ABSTRACT
Background: Patients with cancer are at a higher risk of getting infected with the severe acute respiratory syndrome coronavirus 2 owing to their immunocompromised state. Providing care to these patients amidst the first wave of the coronavirus disease-2019 (COVID-19) pandemic was extremely challenging. Objective(s): This study was aimed at evaluating the clinical profile and disease-related outcomes of pediatric patients with hematological illnesses and cancer. Material(s) and Method(s): This retrospective study was conducted at a tertiary care center in North India during the first wave of the pandemic from March 2020 to December 2020. Children aged up to 18 years, who were treated for a hematological illness or malignancy or underwent hematopoietic stem cell transplantation (HSCT) and tested positive for COVID-19 regardless of symptoms were included in the study. Baseline demographic data related to the age, diagnosis, treatment status, and chemotherapy protocol used were collected. Outcomes including the cure rates, comorbidities, and sequelae were recorded. Result(s): A total of 650 tests for COVID-19 were performed for 181 children;22 patients were found to be COVID-19 positive. The most common diagnosis was acute leukemia (63.6%). None of the patients developed COVID-19 pneumonia. The majority of patients had asymptomatic infection and were managed at home. Among those with a symptomatic infection, the most common symptoms were fever and cough. A total of 3 (13.6%) patients needed oxygen therapy, one developed multisystem inflammatory syndrome of children leading to cardiogenic shock. Three patients required intensive care or respiratory support;all the patients had favorable clinical outcomes. The median time from the onset of COVID-19 to a negative result on the reverse transcription-polymerase chain reaction test was 21.3 days. Cancer treatment was modified in 15 patients (68.2%). Conclusion(s): Our results suggest that children with hemato-oncological illnesses rarely experience severe COVID-19 disease. The impact of the first wave of COVID-19 primarily manifested as disruptions in the logistic planning and administration of essential treatment to these children rather than COVID-19 sequelae.Copyright © 2021 Cancer Research, Statistics, and Treatment Published by Wolters Kluwer - Medknow.
ABSTRACT
Background: Myasthenia gravis is an autoimmune neuromuscular junction disorder characterized by fatigable muscle weakness and autoantibodies. Frequent associations exist between myasthenia gravis and thymic abnormalities, including hyperplasia and thymoma. Several autoimmune illnesses have been identified to be associated with thymoma; however, a few case reports have linked thymoma and achalasia, and the underlying mechanism is unknown. Case report: A 43-year-old man with thymoma-associated myasthenia gravis presented with dysphagia that was refractory to conventional treatment of myasthenia gravis. This dysphagia was challenging to diagnose even after multiple gastroenterology consults and upper endoscopy. The diagnosis of achalasia type II was established after a comprehensive evaluation, including upper endoscopy, barium swallow, and high-resolution esophageal manometry. The patient underwent elective pneumatic balloon dilatation, which successfully alleviated his dysphagia. Conclusion: This case confirmed the association between myasthenia gravis secondary to thymoma and achalasia and showed how the diagnosis of achalasia was challenging. Awareness of this association is crucial for early diagnosis and treatment, improving affected patients' quality of life.
ABSTRACT
Background This systematic review and meta-analysis aimed to investigate the radiological predictors of post- coronavirus disease 19 (COVID-19) pulmonary fibrosis and incomplete absorption of pulmonary lesions. Method We systematically searched PubMed, EMBASE, and Web of Science for studies reporting the predictive value of radiological findings in patients with post-COVID-19 lung residuals published through November 11, 2022. The pooled odds ratios with a 95% confidence interval (CI) were assessed. The random-effects model was used due to the heterogeneity of the true effect sizes. Results We included 11 studies. There were 1777 COVID-19-positive patients, and 1014 (57 %) were male. All studies used chest computed tomography (CT) as a radiologic tool. Moreover, chest X-ray (CXR) and lung ultrasound were used in two studies, along with a CT scan. CT severity score, Radiographic Assessment of Lung Edema score (RALE), interstitial score, lung ultrasound score (LUS), patchy opacities, abnormal CXR, pleural traction, and subpleural abnormalities were found to be predictors of post-COVID-19 sequels. CT severity score (CTSS) and consolidations were the most common predictors among included studies. Pooled analysis revealed that pulmonary residuals in patients with initial consolidation are about four times more likely than in patients without this finding (OR: 3.830;95% CI: 1.811-8.102, I2: 4.640). Conclusion Radiological findings can predict the long-term pulmonary sequelae of COVID-19 patients. CTSS is an important predictor of lung fibrosis and COVID-19 mortality. Lung fibrosis can be diagnosed and tracked using the LUS. Changes in RALE score during hospitalization can be used as an independent predictor of mortality.
