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1.
2022 IEEE International Conference on Distributed Computing and Electrical Circuits and Electronics, ICDCECE 2022 ; 2022.
Article in English | Scopus | ID: covidwho-1932099

ABSTRACT

COVID-19 is an infectious disease, which was first appeared in December 2019 in Wuhan, China. This virus has spread all over the world. So in a situation like this, Twitter is helping people by giving the latest information and to connect with others. As the WHO giving health information, this paper work is an implementation of automation for extracting details of Covid-19 from the latest Tweets of Twitter Social media. Most of the people started with Negative tweets about covid19, but with increasing time people shifted towards positive and neutral comments. At some time most of the comments are about winning against coronavirus. To understand the people's opinion towards this pandemic through their tweets, we have tried to come up with an algorithm that will try to analyze the tweets using the modern computational power and some of the advanced algorithms and finally concluded at a point. Sentiment analysis using LSTM (Long Short Term Memory) which is a type of Recurrent Neural Networks, has been applied to tweets having covid19 Hash tags to see people's reactions to the pandemic. The tweets are classified and labeled as positive, negative, and neutral then visualized the result. Tweets are categorized into three classes and derive some useful patterns from them and trying to come up with some generalized algorithms so that it cannot only be applied for Covid19 or some health-related, rather apply all kind of tweets or some other social media platform such as Instagram or LinkedIn. © 2022 IEEE.

2.
Studies in Computational Intelligence ; 1021:475-492, 2022.
Article in English | Scopus | ID: covidwho-1919581

ABSTRACT

The main aim of this chapter is to build a smart security device to cater to the security problems that have arisen in the recent times, in the healthcare facilities, with the onset of the covid19 pandemic. With more and more people occupied with providing emergency services, the special restricted mode in our designed smart security system will help in flexible surveillance of hospital wards as per requirement. The demand within the global market for healthcare security systems has been rising on account of the need to ensure optimal security and productivity across all hospitals and healthcare facilities. A smart security system with IoT and cloud connectivity, along with multiple smart modes to cater to the needs of the user is the need of the hour. With the onset of the pandemic situation, things have become more intense, with minimal efforts given towards surveillance. This is where our smart security system finds its application along with other restricted zones. With its seamless connection with AWS for 24 × 7 connectivity with the user, one can expect constant updates as per requirement. With the integration of raspberry pi, other security features are also achieved like a fire alarm, motion detection, gas sensing, temperature detection, footfall tracking and noise detection with stable conditions. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

3.
Vox Sanguinis ; 117(SUPPL 1):92-93, 2022.
Article in English | EMBASE | ID: covidwho-1916294

ABSTRACT

Background: E-learning forms a core component of training programmes for healthcare professionals. However, institutions utilize e-learning in different formats with varying degrees of development and validation, and for different purposes. There is limited published data on the use and the effectiveness of e-learning for transfusion medicine. Aims: This survey aims at collecting information on the scope and content of existing transfusion e-learning modules in different blood establishments and transfusion services worldwide. Methods: A survey was designed using the Survey Monkey tool by the ISBT Clinical Transfusion Working Party, with participation of experts in transfusion education and e-learning. The ISBT central office distributed the survey to all ISBT members. Descriptive statistics were utilized to summarize the results. Results: A total of 177 respondents participated, 68 of which had elearning modules in their institutions. Of the 68 respondents with e-learning modules, 56% worked in academic/ university-affiliated institutions. The insitutions included hospital-based transfusion services/blood banks (n = 16, 23.5%), regional blood services/blood centers (n = 11, 16.2%) and hospitalbased blood services (n = 9, 13.2%). These institutions were from different World Health Organization Regions, namely;Europe (n = 27, 39.7%), Americas (n = 12, 17.6%), South East Asia (n = 10, 14.7%), Western Pacific (n = 9, 13.2%), Eastern Mediterranean region (n = 5, 7.4%) and Africa (n = 5, 7.4%). More than half of the e-learning modules were developed inhouse (66%), and 63.2% are available to learners from outside the institutions. In a third of institutions, these modules were established during the COVID-19 pandemic, while 14.7% used e-learning modules for more than 10 years. The modules target different audiences and topics ranging from blood donation to administration and hemovigilance (see Table). The commonest audiences were physicians (n = 48, 71%), laboratory scientists/ technologists (n = 47, 69.1%), transfusion practitioners (n = 43, 63.2%) and medical students (n = 41, 60.3%). More than half of the respondents had modules on transfusion reactions targeting physicians (63%) and transfusion practitioners (57%). E-learning modules on laboratory practice is in use in 63% of the institutions for laboratory scientists/technologists. Formal assessment of learning outcomes is used in 70% of the e-learning programs. Summary/Conclusions: The survey demonstrates the widespread use of e-learning modules in transfusion education, with a substantial proportion being developed during the COVID-19 pandemic. There is considerable variability in the content of e-learning modules. More data are required to understand the effectiveness of this method of education on learning outcomes.

