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1.
PLoS One ; 15(11): e0237799, 2020.
Article in English | MEDLINE | ID: covidwho-1833518

ABSTRACT

OBJECTIVE: The occurrence of pneumonia separates severe cases of COVID-19 from the majority of cases with mild disease. However, the factors determining whether or not pneumonia develops remain to be fully uncovered. We therefore explored the associations of several lifestyle factors with signs of pneumonia in COVID-19. METHODS: Between May and July 2020, we conducted an online survey of 201 adults in Germany who had recently gone through COVID-19, predominantly as outpatients. Of these, 165 had a PCR-based diagnosis and 36 had a retrospective diagnosis by antibody testing. The survey covered demographic information, eight lifestyle factors, comorbidities and medication use. We defined the main outcome as the presence vs. the absence of signs of pneumonia, represented by dyspnea, the requirement for oxygen therapy or intubation. RESULTS: Signs of pneumonia occurred in 39 of the 165 individuals with a PCR-based diagnosis of COVID-19 (23.6%). Among the lifestyle factors examined, only overweight/obesity was associated with signs of pneumonia (odds ratio 2.68 (1.29-5.59) p = 0.008). The observed association remained significant after multivariate adjustment, with BMI as a metric variable, and also after including the antibody-positive individuals into the analysis. CONCLUSIONS: This exploratory study finds an association of overweight/obesity with signs of pneumonia in COVID-19. This finding suggests that a signal proportional to body fat mass, such as the hormone leptin, impairs the body's ability to clear SARS-CoV-2 before pneumonia develops. This hypothesis concurs with previous work and should be investigated further to possibly reduce the proportion of severe cases of COVID-19.


Subject(s)
COVID-19/complications , Life Style , Obesity/complications , Pneumonia/complications , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Comorbidity , Female , Humans , Male , Middle Aged , Pandemics , Surveys and Questionnaires , Young Adult
2.
Acta Inform Med ; 29(1): 45-50, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1811118

ABSTRACT

BACKGROUND: Since December 2019. millions of people in the world have been affected with the novel Coronavirus disease-2019 (COVID-19) pandemic, and high economic impact has affect many countries especially low socioeconomic one like Iraq due to the high cost and limited availability of RT-PCR for diagnosis of COVID-19, so there should be predictive low cost easily available laboratory tests that can be used before proceeding to the high cost techniques. OBJECTIVE: In this retrospective study we aimed to evaluate the diagnostic accuracy of CRP, ferritin, LDH and D-dimer in predicting positive cases of COVID-19 in Iraq. METHODS: It is a retrospective observational cohort study based on STARD guidelines to determine the diagnostic accuracy of (CRP, LDH, ferritin and D dimer) for COVID-19 of electronic medical records of private medical center in Najaf city, at which 566 individuals were recruited. The investigated subjects were either in close contact with previously COVID-19 positive patients or have one or more symptoms of COVID-19. They were categorized into 2 groups, 205 subjects diagnosed with RT-PCR as COVID-19 negative, and 361 COVID-19 positive patients, results of study variables of the cohort were recruited from the medical records. RESULTS: Combining of these parameters had the following findings: CRP + ferritin; AUC: 0.77 with 55% sensitivity and 97% specificity, Ferritin + LDH; AUC: 0.83 with 65% sensitivity and 92% specificity, CRP+LDH; AUC: 0.78 with 56% sensitivity and 98% specificity, CRP + LDH + ferritin; AUC: 0.85, with 73% sensitivity and 88% specificity, CRP + LDH + ferritin + D dimer; AUC: 0.85 75% sensitivity and 87% specificity. CONCLUSION: Combination of routine laboratory biomarkers (CRP, LDH and ferritin ±D dimer) can be used to predict the diagnosis of COVID-19 with an accepted sensitivity and specificity before proceeding to definitive diagnosis by RT-PCR.

