ABSTRACT
Detection of COVID-19 has been a very active field of research with thousands of papers published after outbreaks of COVID-19 in the world. Computer-Aided Design (CAD) based studies have a significant role in the medical field thanks to rapidly developing technology. To help radiologists speed up the diagnostic process, CAD with convolutional neural networks (CNN) can be used as decision support mechanisms. Furthermore, CNN has the power to learn various image features automatically, and it may offer an effective way for COVID-19 detection. In this paper, we propose a CNN design for COVID-19 detection. We used a data set of X-ray images collected from two publicly available sources. This data set consists of 400 images of which 200 are COVID-19 and 200 are healthy. First, we preprocessed all data sets and then divided them by randomly allocating 70 % for training and 30 % for the test. We obtained the accuracy, specificity, and sensitivity rate of our model as 96.11%, 98.89 %, and 93.33 %, respectively. © 2022 IEEE. All rights reserved
ABSTRACT
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to unprecedented healthcare challenges on a global scale. Impressive efforts have led to rapid development of multiple efficacious vaccines against SARS-CoV-2, however concerns remain over the degree of protection vaccination offers to immunocompromised recipients. To answer this question, we have designed a prospective study to evaluate response to vaccination in patients with haematological malignancies (Harrington, Leukaemia 2021;Harrington, BJHaem, 2021). 103 patients were included with samples collected in 60 patients after first dose and 71 patients following second dose. We have analysed humoral and T cell response to a first dose of vaccine against SARS-CoV-2 in patients post allogeneic stem cell transplantation (HSCT) and compared those to patients with CML or MPN. Methods: ELISA plates were coated with antigen Nuclear (N) protein or the S protein. Serial dilutions of plasma were added to wells and incubated for 2 h at room temperature. Control reagents included N-specific monoclonal antibody, S-specific monoclonal antibody, negative control plasma, positive control plasma and blank wells. Secondary antibody was added and incubated for 1h at room temperature. IgG was detected using goat-anti-human-Fc-AP and plates read at 405 nm. Where an EC50 was not reached at 1:25, a plasma was considered seropositive if the OD at 405nm was 4-fold above background and a value of 25 was assigned. T cell functionality was assessed using intracellular cytokine staining after incubation with SARS-CoV-2 specific peptides covering immunogenic domains of the Spike (S) protein. A response was considered positive if there was a 3-fold increase in pro-inflammatory cytokine expression from baseline, and above a threshold of 0.01. Specific peptides (0.25 µg/ml), anti-CD28 and BFA were added to cells. Unstimulated cells were utilised as negative controls. Cells were stained with viability dye, then with antibodies directed against surface markers, and fixed and permeabilised prior to staining for intracellular cytokines TNFa and IFNg. Gating on lymphocytes, single cells, live cells, CD3+ cells, CD4+ cells and CD4- (CD8+) was performed. Results: Of the 103 patients included in this study, post vaccination evaluation on 56 patients have been analysed so far, including 37 patients with chronic myeloid malignancies (MPN n=21 and CML n=16) and 19 patients post HSCT. From the latter group, median time since transplant was 53.9 months (18.7 to 76.8) with 12 participants on extracorporeal photopheresis (ECP) therapy for graft versus host disease (GvHD) with median frequency of 24.5 days (14-42). BNT162b2 vaccine was administered to 48 patients (85.7%). An anti-S IgG response was observed after a first dose in 16/21 (76.1%) of the MPN group and 14/16 (87.5%) of CML patients, but in only 7/19 (36.8%) of post HSCT patients (Fishers Exact Test - p=0.02/0.002, Fig 1a). Of the latter group a low positive value where an EC50 was not reached was observed in 4/19 (21.1%) and a moderate response in 3/19 patients (15.8%). Of the 12 patients with active GvHD on ECP, a positive response was observed in 4 patients (33.3%), however only one patient recorded a response where an EC50 was measurable. A T cell response was observed in 16/20 (80%) of the MPN group and 14/15 (93.3%) of those with CML after a single dose, with a polyfunctional T cell response (>1 cytokine) observed in 65% and 80% respectively. In comparison only 5/19 patients (38.5%) post HSCT mounted a T cell response (p=0.027/p=0.002, Fig 1b), with a CD4+ response in 4 (30.8%) and a CD8+ response in 3 (23.1%). In this group, a polyfunctional T cell response was found in 4/19 patients (30.8%). 