ABSTRACT
BACKGROUND: This prospective follow-up study aimed to determine the temporal changes in respiratory outcomes over 6 months period in patients with and without cancer hospitalized for severe COVID-19 and to determine the associated risk factors based on admission viral load. METHODS: All adult patients hospitalized with a confirmed diagnosis of severe SARS-CoV-2 infection were investigated using rRT-PCR on nasopharyngeal swab specimens. Patients were divided into three arbitrary groups according to their cycle threshold (CT) values obtained at admission as high (CT<25.0), medium (CT between 25.0 and 30.0), and low (CT>30.0) viral load. Patients had pulmonary function tests, chest high-resolution computed tomography (HRCT), and a 6-minute walking time distance measured at each follow-up visit. RESULTS: This follow-up study had a total of 112 participants, of which 75 were cancer-free and 37 had active cancer. Overall, 29.5% had a low viral load, compared to 48.2% who had a high viral load, and 22.3% had a medium viral load. For patients who did not have cancer, the mean age was 57.3 (SD 15.4) and for those who had cancer, it was 62.3 (SD 18.4). Most patients had overall better temporal changes in pulmonary function and tolerance, as well as exercise capacity, even though severe and chronic respiratory abnormalities persisted in a fraction of the patients. In patients without cancer who had a high viral load, we have seen a substantial reduction in diffusion capacity of the lungs for carbon monoxide (DLCO) predicted value with a median of 65 (IQR 63-70) while in patients with cancer, it was 60 (IQR 56-67) at 2 months. At 4 and 6 months, the predicted DLCO values for patients without cancer were 65 (IQR 61-70), whereas the predicted DLCO values for patients with active cancer were 62 (IQR 60-67) and 67 (59-73). Importantly, radiological abnormalities persisted in 22 (29%) non-cancer patients and 16 (43%) cancer patients. Multivariate regression analysis showed an increased odds ratio of impaired HRCT associated with a high viral load of 3.04 (95% CI:1.68-6.14; p < 0.001) for patients without cancer and 5.07 (95% CI: 4.04-10.8; p < 0.0001) for patients with cancer. The CT pneumonia score at hospitalization was 2.25 (95% CI:1.76-3.08; p = 0.041) and 2.85 (95% CI:1.89-5.14; p = 0.031) for non-cancer and cancer patients respectively. CONCLUSIONS: The evidence of persistent pulmonary abnormalities and radiographic changes was found in both patient groups who had high viral load at hospital admission and suggesting that SARS-CoV-2 viral load might serve as a useful indicator to predict the development of respiratory complications in patients with COVID-19.
