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1.
Remote Sensing ; 14(16):3927, 2022.
Article in English | ProQuest Central | ID: covidwho-2024036

ABSTRACT

Airport emissions have received increased attention because of their impact on atmospheric chemical processes, the microphysical properties of aerosols, and human health. At present, the assessment methods for airport pollution emission mainly involve the use of the aircraft emission database established by the International Civil Aviation Organization, but the emission behavior of an engine installed on an aircraft may differ from that of an engine operated in a testbed. In this study, we describe the development of a long-path differential optical absorption spectroscopy (LP-DOAS) instrument for measuring aircraft emissions at an airport. From 15 October to 23 October 2019, a measurement campaign using the LP-DOAS instrument was conducted at Hefei Xinqiao International Airport to investigate the regional concentrations of various trace gases in the airport’s northern area and the variation characteristics of the gas concentrations during an aircraft’s taxiing and take-off phases. The measured light path of the LP-DOAS passed through the aircraft taxiway and the take-off runway concurrently. The aircraft’s take-off produced the maximum peak in NO2 average concentrations of approximately 25 ppbV and SO2 average concentrations of approximately 8 ppbV in measured area. Owing to the airport’s open space, the pollution concentrations decreased rapidly, the overall levels of NO2 and SO2 concentrations in the airport area were very low, and the maximum hourly average NO2 and SO2 concentrations during the observation period were better than the Class 1 ambient air quality standards in China. Additionally, we discovered that the NO2 and SO2 emissions from the Boeing 737–800 aircraft monitored in this experiment were weakly and positively related to the age of the aircraft. This measurement established the security, feasibility, fast and non-contact of the developed LP-DOAS instrument for monitoring airport regional concentrations as well as NO2 and SO2 aircraft emissions during routine airport operations without interfering with the normal operation of the airport.

2.
Psychosom Med ; 83(4): 368-372, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1931979

ABSTRACT

OBJECTIVE: Infectious diseases can cause psychological changes in patients. This study aimed to evaluate the prevalence and related risk factors for anxiety and depression in patients with COVID-19. METHODS: A cross-sectional study was performed on patients with COVID-19 admitted to the Sino-French New City branch of Wuhan Tongji Hospital from January to February 2020. The Zung Self-Rating Anxiety and Depression Scales were used to evaluate the prevalence of anxiety and depression. Demographic, clinical, and sociological data were also collected. Multivariable logistic regression analysis was used to identify independent risk factors of anxiety and depression in patients with COVID-19. RESULTS: In the current study, 183 patients were enrolled (mean age = 53 ± 9 years; 41.1% women). The prevalences of anxiety and depression were 56.3% and 39.3%, respectively. Logistic regression analysis revealed that older age, female sex, being divorced or widowed, COVID-19 disease duration, renal disease, and depression were identified as independent risk factors for anxiety in patients with COVID-19. Factors that were associated with depression were female sex, being widowed, COVID-19 disease duration, and anxiety. CONCLUSIONS: This study demonstrates a high prevalence of anxiety and depression in patients with COVID-19 at the peak of the epidemic in Wuhan, China. The identification of demographic, clinical, and social factors may help identify health care professionals to provide psychological care as part of treatment for patients with COVID-19 and other life-threatening infectious diseases.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Anxiety/etiology , COVID-19/complications , China/epidemiology , Cross-Sectional Studies , Depression/etiology , Female , Humans , Logistic Models , Male , Middle Aged , Prevalence , Psychiatric Status Rating Scales , Risk Factors
3.
Can Respir J ; 2022: 4579030, 2022.
Article in English | MEDLINE | ID: covidwho-1784920

ABSTRACT

Background: The effects of prone positioning (PP) on patients with acute respiratory distress syndrome (ARDS) caused by pulmonary contusion (PC) are unclear. We sought to determine the efficacy of PP among patients whose ARDS was caused by PC. Methods: A retrospective observational study was performed at an intensive care unit (ICU) from January 2017 to June 2021. ARDS patients with PaO2/FiO2 (P/F) < 150 mmHg were enrolled. During the study period, we enrolled 121 patients in the PP group and 117 in the control group. The changes in vital signs, laboratory tests, and compliance of the respiratory system (Crs) were recorded for 3 consecutive days. The mechanical ventilation time, duration of ICU stay, complications, extubation rate, 28-day ventilator-free days, and mortality were also recorded. Results: In the PP group, the P/F and Crs increased over time. Compared to the control group, the P/F and Crs improved in the PP group over 3 consecutive days (P < 0.05). Furthermore, the PP group also had shorter total mechanical ventilation time (5.1 ± 1.4 vs. 9.3 ± 3.1 days, P < 0.05) and invasive ventilation time (4.9 ± 1.2 vs. 8.7 ± 2.7 days, P < 0.05), shorter ICU stay (7.4 ± 1.8 vs. 11.5 ± 3.6days, P < 0.05), higher extubation rate (95.6% vs. 84.4%, P < 0.05), less atelectasis (15 vs. 74, P < 0.05) and pneumothorax (17 vs. 24, P > 0.05), more 28-day ventilator-free days (21.6 ± 5.2 vs. 16.2 ± 7.2 days, P < 0.05), and lower mortality (4.4% vs. 13.3%, P < 0.05). Conclusions: Among PC cases with moderate to severe ARDS, PP can correct hypoxemia more quickly, improve Crs, reduce atelectasis, increase the extubation rate, shorten mechanical ventilation time and length of ICU stay, and reduce mortality.


Subject(s)
Contusions , Pulmonary Atelectasis , Respiratory Distress Syndrome , Contusions/complications , Contusions/therapy , Humans , Intensive Care Units , Prone Position , Respiration, Artificial , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/therapy , Retrospective Studies
4.
Am J Med Sci ; 363(5): 411-419, 2022 05.
Article in English | MEDLINE | ID: covidwho-1701077

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, studies of the physiological effects of masking during exercise have been rare. METHODS: Twelve healthcare workers performed a cardiopulmonary exercise test while wearing a surgical mask, an N95 mask, or no mask. Variables were collected at rest, warm-up, anaerobic threshold, and maximal exercise. RESULTS: From rest to maximal exercise, both the surgical and N95 masks decreased inspiratory flow, minute ventilation, and prolonged inspiratory time compared to the no mask condition. Oxygen uptake (VO2) and oxygen pulse (VO2/HR) decreased at rest, warm-up, and maximal exercise in both the surgical and N95 mask conditions (vs. no mask). At the anaerobic threshold, the surgical mask also led to a reduction of oxygen uptake and oxygen pulse compared to no mask. The maximal oxygen uptake (VO2% predicted) also decreased in both the surgical and N95 mask conditions. In addition, the severity of dyspnea increased, and exercise time decreased for both surgical and N95 masks. Compared to no mask, wearing an N95 mask led to lower breathing frequency and lower ventilation efficacy (assessed by VE/VCO2 and VE/VO2) from rest to maximal exercise (all p < 0.05 for trend). Wearing an N95 also led to retention of carbon dioxide (p < 0.05 for trend). CONCLUSIONS: Wearing a surgical mask leads to a somewhat negative impact on cardiopulmonary function, and this effect is more serious with an N95 mask. Attention should be paid to exercise while wearing surgical or N95 masks.


Subject(s)
COVID-19 , N95 Respirators , Humans , Masks , Oxygen , Pandemics
5.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-325194

ABSTRACT

Background: Current information is not enough to recognize the risk factors of clinical deterioration and to make medical decisions in COVID-19 patients. Methods: : A retrospective study was performed, with collecting data from medical records of COVID-19 patients in three designated hospitals from January 8, 2020 to May 6, 2020. Clinical data were analyzed between the deteriorated and the non-deteriorated patients, which was defined as either a increase of 2 categories on the modified 6-category ordinal scale, or a decline of PaO 2 -to-FIO 2 ratio more than 100mmHg. Results: : Total 238 patients with COVID-19 were selected, where 31 were deteriorated and 207 were non-deteriorated. In the deterioration group, the case fatality rate was up to 41.9%. Compared with non-deteriorated patients, the deteriorated were older (65.8[IQR 54.3-72.3] vs 54.4[41.0-66.1], p=0.004) and were more likely to have chronic medical illnesses (17[54.8%]) vs 92[44.4%]). Multivariable regression showed that three variables, neutrophil-lymphocyte ratio (NLR)≥3.66 (OR, 9.85;95% CI, 1.68-57.57), hyponatremia (OR, 8.35;95% CI, 1.74-40.16), and presence of ground-glass opacities with consolidation (OR, 5.84;95% CI, 1.24-27.49) were associated with increased odds of clinical deterioration. The variable that inspiring air or traditional oxygen therapy only within 72 hours after admission, indicated a decreased odd of illness progression (OR, 0.075;95% CI, 0.012–0.465). Conclusions: : COVID-19 patients with clinical deterioration had more common extra-pulmonary organ impair in early stage and high case fatality rate. Three factors, NLR ≥3.66, hyponatremia and presence of ground-glass opacities with consolidation were determined as high risk factors in deterioration.

6.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-323620

ABSTRACT

Background: The outbreak of a novel coronavirus (2019-nCoV)–infected pneumonia (NCIP) is currently ongoing in China. Most of the critically ill patients received high flow nasal cannula (HFNC). However, the experience of HFNC in this population is lacking. Methods We retrospectively collected the NCIP patients who received HFNC in two hospital of Chongqing, China from January 1st to February 18th, 2020. The clinical characteristics were collected. Patients who required upgrading to noninvasive ventilation (NIV) were defined as HFNC failure. Results We enrolled 17 patients in this study. Of them, 7 patients (41%) experienced HFNC failure (6 required upgrading to NIV, and one to NIV and further to intubation). The HFNC failure rate was 0% (0/6), 57% (4/7) and 75% (3/4) (p =0.03 between 3 groups) in patients with PaO2/FiO2 >200, 150-200, and <150 mmHg, respectively. In the successful patients, the respiratory rate, heart rate and PaO2/FiO2 significantly improved from initiation to termination of HFNC (27±3 vs. 21±2 breaths/min, p <0.01;86±15 vs. 76±12 beats/min, p =0.03;and 213±49 vs. 299±125 mmHg, p =0.04, respectively). However, in the unsuccessful patients, the respiratory rate and PaO2/FiO2 significantly deteriorated (22±3 vs. 25±3 breaths/min, p =0.04;and 160±27 vs. 105±24 mmHg, p =0.01, respectively). When they upgraded to NIV, the PaO2/FiO2 improved after 1-2 h of NIV (105±24 vs. 202±111 mmHg, p =0.04). In the total cohort, only PaO2/FiO2 at baseline was lower in unsuccessful patients than that in successful ones (213±49 vs. 160±27 mmHg, p =0.02). Conclusions This study firstly provides the experience of how to use HFNC in patients with NCIP. Patients with lower PaO2/FiO2 were more likely to experience HFNC failure. Among the failure patients, most of them can avoid intubation when they were ungraded to NIV.

7.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-312714

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has now spread worldwide. This study aimed to provide a reference for comprehensive treatment, personal protection, and team management of patients with critical COVID-19. Methods: The study included critical COVID-19 cases at a single centre in Wuhan, China. We retrospectively analysed data on symptoms, laboratory tests, radiology findings, treatment, and outcomes. Air samples and environmental surface swabs in the isolation ward were tested for SARS-CoV-2. Results: Fourteen critically ill patients (mean age 62.1 years) were treated between February 4, 2020 and April 6, 2020. Less than half had underlying diseases, including hypertension (n=6, 42.9%) and diabetes (n=4, 28.6%). Laboratory tests showed decreased lymphocyte levels and increased serum ferritin and inflammatory cytokine levels. More than half of the patients received antiviral drugs, including lopinavir/ritonavir (n=10;71.4%) and arbidol (n=6, 42.9%). Eight patients (57.1%) received convalescent plasma, and 12 (85.7%) received systemic glucocorticoids. Eleven (78.6%) received high-flow nasal cannula oxygen therapy, five (35.7%) received non-invasive positive pressure ventilation, seven (50.0%) received invasive positive pressure ventilation, and three (21.4%) received extracorporeal membrane oxygenation. By April 6, 2020, nine (64.3%) patients were discharged, four remained in hospital, and one had died. All air samples tested negative for SARS-CoV-2. Of 128 environmental surface swabs, one gastric tube swab and one anal tube swab were positive for SARS-CoV-2. All oropharyngeal swabs taken from medical staff tested negative for SARS-CoV-2. Conclusions: Individualised comprehensive treatment, appropriate personal protection, and teamwork may improve the prognosis in patients with COVID-19 who are critically ill.

8.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-307613

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently spread worldwide partly through environmental and airborne contamination. The number of patients requiring intensive care unit (ICU)-based healthcare services exceeds the available negative-pressure isolation ICU room capacity. Some general wards of Wuhan hospitals have been temporarily converted into COVID-19 ICU wards and pose safety concerns. We explored the safety of these temporary COVID-19 ICU wards. Methods: : Fifteen air samples and 128 environmental surface swabs were collected from 14 patients in 4 departments with temporary COVID-19 ICU wards. Quantitative real-time PCR (RT-PCR) methods confirmed the existence of COVID-19 pathogens. Results: : Four of the 15 air samples were obtained during aerosol-generating medical procedures (1 tracheostomy, 1 high-flow nasal cannula [HFNC], 1 HFNC+nebulization, 1 non-invasive positive pressure ventilation). Five patients were administered invasive positive pressure ventilation through tracheostomy. All air samples tested negative for SARS-CoV-2 by RT-PCR. Viruses were detected on the surface of a patient’s gastric tube, and an anal tube swab tested positive. Five days later, the anal swab of the patient remained positive, although viral RNA of the nasopharyngeal swap turned negative. Conclusions: : Establishing temporary isolation COVID-19 ICU wards is a safe and effective method to increase surge capacity in a hospital. SARS-CoV-2 sheds from the enteric canal after viral clearance in the respiratory tract. Reinforcing disinfection of tubes and circuits given to the patients is essential in COVID-19 isolation wards to decrease nosocomial transmission.

10.
Front Med (Lausanne) ; 8: 730441, 2021.
Article in English | MEDLINE | ID: covidwho-1450819

ABSTRACT

Objective: A considerable part of COVID-19 patients were found to be re-positive in the SARS-CoV-2 RT-PCR test after discharge. Early prediction of re-positive COVID-19 cases is of critical importance in determining the isolation period and developing clinical protocols. Materials and Methods: Ninety-one patients discharged from Wanzhou Three Gorges Central Hospital, Chongqing, China, from February 10, 2020 to March 3, 2020 were administered nasopharyngeal swab SARS-CoV-2 tests within 12-14 days, and 50 eligible patients (32 male and 18 female) with completed data were enrolled. Average age was 48 ± 11.5 years. All patients underwent non-enhanced chest CT on admission. A total of 568 radiomics features were extracted from the CT images, and 17 clinical factors were collected based on the medical record. Student's t-test and support vector machine-based recursive feature elimination (SVM-RFE) method were used to determine an optimal subset of features for the discriminative model development. Results: After Student's t-test, 62 radiomics features showed significant inter-group differences (p < 0.05) between the re-positive and negative cases, and none of the clinical features showed significant differences. These significant features were further selected by SVM-RFE algorithm, and a more compact feature subset containing only two radiomics features was finally determined, achieving the best predictive performance with the accuracy and area under the curve of 72.6% and 0.773 for the identification of the re-positive case. Conclusion: The proposed radiomics method has preliminarily shown potential in identifying the re-positive cases among the recovered COVID-19 patients after discharge. More strategies are to be integrated into the current pipeline to improve its precision, and a larger database with multi-clinical enrollment is required to extensively verify its performance.

12.
Clin Exp Med ; 21(3): 361-367, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1064526

ABSTRACT

BACKGROUND: The recurrence of positive SARS-CoV-2 RT-PCR is frequently found in discharged COVID-19 patients but its clinical significance remains unclear. The potential cause, clinical characteristics and infectiousness of the recurrent positive RT-PCR patients need to be answered. METHODS: A single-centered, retrospective study of 51 discharged COVID-19 patients was carried out at a designated hospital for COVID-19. The demographic data, clinical records and laboratory findings of 25 patients with recurrent positive RT-PCR from hospitalization to follow-up were collected and compared to 26 patients with negative RT-PCR discharged regularly during the same period. Discharged patients' family members and close contacts were also interviewed by telephone to evaluate patients' potential infectiousness. RESULTS: The titer of both IgG and IgM antibodies was significantly lower (p = 0.027, p = 0.011) in patients with recurrent positive RT-PCR. Median duration of viral shedding significantly prolonged in patients with recurrent positive RT-PCR (36.0 days vs 9.0 days, p = 0.000). There was no significant difference in demographic features, clinical features, lymphocyte subsets count and inflammatory cytokines levels between the two groups of patients. No fatal case was noted in two groups. As of the last day of follow-up, none of the discharged patients' family members or close contact developed any symptoms of COVID-19. CONCLUSIONS: Patients with low levels of IgG and IgM are more likely to have recurrent positive SARS-CoV-2 RT-PCR results and lead to a prolonged viral shedding. The recurrent positive of SARS-CoV-2 RT-PCR may not indicate the recurrence or aggravation of COVID-19. The detection of SARS-CoV-2 by RT-PCR in the patients recovered from COVID-19 is not necessarily correlated with the ability of transmission.


