Retinal Vasculitis Following COVID-19 Vaccination: Causation or Coincidence?

BACKGROUND: With the popularity of coronavirus disease 2019 (COVID-19) vaccination, some rare ocular adverse events have gradually been reported. This report shows a rare case of retinal vasculitis following COVID-19 vaccination. DESCRIPTION: A 37-year-old male complained of unilateral severe vision loss 13 days after the first dose of an inactivated COVID-19 vaccine. The initial eye examination showed gray-white edema in the macula, and scattered patchy gray-white lesions in the peripheral retina, accompanied by peripheral retinal small vessel occlusion. After glucocorticoid treatment, the gray-white lesions gradually subsided. However, due to the initial severe damage in the fundus, macular and peripheral retinal lesions were significantly atrophied, and the vision recovery was poor. CONCLUSION: The ocular adverse event in this report may be related to the inactivated COVID-19 vaccination, however, it is difficult to rule out the accidental rare adverse events after a large number of vaccinations.

Ultrasound Imaging Findings of Acute Testicular Infection in Patients With Coronavirus Disease 2019: A Single-Center-Based Study in Wuhan, China.

OBJECTIVES: Coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic, raising widespread public health concerns. Our team treated hospitalized patients with COVID-19 in Wuhan, where the outbreak first began, and we suspected that SARS-CoV-2 may cause testicular infection in male patients. We conducted this study to explore that observation. METHODS: We enrolled male patients with a confirmed diagnosis of COVID-19 and performed a bedside ultrasound (US) examination of the scrotum, focused on findings of acute inflammation such as tunica albuginea thickening, enlargement and heterogeneous echogenicity of the testis, epididymis, or both, an abscess, scrotal wall edema, and hydrocele. Then we compared the proportions of observed epididymo-orchitis in patients from different age groups and COVID-19 severity groups. RESULTS: A total of 142 patients with COVID-19 were enrolled in our study, and 32 (22.5%) patients had acute orchitis, epididymitis, or epididymo-orchitis on scrotal US imaging, according to the diagnosis criteria. The observed risk of acute scrotal infection increased with age, with the incidence reaching 53.3% in men older than 80 years. We also observed that men with severe COVID-19 had a significantly higher possibility of epididymo-orchitis compared to the nonsevere COVID-19 group (P = .037). CONCLUSIONS: This study shows US imaging evidence that SARS-CoV-2 may cause infection of the testis or epididymis, and the risk is worthy of the attention of clinicians.

Elliptical Pipette Generated Large Microdroplets for POC Visual ddPCR Quantification of Low Viral Load.

Rapid point-of-care (POC) quantification of low virus RNA load would significantly reduce the turn-around time for the PCR test and help contain a fast-spreading epidemic. Herein, we report a droplet digital PCR (ddPCR) platform that can achieve this sensitivity and rapidity without bulky lab-bound equipment. The key technology is a flattened pipette tip with an elliptical cross-section, which extends a high aspect-ratio microfluidic chip design to pipette scale, for rapid (<5 min) generation of several thousand monodispersed droplets ∼150 to 350 µm in size with a CV of ∼2.3%. A block copolymer surfactant (polyoxyalkylene F127) is used to stabilize these large droplets in oil during thermal cycling. At this droplet size and number, positive droplets can be counted by eye or imaged by a smartphone with appropriate illumination/filtering to accurately quantify up to 100 target copies. We demonstrate with 2019 nCoV-PCR assay LODs of 3.8 copies per 20 µL of sample and a dynamic range of 4-100 copies. The ddPCR platform is shown to be inhibitor resistant with spiked saliva samples, suggesting RNA extraction may not be necessary. It represents a rapid 1.5-h POC quantitative PCR test that requires just a pipette equipped with elliptical pipette tip, a commercial portable thermal cycler, a smartphone, and a portable trans-illuminator, without bulky and expensive micropumps and optical detectors that prevent POC application.

