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Baikpour M, Carlos A, Morasse R, Gissel H, Perez-Gutierrez V, Nino J, Amaya-Suarez J, Ali F, Toledano T, Arampulikan J, Gold M, Venugopal U, Pillai A, Omonuwa K, Menon V. Role of a Chest X-ray Severity Score in a Multivariable Predictive Model for Mortality in Patients with COVID-19: A Single-Center, Retrospective Study. J Clin Med 2022; 11:jcm11082157. [PMID: 35456249 PMCID: PMC9025720 DOI: 10.3390/jcm11082157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/03/2022] [Accepted: 04/10/2022] [Indexed: 12/24/2022] Open
Abstract
Predicting the mortality risk of patients with Coronavirus Disease 2019 (COVID-19) can be valuable in allocating limited medical resources in the setting of outbreaks. This study assessed the role of a chest X-ray (CXR) scoring system in a multivariable model in predicting the mortality of COVID-19 patients by performing a single-center, retrospective, observational study including consecutive patients admitted with a confirmed diagnosis of COVID-19 and an initial CXR. The CXR severity score was calculated by three radiologists with 12 to 15 years of experience in thoracic imaging, based on the extent of lung involvement and density of lung opacities. Logistic regression analysis was used to identify independent predictive factors for mortality to create a predictive model. A validation dataset was used to calculate its predictive value as the AUROC. A total of 628 patients (58.1% male) were included in this study. Age (p < 0.001), sepsis (p < 0.001), S/F ratio (p < 0.001), need for mechanical ventilation (p < 0.001), and the CXR severity score (p = 0.005) were found to be independent predictive factors for mortality. We used these variables to develop a predictive model with an AUROC of 0.926 (0.891, 0.962), which was significantly higher than that of the WHO COVID severity classification, 0.853 (0.798, 0.909) (one-tailed p-value = 0.028), showing that our model can accurately predict mortality of hospitalized COVID-19 patients.
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Affiliation(s)
- Masoud Baikpour
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA;
| | - Alex Carlos
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Ryan Morasse
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Hannah Gissel
- Department of Interventional Radiology, George Washington University Hospital, 900 23rd Street NW, Washington, DC 20037, USA;
| | - Victor Perez-Gutierrez
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Jessica Nino
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Jose Amaya-Suarez
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Fatimatu Ali
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Talya Toledano
- Department of Radiology, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (T.T.); (J.A.); (M.G.)
| | - Joseph Arampulikan
- Department of Radiology, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (T.T.); (J.A.); (M.G.)
| | - Menachem Gold
- Department of Radiology, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (T.T.); (J.A.); (M.G.)
| | - Usha Venugopal
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Anjana Pillai
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Kennedy Omonuwa
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
| | - Vidya Menon
- Department of Medicine, NYC Health and Hospitals/Lincoln, 234 East 149th Street, Bronx, NY 10451, USA; (A.C.); (R.M.); (V.P.-G.); (J.N.); (J.A.-S.); (F.A.); (U.V.); (A.P.); (K.O.)
- Correspondence:
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Pahwani S, Jadwani M, Dhanwani A, Gul M, Lal D, Rakesh FNU, Shabbir R, Rizwan A. Efficacy of Oral Famotidine in Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2. Cureus 2022; 14:e22404. [PMID: 35345695 PMCID: PMC8942052 DOI: 10.7759/cureus.22404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The clinical benefit of famotidine has been observed in the management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, its use in the management of SARS-CoV-2 is intriguing and not well established yet. In this study, we aimed to determine the role of famotidine as adjuvant therapy in improving the outcome of patients hospitalized with coronavirus disease-2019 (COVID-19). Methods This two-arm open-label randomized interventional study was conducted in the COVID-19 unit of a tertiary care hospital in Pakistan from December 2020 to September 2021. Patients between the ages of 18 to 65 years, hospitalized with COVID-19 infection, were enrolled in the study. Participants were randomized into two groups. The intervention group received 40 mg oral famotidine daily in addition to the standard care and the control group received standard care as per national guidelines for the treatment of COVID-19 in Pakistan. Results Patients admitted with COVID-19 who received famotidine took comparatively fewer days to become symptom-free (8.5 ± 1.7 vs. 9.4 ± 1.9 days, p-value: <0.001) and spent fewer days in hospital (8.6 ± 1.6 vs. 10.3 ± 2.2 days; p-value: <0.0001). However, the overall difference in the need for mechanical ventilation and mortality between the interventional arm and placebo was not significant. Conclusion In this study, adding famotidine to standard treatment of COVID-19 was associated with faster clinical recovery and shorter stay in the hospital. However, there was no difference in the need for mechanical ventilation, need for intensive care unit, and overall mortality. Further large-scale studies are needed to understand the role of famotidine in COVID-19 and its mechanism of action in patients with COVID-19.