3.
J Med Internet Res ; 23(2): e26107, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1574541

ABSTRACT

BACKGROUND: Changes in autonomic nervous system function, characterized by heart rate variability (HRV), have been associated with infection and observed prior to its clinical identification. OBJECTIVE: We performed an evaluation of HRV collected by a wearable device to identify and predict COVID-19 and its related symptoms. METHODS: Health care workers in the Mount Sinai Health System were prospectively followed in an ongoing observational study using the custom Warrior Watch Study app, which was downloaded to their smartphones. Participants wore an Apple Watch for the duration of the study, measuring HRV throughout the follow-up period. Surveys assessing infection and symptom-related questions were obtained daily. RESULTS: Using a mixed-effect cosinor model, the mean amplitude of the circadian pattern of the standard deviation of the interbeat interval of normal sinus beats (SDNN), an HRV metric, differed between subjects with and without COVID-19 (P=.006). The mean amplitude of this circadian pattern differed between individuals during the 7 days before and the 7 days after a COVID-19 diagnosis compared to this metric during uninfected time periods (P=.01). Significant changes in the mean and amplitude of the circadian pattern of the SDNN was observed between the first day of reporting a COVID-19-related symptom compared to all other symptom-free days (P=.01). CONCLUSIONS: Longitudinally collected HRV metrics from a commonly worn commercial wearable device (Apple Watch) can predict the diagnosis of COVID-19 and identify COVID-19-related symptoms. Prior to the diagnosis of COVID-19 by nasal swab polymerase chain reaction testing, significant changes in HRV were observed, demonstrating the predictive ability of this metric to identify COVID-19 infection.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , COVID-19/physiopathology , Heart Rate/physiology , Wearable Electronic Devices , Adult , COVID-19/virology , Circadian Rhythm/physiology , Female , Health Personnel , Humans , Male , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification
4.
Rev Med Virol ; 31(6): e2215, 2021 11.
Article in English | MEDLINE | ID: covidwho-1573992

ABSTRACT

The novel coronavirus disease-2019 (Covid-19) public health emergency has caused enormous loss around the world. This pandemic is a concrete example of the existing gap between availability of advanced diagnostics and current need for cost-effective methodology. The advent of the loop-mediated isothermal amplification (LAMP) assay provided an innovative tool for establishing a rapid diagnostic technique based on the molecular amplification of pathogen RNA or DNA. In this review, we explore the applications, diagnostic effectiveness of LAMP test for molecular diagnosis and surveillance of severe acute respiratory syndrome coronavirus 2. Our results show that LAMP can be considered as an effective point-of-care test for the diagnosis of Covid-19 in endemic areas, especially for low- and middle-income countries.


Subject(s)
COVID-19 Nucleic Acid Testing/methods , COVID-19/diagnosis , Molecular Diagnostic Techniques/methods , Nucleic Acid Amplification Techniques/methods , Point-of-Care Testing/organization & administration , SARS-CoV-2/genetics , Bibliometrics , COVID-19/epidemiology , COVID-19/pathology , COVID-19/virology , COVID-19 Nucleic Acid Testing/economics , COVID-19 Nucleic Acid Testing/instrumentation , Humans , Molecular Diagnostic Techniques/economics , Molecular Diagnostic Techniques/instrumentation , Nucleic Acid Amplification Techniques/economics , Nucleic Acid Amplification Techniques/instrumentation , Point-of-Care Testing/economics , RNA, Viral/genetics , SARS-CoV-2/pathogenicity , Sensitivity and Specificity
7.
Rev Esp Quimioter ; 33(6): 444-447, 2020 Dec.
Article in Spanish | MEDLINE | ID: covidwho-1390020

ABSTRACT

OBJECTIVE: Co-circulation of the two Influenza B lineages hinders forecast of strain to include in trivalent vaccine. Autonomous Communities such as Cantabria continue without supplying tetravalent vaccine. The aim of this study was to analyse epidemiological characteristics of influenza type B in Cantabria (2019-2020 season) as well as to establish the predominant lineage and its relation to the recommended vaccine. METHODS: Retrospective study whereby flu diagnosis and lineage analysis were determined by RT-PCR. RESULTS: All samples belonged to the Victoria lineage. Most prevalent viral co-infection was due to SARS-CoV-2. The population affected by influenza B was mainly paediatric and non-vaccinated patients more frequently required hospital admittance. CONCLUSIONS: Influenza type B has a higher incidence in the paediatric population and type A affects more the adult population. Only 28.8% of patients with Influenza B that presented with some underlying condition or risk factor were vaccinated. This shows the need to increase coverage with tetravalent vaccines in order to reduce the burden of disease associated with the Influenza B virus.


Subject(s)
COVID-19/epidemiology , Influenza B virus , Influenza, Human/epidemiology , Pandemics , SARS-CoV-2 , Adult , COVID-19/virology , Chi-Square Distribution , Child , Coinfection/epidemiology , Coinfection/virology , Epidemics , Female , Hospitalization/statistics & numerical data , Humans , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Influenza, Human/virology , Male , Retrospective Studies , Seasons , Spain/epidemiology , Statistics, Nonparametric
8.
J Glaucoma ; 30(8): 711-717, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1358502

ABSTRACT

PRECIS: Vascular diseases have been linked to alterations in optic nerve head perfusion. PURPOSE: The main objective was to investigate the changes in peripapillary vessel density (VD) in post coronavirus disease (COVID-19) patients. METHODS: In this prospective pilot exploratory study, patients with COVID-19 that were attended in the Emergency Department of Hospital Clinico San Carlos (Madrid) were included. All patients underwent optic nerve head optical coherence tomography angiography using the Cirrus HD-OCT 500 with AngioPlex OCTA (Zeiss, Dublin, CA) 4 and 12 weeks after diagnosis by positive reverse transcriptase-polymerase chain reaction test from nasopharyngeal swab at the Emergency Department. Sociodemographic data, medical history, disease severity, and laboratory work-up were collected. RESULTS: One hundred and eighty eyes of 90 patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection were included. None of the patients reported visual changes. Severe patients were older, more frequently hispanic, dyslipidemic, and presented lower lymphocytes counts, as well as increased ferritin, D-dimer, fibrinogen, and international normalized ratio levels. No changes in optic nerve head vascularization were observed when both visits were compared. No correlation was found between VD and clinical parameters, disease severity and laboratory work-up. CONCLUSIONS: Changes to peripapillary VD were not observed in patients with COVID-19 in the early months following diagnosis.


Subject(s)
COVID-19 , Optic Disk , Fluorescein Angiography , Humans , Intraocular Pressure , Prospective Studies , Retinal Vessels , SARS-CoV-2 , Tomography, Optical Coherence
9.
J Hosp Infect ; 114: 144-152, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1343269

ABSTRACT

BACKGROUND: In a hospital setting, there is a need for rapid detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to guide isolation measures and targeted admission. AIM: To evaluate the diagnostic performance of five SARS-CoV-2 rapid nucleocapsid protein antigen detection (RAD) assays (Biosynex, Biotical, Orient Gene, Panbio and SD Biosensor), and describe the performance and impact of implementation of the SD Biosensor assay in an emergency department. METHODS: Sensitivity and specificity of the five RAD assays were analysed on 100 respiratory samples: 60 real-time reverse transcriptase polymerase chain reaction (rRT-PCR)-confirmed SARS-CoV-2-positive samples, 24 SARS-CoV-2 RNA-negative samples and 16 samples positive for other respiratory pathogens. The manufacturer's protocol was adapted to validate the antigen tests on transport media used for rRT-PCR in the authors' routine practice. The SD Biosensor RAD assay was implemented as a screening method for rapid diagnosis and targeted admission. FINDINGS: Sensitivity of the five RAD assays ranged from 88.9% to 100% for samples with cycle threshold values <26, and specificity ranged from 46.2% to 100%. During the implementation period, 4195 RAD tests were performed. Due to the rapid RAD result, 157 patients were transferred directly to the coronavirus disease 2019 (COVID-19) cohort ward instead of the regular ward (N=47) or the temporary COVID-19 ward (N=110). CONCLUSION: The SD Biosensor, Biotical and Panbio SARS-CoV-2 antigen tests showed acceptable overall performance, and identified the majority of contagious patients. In the context of high prevalence of SARS-CoV-2, RAD tests can be used as a rapid screening tool to guide infection prevention measures and aid targeted admission.