Subject(s)
Antibodies, Viral/blood , COVID-19/diagnosis , RNA, Viral/genetics , Reinfection/virology , SARS-CoV-2/isolation & purification , Adult , COVID-19/blood , COVID-19/immunology , Case-Control Studies , China , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Patient Discharge , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , SARS-CoV-2/genetics , SARS-CoV-2/physiology , Time Factors , Virus Shedding
13.
Med Clin (Barc) ; 156(8): 386-389, 2021 04 23.
Article in English, Spanish | MEDLINE | ID: covidwho-1042975

ABSTRACT

OBJECTIVE: In December 2019, Wuhan, China, experienced an outbreak of coronavirus disease 2019 (COVID-19). Some patients admitted to our hospital were treated with early prone positioning (PP). Here, we analyzed its clinical significance. METHODS: This was a retrospective observational study. We defined the early PP group as mild COVID-19 patients who were placed into a prone position within 24h of admission; others served as the control group. We recorded basic data and outcomes of early PP and compared the results to those of controls. RESULTS: After 1 day of treatment, oxygenation was greater in the early PP group than in the control group (P/F: 421.6±39.74 vs. 382.1±38.84mmHg [1mmHg=0.133kPa], p<0.01). And early PP group spent less total time in prone position (11.1±4.17 vs. 16.9±5.20 days, p<0.01), and required shorter hospitalization duration (12.2±4.49 vs. 23.2±4.83 days, p<0.001). CONCLUSIONS: Early PP treatment can improve hypoxia and shorten the prone position time and hospitalization duration in mild COVID-19 patients. It is a potential clinically applicable intervention.


Subject(s)
COVID-19/therapy , Patient Positioning , Prone Position , Adult , China/epidemiology , Female , Humans , Male , Middle Aged
14.
EBioMedicine ; 62: 103125, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-938894

ABSTRACT

BACKGROUND: The pharmacokinetics and appropriate dose regimens of favipiravir are unknown in hospitalized influenza patients; such data are also needed to determine dosage selection for favipiravir trials in COVID-19. METHODS: In this dose-escalating study, favipiravir pharmacokinetics and tolerability were assessed in critically ill influenza patients. Participants received one of two dosing regimens; Japan licensed dose (1600 mg BID on day 1 and 600 mg BID on the following days) and the higher dose (1800 mg/800 mg BID) trialed in uncomplicated influenza. The primary pharmacokinetic endpoint was the proportion of patients with a minimum observed plasma trough concentration (Ctrough) ≥20 mg/L at all measured time points after the second dose. RESULTS: Sixteen patients were enrolled into the low dose group and 19 patients into the high dose group of the study. Favipiravir Ctrough decreased significantly over time in both groups (p <0.01). Relative to day 2 (48 hrs), concentrations were 91.7% and 90.3% lower in the 1600/600 mg group and 79.3% and 89.5% lower in the 1800/800 mg group at day 7 and 10, respectively. In contrast, oseltamivir concentrations did not change significantly over time. A 2-compartment disposition model with first-order absorption and elimination described the observed favipiravir concentration-time data well. Modeling demonstrated that less than 50% of patients achieved Ctrough ≥20 mg/L for >80% of the duration of treatment of the two dose regimens evaluated (18.8% and 42.1% of patients for low and high dose regimen, respectively). Increasing the favipravir dosage predicted a higher proportion of patients reaching this threshold of 20 mg/L, suggesting that dosing regimens of ≥3600/2600 mg might be required for adequate concentrations. The two dosing regimens were well-tolerated in critical ill patients with influenza. CONCLUSION: The two dosing regimens proposed for uncomplicated influenza did not achieve our pre-defined treatment threshold.


Subject(s)
Amides , Influenza, Human/drug therapy , Oseltamivir , Pyrazines , Aged , Amides/administration & dosage , Amides/pharmacokinetics , Drug Therapy, Combination , Female , Humans , Influenza, Human/blood , Male , Middle Aged , Oseltamivir/administration & dosage , Oseltamivir/pharmacokinetics , Pyrazines/administration & dosage , Pyrazines/pharmacokinetics , Severity of Illness Index
15.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(10): 1251-1252, 2020 Oct.
Article in Chinese | MEDLINE | ID: covidwho-926669

ABSTRACT

During the epidemic of coronavirus disease 2019, due to the need to collect a large number of nucleic acid samples, the staff are under great pressure. For this reason, the medical staff of China-Japan Friendship Hospital developed a mobile positive pressure clean chamber and applied for a national utility model patent (application number: 202021173605.8). The equipment is composed of a cabin body, an operation hole equipped with rubber gloves, an interactive channel with two electric doors, an environmental control unitandanair-conditioner. When in use, the medical staff are located inside the cabin, and their hands are protruded by two operating holes to calculate and sample for the tested personnel. Then the samples are placed on the table outside the cabin waiting for inspection. The clean chamber can be used in hospitals, communities and other places, while achieving the goal of efficient sampling, and the risk of infection in the process is reduced by effectively blocking the contact between medical staff and the source of infection.