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Toğaçar M, Muzoğlu N, Ergen B, Yarman BSB, Halefoğlu AM. Detection of COVID-19 findings by the local interpretable model-agnostic explanations method of types-based activations extracted from CNNs. Biomed Signal Process Control 2021; 71:103128. [PMID: 34490055 PMCID: PMC8410514 DOI: 10.1016/j.bspc.2021.103128] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 12/17/2022]
Abstract
Covid-19 is a disease that affects the upper and lower respiratory tract and has fatal consequences in individuals. Early diagnosis of COVID-19 disease is important. Datasets used in this study were collected from hospitals in Istanbul. The first dataset consists of COVID-19, viral pneumonia, and bacterial pneumonia types. The second dataset consists of the following findings of COVID-19: ground glass opacity, ground glass opacity, and nodule, crazy paving pattern, consolidation, consolidation, and ground glass. The approach suggested in this paper is based on artificial intelligence. The proposed approach consists of three steps. As a first step, preprocessing was applied and, in this step, the Fourier Transform and Gradient-weighted Class Activation Mapping methods were applied to the input images together. In the second step, type-based activation sets were created with three different ResNet models before the Softmax method. In the third step, the best type-based activations were selected among the CNN models using the local interpretable model-agnostic explanations method and re-classified with the Softmax method. An overall accuracy success of 99.15% was achieved with the proposed approach in the dataset containing three types of image sets. In the dataset consisting of COVID-19 findings, an overall accuracy success of 99.62% was achieved with the recommended approach.
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Affiliation(s)
- Mesut Toğaçar
- Department of Computer Technologies, Technical Sciences Vocational School, Fırat University, Elazig, Turkey
| | - Nedim Muzoğlu
- Department of Biomedical Sciences, Faculty of Engineering, Istanbul University, Istanbul, Turkey
| | - Burhan Ergen
- Department of Computer Engineering, Faculty of Engineering, Fırat University, Elazig, Turkey
| | - Bekir Sıddık Binboğa Yarman
- Department of Electric-Electronic Engineering, Faculty of Engineering, Istanbul University, Istanbul, Turkey
| | - Ahmet Mesrur Halefoğlu
- Department of Radiology, Şişli Hamidiye Etfal Training and Research Hospital, Health Sciences University, Istanbul, Turkey
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Gupta A, Garg I, Iqbal A, Talpur AS, Mañego AMB, Kavuri RK, Bachani P, Naz S, Iqbal ZQ. Long-Term X-ray Findings in Patients With Coronavirus Disease-2019. Cureus 2021; 13:e15304. [PMID: 34211809 PMCID: PMC8236307 DOI: 10.7759/cureus.15304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Reverse transcription-polymerase chain reaction (RT-PCR) and chest X-ray (CXR) are commonly used techniques for diagnosing and assessing prognosis in patients with coronavirus disease-2019 (COVID-19). This study aims to highlight the long-term radiological findings observed on CXR after recovery, in patients with COVID-19. This will help identify patients suffering from long-term consequences of COVID-19 and help them provide adequate care. METHODS This study was conducted in the COVID-19 unit of a tertiary care hospital, Pakistan from August 2020 to February 2021. CXR of patients who were being discharged after negative PCR was done. Participants with positive X-ray findings, which included consolidation, reticular thickening, ground-glass opacities (GGO), pulmonary nodules, and pleural effusions, were enrolled in the study after getting informed consent. All findings were recorded in a self-structured questionnaire. Participants were scheduled to come for follow-up on day 30 after their initial CXR, where their CXR was repeated. RESULT Our results showed that n=429 (60.2%) participants had positive CXR at the time of discharge. After 30 days, n=371 participants returned for a follow-up X-ray. Out of the 371 participants, after 30 days, 123 participants still had positive CXR. Fatigue (41.4%) was the common symptom after 30 days. The most common finding was consolidation (82.1%), followed by reticular thickening (23.5%) on day 30. CONCLUSION In this study, although most of the patients completely recovered serologically from COVID-19, they still had radiological findings in their chest X-rays. Radiological findings are especially important in predicting the clinical course of the disease and may be used to monitor long-term complications.
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Affiliation(s)
- Aarzoo Gupta
- Internal Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, Faridabad, IND
| | - Ishan Garg
- Clinical Medicine, Ross University School of Medicine, Bridgetown, BRB
| | - Abbas Iqbal
- Pediatrics, Ayub Teaching Hospital, Abottabad, PAK
| | | | | | - Rama Kalyani Kavuri
- Internal Medicine, Maratha Vidya Prasarak Samaj's Dr. Vasantrao Pawar Medical College Hospital and Research Centre, Nashik, IND
| | - Parkash Bachani
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Sidra Naz
- Internal Medicine, University of Health Sciences (UHS), Lahore, PAK
| | - Zoya Qamar Iqbal
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Mohammad-Rahimi H, Nadimi M, Ghalyanchi-Langeroudi A, Taheri M, Ghafouri-Fard S. Application of Machine Learning in Diagnosis of COVID-19 Through X-Ray and CT Images: A Scoping Review. Front Cardiovasc Med 2021; 8:638011. [PMID: 33842563 PMCID: PMC8027078 DOI: 10.3389/fcvm.2021.638011] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 02/23/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease, first detected in late 2019 (COVID-19), has spread fast throughout the world, leading to high mortality. This condition can be diagnosed using RT-PCR technique on nasopharyngeal and throat swabs with sensitivity values ranging from 30 to 70%. However, chest CT scans and X-ray images have been reported to have sensitivity values of 98 and 69%, respectively. The application of machine learning methods on CT and X-ray images has facilitated the accurate diagnosis of COVID-19. In this study, we reviewed studies which used machine and deep learning methods on chest X-ray images and CT scans for COVID-19 diagnosis and compared their performance. The accuracy of these methods ranged from 76% to more than 99%, indicating the applicability of machine and deep learning methods in the clinical diagnosis of COVID-19.