Subject(s)
Antigens, Viral/isolation & purification , COVID-19 Testing , COVID-19 , COVID-19/diagnosis , COVID-19 Testing/methods , Hospitals , Humans , RNA, Viral , SARS-CoV-2 , Sensitivity and Specificity
10.
J Med Virol ; 93(8): 5182-5187, 2021 08.
Article in English | MEDLINE | ID: covidwho-1298501

ABSTRACT

Infections due to human herpesvirus 6 (HHV-6) are frequent during early childhood. Usually, they have a favorable clinical course. Conversely, HHV-6 congenital infections occur in about 1% of neonates and may present with more severe clinical pictures. HHV-6 can be found in lung tissues and bronchoalveolar lavage (BAL) samples from patients with pneumonia and in immunocompromised patients can cause mild to severe pneumonia. In neonates, the role of HHV-6 in the genesis of severe pneumonia is poorly defined still now. We describe a healthy infant with a late-onset (15 days of life) severe interstitial pneumonia and heavy HHV-6 genome load, persistently detected in its BAL fluid. The baby underwent high-frequency oscillatory ventilation, hydroxychloroquine, steroids, and ganciclovir for 6 weeks and at 9 months she died. Next-generation sequencing of genes known to cause neonatal respiratory insufficiency revealed the presence of a "probably pathogenetic" heterozygous variant in the autosomal recessive DRC1 gene, a heterozygous variant of unknown significance (VUS) in the autosomal recessive RSPH9 gene, and a heterozygous VUS in the autosomal recessive MUC5B gene. HHV-6 infection should be considered in the differential diagnosis of late-onset severe respiratory distress in neonates and the co-occurrence of genetic predisposing factors or modifiers should be tested by specific molecular techniques. The intensity of HHV-6 genome load in BAL fluid could be an indicator of the response to antiviral therapy.


Subject(s)
Genetic Predisposition to Disease/genetics , Lung Diseases, Interstitial/genetics , Roseolovirus Infections/genetics , Cytoskeletal Proteins/genetics , Fatal Outcome , Female , Genetic Variation , Herpesvirus 6, Human/genetics , Herpesvirus 6, Human/isolation & purification , Heterozygote , Humans , Infant, Newborn , Lung Diseases, Interstitial/therapy , Lung Diseases, Interstitial/virology , Microtubule-Associated Proteins/genetics , Mucin-5B/genetics , Pneumonia, Viral/genetics , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Roseolovirus Infections/therapy , Roseolovirus Infections/virology , Viral Load
11.
Transl Lung Cancer Res ; 10(2): 1110-1123, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1289361

ABSTRACT

The diagnosis and treatment of early-stage lung cancer remains a clinical challenge. The broadening implementation of lung cancer screening has resulted in positive findings in numerous patients that are mostly non-malignant. Many other patients have indeterminate nodules that are difficult to assess through simple observation. The critical interpretation of such screening results remains a challenge for radiologists and multidisciplinary teams involved in screening for lung cancer. The evaluation and diagnosis of each participant suspected for malignancy should be based on the basic clinical principles such as a carefully collected medical history, physical examination, and detailed analysis of all imaging tests performed. Indeed, the decision to go ahead with more invasive diagnostics requires consideration of the both the risks and benefits, with reflection upon the complete clinical and radiological picture. Although transthoracic needle aspiration biopsy remains the first-choice method of diagnosis, several newer technologies have slowly begun to emerge as potential replacements. The guiding strategy for method selection is to choose the least harmful approach that offers the most relevant potential insights. Transthoracic biopsy is an effective method that allows the collection of cytological and tissue material from small, peripheral tumors, but it carries a moderate risk of complications. Bronchofiberoscopy, especially in combination with electromagnetic navigation, fluoroscopy or radial EBUS, also allows effective diagnosis of the peripheral pulmonary nodules. One of the most important diagnostic methods is the EBUS examination, which allows determining of staging in addition to diagnosis. Anatomical lung lobe resection and lymphadenectomy or sampling of the hilar and mediastinal lymph nodes is currently the treatment of choice for patients with stage I and II non-small cell lung cancer (NSCLC), but sublobar resections are recommended when a patient has limited pulmonary function or other significant comorbidities. Notably, several studies have highlighted the potential utility of more limited resections in small malignant lesions less than 2cm in diameter, with pure AIS histology, when more than 50% of the diameter of pulmonary nodule has ground-glass opacity (GGO) attenuation on CT, or long volume doubling time (VDT). Videothoracoscopy is the preferred surgical approach for resection of early-stage lung cancer. Patients who are not candidates for surgery or do not agree to surgery can be offered radical radiotherapy. Stereotactic body radiation therapy (SBRT) is a type of radical radiotherapy with proven effectiveness, a high rate of local control and an acceptable risk of the development of later complications. Future trials are expected to define the role of SBRT in the treatment of early lung cancer in healthy subjects.