Subject(s)
COVID-19 , Neoplasms , Adult , Humans , Middle Aged , SARS-CoV-2 , Follow-Up Studies , Prospective Studies , Viral Load , Hospitalization , Neoplasms/complicationsABSTRACT
The early diagnosis of coronavirus disease 2019 (COVID-19) is one of the crucial points in order to reduce virus spread, also containing morbidity and mortality of the pandemic. Despite the utility of specific molecular tests (such as real time polymerase chain reaction, RT-PCR), imaging is considered one of the key strategies for an early diagnostic typing of the disease, and to individualize patient management [1-3]. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
ABSTRACT
Tinospora cordifolia herbal supplements have recently gained prominence due to their promising immunomodulatory and anti-viral effects against SARS-CoV-2. Mislabelling or diluting Tinospora supplements for profit may harm public health. Thus, validating the label claim of these supplements in markets is critical. This study investigated how high resolution mass spectrometry-based metabolomics and chemometrics can be used to distinguish Tinospora cordifolia from two other closely related species (T. crispa and T. sinensis). The Orthogonal Partial Least Square Discriminant Analysis (OPLS-DA) and PLS-DA based chemometric models predicted the species identity of Tinospora with 94.44% accuracy. These classification models were trained using 54 T. cordifolia, 21 T. crispa, and 21 T. sinensis samples. We identified 7 biomarkers, including corydine, malabarolide, ecdysterone, and reticuline, which discriminated Tinospora cordifolia from the two other species. The label claim of 25 commercial Tinospora samples collected from different parts of India was verified based on the relative abundance of the biomarker compounds, of which 20 were found authentic. The relative abundance of biomarkers significantly varied in the 5 suspicious market samples. This pilot study demonstrates a robust metabolomic approach for authenticating Tinospora species, which can further be used in other herbal matrices for product authentication and securing quality. © 2023 Elsevier B.V.
ABSTRACT
Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses a considerable threat to global public health. This study developed and evaluated a rapid, low-cost, expandable, and sequencing-free high-resolution melting (HRM) assay for the direct detection of SARS-CoV-2 variants. A panel of 64 common bacterial and viral pathogens that can cause respiratory tract infections was employed to evaluate our method's specificity. Serial dilutions of viral isolates determined the sensitivity of the method. Finally, the assay's clinical performance was assessed using 324 clinical samples with potential SARS-CoV-2 infection. Multiplex HRM analysis accurately identified SARS-CoV-2 (as confirmed with parallel reverse transcription-quantitative PCR [qRT-PCR] tests), differentiating between mutations at each marker site within approximately 2 h. For each target, the limit of detection (LOD) was lower than 10 copies/reaction (the LOD of N, G142D, R158G, Y505H, V213G, G446S, S413R, F486V, and S704L was 7.38, 9.72, 9.96, 9.96, 9.50, 7.80, 9.33, 8.25, and 8.25 copies/reaction, respectively). No cross-reactivity occurred with organisms of the specificity testing panel. In terms of variant detection, our results had a 97.9% (47/48) rate of agreement with standard Sanger sequencing. The multiplex HRM assay therefore offers a rapid and simple procedure for detecting SARS-CoV-2 variants. IMPORTANCE In the face of the current severe situation of increasing SARS-CoV-2 variants, we developed an upgraded multiplex HRM method for the predominant SARS-CoV-2 variants based on our original research. This method not only could identify the variants but also could be utilized in subsequent detection of novel variants since the assay has great performance in terms of flexibility. In summary, the upgraded multiplex HRM assay is a rapid, reliable, and economical detection method, which could better screen prevalent virus strains, monitor the epidemic situation, and help to develop measures for the prevention and control of SARS-CoV-2.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , SARS-CoV-2/genetics , COVID-19/diagnosis , Sensitivity and Specificity , Polymerase Chain ReactionABSTRACT
Background: Evidence of COVID-19 respiratory sequels is restricted and predisposing factors are not well studied more than two years passing pandemic. This study followed COVID-19 patients 12 weeks after discharge from hospital for respiratory sequels. Material(s) and Method(s): This was a prospective study on discharged COVID-19 patients in 2021, in Jahrom, Iran. Exposure was COVID-19 clinical features at hospitalization, including symptoms and physical examination and laboratory findings, and primary endpoint was 12-week lung sequel, being evaluated by a chest CT scan. Demographics and previous medical history were considered covariates. SPO2and CRP 6-week changes were followed as an early tool for prediction of 12-week lung sequel. Result(s): Totally, 383 participants (17 had sequels) with mean age of 57.43 18.03 years old (50.13% male) completed 12-week study follow-ups. Ninety-one (23.8%) subjects had an ICU admission history. SPO2% in 6th week was statistically significantly associated with a higher rate of 12-week sequelae (p<0.001). Also, patients having CT scan scores between 40% to 50% (p=0.012) and higher than 50% (p=0.040) had higher chance of experiencing lung sequelae than patients with CT scan score of below 40%, as well as having ICU admission history and lower SPO2% at 6th week of discharge. There was a statistically significant increasing trend of SPO2% (P<0.001) and a statistically significant decreasing trend of CRP levels (P<0.001), overall. SPO2% increase after 6 weeks was lower in participants with lung sequels than fully improved ones (P=0.002) and as well as total 12-week change in SPO2% (P=0.001). CRP changes in none of evaluated periods were different among study groups (P>0.05). Conclusion(s): Our results were in favor of closely following SPO2levels after patient discharge, while CRP assessment seems not helpful based on our results [GMJ.2023;12:e2695].Copyright © 2023 Shiraz University of Medical Sciences. All rights reserved.