4.
COMPUTER SYSTEMS SCIENCE AND ENGINEERING ; 44(1):519-534, 2023.
Article in English | Web of Science | ID: covidwho-1912678

ABSTRACT

COVID-19 has created a panic all around the globe. It is a contagious disoriginated from Wuhan in December 2019 and spread quickly all over the world. The healthcare sector of the world is facing great challenges tackling COVID cases. One of the problems many have witnessed is the misdiagnosis of COVID-19 cases with that of healthy and pneumonia cases. In this article, we propose a deep Convolutional Neural Network (CNN) based approach to detect COVID+ (i.e., patients with COVID-19), pneumonia and normal cases, from the chest X-ray images. COVID-19 detection from chest X-ray is suitable considering all aspects in comparison to Reverse Transcription Polymerase Chain Reaction (RT-PCR) and Computed DenseNet121, DenseNet201 and InceptionResNetV2 have been adopted in this proposed work. They have been trained individually to make particular predictions. Empirical results demonstrate that DenseNet201 provides overall better performance with accuracy, recall, F1-score and precision of 94.75%, 96%, 95% and 95% respectively. After careful comparison with results available in the literature, we have found to develop models with a higher reliability. All the studies were carried out using a publicly available chest X-ray (CXR) image data-set.

5.
Traditional Medicine Research ; 7(5):9, 2022.
Article in English | Web of Science | ID: covidwho-1897403

ABSTRACT

The whole world has been challenged by the COVID-19, where people with poor immune status became the target. It is high time for us to strengthen our immunity through some safe, efficient and cost-effective immune boosters. Tinospora cordifolia (Thunb.) Miers is a well-known medicinal plant as the whole plant (leaves, stems and roots) is used extensively for different ailments, since it is rich in many bioactive secondary metabolites. The immunomodulatory efficacy of Tinospora cordifolia was reported by several workers and this plant is considered to be a "Rasayana" herb in Ayurveda because of its potential cell renewal, health re-establishment and physical equilibrium maintenance capabilities. 1,4-Linked arabinogalactan polysaccharide (G1-4A), an acidic polysaccharide and arabinogalactan polymer is reported to strengthen host innate immunity by multifactorial pathways. It induces immune cells (neutrophil, macrophage, T lymphocyte) proliferation and increases cytokine/chemokine production and reactive oxygen species generation thereby contributing to boost our immunity. G1-4A activates macrophages by a classical pathway in toll-like receptor 4 - myeloid differentiation primary response 88 dependent manner, natural killer cells and cytotoxic T cells to destroy pathogens, virus-infected cells, or tumor cells. Binding of G1-4A to the toll-like receptor or mannose receptor activates a cascade of events along with nuclear translocation of nuclear factor-kappa B leading to the synthesis of different cytokine/chemokine and reactive oxygen species generation. Natural immunomodulators like G1-4A are safer and cheaper, when extracted from botanical sources. Therefore, such phytocompounds can be taken as a daily supplement to enhance immunity, which might be beneficial to fight and survive in this ongoing pandemic health crisis.

