Usefulness of day-one chest X-ray score for predicting mortality and ICU admission in COVID-19 patients

We aimed to investigate the performance of a chest X-ray (CXR) scoring scale of lung injury in prediction of death and ICU admission among patients with COVID-19 admitted at Vinmec Central Park hospital (HCM City, VN) during the peak epidemic in 2021. X-ray images and clinical data were collected from patients with SARS-CoV-2 PCR positive from July to September 2021. Three radiologists independently assessed the CXR score at admission which is the sum of severity and extent of lung injuries on four lung quadrants (maximum score = 24). Among 219 patients included, 28 died including 25 from 34 patients admitted to the ICU. There was a high consensus for CXR scoring among radiologists (kappa = 0.90;CI95%: 0.89-0.92). CXR score was the strongest predictor of mortality (tdAUC 0.85;CI95%: 0.69-1) within the first 3 weeks after admission. Multivariate model with adjustment for age confirmed a significant effect of increased CXR score on mortality risk (HR = 1.33, CI95%: 1.10 to 1.62). At a threshold of 16 points, the CXR score allows predicting in-hospital mortality and ICU admission with good sensitivity (0.82 (CI95%: 0.78 to 0.87) and 0.86 (CI95%: 0.81 to 0.90)) and specificity (0.89 (CI95%: 0.88 to 0.90) and 0.87 (CI95%: 0.86 to 0.89), respectively). The day-one CXR score is a reliable predictor of the risk of death and ICU admission and could be used to identify high-risk patients in needy countries like Vietnam.

The potential impact of COVID-19 on male reproductive health.

The SARS-CoV-2 virus continues to overwhelm health care systems impairing human to human social and economic interactions. Invasion or damage to the male reproductive system is one of the documented outcomes of viral infection. Existing studies have reported that SARS-CoV-2 may contribute to this loss in relation to inflammatory responses and the formation of cytokine storms in COVID-19 patients. Although direct infection of the testes and entry of SARS-CoV-2 into semen as well as subsequent consequences on the male reproductive system need to be studied more systematically, warnings from two organising ASRM and SART for prospective parents when infected with SARS-CoV-2 should be considered. In the context of an increasingly complex pandemic, this review provides preliminary examples of the potential impact of COVID-19 on male reproductive health and guidance for prospective parents currently infected with or recovering from SARS-CoV-2.