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2.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-308027

ABSTRACT

The excessive spread of the pandemic COVID19 around the globe has put mankind at risk. The medical infrastructure and resources are frazzled, even for world's top economies, due to the large COVID19 infection. To cope up with this situation, countries are exploring the pool test strategies. In this paper, a detailed analysis has been done to explore the efficient pooling strategies. Given a population and the known fact that the percentage of people infected by the virus, the minimum number of tests to identify COVID19 positive cases from the entire population is observed. The analysis reveals that the tests needed are very less when compared to the total population. This can be looked as an essential step towards efficient utilization of sparse available resources of COVID19 testing kits, especially for the countries having limited medical infrastructure.

3.
PLoS One ; 16(12): e0261529, 2021.
Article in English | MEDLINE | ID: covidwho-1599654

ABSTRACT

BACKGROUND: Risk factors for the development of severe COVID-19 disease and death have been widely reported across several studies. Knowledge about the determinants of severe disease and mortality in the Indian context can guide early clinical management. METHODS: We conducted a hospital-based case control study across nine sites in India to identify the determinants of severe and critical COVID-19 disease. FINDINGS: We identified age above 60 years, duration before admission >5 days, chronic kidney disease, leucocytosis, prothrombin time > 14 sec, serum ferritin >250 ng/mL, d-dimer >0.5 ng/mL, pro-calcitonin >0.15 µg/L, fibrin degradation products >5 µg/mL, C-reactive protein >5 mg/L, lactate dehydrogenase >150 U/L, interleukin-6 >25 pg/mL, NLR ≥3, and deranged liver function, renal function and serum electrolytes as significant factors associated with severe COVID-19 disease. INTERPRETATION: We have identified a set of parameters that can help in characterising severe COVID-19 cases in India. These parameters are part of routinely available investigations within Indian hospital settings, both public and private. Study findings have the potential to inform clinical management protocols and identify patients at high risk of severe outcomes at an early stage.


Subject(s)
COVID-19/blood , COVID-19/epidemiology , Hospitalization , SARS-CoV-2 , Severity of Illness Index , Adolescent , Adult , Age Factors , C-Reactive Protein/analysis , Case-Control Studies , Female , Fibrin Fibrinogen Degradation Products/analysis , Hospitals , Humans , India/epidemiology , Interleukin-6/blood , L-Lactate Dehydrogenase/blood , Male , Middle Aged , Procalcitonin/blood , Risk Factors , Young Adult
4.
Epidemiologic Methods ; (s1)2021.
Article in English | ProQuest Central | ID: covidwho-1496581

ABSTRACT

The excessive spread of the pandemic COVID-19 around the globe has put mankind at risk. The medical infrastructure and resources are frazzled, even for the world's top economies, due to the large COVID-19 infection. To cope up with this situation, countries are exploring the pool test strategies. In this paper, a detailed analysis has been done to explore the efficient pooling strategies. Given a population and the known fact that the percentage of people infected by the virus, the minimum number of tests to identify COVID-19 positive cases from the entire population are found. In this paper, the problem is formulated with an objective to find a minimum number of tests in the worst case where exactly one positive sample is there in a pool which can happen considering the fact that the groups are formed by choosing samples randomly. Therefore, the thrust stress is on minimizing the total number of tests by finding varying pool sizes at different levels (not necessarily same size at all levels), although levels can also be controlled.Initially the problem is formulated as an optimization problem and there is no constraint on the number of levels upto which pooling can be done. Finding an analytical solution of the problem was challenging and thus the approximate solution was obtained and analyzed. Further, it is observed that many times it is pertinent to put a constraint on the number of levels upto which pooling can be done and thus optimizing with such a constraint is also done using genetic algorithm.An empirical evaluation on both realistic and synthetic examples is done to show the efficiency of the procedures and for lower values of percentage infection, the total number of tests are very much less than the population size. Further, the findings of this study show that the general COVID-19 pool test gives the better solution for a small infection while as the value of infection becomes significant the single COVID-19 pool test gives better results.This paper illustrates the formation and analysis of polling strategies, which can be opted for the better utilization of the resources. Two different pooling strategies are proposed and these strategies yield accurate insight considering the worst case scenario. The analysis finds that the proposed bounds can be efficiently exploited to ascertain the pool testing in view of the COVID-19 infection rate.