ABSTRACT
In recent years, on-site visitation has been strictly restricted in many scenic areas due to the global spread of the COVID-19 pandemic. "Cloud tourism”, also called online travel, uses high-resolution photographs taken by unmanned aerial vehicles (UAVs) as the dominant data source and has attracted much attention. Due to the differences between ground and aerial observation perspectives, the landscape elements that affect the beauty of colored-leaved forests are quite different. In this paper, Qixia National Forest Park in Nanjing, China, was chosen as the case study area, and the best viewpoints were selected by combining tourists' preferred viewing routes with a field survey, followed by a scenic beauty evaluation (SBE) of the forests with autumn-colored leaves in 2021 from the aerial and ground perspectives. The results show that (1) the best viewpoints can be obtained through the spatial overlay of five landscape factors: elevation, surface runoff, slope, aspect, and distance from the road;(2) the dominant factors influencing the beauty of colored-leaved forests from the aerial perspective are terrain changes, forest coverage, landscape composition, landscape contrast, the condition of the human landscape, and recreation frequency;and (3) the beauty of the ground perspective of the colored-leaved forests is strongly influenced by the average diameter at breast height (DBH), the dominant color of the leaves, the ratio of the colored-leaved tree species, the canopy width, and the fallen leaf coverage. The research results can provide scientific reference for the creation of management measures for forests with autumn-colored leaves. © 2023 by the authors.
ABSTRACT
Background. Interstitial lung disease (ILD) is the common internal organ manifestation of idiopathic inflammatory myopathies (IIM) that can severely affect the course and prognosis of the disease. Rituximab (RTX) has been used to treat IIM, including variants with ILD. Objectives. To describe the course of disease in IIM patients with ILD, treated with RTX in long-term follow-up. Methods. Our prospective study included 35 pts with IIM fulfilling Bohan and Peter criteria and having ILD. The mean age was 51.8+/-11.9 years, female-26 pts (74%);24 (68.5%) with antisynthetase syndrome, 5 (14.3%) dermatomyositis (DM), 5 (14.3%) with a-Pm/Scl overlap myositis and 1 (2,9%) with a-SRP necrotizing myopathy were included. 25 (71,4% ) patients had nonspecific interstitial pneumonia, 9 (25,7%) organizing pneumonia (OP) and 1 (2,9%) OP, transformed to diffuse alveolar damage. All pts had the standard examination including manual muscle testing (MMT), creatinkinase (CK) anti-Jo-1 antibodies (anti-Jo-1) assay;forced vital capacity (FVC) and carbon monoxide diffusion capacity (DLCO) evaluation as well as high-resolution computed tomography (HRCT) scanning of the chest were performed at baseline, and 36 and more months. The median disease duration was 3.2 [0.16-18] years, 21 (60%) of pts were positive for a-Jo-1 antibody. All pts received prednisolone at a mean dose of 24.3+/-13 mg/day, immunosupressants at inclusion received 25 (71%) pts: cyclophosphamide 18 , mycophenolate mofetil 6 and comdination 1;Rituximab (RTX) was administered in case of severe course of disease and intolerance or inadequate response to GC and other immunosuppressive drugs. Results. The mean follow-up period after the first infusion of RTX was 47.2+/-11.9 months. Pts received 1-11 courses of RTX . The cumulative mean dose of RTX was 4.6 +/-2.5g. MMT 8 increased from 135.8+/-13.5 to 148.75+/-3.5 (p=0.000001). CK level decreased DELTACK - 762 u/l(median 340;25th% 9;75th% 821). anti-Jo-1 decreased from 173.4+/-37 to 