6.
Egyptian Journal of Radiology and Nuclear Medicine ; 53(1), 2022.
Article in English | EMBASE | ID: covidwho-1896398

ABSTRACT

Background: In India, two vaccines received emergent use authorization, namely Covishield (a brand of the Oxford—Astra Zeneca vaccine manufactured by the Serum institute of India) and Covaxin (developed by Bharat Biotech) against COVID-19 disease. Chest CT is an objective way to assess the extent of pulmonary parenchymal involvement. This study aims to estimate the disease severity and outcome due to COVID-19 among vaccinated and non-vaccinated symptomatic patients and compare the same in Covishield versus Covaxin recipients using CT severity score. Results: A total of 306 patients were retrospectively evaluated. The mean age was 62.56 ± 8.9 years, and males [n-208 (67.97%)] were commonly affected. Of 306 patients, 143 were non-vaccinated (47%), 124 were partially vaccinated (40%), and 39 were completely vaccinated (13%). CT severity scores were reduced in both Covishield and Covaxin recipients in comparison with the non-vaccinated group [χ2 (2) = 16.32, p < 0.001]. There is a reduction in LOS among the vaccinated group, predominantly among the Covishield recipients. Conclusion: Vaccination confers protection from severe SARS-CoV2 infection and is associated with an overall reduction in mortality.

7.
Reference Series in Phytochemistry ; : 573-597, 2022.
Article in English | Scopus | ID: covidwho-1888827

ABSTRACT

Chronic inflammation and oxidative damage have been proven as fundamental factors associated with many systemic diseases, leading to increased morbidity. To deal with this, formulation of new functional foods, dietary polyphenols, and supplements containing multiple natural antioxidants and/or anti-inflammatory agents is required to reduce oxidative stress and inflammatory cascade. Several studies have shown a positive association between increased intake of dietary antioxidants and reduced risk for chronic inflammatory diseases and oxidative stress. This chapter concentrates on the underlying mechanisms of how different groups of dietary antioxidants, like vitamin C, vitamin E, flavonoids, carotenoids, and plant polyphenols, prevent the processes of inflammation and oxidative stress responses. Oxidative stress and inflammation mechanisms are discussed in the light of critical balance of pro- and anti-inflammatory cytokines. Also, roles of dietary antioxidants were discussed as an adjunctive treatment strategy to COVID-19 patients. Given the convincing evidence for protective as well as curative role of dietary antioxidants in inflammatory processes, more detailed understanding on the effects of nutrients on multiple aspects and development of novel anti-inflammatory agents is required to optimize approaches. To improve the bioavailability and targeted delivery of external antioxidants, nonreactive carriers or vehicles are needed to be designed with more precision and accuracy. © 2022, Springer Nature Switzerland AG.

8.
Journal of Pacific Rim Psychology ; 16:18, 2022.
Article in English | Web of Science | ID: covidwho-1886894

ABSTRACT

While most studies have been reporting the psychological issues being faced by the public due to the global spread of coronavirus and sudden restrictions and changes accompanying it, the present study attempted to explore dynamic human experiences during the COVID-19 pandemic and resultant lockdown, so as to understand the psycho-social factors that acted as adaptive resources or as buffers to maintain a stable mental state amidst this crisis. In-depth telephonic interviews with 30 participants were conducted to explore their experiences in dealing with the COVID-19 pandemic and the lockdown. Thematic analysis performed to identify the positive and protective factors that helped people adapt in a healthy way revealed that although the initial response of the participants to the pandemic was "optimistic bias" followed by downplaying the seriousness of the issue, later they demonstrated increased realization and acceptance to the seriousness of the situation. Upon realizing the situation, their positive psychological resources acted as a buffer against the ill effects of the pandemic, and they used both cognitive and behavioral coping. The study clearly demonstrates that crisis in life is not just a source of stress, anxiety, and uncertainty but also an opportunity to test one's psychological resources to learn and grow.