12.
Ultrasound Med Biol ; 47(8): 1997-2005, 2021 08.
Article in English | MEDLINE | ID: covidwho-1286382

ABSTRACT

The goal of this review was to systematize the evidence on pulmonary ultrasound (PU) use in diagnosis, monitorization or hospital discharge criteria for patients with coronavirus disease 2019 (COVID-19). Evidence on the use of PU for diagnosis and monitorization of or as hospital discharge criteria for COVID-19 patients confirmed to have COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) between December 1, 2019 and July 5, 2020 was compared with evidence obtained with thoracic radiography (TR), chest computed tomography (CT) and RT-PCR. The type of study, motives for use of PU, population, type of transducer and protocol, results of PU and quantitative or qualitative correlation with TR and/or chest CT and/or RT-PCR were evaluated. A total of 28 articles comprising 418 patients were involved. The average age was 50 y (standard deviation: 25.1 y), and there were 395 adults and 23 children. One hundred forty-three were women, 13 of whom were pregnant. The most frequent result was diffuse, coalescent and confluent B-lines. The plural line was irregular, interrupted or thickened. The presence of subpleural consolidation was noduliform, lobar or multilobar. There was good qualitative correlation between TR and chest CT and a quantitative correlation with chest CT of r = 0.65 (p < 0.001). Forty-four patients were evaluated only with PU. PU is a useful tool for diagnosis and monitorization and as criteria for hospital discharge for patients with COVID-19.


Subject(s)
COVID-19 Testing/methods , COVID-19/diagnosis , Lung/diagnostic imaging , Ultrasonography/methods , Humans , SARS-CoV-2
13.
J Minim Invasive Gynecol ; 28(12): 2047-2051, 2021 12.
Article in English | MEDLINE | ID: covidwho-1275500

ABSTRACT

STUDY OBJECTIVE: Coronavirus disease 2019 (COVID-19) infection poses significant risks during surgical interventions. We investigated the intraperitoneal presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients who are COVID-19 positive. DESIGN: A prospective group study. SETTING: Department of Obstetrics and Gynecology designated for patients with COVID-19, Central Clinical Hospital of the Ministry of Interior, Warsaw. PATIENTS: Overall, 65 pregnant women with COVID-19 infection underwent cesarian section. The diagnosis was confirmed either by positive antigen test or by positive reverse transcriptase-polymerase chain reaction assay performed within no more than 13 days before the operation. INTERVENTIONS: On the day of the operation, a nasopharyngeal swab was taken, and peritoneal fluid was collected at the beginning of the operation. Both the nasopharyngeal swab and peritoneal fluid samples were tested for SARS-CoV-2. MEASUREMENTS AND MAIN RESULTS: A total of 65 pregnant women with COVID-19 infection were enrolled in the study. The SARS-CoV-2 ribonucleic acid test by nasopharyngeal swab produced positive results in 34 patients. In this group as well as in 31 nonconfirmed patients, all peritoneal fluid samples tested negative for SARS-CoV-2 ribonucleic acid. CONCLUSION: These results suggest a low risk of COVID-19 transmission from the peritoneal cavity at the time of laparoscopy or laparotomy.