96.5+/-79 u/ml (p=0.00002), FVC increased from 82+/-22.6 to 96,9+/-22% (p=0.00011). DLCO increased from 51.4+/-15.2 to 60+/-77.8% (p=0.0001). The mean prednisone dose was reduced from 24.3+/-13 to 5.7+/-2.4 mg/day. 3 pts died: ILD progression was the cause of death in 1 case, 1 bacterial pneumonia and COVID19 pneumonia. Conclusions. The results of this study confirm the positive effect of RTX in IIM patients with ILD (increase of muscle strength and improve lung function, decrease in anti-Jo-1 levels) and also its good steroid-sparing effect. RTX could be considered as an effective drug for the complex therapy of IIM patients with ILD when standard therapy is ineffective or impossible.
ABSTRACT
This research work is carried out to quantify the COVID-19 disease and to explore whether the quantitative can be used to analyze the survivability of the patient during admission. In this method, a novel percentage split distribution (PSD), thresholding-based image segmentation method is proposed to quantify normal and lesion regions by analyzing the benign GGOs. The method segments the lung-CT image based on pixel distribution. The segmented regions are quantified as a fraction of region of interest with total number of pixels. The study is also extended to analyze the left and right lungs separately with some common findings on lesion distribution involved with COVID-19 disease. The performance of PSD method has been compared with two traditional image segmentation-based methods. From the results, it has been observed that the segments created by the PSD method are better than experimental methods and clearly identify the margins of lesion and normal regions. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
ABSTRACT
PurposeCarbon trading mechanism has been adopted to foster the green transformation of the economy on a global scale, but its effectiveness for the power industry remains controversial. Given that energy-related greenhouse gas emissions account for most of all anthropogenic emissions, this paper aims to evaluate the effectiveness of this trading mechanism at the plant level to support relevant decision-making and mechanism design.Design/methodology/approachThis paper constructs a novel spatiotemporal data set by matching satellite-based high-resolution (1 × 1 km) CO2 and PM2.5 emission data with accurate geolocation of power plants. It then applies a difference-in-differences model to analyse the impact of carbon trading mechanism on emission reduction for the power industry in China from 2007 to 2016.FindingsResults suggest that the carbon trading mechanism induces 2.7% of CO2 emission reduction and 6.7% of PM2.5 emission reduction in power plants in pilot areas on average. However, the reduction effect is significant only in coal-fired power plants but not in gas-fired power plants. Besides, the reduction effect is significant for power plants operated with different technologies and is more pronounced for those with outdated production technology, indicating the strong potential for green development of backward power plants. The reduction effect is also more intense for power plants without affiliation relationships than those affiliated with particular manufacturers.Originality/valueThis paper identifies the causal relationship between the carbon trading mechanism and emission reduction in the power industry by providing an innovative methodology for identifying plant-level emissions based on high-resolution satellite data, which has been practically absent in previous studies. It serves as a reference for stakeholders involved in detailed policy formulation and execution, including policymakers, power plant managers and green investors.