5.
Clin Chem Lab Med ; 59(9): 1507-1515, 2021 08 26.
Article in English | MEDLINE | ID: covidwho-1206212

ABSTRACT

With an almost unremittent progression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections all around the world, there is a compelling need to introduce rapid, reliable, and high-throughput testing to allow appropriate clinical management and/or timely isolation of infected individuals. Although nucleic acid amplification testing (NAAT) remains the gold standard for detecting and theoretically quantifying SARS-CoV-2 mRNA in various specimen types, antigen assays may be considered a suitable alternative, under specific circumstances. Rapid antigen tests are meant to detect viral antigen proteins in biological specimens (e.g. nasal, nasopharyngeal, saliva), to indicate current SARS-CoV-2 infection. The available assay methodology includes rapid chromatographic immunoassays, used at the point-of-care, which carries some advantages and drawbacks compared to more conventional, instrumentation-based, laboratory immunoassays. Therefore, this document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 aims to summarize available data on the performance of currently available SARS-CoV-2 antigen rapid detection tests (Ag-RDTs), providing interim guidance on clinical indications and target populations, assay selection, and evaluation, test interpretation and limitations, as well as on pre-analytical considerations. This document is hence mainly aimed to assist laboratory and regulated health professionals in selecting, validating, and implementing regulatory approved Ag-RDTs.


Subject(s)
Antigens, Viral/immunology , COVID-19/diagnosis , Immunoassay/standards , Point-of-Care Testing/standards , Practice Guidelines as Topic/standards , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Asymptomatic Infections/classification , COVID-19/immunology , COVID-19/virology , Humans
6.
J Biomol Struct Dyn ; 40(13): 5836-5847, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1039690

ABSTRACT

In the hospital, because of the rise in cases daily, there are a small number of COVID-19 test kits available. For this purpose, a rapid alternative diagnostic choice to prevent COVID-19 spread among individuals must be implemented as an automatic detection method. In this article, the multi-objective optimization and deep learning-based technique for identifying infected patients with coronavirus using X-rays is proposed. J48 decision tree approach classifies the deep feature of corona affected X-ray images for the efficient detection of infected patients. In this study, 11 different convolutional neural network-based (CNN) models (AlexNet, VGG16, VGG19, GoogleNet, ResNet18, ResNet50, ResNet101, InceptionV3, InceptionResNetV2, DenseNet201 and XceptionNet) are developed for detection of infected patients with coronavirus pneumonia using X-ray images. The efficiency of the proposed model is tested using k-fold cross-validation method. Moreover, the parameters of CNN deep learning model are tuned using multi-objective spotted hyena optimizer (MOSHO). Extensive analysis shows that the proposed model can classify the X-ray images at a good accuracy, precision, recall, specificity and F1-score rates. Extensive experimental results reveal that the proposed model outperforms competitive models in terms of well-known performance metrics. Hence, the proposed model is useful for real-time COVID-19 disease classification from X-ray chest images.Communicated by Ramaswamy H. Sarma.


Subject(s)
COVID-19 , Deep Learning , COVID-19/diagnostic imaging , Humans , Neural Networks, Computer , SARS-CoV-2 , X-Rays
7.
BMJ Open ; 10(11): e037335, 2020 11 03.
Article in English | MEDLINE | ID: covidwho-991817

ABSTRACT

INTRODUCTION: Around 9% of India's children under six are diagnosed with neurodevelopmental disorders. Low-resource, rural communities often lack programmes for early identification and intervention. The Prechtl General Movement Assessment (GMA) is regarded as the best clinical tool to predict cerebral palsy in infants <5 months. In addition, children with developmental delay, intellectual disabilities, late detected genetic disorders or autism spectrum disorder show abnormal general movements (GMs) during infancy. General Movement Assessment in Neonates for Early Identification and Intervention, Social Support and Health Awareness (G.A.N.E.S.H.) aims to (1) provide evidence as to whether community health workers can support the identification of infants at high-risk for neurological and developmental disorders and disabilities, (2) monitor further development in those infants and (3) initiate early and targeted intervention procedures. METHODS: This 3-year observational cohort study will comprise at least 2000 infants born across four districts of Uttar Pradesh, India. Community health workers, certified for GMA, video record and assess the infants' GMs twice, that is, within 2 months after birth and at 3-5 months. In case of abnormal GMs and/or reduced MOSs, infants are further examined by a paediatrician and a neurologist. If necessary, early intervention strategies (treatment as usual) are introduced. After paediatric and neurodevelopmental assessments at 12-24 months, outcomes are categorised as normal or neurological/developmental disorders. Research objective (1): to relate the GMA to the outcome at 12-24 months. Research objective (2): to investigate the impact of predefined exposures. Research objective (3): to evaluate the interscorer agreement of GMA. ETHICS AND DISSEMINATION: G.A.N.E.S.H. received ethics approval from the Indian Government Chief Medical Officers of Varanasi and Mirzapur and from the Ramakrishna Mission Home of Service in Varanasi. GMA is a worldwide used diagnostic tool, approved by the Ethics Committee of the Medical University of Graz, Austria (27-388 ex 14/15). Apart from peer-reviewed publications, we are planning to deploy G.A.N.E.S.H. in other vulnerable settings.