Application of quantitative lung ultrasound instead of CT for monitoring COVID-19 pneumonia in pregnant women: a single-center retrospective study.

BACKGROUND: Computed tomography (CT) is the preferred imaging technique for the evaluation of COVID-19 pneumonia. However, it is not suitable as a monitoring tool for pregnant women because of the risk of ionizing radiation damage to the fetus as well as the possible infection of others. In this study, we explored the value of bedside lung ultrasound (LUS) as an alternative to CT for the detection and monitoring of lung involvement in pregnant women with COVID-19. METHODS: Clinical and LUS data of 39 pregnant women with COVID-19 were retrospectively reviewed. All LUS and CT images were analyzed to summarize the findings and calculate LUS scores and CT scores for each patient. LUS findings were compared with CT, and correlation between LUS scores and CT scores was evaluated. RESULTS: Among the 39 pregnant women, there were 6 mild-type cases, 29 common-type cases, 4 severe-type cases, and no critical-type cases. The most common LUS findings of COVID-19 pneumonia in pregnant women were various grades of multiple B-lines (84.6%), thickened and irregular pleural lines (71.8%), pleural effusion (61.5%) and small multifocal consolidation limited to the subpleural space (35.9%). The mean LUS score at admission was 0 points in mild-type cases, 10.6 points in common-type cases and 15.3 points in severe-type cases (P < 0.01). The correlation between LUS scores and CT was 0.793. All patients were clinically cured and each underwent an average of three LUS follow-ups during hospitalization. The mean LUS score at discharge was 5.6 points lower than that at admission. The consistency of LUS and chest CT during follow-up was 0.652. CONCLUSIONS: Quantitative LUS scoring can effectively instead of CT for detecting and monitoring of COVID-19 pneumonia in pregnant women and protect fetuses from the risk of ionizing radiation.

Safety and Effectiveness of Orthopaedic Medical Staff in Providing Support in Combating the COVID-19 Pandemic: A Retrospective Investigation from Wuhan, China.

OBJECTIVE: To evaluate whether it is safe and effective for orthopaedic medical staff to provide support to the work against COVID-19. METHODS: One hundred and twenty-two orthopaedic medical staff from the orthopaedic center of Zhongnan Hospital of Wuhan University were included in this retrospective investigation. A total of 43 surgeons and 69 nurses provided medical support in the treatment of COVID-19 patients from 1 January 2020 to 8 April 2020 in four different hospitals in Wuhan. We collected data on the age, gender, and body temperature of orthopaedic medical staff, as well as the results for their chest CT scans, SARS-CoV-2 RNA, SARS-CoV-2 IgM and SARS-CoV-2 IgG tests, and training and examinations on COVID-19 knowledge. We also collected data on the time span of work, the number of infected staff during the support period, the number of COVID-19 patients the surgeons treated and the cure rate, the performance of the surgeons as assessed by the specialists and patients, and the number of infected staff during the pandemic. RESULTS: Among the 49 surgeons and 73 nurses, 43 surgeons and 69 nurses provided support against COVID-19. A total of 12 surgeons and 11 nurses provided support in the fields of respiration, intensive care, and emergency. A total of 34 surgeons and 58 nurses worked in the designated wards restructured for COVID-19 in the orthopaedic building. The average time span of work for the surgeons and nurses was 14.78 ± 3.64 days and 24.77 ± 7.58 days, respectively. No staff were infected during the support period. Over 1000 patients were received in the fever clinic by orthopaedic surgeons. The overall number of the treated hospitalized patients was 622. Among these patients, 226 cases were mild, 318 were mild to moderate, and 58 were severe or critical. The cure rate was 96.01%, 99.37%, and 52.00% respectively. The performance of the surgeons was scored 87.02 ± 3.17 and 90.69 ± 3.58 by the specialists and the patients, respectively. During the whole pandemic, 3 surgeons and 3 nurses who did not participate in the support work were infected in the early stages. The morbidity of all the orthopaedic staff was 4.92% during the whole pandemic, while no one was infected during the support work. CONCLUSION: Our investigation indicated that although they worked outside their specialty, it was safe and effective for the orthopaedic staff to provide medical support in the work against COVID-19 with adequate precautions and proper training.