9.
Online Information Review ; : 17, 2022.
Article in English | Web of Science | ID: covidwho-1886578

ABSTRACT

Purpose - This study explores how effectively the Indian government utilized social media to communicate emergency information and promote citizen engagement and awareness during the first wave of COVID-19 crisis. Design/methodology/approach - This research investigates the tweets scraped from the official Twitter handle "CovidnewsbyMlB" of the Ministry of Information and Broadcasting Government of India;the authors unearthed patterns in the communications between the government and its citizens by adopting various social media analysis techniques. Further, the authors also tried to examine the influence of media richness and dialogic loop on citizen engagement through government social media (CEGSM) using multivariate analysis method. Findings - The results highlighted clusters of words/terms present in the tweets related to COVID-19 combating strategies, guidelines, and updates. The authors also found that media richness has a significant positive relationship with CEGSM, but dialogic loop has an insignificant relationship with CEGSM. Originality/value - This study provides suggestions to government agencies about ways to improve CEGSM by enhancing media richness and dialogic loop elements such as surveys, polls, and responses in the crisis communication.

11.
IEEE Sensors Journal ; : 1-1, 2022.
Article in English | Scopus | ID: covidwho-1874326

ABSTRACT

We present the design and analysis of a graphene metasurface-based cross polarization converter operating within the terahertz gap for detecting biomolecules over a broad spectral range, taking the SARS-CoV-2 virus as a specific example. To the best of our knowledge, our design reports the widest band of operation in the THz region of a graphene-based metasensor. Each meta-atom comprises a graphene pattern on silicon dioxide atop a continuous gold layer and exhibits near-unity cross polarization conversion ratio (PCR) and a 90% PCR bandwidth of 0.926 THz within the desired band (1.88 THz-2.81 THz). The proposed device demonstrates additional benefits which include a thin configuration (λ/7.84) and compact lattice size (λ/10.66), which are significantly better than other recently reported graphene metasurface biosensors. The device provides a sensitivity up to 490 GHz/RIU and a figure of merit (FoM) of 0.377 over a wide span of 0.926 THz within the terahertz gap. The electromagnetic response of this device has been validated via rigorous numerical analyses of simulated outputs as well as by developing a detailed circuit model representation of the same. The device demonstrates angular stability of nearly 40°under oblique incidence of the incident wave. IEEE

12.
Electronic Journal of the International Federation of Clinical Chemistry and Laboratory Medicine ; 32(2):265-279, 2021.
Article in English | Scopus | ID: covidwho-1870692

ABSTRACT

Background Despite best efforts, false positive and false negative test results for SARS-CoV-2 are unavoidable. Likelihood ratios convert a clinical opinion of pre-test probability to post-test probability, independently of prevalence of disease in the test population. Methods The authors examined results of PPA (Positive Percent Agreement, sensitivity) and NPA (Negative Percent Agreement, specificity) from 73 laboratory experiments for molecular tests for SARS-CoV-2 as reported to the FIND database, and for two manufacturers’ claims in FDA EUA submissions. PPA and NPA were converted to likelihood ratios to calculate post-test probability of disease based on clinical opinion of pre-test probability. Confidence intervals were based on the number of samples tested. An online calculator was created to help clinicians identify false-positive, or false-negative SARS-CoV-2 test results for COVID-19 disease. Results Laboratory results from the same test methods did not mirror each other or the manufacturer. Laboratory studies showed PPA from 17% to 100% and NPA from 70.4% to 100%. The number of known samples varied 8 to 675 known patient samples, which greatly impacted confidence intervals. Conclusion Post-test probability of the presence of disease (true-positive or false-negative tests) varies with clinical pre-test probability, likelihood ratios and confidence intervals. The Clinician’s Probability Calculator creates reports to help clinicians estimate post-test probability of COVID-19 based on the testing laboratory’s verified PPA and NPA. © 2021 International Federation of Clinical Chemistry and Laboratory Medicine. All rights reserved.