ABSTRACT
We have been effectively protected by disposable propylene face masks during the COVID-19 pandemic; however, they may pose health risks due to the release of fine particles and chemicals. We measured micro/nanoparticles and organic chemicals in disposable medical masks, surgical masks, and (K)N95 respirators. In the breathing-simulation experiment, no notable differences were found in the total number of particles among mask types or between breathing intensities. However, when considering subranges, <2.5 µm particles accounted for â¼90% of the total number of micro/nanoparticles. GC-HRMS-based suspect screening tentatively revealed 79 (semi)volatile organic compounds in masks, with 18 being detected in ≥80% of samples and 44 in ≤20% of samples. Three synthetic phenolic antioxidants were quantified, and AO168 reached a median concentration of 2968 ng/g. By screening particles collected from bulk mask fabrics, we detected 18 chemicals, including four commonly detected in masks, suggesting chemical partition between the particles and the fabric fibers and chemical exposure via particle inhalation. These particles and chemicals are believed to originate from raw materials, intentionally and nonintentionally added substances in mask production, and their transformation products. This study highlights the need to study the long-term health risks associated with mask wearing and raises concerns over mask quality control.
Subject(s)
COVID-19 , Nanoparticles , Humans , COVID-19/prevention & control , Masks , Polypropylenes , Pandemics/prevention & controlABSTRACT
BACKGROUND: Chest high-resolution computed tomography (HRCT) is mandatory for patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a high respiratory rate (RR) because sublobar consolidation is the likely pathological pattern in addition to ground glass opacities (GGOs). OBJECTIVE: The present study determined the correlation between the percentage extent of typical pulmonary lesions on HRCT, as a representation of severity, and the RR and peripheral oxygen saturation level (SpO2), as measured through pulse oximetry, in patients with reverse transcriptase polymerase chain reaction (RT-PCR)-confirmed primary (noncomplicated) SARS-CoV-2 pneumonia. METHODS: The present retrospective study was conducted in 332 adult patients who presented withzdyspnea and hypoxemia and were admitted to Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia between May 15, 2020 and December 15, 2020. All the patients underwent chest HRCT. Of the total, 198 patients with primary noncomplicated SARS-CoV-2 pneumonia were finally selected based on the typical chest HRCT patterns. The main CT patterns, GGO and sublobar consolidation, were individually quantified as a percentage of the total pulmonary involvement through algebraic summation of the percentage of the 19 pulmonary segments affected. Additionally, the statistical correlation strength between the total percentage pulmonary involvement and the age, initial RR, and percentage SpO2 of the patients was determined. RESULTS: The mean ± standard deviation (SD) age of the 198 patients was 48.9 ± 11.4 years. GGO magnitude alone exhibited a significant weak positive correlation with patients' age (r = 0.2; p = 0.04). Sublobar consolidation extent exhibited a relatively stronger positive correlation with RR than GGO magnitude (r = 0.23; p = 0.002). A relatively stronger negative correlation was observed between the GGO extent and SpO2 (r = - 0.38; p = 0.002) than that between sublobar consolidation and SpO2 (r = - 0.2; p = 0.04). An increase in the correlation strength was demonstrated with increased case segregation with GGO extent (r = - 0.34; p = 0.01). CONCLUSION: The correlation between the magnitudes of typical pulmonary lesion patterns, particularly GGO, which exhibited an incremental correlation pattern on chest HRCT, and the SpO2 percentage, may allow the establishment of an artificial intelligence program to differentiate primary SARS-CoV-2 pneumonia from other complications and associated pathology influencing SpO2.
ABSTRACT
Introduction: Patients who were affected by severe SARS-CoV2 pneumonia are now presenting respiratory sequelae. High resolution CT (HRCT) offers information about the evolution of the disease and its possible progression in form of pulmonary fibrosis. Aim(s): To assess the radiological findings during 1-year follow-up in patients affected by severe SARS-CoV-2 pneumonia, to determine the incidence of pulmonary fibrosis and its possible risk factors. Method(s): A prospective cohort study was conducted at Dr. Josep Trueta Hospital and Santa Caterina Hospital, including patients with severe SARS-CoV-2 pneumonia hospitalized at the Pulmonology service between March and June 2020. A 1-year follow-up was done, with controls in the 3rd and 6th months. We analysed clinical data, radiological findings, quality of life, grade of dyspnoea, pulmonary function testing and exercise capacity. Pulmonary fibrosis was defined by traction bronchiectasis/bronchiolectasis, pulmonary distortion or honeycomb pattern. Result(s): 94 patients were analysed. In a year span, 47.9% of HRCT were pathological, showing pulmonary fibrosis in 25.8% of them. Ground-glass opacities (GGO) were found in 66.5% of HRCT at the 3rd month, showing an improvement at the 6th month and a practical resolution at the 12th month. However, the fibrotic disease remained stable from the 6th month. The multivariant analysis showed a significant major incidence of pulmonary fibrosis among elderly patients. Conclusion(s): A practical resolution of the GGO is seen in most patients at the 6th month. Up to a quarter of patients develop fibrotic changes at the 1-year follow-up, however it remains stable from the 6th month onwards. Old age would be considered as a risk factor.
