Relationship between hepatic and pancreatic steatosis and the COVID-19 pneumonia total severity score and prognosis with an emphasis on prognostic strength.

PURPOSE: To investigate the relationship between hepatic steatosis (HS), pancreatic steatosis (PS), and coexisting HS and PS and the Coronavirus disease-2019 (COVID-19) pneumonia total severity score (TSS) and prognosis, assessed through computed tomography (CT), and to evaluate the degree of effectiveness of the three steatosis conditions on TSS and prognosis. METHODS: This retrospective study involved 461 patients (255 male and 206 female, median age of 53 years) with COVID-19 who underwent unenhanced chest CT. HS, PS, and coexisting HS and PS, assessed through CT, were compared with patient demographics, comorbidities, TSS, hospitalization and intubation requirements, and mortality rates. The parameters were compared using Mann-Whitney U and chi-square tests. The parameters of three groups of patients with only HS, only PS, and both HS and PS were compared using the Kruskal-Wallis test. RESULTS: Results revealed that TSS (P < 0.001 for all) and hospitalization rates (P < 0.001 for all except for HS [P = 0.004]) were higher in patients with HS, PS, and both than in those without. Intubation (P = 0.003) and mortality rates (P = 0.018) were significant solely in patients with PS. However, TSS, hospitalization, and diabetes mellitus were significant in age-standardized analyses for PS. In a comparison between only HS, only PS, and coexisting HS and PS in 210 patients, the highest TSS was in the coexistence group (P < 0.001). CONCLUSION: The TSS and hospitalization rates correlate with HS, PS, and coexisting HS and PS, whereas intubation and mortality rates only correlate with PS. However, TSS correlates with coexisting HS and PS at the highest rate.

Knowing the ABCs: teaching the principles of radiology to medical students in Turkey.

BACKGROUND: Radiology education in Turkey is mainly taught during clinical years of medical school and often lacks main principles. Exposure to the fundamentals of radiology at an early stage of medical education may drastically help students generate a better understanding of radiology and expand their interest in the specialty. With the Principles of Radiology Course that we provided, pre- and post-session tests, and assessment survey at the end of the course, we aimed to evaluate the effectiveness of such an online course among Turkish medical students. METHODS: A total of nine online sessions on imaging modalities principles was developed by radiology professors. Each session was given through Zoom by radiologists from different U.S.-institutions to Turkish medical students from state (n = 33) and private (n = 8) universities. Pretests and post-tests were given to participants via Qualtrics before and after each session, respectively. Paired two-sample t-tests were conducted to detect the variance and p=-.05 was used as the significance level. An evaluation survey was distributed at the end of the course to collect their feedback through SurveyMonkey. RESULTS: A total of 1,438 predominantly Turkish (99.32%) medical students engaged with this course. An average of 506 students completed both pre-test and post-test. There was a statistically significant (p < .001) increase in the scores in post-test (mean[range]:7.58[5.21-8.53]) relative to pre-test (mean[range]:5.10[3.52-8.53]). Four hundred and thirty-nine participants (F/M:63.33%/35.54%) completed the end-of-course survey. A total of 71% and 69.70% of the participants strongly agreed that the course would be useful in their clinical practice and had increased their understanding of radiology. They also reported that their level of confidence in the subjects had increased 68% and reached a weighted average of 3.09/4. The survey revealed that 396 (90.21%) of the participants strongly or somewhat agree that introductory principles and concepts should be presented in earlier years of medical education. Compared to in-person education, 358 (81.55%) found the course extremely or very convenient. CONCLUSION: Online lecture series consisting of the principles of the radiological imaging modalities can be offered to Turkish medical students to enhance their grasp of the various imaging modalities and their correct clinical application.

Yoğun Bakımda COVID-19 Tanılı Gebenin Ízlem ve Tedavisi

Amaç: Yeni tip koronavirüs hastalığının (COVID-19) özellikle Delta varyantı gebe hastaları çok etkilemiştir. Biz bu olguda aşısız hemşire bir gebe hastamızın takip ve tedavisini sunmayı amaçladık. Olgu: Otuz beş yaşında bilinen sistemik hastalığı olmayan 33 haftalık gebe hasta, COVID-19 tanısı aldıktan 10 gün sonra nefes darlığı şikayeti ile yatırılarak servis takibine başlanmış. Hastaya seftriakson, metilprenizolon, enoksiparin ve inhaler tedavi uygulanmış. Yatışının 4. gününde solunum sıkıntısı artan hasta, rezervuarlı maske ile 15 lt/dk’den oksijen desteğine rağmen saturasyonu %86-88 olması üzerine yoğun bakım ünitesine transfer edildi. Yüksek akımlı oksijen tedavisine rağmen desatüre seyreden, kan gazı: Ph: 7,25, pCO2 : 66,7, pO2 : 48,2, lac: 1,8, sO2 : 83 olan ve bilateral akciğer tutulumu olan CO-RADS5 kabul edilen hastada yoğun bakıma yatışının 8. saatinde ilgili branşların ortak değerlendirmesi ile sezaryan kararı alındı. Post-sezeryan hasta entübe şekilde YBÜ’ye transferi sağlandı. Çocuk sağlıklı idi ve pediyatri ekibince takibine başlandı. Hastaya SIMV mod FiO2 : 80, peep: 10/22 mekanik ventilasyon desteği verildi. Midozalam ve remifentanil ile derin sedasyon sağlandı, 2 gün roküronyum infüzyonu verildi. Post-sezeryan 6. saatte pron pozisyonuna alındı. Hastaya toplamda 3 gün 12-16 saat arası pron pozisyon uygulanabildi. Bu şekilde kan gazı Ph: 7,42, pCO2 : 34, pO2 : 62, lac: 3,2, SO2 : 92,7, P/F oranı: 95 idi. Hastaya deltakortil, antikoagülan ve inhaler tedavi uygulandı. Seftriakson tedavisi devam edildi. MAS açısından yakın takip edildi. Tablo 1’de yer alan kan tetkikleri istendi. Anti-sitokin tedaviye gerek olmadı. Destek tedavisine ihtiyacı giderek azalan hasta yatışının 8. günü kontrollü şekilde ekstübe edildi. Ekstübasyon sonrası 4 gün daha HFNC desteği alan hasta, yoğun bakıma yatışının 13. gününde nazal kanül desteği ile göğüs hastalıkları servisine devredildi. Sonuç: COVID-19 tanılı gebe hastanın doğum kararı, annede tedavinin seyrini değiştirebilmektedir. Bu olguda erken doğum, erken entübasyon ve erken ekstübasyon kararının survey üzerine olan olumlu etkisine vurgu yapmayı amaçladık. Entübasyondan sonra gaz değişimi belirgin düzeldi. Ekstübasyondan sonra HFNC desteği ile hem weaning başarısı artırıldı hem gelişebilecek koplikasyonlardan hasta korunmuş oldu. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Computed tomography evaluation of pancreatic steatosis: correlation with COVID-19 prognosis.