Subject(s)
COVID-19 , Ascitic Fluid , Female , Humans , Pregnancy , Pregnant Women , Prospective Studies , RNA, Viral/genetics , SARS-CoV-2
14.
Clin Chem Lab Med ; 59(7): 1315-1322, 2021 Jun 25.
Article in English | MEDLINE | ID: covidwho-1278216

ABSTRACT

OBJECTIVES: Severe forms of coronavirus disease 2019 (COVID-19) are characterized by an excessive production of inflammatory cytokines. Activated monocytes secrete high levels of cytokines. Human monocytes are divided into three major populations: conventional (CD14posCD16neg), non-classical (CD14dimCD16pos), and intermediate (CD14posCD16pos) monocytes. The aim of this study was to analyze whether the distribution of conventional (CD16neg) and CD16pos monocytes is different in patients with COVID-19 and whether the variations could be predictive of the outcome of the disease. METHODS: We performed a prospective study on 390 consecutive patients referred to the Emergency Unit, with a proven diagnosis of SARS-CoV 2 infection by RT-PCR. Using the CytoDiff™ reagent, an automated routine leukocyte differential, we quantified CD16neg and CD16pos monocytes. RESULTS: In the entire population, median CD16neg and CD16pos monocyte levels (0.398 and 0.054×109/L, respectively) were in the normal range [(0.3-0.7×109/L) and (0.015-0.065×109/L), respectively], but the 35 patients in the intensive care unit (ICU) had a significantly (p<0.001) lower CD16pos monocyte count (0.018 × 109/L) in comparison to the 70 patients who were discharged (0.064 × 109/L) or were hospitalized in conventional units (0.058 × 109/L). By ROC curve analysis, the ratio [absolute neutrophil count/CD16pos monocyte count] was highly discriminant to identify patients requiring ICU hospitalization: with a cut-off 193.1, the sensitivity and the specificity were 74.3 and 81.8%, respectively (area under the curve=0.817). CONCLUSIONS: Quantification of CD16pos monocytes and the ratio [absolute neutrophil count/CD16pos monocyte count] could constitute a marker of the severity of disease in COVID-19 patients.


Subject(s)
COVID-19/diagnosis , Monocytes/cytology , Adult , Aged , Aged, 80 and over , Area Under Curve , Biomarkers/blood , COVID-19/blood , Female , Humans , Intensive Care Units/statistics & numerical data , Leukocyte Count/statistics & numerical data , Male , Middle Aged , Monocytes/classification , Prognosis , Prospective Studies , ROC Curve , SARS-CoV-2 , Young Adult
15.
Int J Clin Pract ; 75(10): e14532, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1269740

ABSTRACT

BACKGROUND: There is a great need to make a rapid differential clinical diagnosis of COVID-19 among respiratory disease patients and determining the prevalence rate of these diseases among the COVID-19 population. METHOD: Approximately 522 patients with allergic rhinitis, asthma, COPD, and COVID-19 were analysed for demographic and clinical features. Radiological features were analysed only for COVID-19 patients. RESULTS: COPD and asthma were more common among COVID-19 patients than allergic rhinitis. All chest CT scans of COVID-19 patients showed bilateral ground-glass opacity. Fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips were significantly higher in all COVID-19 patients compared to COPD, asthma, and allergic rhinitis patients. CONCLUSION: The presence of clinical symptoms such as fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips in COVID-19 patients, can be used for differential diagnosis between COVID-19 patients and other respiratory diseases. Then, the diagnosis can be confirmed by chest CT scan for COVID-19 patients without the need for a nasopharyngeal swab or PCR test, especially in epidemic countries. Allergic rhinitis patients are the least exposed to COVID-19 infection among other respiratory disease patients.


Subject(s)
Asthma , COVID-19 , Pulmonary Disease, Chronic Obstructive , Rhinitis, Allergic , Asthma/diagnosis , Asthma/epidemiology , Diagnosis, Differential , Humans , Prevalence , Pulmonary Disease, Chronic Obstructive/complications , Pulmonary Disease, Chronic Obstructive/diagnosis , Pulmonary Disease, Chronic Obstructive/epidemiology , Rhinitis, Allergic/diagnosis , Rhinitis, Allergic/epidemiology , SARS-CoV-2
16.
Ann Med Surg (Lond) ; 67: 102468, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1267584

