnosing life-threatening emergency conditions on chest x-ray. METHOD: This is a cross-sectional nationwide survey across all medical schools in Jordan. Through an electronic questionnaire, participants were sequentially shown a total of six abnormal X-rays and one normal. For each X-ray, participants were asked to choose the most likely diagnosis, and to grade the degree of self-confidence regarding the accuracy of their answer in a score from 0 (not confident) to 10 (very confident). RESULTS: We included a total of 530 participants. All participants answered at least six out of seven questions correctly, out of them, 139 (26.2%) participants answered all questions correctly. Pneumoperitoneum was the highest correct answer (93.8%), whereas flail chest was the least correctly answered case with only 310 (58.5%) correct answers. Regarding self-confidence for each question, 338 participants (63.8%) reported very high overall self-confidence level. Answers related to tension pneumothorax had the highest confidence level. CONCLUSION: Senior Jordanian medical students showed good knowledge with high confidence levels in diagnosing life-threatening conditions on chest x-rays, supporting their incorporation in the emergency department during pandemics and confirming the reliability of information they can extract.