13.
Current Research in Nutrition and Food Science ; 10(1):31-44, 2022.
Article in English | Web of Science | ID: covidwho-1870122

ABSTRACT

Coronavirus disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Coronavirus- 2 (SARS-CoV-2) due to its rapid community transmission and absence of an effective antiviral drug has caused a high morbidity and mortality in human lives world over. According to the WHO Situation Report No. 102 as on January 12, 2022, India recorded 35.87 million confirmed cases of COVID 19 with a death rate of 1.34 %, the total death being 0.48 million, in comparison to the global death rate of 1.78%. The host-pathogen interactions are important to understand an infectious disease and to follow specific treatment for cure and measures for prevention. Various factors involved in disease emergence with interplay between pathogens, hosts and environment changes the disease ecology creating novel transmission patterns and severity. Indian conventional foods and culinary spices contain a number of active principles, including polysaccharides, terpenoids, alkaloids, flavonoids, glycosides, and essential oils, which act as immunomodulators and have tremendous capability to maintain and/or stimulate the immune system primarilythrough the modulation of nonspecific immune responses. This review highlights the bioactive components of some of the most commonly used Indian culinary spices grounding a new dimension of research on these natural phytoproducts to bring out their functional and medicinal values vis-a-vis improvement of human health. In conclusion, the structure of bioactive molecules present in the Indian dietary spices may pave way for the development of anti-SARS-CoV-2 drugs for the prevention and treatment of COVID-19.

14.
Journal of Clinical and Diagnostic Research ; 16(5):27-31, 2022.
Article in English | EMBASE | ID: covidwho-1863297

ABSTRACT

Introduction: Focus of Blood transfusion services is continuous, judicious and well-timed supply of safe Blood. The Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) pandemic has caused the major disruption throughout the world and declaration of nationwide lockdown by Government of India from 25th March 2020 to 31st May 2020 to halt the spread of virus has afflicted the blood bank services enormously. Aim: To keep the focal point on approaches implemented for safe blood transfusion services during Coronavirus Disease-2019 (COVID-19) pandemic in rural blood bank and to observe how COVID-19 pandemic has affected blood transfusion services in year 2020 with regards to blood collection, supply and organization of camps as compared to year 2019. Materials and Methods: A retrospective study was done in the Blood Bank in a rural tertiary care hospital in Southern India, from January 2019 to December 2020. Various measures were implemented to increase the donor safety and prevention of spread to community and to increase the number of voluntary donors. Statistical analysis performed using Statistical Package for Social Sciences (SPSS) software version 21.0. All data was entered and tabulated in excel sheet. A two sided t-test was utilized for comparing dual variables and one sided Analysis of Variance (ANOVA) for multiple variables. The p-value <0.05 was considered significant. Results: Mean number of units received during pre-COVID-19 year were significantly higher (4468±4127.2) as compared to COVID-19 year 2020 (2282±1856.4) with significant p-value <0.001. Overall utilisation of Packed Red Blood Cell (PRBC) (0.001), Human Platelets (Single Donor Platelets (SDP)/Random Donor platelets (RDP)) p-value 0.003,Fresh Frozen Plasma) FFP (p-value 0.001) was significantly higher in pre-COVID-19 year as compared to COVID-19 year 2020. Total number of camps conducted in pre-COVID-19 year was 41 as compared to 23 in COVID-19 year 2020. Patients deferred for blood donation were much higher in COVID-19 year 2020 (n=400) with maximum (32.5%) under category of self-deferral due to clinical illness as compared to year 2019 (n=200). Conclusion: As a result of our strict and effective implementation of COVID-19 safety protocols, no donor had complained of post donation COVID related symptoms and none of our blood bank staff had developed any COVID-19 related illness. Hence during the COVID-19 pandemic, our blood bank maintained 100% attendance (with staggered duty hours).