ABSTRACT

INTRODUCTION AND IMPORTANCE: Coronavirus disease 2019 (COVID-19) is a pandemic disease that spread rapidly throughout the world and became a major public health concern. Approximately 5-12% of COVID-19 patients require admission to the intensive-care unit (ICU), where they often require oxygen therapy and prolonged intubation. Post-intubation laryngotracheal stenosis (PILS) is a complication that occurs in 10-22% of non-COVID-19 patients after prolonged intubation, while the rate of COVID-19 related PILS remains unknown. Additionally, there is still no consensus in the literature regarding the management modalities for PILS following COVID-19. CASE PRESENTATION: Here we report two cases of tracheal stenosis after prolonged intubation due to severe COVID-19 infection. The first patient was admitted to the ICU and intubated for 21 days; 3 months after discharge, he developed a 3 cm long tracheal stenosis that narrowed 70% of the lumen. The second patient was intubated for 2 months and, 4 months after discharge, developed a 2.5 cm long tracheal stenosis that narrowed 80% of the lumen. CLINICAL DISCUSSION: In both cases, the diagnosis was confirmed by CT scan and Rigid bronchoscopy; then, they were managed successfully with tracheal resection and reconstruction by end-to-end anastomosis. CONCLUSION: In conclusion, we would like to highlight the importance of suspecting PILS in recovered COVID-19 patients re-presenting with breathing difficulties following weaning from mechanical ventilation; therefore, careful follow-up in such patients is required. Moreover, we would like to point out that the management of tracheal stenosis after COVID-19 appears to be similar to that of tracheal stenosis in general.

17.
Front Robot AI ; 8: 645756, 2021.
Article in English | MEDLINE | ID: covidwho-1266692

ABSTRACT

The COVID-19 pandemic has emerged as a serious global health crisis, with the predominant morbidity and mortality linked to pulmonary involvement. Point-of-Care ultrasound (POCUS) scanning, becoming one of the primary determinative methods for its diagnosis and staging, requires, however, close contact of healthcare workers with patients, therefore increasing the risk of infection. This work thus proposes an autonomous robotic solution that enables POCUS scanning of COVID-19 patients' lungs for diagnosis and staging. An algorithm was developed for approximating the optimal position of an ultrasound probe on a patient from prior CT scans to reach predefined lung infiltrates. In the absence of prior CT scans, a deep learning method was developed for predicting 3D landmark positions of a human ribcage given a torso surface model. The landmarks, combined with the surface model, are subsequently used for estimating optimal ultrasound probe position on the patient for imaging infiltrates. These algorithms, combined with a force-displacement profile collection methodology, enabled the system to successfully image all points of interest in a simulated experimental setup with an average accuracy of 20.6 ± 14.7 mm using prior CT scans, and 19.8 ± 16.9 mm using only ribcage landmark estimation. A study on a full torso ultrasound phantom showed that autonomously acquired ultrasound images were 100% interpretable when using force feedback with prior CT and 88% with landmark estimation, compared to 75 and 58% without force feedback, respectively. This demonstrates the preliminary feasibility of the system, and its potential for offering a solution to help mitigate the spread of COVID-19 in vulnerable environments.

18.
Front Artif Intell ; 4: 598932, 2021.
Article in English | MEDLINE | ID: covidwho-1266690

ABSTRACT

The newly discovered Coronavirus Disease 2019 (COVID-19) has been globally spreading and causing hundreds of thousands of deaths around the world as of its first emergence in late 2019. The rapid outbreak of this disease has overwhelmed health care infrastructures and arises the need to allocate medical equipment and resources more efficiently. The early diagnosis of this disease will lead to the rapid separation of COVID-19 and non-COVID cases, which will be helpful for health care authorities to optimize resource allocation plans and early prevention of the disease. In this regard, a growing number of studies are investigating the capability of deep learning for early diagnosis of COVID-19. Computed tomography (CT) scans have shown distinctive features and higher sensitivity compared to other diagnostic tests, in particular the current gold standard, i.e., the Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. Current deep learning-based algorithms are mainly developed based on Convolutional Neural Networks (CNNs) to identify COVID-19 pneumonia cases. CNNs, however, require extensive data augmentation and large datasets to identify detailed spatial relations between image instances. Furthermore, existing algorithms utilizing CT scans, either extend slice-level predictions to patient-level ones using a simple thresholding mechanism or rely on a sophisticated infection segmentation to identify the disease. In this paper, we propose a two-stage fully automated CT-based framework for identification of COVID-19 positive cases referred to as the "COVID-FACT". COVID-FACT utilizes Capsule Networks, as its main building blocks and is, therefore, capable of capturing spatial information. In particular, to make the proposed COVID-FACT independent from sophisticated segmentations of the area of infection, slices demonstrating infection are detected at the first stage and the second stage is responsible for classifying patients into COVID and non-COVID cases. COVID-FACT detects slices with infection, and identifies positive COVID-19 cases using an in-house CT scan dataset, containing COVID-19, community acquired pneumonia, and normal cases. Based on our experiments, COVID-FACT achieves an accuracy of 90.82 % , a sensitivity of 94.55 % , a specificity of 86.04 % , and an Area Under the Curve (AUC) of 0.98, while depending on far less supervision and annotation, in comparison to its counterparts.