33.3% of patients with GVHD requiring ECP had a T cell response, compared with 42.9% in post HSCT without GVHD. Summary: Despite encouraging results of antibody and T cell response to a first vaccination dose in patients with chronic myeloid malignancies, these results raise concerns regarding the humoral and T cell respo ses to vaccination in patients post HSCT, recognised as a particularly immunosuppressed group. Further longitudinal data is required to determine if these results translate into a reduction in cases and severity of infection in these groups. We are currently analysing the response to a second vaccine injection and responses to sequential doses of vaccination across the whole cohort will be presented. [Formula presented] Disclosures: Harrington: Bristol Myers Squibb: Research Funding;Incyte: Honoraria. Radia: Blueprint Medicines Corporation: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Study steering group member, Research Funding;Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Education events;Cogent Biosciences Incorporated: Other: Study Steering Committee;EXPLORER and PATHFINDER studies: Other: Member of the Response Adjudication Committee. Kordasti: Beckman Coulter: Honoraria;Celgene: Research Funding;Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding;Alexion: Honoraria. Dillon: Menarini: Membership on an entity's Board of Directors or advisory committees;Novartis: Membership on an entity's Board of Directors or advisory committees, Other: Session chair (paid to institution), Speakers Bureau;Astellas: Consultancy, Other: Educational Events, Speakers Bureau;Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Research Support, Educational Events;Amgen: Other: Research support (paid to institution);Pfizer: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: educational events;Jazz: Other: Education events;Shattuck Labs: Membership on an entity's Board of Directors or advisory committees. Harrison: Promedior: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;AOP Orphan Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Incyte Corporation: Speakers Bureau;Gilead Sciences: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Constellation Pharmaceuticals: Research Funding;Galacteo: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Geron: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;BMS: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Sierra Oncology: Honoraria;Roche: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Shire: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;CTI BioPharma: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Keros: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. de Lavallade: Bristol Myers Squibb: Research Funding;Incyte: Honoraria, Research Funding;Novartis: Speakers Bureau.
ABSTRACT
Introduction: Herein, we will present the details of the patients admitted to a tertiary center, in Turkey, with laboratory-confirmed COVID-19 who were carrying the criteria for in-patient treatment. The definite clinical outcomes (death or discharge) of the patients are recorded and we aimed to determine the effects of comorbidities and the drugs they were using on outcomes. Materials and methods: Patient records were retrospectively evaluated from medical records. The detection of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in respiratory specimens is performed by next-generation sequencing or real-time RT-PCR methods. Results: Totally 298 patients diagnosed with and in-patient followed for COVID-19 infection were included in the study. During follow-ups, 239 were discharged without intensive care unit (ICU) requirements. The mortality rate was 8.7% in these hospitalized patients. The mean age of the expired and discharged patients were significantly different (69.48 ±10.02 vs. 56.82 ±15.52, p:0.001). ACE-I-ARB and beta-blocker usages were significantly more common in expired patients. Risk estimates were performed with crosstabs. Regarding these findings, age ≥ 65 years increased the risk of mortality for 5.145 times (2.130 -12.426);the presence of hypertension increased the risk of mortality for 3.55 times (1.63-7.74);coronary artery disease for 3.07 times (1.39-6.78);ACE-I-ARB usage for 2.77 times (1.32 - 5.82);beta-blocker usage for 2.88 times (1.33-6.23) and sulfonylurea usage for 3.42 times (1.34-8.72). Conclusion: Older age, presence of hypertension and coronary artery disease and using ACE-I, ARB or beta-blockers were increasing the risk of mortality. © 2021 A. CARBONE Editore. All rights reserved.
ABSTRACT
The most important factor in the transmission of the COVID-19 is asymptomatic carriers. We've tested all oncology patients , that receive anti-cancer therapy, for COVID-19. We aimed to determine the rate of asymptomatic carriers, and analyze the clinical and radiological findings of infected patients. Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography examination. Infected patients were given the recommended treatment for COVID-19. PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms, 25 patients (89.3%) had no symptoms. Covid-19 testing before anti-cancer treatment may be recommended in order to continue their treatment without any problems and to prevent the risk of transmission due to the high rate of asymptomatics in infected patients.