Subject(s)
Autism Spectrum Disorder , Cerebral Palsy , Austria , Autism Spectrum Disorder/diagnosis , Cohort Studies , Female , Humans , India , Infant , Infant, Newborn , Pregnancy
8.
Clin Chem Lab Med ; 58(12): 2009-2016, 2020 10 07.
Article in English | MEDLINE | ID: covidwho-835982

ABSTRACT

Routine biochemical and hematological tests have been reported to be useful in the stratification and prognostication of pediatric and adult patients with diagnosed coronavirus disease (COVID-19), correlating with poor outcomes such as the need for mechanical ventilation or intensive care, progression to multisystem organ failure, and/or death. While these tests are already well established in most clinical laboratories, there is still debate regarding their clinical value in the management of COVID-19, particularly in pediatrics, as well as the value of composite clinical risk scores in COVID-19 prognostication. This document by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications for testing, (B) recommendations for test selection and interpretation, (C) considerations in test interpretation, and (D) current limitations of biochemical/hematological monitoring of COVID-19 patients. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide, underscoring the contribution of biochemical and hematological testing to our collective pandemic response.


Subject(s)
Coronavirus Infections/metabolism , Hematologic Tests , International Agencies , Pneumonia, Viral/metabolism , Practice Guidelines as Topic , Adult , Biomarkers/blood , COVID-19 , Cardiovascular Diseases/complications , Child , Coronavirus Infections/blood , Coronavirus Infections/complications , Female , Humans , Male , Multiple Organ Failure/complications , Pandemics , Pneumonia, Viral/blood , Pneumonia, Viral/complications
9.
Clin Chem Lab Med ; 58(12): 2001-2008, 2020 10 07.
Article in English | MEDLINE | ID: covidwho-835981

ABSTRACT

Serological testing for the detection of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as an important component of the clinical management of patients with coronavirus disease 2019 (COVID-19) as well as the epidemiological assessment of SARS-CoV-2 exposure worldwide. In addition to molecular testing for the detection of SARS-CoV-2 infection, clinical laboratories have also needed to increase testing capacity to include serological evaluation of patients with suspected or known COVID-19. While regulatory approved serological immunoassays are now widely available from diagnostic manufacturers globally, there is significant debate regarding the clinical utility of these tests, as well as their clinical and analytical performance requirements prior to application. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Taskforce on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay evaluation, and (D) test interpretation and limitations for serological testing of antibodies against SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories in the selection, verification, and implementation of serological assays and are of the utmost importance as we expand our pandemic response from initial case tracing and containment to mitigation strategies to minimize resurgence and further morbidity and mortality.


Subject(s)
Antibodies, Viral/blood , Betacoronavirus/immunology , International Agencies , Practice Guidelines as Topic , Serologic Tests/methods , Antibodies, Viral/immunology , Humans , SARS-CoV-2
10.
Clin Chem Lab Med ; 58(12): 1993-2000, 2020 10 07.
Article in English | MEDLINE | ID: covidwho-835980

ABSTRACT

The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection globally has relied extensively on molecular testing, contributing vitally to case identification, isolation, contact tracing, and rationalization of infection control measures during the coronavirus disease 2019 (COVID-19) pandemic. Clinical laboratories have thus needed to verify newly developed molecular tests and increase testing capacity at an unprecedented rate. As the COVID-19 pandemic continues to pose a global health threat, laboratories continue to encounter challenges in the selection, verification, and interpretation of these tests. This document by the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications and target populations, (B) assay selection, (C) assay verification, and (D) test interpretation and limitations for molecular testing of SARS-CoV-2 infection. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide and highlight the continued importance of laboratory medicine in our collective pandemic response.


Subject(s)
Coronavirus Infections/diagnosis , International Agencies , Molecular Diagnostic Techniques , Pneumonia, Viral/diagnosis , Practice Guidelines as Topic , Betacoronavirus/genetics , Betacoronavirus/physiology , COVID-19 , Humans , Pandemics , SARS-CoV-2
12.
Romanian Journal of Information Science and Technology ; 23:S91-S105, 2020.
Article | WHO COVID | ID: covidwho-599053

ABSTRACT

A beta coronavirus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified recently. This virus caused pneumonia of unknown etiology and is named as Coronavirus Disease 2019 (COVID-19). The disease is novel and hence no medicine to cure the infected patients is available. The only way to control the pandemic is by breaking the chain of the virus. The chain can be broken by massive diagnosis and social distancing. Radiological examinations, included computed tomography is identified as an effective way for disease diagnosis. CT and Chest X-ray images are considered to be an effective way for making clinical decisions. The X-ray facility is available even in the remotest parts and thus X-ray images can be easily acquired for patients. These images can help in prevention of infection, diagnosis and control. In this paper, an initial investigation report on the various aspects of COVID-19 is presented. An automated method for diagnosis of COVID-19 from X-ray images is proposed. The proposed model is based on XceptionNet that uses depth wise separable convolutions. The results obtained from the proposed model have high accuracy. The proposed method is compared with four other state of the art methods. The comparative study reveals that the proposed method performs better than the existing methods. Thus the method can be effectively used for diagnosis of the novel coronavirus.

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