ABSTRACT
Background: Coronavirus disease (COVID-19) is a recently prevalent infectious disease that is caused by a virus from the coronavirus family and causes acute respiratory syndrome. It is a pandemic catastrophe that has affected more than 60 million people around the world and has caused about 1.5 million deaths, as reported by the WHO. This disease affects the respiratory system and leads to different forms of symptoms and signs. Pneumonia is a common cause for hospitalization, with most patients treated in hospital wards and others requiring ICU. Although the number of complete recoveries from COVID-19 has increased, there is still concern about complications associated with the disease that appear after recovery. The studies that have looked at past types and other forms of coronavirus epidemics, such as SARS have shown that some cases had respiratory complications from the infection after being full recovered, as 36 and 30% of the entire study population had clinical and high-resolution computed tomography (HRCT) changes at 3 and 6 months after recovery, respectively. Mostly, the abnormalities seen in pulmonary function test (PFT) results are sequelae of diffusion capacity defect. In recovered cases of Middle East respiratory syndrome, 36% of patients showed HRCT sequelae at follow-up of 6 weeks, because of fibrosis. Data on COVID-19 indicate that prolonged disease and persistent symptoms show post-PFT affection and follow-up radiographic changes after recovery from COVID-19 as interstitial pulmonary changes and a degree of pulmonary vasculopathy. In recovered cases of COVID-19, capacity of diffusion is the commonest defect in lung function, followed by the restrictive pattern defects on spirometry;both are related to the degree of severity of pneumonic COVID-19. PFTs (involving spirometry as well as diffusion capacity) are considered as routine follow-up examinations for some of the recovered cases, especially severe cases. Rehabilitation programs of the respiratory system are an option strategy that might be considered. This study aims to show changes in pulmonary function and HRCT of chest in post-COVID-19-infected patients to detect long-term effects on the lungs after 3 months as obstructive or restrictive, or both, lung diseases. Patients and Methods: The study was conducted on 100 confirmed PCR-positive COVID-19 cases that were admitted to Ain Shams University Isolation Hospitals, and the follow-up was performed in the outpatient clinic. PCR samples (Combined nasopharyngeal and oropharyngeal swab) were taken after 3 months from discharge of patients above the age of 18 years who become negative with clinical improvement. PFT [spirometry and diffusion for carbon monoxide (DLCO)] and chest HRCT were done. All patients' clinical data were recorded, and CT chest imaging data of these patients were correlated with the clinical data. Result(s): A total of 100 patients were included in this study, where males represented 58% and female represented 42%. The mean+/-SD age of cases in this study was 45.05 +/- 11.80 years and ranged from 20 to 79 years. CT chest severity score (SS) of abnormality in COVID-19-infectedd patients based on HRCT chest findings before and after 3 months from treatment showed a highly significant correlation (P=0.000). The results of PFT in the studied group after 3 months of discharge showed restrictive pattern in 14.9%, obstructive pattern in 17.8%, and both obstructive and restrictive patterns in 5.9% of the total number of cases. There was a significant correlation between DLCO abnormality findings and age of studied group (P=0.032), a significant correlation between abnormality findings on PFT and HRCT chest SS after discharge of the studied group (P0.001). There was a significant correlation between abnormality findings of DLCO and HRCT chest SS after 3 months of the studied group (P=0.000) and before treatment (P=0.001), whereas there was no significant correlation between other findings of PFT and HRCT chest SS after 3 months and before. There was a significant correlation between H
ABSTRACT
