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Journal of Clinical Medicine ; 9(9):1-11, 2020.
Article | WHO COVID | ID: covidwho-963402


At the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) outbreak in Italy, the cluster of Vò Euganeo was managed by the University Hospital of Padova The Department of Diagnostic Imaging (DDI) conceived an organizational approach based on three different pathways for low-risk, high-risk, and confirmed Coronavirus Disease 19 (COVID-19) patients to accomplish three main targets: guarantee a safe pathway for non-COVID-19 patients, ensure health personnel safety, and maintain an efficient workload Thus, an additional pathway was created with the aid of a trailer-mounted Computed Tomography (CT) scanner devoted to positive patients We evaluated the performance of our approach from February 21 through April 12 in terms of workload (e g , number of CT examinations) and safety (COVID-19-positive healthcare workers) There was an average of 72 2 and 17 8 COVID-19 patients per day in wards and the Intensive Care Unit (ICU), respectively A total of 176 high-risk and positive patients were examined High Resolution Computed Tomography (HRCT) was one of the most common exams, and 24 pulmonary embolism scans were performed No in-hospital transmission occurred in the DDI neither among patients nor among health personnel The weekly number of in-patient CT examinations decreased by 27 4%, and the surgical procedures decreased by 29 5% Patient screening and dedicated diagnostic pathways allowed the maintenance of high standards of care while working in safety

ERJ Open Research ; 6(4):1-9, 2020.
Article | WHO COVID | ID: covidwho-917913


Objectives: The aim of this study was to validate a composed coronavirus disease 2019 (COVID-19) chest radiography score (CARE) based on the extension of ground-glass opacity (GG) and consolidations (Co), separately assessed, and to investigate its prognostic performance Methods: COVID-19-positive patients referring to our tertiary centre during the first month of the outbreak in our area and with a known outcome were retrospectively evaluated Each lung was subdivided into three areas and a three-grade score assessing the extension of GG and Co was used The CARE was derived from the sum of the subscores A mixed-model ANOVA with post hoc Bonferroni correction was used to evaluate whether differences related to the referring unit (emergency room, COVID-19 wards and intensive care unit (ICU)) occurred Logistic regression analyses were used to investigate the impact of CARE, patients’ age and sex on the outcome To evaluate the prognostic performance of CARE, receiver operating characteristic curves were computed for the entire stay and at admission only Results: A total of 1203 chest radiographs of 175 patients (120 males;mean age 67 81±15 5 years old) were examined On average, each patient underwent 6 8±10 3 radiographs Patients in ICU as well as deceased patients showed higher CARE scores (p<0 05, each) Age, Co and CARE significantly influenced the outcome (p<0 05 each) The CARE demonstrated good accuracy (area under the curve (AUC)=0 736) using longitudinal data as well as at admission only (AUC=0 740) A CARE score of 17 5 during hospitalisation showed 75% sensitivity and 69 9% specificity Conclusions: The CARE was demonstrated to be a reliable tool to assess the severity of pulmonary involvement at chest radiography with a good prognostic performance