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Affiliation(s)
- Hossein Mohammad-Rahimi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Nadimi
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran, Iran
| | - Azadeh Ghalyanchi-Langeroudi
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Research Center for Biomedical Technologies and Robotics (RCBTR), Tehran, Iran
| | - Mohammad Taheri
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mousa AY, Broce M, Lucas BD. Cardiovascular disease due to novel coronavirus and the search for investigational therapies. J Vasc Surg 2021; 73:13-17. [PMID: 32425326 PMCID: PMC7231490 DOI: 10.1016/j.jvs.2020.04.503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/28/2020] [Indexed: 01/04/2023]
Abstract
Objective The primary purpose of the study was to investigate and to summarize the registered trials that listed COVID-19 as the primary condition. Methods We performed a search on ClinicalTrials.gov using the independent search terms COVID-19, SARS, and SARS-CoV-2 and then downloaded the data file on March 23, 2020. All trials were downloaded to a csv file and searched for appropriateness. Results Of 124 registered trials, 56 (45.2%) were listed as recruiting. The majority (85 [68.5%]) were classified as interventional, 37 (29.8%) as observational, and one (0.8%) each as either expanded access: individual patients|treatment investigational new drug/protocol or expanded access: intermediate-size population|treatment investigational new drug/protocol. There were 67 (54.0%) trials that listed drug as the type of study. Immunologic and antiviral trials were the most common, representing approximately 30% and 21%, respectively. When immunologic and antiviral drugs were used alone or in combination, they represented 41.9% and 34.4%, respectively. Antimalarial agents are represented in 7.5% of trials. Approximately 14% of trials involved traditional Chinese medicine. The study agents used solely or in combination represented approximately 80% of therapeutic approaches to COVID-19. Conclusions There was a large and quick response on ClinicalTrials.gov to the COVID-19 outbreak. Many of the registered trials are currently recruiting new patients, whereas some will begin in the near future. Specific potential experimental therapies, including dosing and monitoring, might be found by reviewing content. Within ClinicalTrials.gov, patients, family members, health care professionals, and researchers can search and find ongoing and future trials for COVID-19.
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Affiliation(s)
- Albeir Y. Mousa
- Department of Surgery, Robert C. Byrd Health Sciences Center/West Virginia University, Charleston, WV,Correspondence: Albeir Y. Mousa, MD, Department of Surgery, Robert C. Byrd Health Sciences Center/West Virginia University, Charleston Area Medical Center, Vascular Center of Excellence, 3110 MacCorkle Ave SE, Charleston, WV 25304
| | - Mike Broce
- Center for Health Services and Outcomes Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, WV
| | - B. Daniel Lucas
- Center for Clinical Sciences Research, Charleston Area Medical Center Health Education and Research Institute, Charleston, WV
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Mathew RP, Jose M, Jayaram V, Joy P, George D, Joseph M, Sleeba T, Toms A. Current status quo on COVID-19 including chest imaging. World J Radiol 2020; 12:272-288. [PMID: 33510852 PMCID: PMC7802080 DOI: 10.4329/wjr.v12.i12.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 02/06/2023] Open
Abstract
With each day the number coronavirus disease 2019 (COVID-19) cases continue to rise rapidly and our imaging knowledge of this disease is expeditiously evolving. The role of chest computed tomography (CT) in the screening or diagnosis of COVID-19 remains the subject of much debate. Despite several months having passed since identifying the disease, and numerous studies related to it, controversy and concern still exists regarding the widespread use of chest CT in the evaluation and management of COVID-19 suspect patients. Several institutes and organizations around the world have released guidelines, recommendations and statements against the use of CT for diagnosing or screening COVID-19 infection and advocating its use only for those cases with a strong clinical suspicion of complication or an alternate diagnosis. However, these guidelines and recommendations are in disagreement with majority of the widely available literature, which strongly favour CT as a pivotal tool in the early diagnosis, management and even follow-up of COVID-19 infection. This article besides comprehensively reviewing the current status quo on COVID-19 disease in general, also writes upon the current consensus statements/recommendations on the use of diagnostic imaging in COVID-19 as well as highlighting the precautions and various disinfection procedures being employed world-wide at the workplace to prevent the spread of infection.
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Affiliation(s)
| | - Merin Jose
- Department of Radiology, Rajagiri Hospital, Kochi 683112, Kerala, India
| | - Vinayak Jayaram
- