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Background: Clinical outcome and parenchymal lung abnormalities (PLA) data from hospitalized patients with COVID 19 pneumonia are limited. Objective(s): (1) Understand and compare the patterns of PLA on high resolution computed tomographic (HRCT) at admission, 4-8 weeks post-admission in all patients and 10-12 weeks post-admission in a subgroup of patients (2) follow up their general health status on phone 6 months post admissionMethods: Prospective, observational study of consecutive adult patients hospitalized with RT-PCR confirmed COVID-19 pneumonia in a tertiary centre, India. Clinical data and HRCT image patterns and distribution of PLA at admission, 4-8 weeks in all patients and at 10-12 weeks in a subgroup of patients were analysed using a novel, composite radiological score (CRS). Surviving patients were followed up telephonically 6 months later. Finding(s): Of 179 patients, HRCT features were ground glass opacity (144, 80.4%), consolidation (23, 12.8%) and reticulation (7, 4%) at admission. 74% demonstrated resolving PLA with 14% showing complete resolution at 4-8 weeks. Fine reticulations were seen in 12% at 8 weeks and 20% in a subgroup of 44 patients who had persisting symptoms at 10-12 weeks. CRS correlated well with clinical severity and recovery (p=0.003). At 6 months, 144 responded to the phone follow up, reported no functional impairment and had returned to their pre-COVID health status. Conclusion(s): PLA resolved in 88% at 8 weeks and all the 144 patients who were followed up at 6 months reported return to pre-COVID 19 health status. This is quite reassuring amidst concerns of 'long COVID'.
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OBJECTIVE: To document laryngeal framework rupture following voluntary cough-holding as an airway complication of donning a personal protective equipment suit that was too small in size. METHODS: Clinical record and literature review, with proposition of plausible aerodynamics of the airway injury. RESULTS: Whilst carrying out his duty in the coronavirus disease ward, a resident attempted to stifle a paroxysm of cough when wearing a personal protective equipment suit that was too small with his neck flexed and restricted. There was a sudden release of pressure, intense pain and swelling in the neck with crepitus. Imaging revealed a non-displaced fracture in the lower end of the partially ossified right thyroid lamina, a cricothyroid membrane tear and subcutaneous emphysema. The symptoms resolved gradually on conservative management. CONCLUSION: This report underlines the importance of donning appropriately sized personal protective equipment and encouraging its proper use amongst coronavirus disease 2019 caregivers. Non-traumatic laryngeal injury, itself a rare event, has never been reported as a posture-related complication of wearing personal protective equipment.
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Background: Covid 19 causes a spectrum of disease. Early changes may present radiologically as traction bronchiectasis, architectural lung distortion, crazy paving or thickened interlobular septa. Analogy from other fibrotic interstitial pneumonia suggest up regulation of TGF B, FGF and PDGF leading to lung fibrosis (1). Early data of post covid 19 pneumonia shows a residual restrictive pattern on pulmonary function testing (2). Also radiological persistence of GGO has been observed (3). The autopsy studies from acute COVID 19 pneumonia has demonstrated feature of Diffuse Alveolar Damage (DAD) and fibrotic organising pneumonia (4). The epidemics of SARS and MERS showed similar features, suggestive of developing lung fibrosis (5). The present study is designed to study the clinical and CT radiographic patterns at presentation and their outcome on follow up, which will enhance our current understanding of covid 19 manifestations and outcome with this prospective observational study. Methods: The CT scans (admission & 4-8 weeks follow up) were collected from Medanta the Medicity, and deidentified in the local image archive system (PACS). Three chest radiologists with > 15 years of experience, from three tertiary care centres performed independent reporting of the CT scans, to pre-specified radiologic criteria. They were blinded to the clinical severity of disease. For the reading process, the radiologists reviewed the cases online via screen sharing (Zoom). Results: A composite score of the density of lesions and the extent of lung involvement has been proposed to provide a more comprehensive picture of the radiological severity and its impact on clinical severity and outcome of disease. Final result yet to be analyzed.
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Nowadays we are facing a pandemic, there is a situation where people are not ready to wear face masks, or they do not wear them properly, so, in this research, we are introducing an automatic mask detection system using image processing and soft computing techniques to tackle this problem. In the midst of the pandemic, covering our faces with a mask has become a new normal, as face masks are active in preventing the spread of the virus. Other precautionary measures are also advocated by the government apart from covering faces, to ensure protection and hygiene. In addition, because of the limited supply of masks in the industry, millions of people are learning to make their face masks. On the opposite, identifying faces with masks on any surveillance devices would be demanding while ensuring less access control in buildings. Face coverage with masks is a problem for algorithms and success in face detection. Currently, the authorities have to manually ask people to wear masks even then they tend to fool the authorities, to avoid that we are proposing a face Machine learning-based model of recognition. In the field of computer vision, this is a common research direction by extracting features directly from the detection region and then using machine detection learning algorithms to identify and recognize. In this Face mask detection-based attendance System, people will be only able to mark their attendance only if they wear a mask, besides if they do not wear a mask, they are given an alert and they would have to wear a mask. © 2021 IEEE.
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RATIONALE: Idiopathic pulmonary fibrosis (IPF) is a chronic, fibrosing, interstitial pneumonia which ultimately leads to an irreversible loss of lung function and respiratory compromise. The anti-fibrotic agents, pirfenidone and nintedanib have been shown to slow the rate of decline in forced vital capacity (FVC) but, neither treatment halts disease progression. Pentraxin-2 plays important biologically relevant roles in wound repair and prevention of fibrosis. Pentraxin-2, inhibits monocyte differentiation into pro-fibrotic fibrocytes and pro-inflammatory macrophages. Plasma pentraxin-2 concentrations are reduced in patients with IPF and correlate with disease severity. Recombinant human pentraxin-2 (rhPTX-2;also known as PRM-151) was evaluated for its therapeutic potential within a phase II trial (NCT02550873). This trial demonstrated statistically significant and clinically meaningful outcomes of rhPTX-2 treatment in patients with IPF. Here we report the phase III study design to further evaluate these findings. METHODS: STARSCAPE (NCT04552899) is a phase III, multi-center, randomized, double-blind, placebo controlled trial. 658 patients with IPF will be randomized (1:1) to receive either intravenous rhPTX-2 or matching placebo administered on Days 1, 3, 5 and every 4 weeks thereafter through 48 weeks. The primary endpoint is absolute change from baseline to Week 52 in FVC [mL]. The key secondary endpoint is absolute change from baseline to Week 52 in 6-minute walk distance. Eligible patients are 40-85 years, with a documented diagnosis of IPF confirmed centrally by high resolution computed tomography scan (and lung biopsy if available). Patients must demonstrate FVC ≥ 45%, FEV1/FVC ratio > 0.70 and DLCO ≥ 30% and ≤ 90% during screening. Patients are permitted to take background therapy with nintedanib or pirfenidone. Initiating a global phase III trial during the COVID-19 pandemic brings unique and unprecedented challenges. A large number of countries and sites will be included in order to mitigate potential regional recruitment challenges that may arise during the pandemic. In addition, SARS-CoV-2 serology testing will be conducted to allow exploratory analyses on the impact of COVID-19 on lung function parameters in patients with IPF. CONCLUSIONS: rhPTX-2 has demonstrated preliminary evidence of clinical efficacy on top of approved standard of care. The phase III STARSCAPE trial aims to confirm the therapeutic potential of rhPTX-2 through evaluation of a broad range of efficacy, safety, quality of life, pharmacokinetic and biomarker assessments over 52 weeks. Patients that complete this 52-week trial may be eligible to enroll into an open label extension trial.