Background: Despite recovery from COVID-19,concern remains that some organs, including the lungs, might have long-term impairment following infection. Aim(s): Assess symptoms,pulmonary function,exercise capacity and chest HRCT changes in non-intubated patients hospitalised with severe COVID19 pneumonia at 3months. Method(s): In this prospective,longitudinal study,patients admitted to hospital for severe COVID19 who did not require mechanical ventilation were prospectively followed up at 3months after discharge from respiratory department Rabta Hospital of Tunis. During the follow-up,patients were interviewed and underwent pulmonary function tests(PFT),chest high-resolution CT(HRCT)and 6-min walk distance test(6MWT). PFT included:diffusing capacity of the lungs for carbon monoxide (DLCO);forced vital capacity(FVC);forced expiratory volume in 1 second (FEV1) and total lung capacity (TLC). Result(s): Between June 1st, and august 31, 2021;47 patients (mean age 56 +/- 12 years;sex ratio 0.74)were included. At 3 months, the most common persistent symptoms were dyspnea(78.7%),cough(46.8%),fatigue(36.2%) and anxiety(17%). Abnormal HRCT findings were pulmonary fibrosis (4%),ground glass opacities(42.5%) and consolidation(32%). Median FVC, FEV1 and TLC were respectively 97% (53-119%), 87.5% (30-120%) and 87% (72- 127%). DLCO was below the lower limit of normal in 12.7% of patients. During 6MWT, the average walked distance was 480 meters [120-680];22 patients (46.8%) showed reduced physical capacity. Conclusion(s): At 3 months after severe COVID pneumonia,a substantial number of patients still have respiratory symptoms with radiological and functional impairment. A long-term monitoring is mandatory.
ABSTRACT
To assess risk factors for COVID-19 transmission and address the closure of mass gathering events since March 2020, the UK Government ran the Events Research Programme (ERP), following which it reopened live events in sports, music, and culture in July 2021. We report the rapid post-occupancy evaluation of Indoor Air Quality (IAQ) and associated long-range airborne transmission risk conducted in the Environmental Study of the ERP. Ten large venues around the UK were monitored with CO2 sensors at a high spatial and temporal resolution during 90 events. An IAQ Index based on CO2 concentration was developed, and all monitored spaces were classified in bands from A to G based on their average and maximum CO2 concentrations from all events. High resolution monitoring and the IAQ Index depicted the overall state of ventilation at live events, and allowed identification of issues with ventilation effectiveness and distribution, and of spaces with poor ventilation and the settings in which long-range airborne transmission risk may be increased. In numerous settings, CO2 concentrations were found to follow patterns relating to event management and specific occupancy of spaces around the venues. Good ventilation was observed in 90% of spaces monitored for given occupancies. Practical applications: High-resolution monitoring of indoor CO2 concentrations is necessary to detect the spatial variation of indoor air quality (IAQ) in large mass gathering event venues. The paper summarises COVID-19 ventilation guidance for buildings and defines a methodology for measurement and rapid assessment of IAQ during occupancy at live events that can be implemented by venue managers. Comparisons of the CO2 concentrations measured during the events identified the spaces at high risk of long-range transmission of airborne pathogens. Building operators should be mindful of the ventilation strategies used relative to the total occupancy in different spaces and the occupant's activities.
ABSTRACT
Pulmonary artery pseudoaneurysms (PAPs) are uncommon entities consisting of contained rupture of the pulmonary artery and are a potentially fatal cause of hemoptysis. We describe two index cases of left lower lobe PAPs and arterial ectasia post-COVID-19 pneumonitis and their endovascular treatment with Amplatzer vascular plug, coils, and glue.Copyright © 2022. Indian Society of Vascular and Interventional Radiology. All rights reserved.