Subject(s)
Coronavirus Infections , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , China , Humans , SARS-CoV-2
16.
Journal of Third Military Medical University ; 42(15):1489-1494, 2020.
Article in Chinese | GIM | ID: covidwho-889201

ABSTRACT

Objective: To explore the application value of chemiluminescence detection of SARS-CoV-2 IgM/IgG antibodies in the adjuvant diagnosis and treatment of coronavirus disease 2019 (COVID-19).

17.
Ther Adv Respir Dis ; 14: 1753466620963019, 2020.
Article in English | MEDLINE | ID: covidwho-873871

ABSTRACT

BACKGROUND: A simple scoring system for triage of suspected patients with COVID-19 is lacking. METHODS: A multi-disciplinary team developed a screening score taking into account epidemiology history, clinical feature, radiographic feature, and routine blood test. At fever clinics, the screening score was used to identify the patients with moderate to high probability of COVID-19 among all the suspected patients. The patients with moderate to high probability of COVID-19 were allocated to a single room in an isolation ward with level-3 protection. And those with low probability were allocated to a single room in a general ward with level-2 protection. At the isolation ward, the screening score was used to identify the confirmed and probable cases after two consecutive real-time reverse transcription polymerase chain reaction (RT-PCR) tests. The data in the People's Hospital of Changshou District were used for internal validation and those in the People's Hospital of Yubei District for external validation. RESULTS: We enrolled 76 and 40 patients for internal and external validation, respectively. In the internal validation cohort, the area under the curve of receiver operating characteristics (AUC) was 0.96 [95% confidence interval (CI): 0.89-0.99] for the diagnosis of moderate to high probability of cases among all the suspected patients. Using 60 as cut-off value, the sensitivity and specificity were 88% and 93%, respectively. In the isolation ward, the AUC was 0.94 (95% CI: 0.83-0.99) for the diagnosis of confirmed and probable cases. Using 90 as cut-off value, the sensitivity and specificity were 78% and 100%, respectively. These results were confirmed in the validation cohort. CONCLUSION: The scoring system provides a reference on COVID-19 triage in fever clinics to reduce misdiagnosis and consumption of protective supplies.The reviews of this paper are available via the supplemental material section.


Subject(s)
Betacoronavirus , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Triage , Adult , Aged , COVID-19 , Coronavirus Infections/complications , Female , Humans , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity , Severity of Illness Index
18.
Heart Lung ; 50(1): 37-43, 2021.
Article in English | MEDLINE | ID: covidwho-856729

ABSTRACT

BACKGROUND: The clinical characteristics of the patients with COVID-19 complicated by pneumothorax have not been clarified. OBJECTIVES: To determine the epidemiology and risks of pneumothorax in the critically ill patients with COVID-19. METHODS: Retrospectively collecting and analysing medical records, laboratory findings, chest X-ray and CT images of 5 patients complicated by pneumothorax. RESULTS: The incidence of pneumothorax was 10% (5/49) in patients with ARDS, 24% (5/21) in patients receiving mechanical ventilation, and 56% (5/9) in patients requiring invasive mechanical ventilation, with 80% (4/5) patients died. All the 5 patients were male and aged ranging from 54 to 79 years old. Pneumothorax was most likely to occur 2 weeks after the beginning of dyspnea and associated with reduction of neuromuscular blockers, recruitment maneuver, severe cough, changes of lung structure and function. CONCLUSIONS: Pneumothorax is a frequent and fatal complication of critically ill patients with COVID-19.


Subject(s)
COVID-19 , Pneumothorax , Aged , Critical Illness , Humans , Incidence , Male , Middle Aged , Pneumothorax/epidemiology , Pneumothorax/etiology , Retrospective Studies , SARS-CoV-2
20.
SSRN; 2020.
Preprint | SSRN | ID: ppcovidwho-933

ABSTRACT

Background: Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), a novel betacoronavirus, has caused an outburst of pneumonia cases in Wuhan, China. We

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