15.
Lung India ; 39(SUPPL 1):S5, 2022.
Article in English | EMBASE | ID: covidwho-1857098

ABSTRACT

Background: OSA patients like other high risk category patients suffered and experienced post covid syndromes significantly. Aim: To study the severity and impact of COVID 19 infection in patients already diagnosed with Obstructive Sleep Apnea (OSA). Methodology: This is a longitudinal observational study of 19 patients diagnosed with OSA in January to April 2021, these patients suffered COVID 19 infection over next three months and 12 patients were studied within 4 months of discharge from COVID ward as 5 patients died and 2 patients lost to follow up.12 subjects had mean age of 52.92 (SD: 6.88) and majority were male 8 (66.7%) and mean BMI was 27.72 (SD: 3.60). Subjects were assessed through COVID 19 infection medical record, repeat Epworth Sleepiness Score and present complaints and Polysomnography. Results: Most of the OSA patients (66.7%) suffered from Severe COVID 19 infection and of them majority were male (62.5%). Severity of COVID correlated significantly with BMI and AHI (r=0.774;p 0.003 and r=0.907;p<0.001) and associated with more use of high flow oxygen device and noninvasive ventilation with mean hospital stay of 27.33 (SD:10.7). Mean AHI, ESS scores increased in post covid period (mean AHI-22.58;SD: 11.12 to 24.58;SD: 12.01 and mean ESS- 15.08;SD: 3.67 to 18.67;SD: 3.52) significantly (r=0.907;p<0.001 and r= 0.893;p<0.001 respectively) and maximum desaturation dropped significantly from mean 83.33 (SD: 4.83) to 79.50 (SD: 4.81) (r=0.727;p=0.007). Conclusion: This study reveals that OSA patients suffered from severe COVID 19 infection. Sleepiness and severity of OSA both has increased in post COVID period. This result may be an explanation for persistent post COVID symptoms in OSA patients.

16.
Psychiatria Danubina ; 34(1):189-189, 2022.
Article in English | Web of Science | ID: covidwho-1848526
17.
International Management Conference, IMC 2021 ; : 265-283, 2022.
Article in English | Scopus | ID: covidwho-1826320

ABSTRACT

Novel COVID-19 (SARS-COV-2) has emerged as one of the most hazardous pandemics across the globe. Due to the spread of this virus, there was a forcible postponement of physical education. This moved the whole education system into a fringe condition for a certain period with hopeless progress shortly. Though few countries have opted for online education, a country like India has partially succeeded. In this paper, a detailed study has been executed on the impact of COVID-19 at all levels of education with their pros and cons. The article is four-folded: Firstly, the impact of COVID-19 on the global education system is thoroughly studied with a special focus on Indian education. Second, a brief study on acceptance and adaptation of the online education process to fill the gap of schedules is done. Thirdly, an impactful analysis on the growth of development of online educational apps to fulfil the absence of offline education is emphasized. Fourthly, an insightful study on the role of intelligent computing approaches for analysing such a study is deeply investigated. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

18.
5th International Conference on Smart Computing and Informatics, SCI 2021 ; 282:151-159, 2022.
Article in English | Scopus | ID: covidwho-1826286

ABSTRACT

Sentiment analysis is a perfect machine learning process to analyze text and returns the text whether in positive or negative. The machine is trained with the emotions in text, then the machine can automatically understand text and predict the sentiment analysis. Sentiment analysis is an information extraction task that gives the result based on users writing emotions such as positive and negative thoughts, feelings. The emotions can be categorized as positive or negative words. Now, natural language processing (NLP) is an upcoming field in machine learning which gives hybrid applications in daily life. For example, the keyword which is taken from the text will undergo for intelligent learning. The output of the NLP algorithm enables sentiment analysis report daily activities. In this paper, we exposed the Covid-19 tweets from social media and did sentiment analysis using support vector machine (SVM). We trained the system using sentiment model and found the emotions from the Covid-19 tweets. Based on the trained system, we found the emotions in terms of negative, positive, and neutral emotions from Covid-19 tweet messages. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

