CT Image Enhancement Using Variational Mode Decomposition for AI-Enabled COVID Classification

SARS-COV-2, also known as COVID-19 pandemic, has escalated calamity in the entire world. Due to its contagious properties, the disease spreads swiftly from person to person via direct contact. More than 210 million people got infected worldwide with more than 18 million active patients as of August 29, 2021. In numerous places, the test process for COVID-19 detection takes longer than 2 days. Once the patient is affected by COVID-19, the obstruction in lungs causes difficulty in analyzing the presence of other lung diseases, such as variants of pneumonia. In this paper, we propose an enhancement technique via the acclaimed signal processing method called variational mode decomposition (VMD) aiding any X-ray image classification method for the detection of pneumonia using convolutional neural networks (CNN). The experiments were conducted on VGG-16 model loaded with ImageNet weights followed by numerous configurations of dense layers. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Factors associated with mortality in patients with COVID-19 admitted to intensive care: a systematic review and meta-analysis.

Identification of high-risk patients admitted to intensive care with COVID-19 may inform management strategies. The objective of this meta-analysis was to determine factors associated with mortality among adults with COVID-19 admitted to intensive care by searching databases for studies published between 1 January 2020 and 6 December 2020. Observational studies of COVID-19 adults admitted to critical care were included. Studies of mixed cohorts and intensive care cohorts restricted to a specific patient sub-group were excluded. Dichotomous variables were reported with pooled OR and 95%CI, and continuous variables with pooled standardised mean difference (SMD) and 95%CI. Fifty-eight studies (44,305 patients) were included in the review. Increasing age (SMD 0.65, 95%CI 0.53-0.77); smoking (OR 1.40, 95%CI 1.03-1.90); hypertension (OR 1.54, 95%CI 1.29-1.85); diabetes (OR 1.41, 95%CI 1.22-1.63); cardiovascular disease (OR 1.91, 95%CI 1.52-2.38); respiratory disease (OR 1.75, 95%CI 1.33-2.31); renal disease (OR 2.39, 95%CI 1.68-3.40); and malignancy (OR 1.81, 95%CI 1.30-2.52) were associated with mortality. A higher sequential organ failure assessment score (SMD 0.86, 95%CI 0.63-1.10) and acute physiology and chronic health evaluation-2 score (SMD 0.89, 95%CI 0.65-1.13); a lower PaO2 :FI O2 (SMD -0.44, 95%CI -0.62 to -0.26) and the need for mechanical ventilation at admission (OR 2.53, 95%CI 1.90-3.37) were associated with mortality. Higher white cell counts (SMD 0.37, 95%CI 0.22-0.51); neutrophils (SMD 0.42, 95%CI 0.19-0.64); D-dimers (SMD 0.56, 95%CI 0.43-0.69); ferritin (SMD 0.32, 95%CI 0.19-0.45); lower platelet (SMD -0.22, 95%CI -0.35 to -0.10); and lymphocyte counts (SMD -0.37, 95%CI -0.54 to -0.19) were all associated with mortality. In conclusion, increasing age, pre-existing comorbidities, severity of illness based on validated scoring systems, and the host response to the disease were associated with mortality; while male sex and increasing BMI were not. These factors have prognostic relevance for patients admitted to intensive care with COVID-19.

Leading in a VUCA World

The current COVID-19 virus has put the entire world in lockdown, creating one of the worst times of a VUCA world. The changes that are happening because of the pandemic are large scale and occur suddenly. There is a shortage of leadership everywhere. Leaders are unprepared to lead effectively. In this fast-changing and disruptive environment, command and control structures fail. Leaders are expected to act on incomplete or insufficient information. They do not know where to start to drive change as increased complexity makes it difficult. Leaders lack time to reflect and end up acting too quickly or acting too late as they get stuck in analysis paralysis. They are far removed from the source and are forced to act with a limited understanding of events and their meanings. The role and type of leadership are being tested as we are trying to come out of this crisis. Leaders cannot predict the future but need to make sense of it in order to thrive. This paper would analyse challenges that are being faced by leaders in this critical period and how these can be converted into opportunities like a vaccine for the virus.

COVID-19-associated nephropathy (COVAN): An emerging entity of severe viral podocyte injury and collapsing glomerulopathy in kidney biopsies

Background: COVID19 caused by novel Coronavirus SARS-COV-2 initially presenting primarily as a respiratory illness, is now known to affect several organ systems as part of multiorgan failure including acute kidny injury (AKI), some cases also manifesting nephrotic range proteinuria or syndrome. Methods: 10 renal biopsies from 6 institutions (1 transplant) performed in April-May 2020 were processed for light microscopy, immunostaining (IS) and electron microscopy (EM) for clinco-pathologic analysis. Results: The 10 patients ranged from 25-73 years (Mean 43), male:female 5:5, 8 African American, 1 Hispanic, 1 Asian Indian, having pre-existing co-morbidities of hypertension (7), Diabetes mellitus (5), obesity (9), presenting with AKI (10), nephrotic syndrome (9), proteinuria ranging from 1.5-25g/24hrs, lung symptoms or pneumonia (7), fever (5). SARS-COV-2 RT-PCR positive (7), IgG antibody positive (2), both negative (1). All kidney biopsies showed widespread acute tubular injury with focal necrosis, 9 with typical features of segmental/global collapsing glomerulopathy in 10-53% of glomeruli, global glomerulosclerosis (0-35%), focal tubular microcystic changes (8), patchy (7) or diffuse (2) active tubulointerstitial inflammation and scarring (10-40%), focal & diffuse peritubular capillary inflammation, moderate vascular sclerosis anddiabetic kidney disease in 2. No immune deposits were localized by IS. By EM, varied glomerular capillary wall wrinkling and collapse with segmental or global loss of patency (7), total foot process effacement (7), with hyperplastic and vacuolated epithelial cells having protein droplets are noted. The endothelial cells are variably swollen, with tubuloreticular inclusions in 2. Viral particles are identified within cells of glomeruli and tubulointerstitium, scattered or in clustesr in the cytoplasm and endoplasmic reticulum vesicles, confirmed by IS. Conclusions: The constellation of typical glomerular collapsing features with tubulointerstitial findings and localization of virus by EM, suggests a distinct viral associated nephropathy, reminicent of HIV associated nephropathy. A role for viral cytopathic effect, cytokines and underlying APOL1 gene variants could be considered.