The Accomplishment of Nursing Power - Epidemic Prevention in Kaohsiung Medical University Hospital / 護理的力量－高醫護理防疫作為

新型冠狀病毒（COVID-19）在2019的歲暮，悄沒聲息地在大陸對岸現蹤後，迅速的在地球村各地蔓延開來，台灣政府的防疫不僅超前部署，並提出一系列防疫管理措施。在醫院的防疫管理過程中護理扮演關鍵的角色，本文以高雄醫學大學附設中和紀念醫院護理防疫作為之服務、教學、研究等方面進行分享，「因應嚴重特殊傳染性肺炎疫情計畫」中「整備」與「應變」，藉由知識產生力量與信心是恆久不變的法則，透過體系醫院在人力調度、資財盤點、環境管理、防疫相關資訊系統的建置、護理照護、教育訓練和團隊風險溝通各面向的護理執行經驗。同步與醫療團隊進行相關行動研究發想，已陸續刊載於國內外期刊文獻中。期望本文之護理防疫作為內容能提供所有醫療機構作為參考。 At the end of 2019, the new coronavirus (COVID-19) silently appeared from the other side of the shore - mainland China. It rapidly outspread across the global villages;Taiwanese epidemic preventing government deployed ahead of schedule and proposed a series of anti-epidemic management measures. Nursing plays a key role in the hospital's epidemic prevention management procedures. This article will share our experience of epidemic prevention in the aspects of 'service, teaching, and research' from nursing department at Kaohsiung Medical University Chung-Ho Memorial Hospital. There are critical points in the 'responds to the severe acute respiratory syndrome COVID-19 scheme' that include preparation and emergency response. The permanent law is consolidation based on resilience generated from our knowledge. Through our hospital healthcare systems, nursing management can unify manpower scheduling, financial inventory, environmental management, establishment of information systems related to epidemic prevention, nursing care, education and training, as well as team risk communication in terms of all aspects regarding executive experience. Simultaneously, we can conduct relevant action research ideas with the medical team, which have been published in domestic and foreign journals. Hopefully, this epidemic prevention article can serve as a reference to all medical institutions.

Semiquantitative lung ultrasound scores in the evaluation and follow-up of critically ill patients with COVID-19: a single-center study.

RATIONALE AND OBJECTIVES: Chest CT is not suitable for critically ill patients with COVID-19 and lung ultrasound (LUS) may play an important role for these patients. In this study, we summarized the findings of LUS and explore the value of semiquantitative LUS scores in evaluation and follow-up of COVID-19 pneumonia. MATERIALS AND METHODS: Retrospectively studied the LUS and chest CT imaging of 128 critically ill patients with COVID-19. The imaging data were reviewed to acquire the LUS and CT scores. The correlation between LUS scores and CT scores were made to evaluate the accuracy of LUS. A cut-off point of LUS score was calculated to distinguish critical-type patients from severe-type patients. LUS follow-up of 72 patients were compared with the gold standard chest CT. RESULTS: The most common LUS features of COVID-19 pneumonia were crowded or coalescent B-lines with multifocal small consolidations in multi-zone. The mean LUS score was 8.1 points in severe-type patients and 15.7 points in critical-type patients (P<0.05). The correlation between LUS scores and CT scores was high (r=0.891, p<0.01) and it was higher in critical-type patients than that in severe-type patients. The LUS score higher than 10.5 points had a 97.4% sensitivity and 75.0% specificity to distinguish critical-type patients. The consistency of LUS and chest CT in follow-up was 0.596, with higher consistency in diagnosis of lesion progression (Kappa values was 0.774). CONCLUSION: Our scoring system provides a more quantitative use of LUS findings and accurate evaluation of lung damage for critically ill patients with COVID-19.