Aim: To investigate the relationship between pancreatic steatosis (PS) assessed on computed tomography (CT) and COVID-19 prognosis. Materials & methods: This retrospective study covers 396 patients with COVID-19 (mean age: 52.50 ± 16.86 years), who underwent unenhanced chest CT. PS was compared with clinical findings, comorbidities, requirements for hospitalization, intubation and intensive care unit (ICU), length of hospitalization and death. Results: PS was found to be strongly correlated with the severity of clinical findings and hospitalization rates (p < 0.001). In hospitalized patients, length of hospitalization (p = 0.002) and rates of ICU requirement (p = 0.003) were higher in patients with PS. Conclusion: PS, correlated with clinical severity and hospitalization requirement, is an independent risk factor for COVID-19.

Computed tomography evaluation of pancreatic steatosis: correlation with COVID-19 prognosis

Aim: To investigate the relationship between pancreatic steatosis (PS) assessed on computed tomography (CT) and COVID-19 prognosis. Materials & methods: This retrospective study covers 396 patients with COVID-19 (mean age: 52.50 ± 16.86 years), who underwent unenhanced chest CT. PS was compared with clinical findings, comorbidities, requirements for hospitalization, intubation and intensive care unit (ICU), length of hospitalization and death. Results: PS was found to be strongly correlated with the severity of clinical findings and hospitalization rates (p < 0.001). In hospitalized patients, length of hospitalization (p = 0.002) and rates of ICU requirement (p = 0.003) were higher in patients with PS. Conclusion: PS, correlated with clinical severity and hospitalization requirement, is an independent risk factor for COVID-19. Plain language summary Fat accumulation in the pancreas that is associated with obesity and metabolic syndrome can be used for estimating the clinical course of patients with COVID-19. Fat accumulation was determined by comparing the pancreas and spleen using computed tomography tools. In our study with 396 COVID-19 patients, the patients with fatty pancreas clearly seemed to have more severe clinical findings. Similarly, the rates of the requirement for hospitalization/intensive care unit and length of hospitalization were higher than in patients without fatty pancreas. The median length of hospitalization was 9 days in patients with fatty pancreas and 6 days in patients without fatty pancreas. However, death rates were only slightly higher in patients with fatty pancreas. Tweetable In COVID-19 patients, the patients with fatty pancreas assessed using computed tomography have a more severe clinical course, higher rates of hospitalization/ICU requirement and increased length of hospitalization compared with the patients without fatty pancreas. #COVID-19 #computed tomography #fatty pancreas. Graphical

Deep COVID DeteCT: an international experience on COVID-19 lung detection and prognosis using chest CT.

The Coronavirus disease 2019 (COVID-19) presents open questions in how we clinically diagnose and assess disease course. Recently, chest computed tomography (CT) has shown utility for COVID-19 diagnosis. In this study, we developed Deep COVID DeteCT (DCD), a deep learning convolutional neural network (CNN) that uses the entire chest CT volume to automatically predict COVID-19 (COVID+) from non-COVID-19 (COVID-) pneumonia and normal controls. We discuss training strategies and differences in performance across 13 international institutions and 8 countries. The inclusion of non-China sites in training significantly improved classification performance with area under the curve (AUCs) and accuracies above 0.8 on most test sites. Furthermore, using available follow-up scans, we investigate methods to track patient disease course and predict prognosis.

Radiological approach to COVID-19 pneumonia with an emphasis on chest CT.

Coronavirus disease 2019 (COVID-19) has recently become a worldwide outbreak with several millions of people infected and more than 160.000 deaths. A fast and accurate diagnosis in this outbreak is critical to isolate and treat patients. Radiology plays an important role in the diagnosis and management of the patients. Among various imaging modalities, chest CT has received attention with its higher sensitivity and specificity rates. Shortcomings of the real-time reverse transcriptase-polymerase chain reaction test, including inappropriate sample collection and analysis methods, initial false negative results, and limited availability has led to widespread use of chest CT in the diagnostic algorithm. This review summarizes the role of radiology in COVID-19 pneumonia, diagnostic accuracy of imaging, and chest CT findings of the disease.