19.
Asia Pacific Journal of Health Management ; 17(1):8, 2022.
Article in English | Web of Science | ID: covidwho-1820531

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) continues to spread all over world and is outpacing the resources and capacity of health care systems. This rapidly spreading COVI D-19 infection is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been challenging the medical community and keeping the whole world in great threat to an unprecedented degree. OBJECTIVES: The objective of this review article is to describe details of social distancing, hand hygiene and wearing face masks including there role in controlling the current COVID-19 pandemic. METHOD: We conducted an electronic search of Google Scholar, Scopus, Medline and PubMed databases for articles between June to September 2021. RESULTS: The novel SARS-CoV-2 virus is transmitted from person to person by respiratory droplets or contact with an infected person. There are no established medications and vaccine available until now to restrain the transmission of the COVID-19 infection. Currently, social distancing, hand hygiene and wearing a mask are key steps to lower the transmission of the SARS-CoV-2 virus in COVID-19 pandemic. As this infection is highly contagious via a respiratory pathway through coughing, sneezing and contact with an infected surface, the spread can be reduced by the proper practice of social distancing, hand hygiene or frequent hand washing and wearing mask. These universal precautions should be done as COVID-19 patients may be asymptomatic. CONCLUSION: Social distancing, hand washing and wearing face masks are cheap and widely acceptable methods for the prevention of the COVID-19 infection. The goal of this review paper is to discuss social distancing, hand hygiene and face mask information, including its role in managing the current COVID-19 pandemic

20.
PubMed; 2020.
Preprint in English | PubMed | ID: ppcovidwho-333545

ABSTRACT

IMPORTANCE: Microvascular lesions are common in patients with severe COVID-19. Radiologic-pathologic correlation in one case suggests a combination of microvascular hemorrhagic and ischemic lesions that may reflect an underlying hypoxic mechanism of injury, which requires validation in larger studies. OBJECTIVE: To determine the incidence, distribution, and clinical and histopathologic correlates of microvascular lesions in patients with severe COVID-19. DESIGN: Observational, retrospective cohort study: March to May 2020. SETTING: Single academic medical center. PARTICIPANTS: Consecutive patients (16) admitted to the intensive care unit with severe COVID-19, undergoing brain MRI for evaluation of coma or focal neurologic deficits. EXPOSURES: Not applicable. MAIN OUTCOME AND MEASURES: Hypointense microvascular lesions identified by a prototype ultrafast high-resolution susceptibility-weighted imaging (SWI) MRI sequence, counted by two neuroradiologists and categorized by neuroanatomic location. Clinical and laboratory data (most recent measurements before brain MRI). Brain autopsy and cerebrospinal fluid PCR for SARS-CoV 2 in one patient who died from severe COVID-19. RESULTS: Eleven of 16 patients (69%) had punctate and linear SWI lesions in the subcortical and deep white matter, and eight patients (50%) had >10 SWI lesions. In 4/16 patients (25%), lesions involved the corpus callosum. Brain autopsy in one patient revealed that SWI lesions corresponded to widespread microvascular injury, characterized by perivascular and parenchymal petechial hemorrhages and microscopic ischemic lesions. CONCLUSIONS AND RELEVANCE: SWI lesions are common in patients with neurological manifestations of severe COVID-19 (coma and focal neurologic deficits). The distribution of lesions is similar to that seen in patients with hypoxic respiratory failure, sepsis, and disseminated intravascular coagulation. Collectively, these radiologic and histopathologic findings suggest that patients with severe COVID-19 are at risk for multifocal microvascular hemorrhagic and ischemic lesions in the subcortical and deep white matter.

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