19.
Rev Recent Clin Trials ; 16(2): 122-125, 2021.
Article in English | MEDLINE | ID: covidwho-1264271

ABSTRACT

BACKGROUND: In the current coronavirus disease 2019 (COVID-19) pandemic, health systems are struggling to prioritize care for affected patients; however, physicians globally are also attempting to maintain care for other less-threatening medical conditions that may lead to permanent disabilities if untreated. Idiopathic intracranial hypertension (IIH) is a relatively common condition affecting young females that could lead to permanent blindness if not properly treated. In this article, we provide some insight and recommendations regarding the management of IIH during the pandemic. METHODS: The diagnosis, follow-up, and treatment methods of IIH during the COVID-19 pandemic period are reviewed. COVID-19, as a mimic of IIH, is also discussed. RESULTS: Diagnosis and follow-up of papilledema due to IIH during the COVID-19 pandemic can be facilitated by nonmydriatic fundus photography and optical coherence tomography. COVID-19 may mimic IIH by presenting as cerebral venous sinus thrombosis, papillophlebitis, or meningoencephalitis, so a high index of suspicion is required in these cases. When surgical treatment is indicated, optic nerve sheath fenestration may be the primary procedure of choice during the pandemic period. CONCLUSION: IIH is a serious vision-threatening condition that could lead to permanent blindness and disability at a relatively young age if left untreated. It could be the first presentation of a COVID-19 infection. Certain precautions during the diagnosis and management of this condition could be taken that may allow appropriate care to be delivered to these patients while minimizing the risk of coronavirus infection.


Subject(s)
COVID-19 , Pseudotumor Cerebri/diagnosis , Pseudotumor Cerebri/therapy , Algorithms , Humans , Practice Guidelines as Topic
20.
Praxis (Bern 1994) ; 110(8): 431-437, 2021 Jun.
Article in Italian | MEDLINE | ID: covidwho-1263462

ABSTRACT

COVID-19 and Pulmonary Ultrasound: An Innovative Approach to the Disease in the GP's Office Abstract. SARS-CoV-2 disease has required significant efforts from treating physicians to adapt their working methods. In a short time, we had to get to know the disease and implement a strategy for patient care. The goal is to provide safe consultation in the office (without contaminating patients), providing an early diagnosis and reproducible follow-up. Lung ultrasound proved to be a safe and reliable method for diagnosing this disease during the pandemic. This article describes the experience gained by treating 116 patients between February 2020 and March 2021.


Sommario. La malattia da SARS-CoV-2 ha richiesto ai medici curanti uno sforzo notevole nell'adattare il proprio metodo di lavoro. In breve tempo abbiamo dovuto conoscere la malattia e attuare una strategia per la presa in carico dei pazienti. Lo scopo è quello di riuscire a fornire nella Praxis una consulenza sicura (senza contaminazioni dei pazienti), con diagnosi precoce e follow-up riproducibile. L'ecografia polmonare è risultata essere una metodica sicura e affidabile per la diagnosi di questa malattia durante la pandemia. In questo articolo viene descritta l'esperienza conseguita su 116 pazienti nel periodo compreso tra febbraio 2020 a marzo 2021.


Subject(s)
COVID-19 , Humans , Lung , Pandemics , SARS-CoV-2 , Ultrasonography
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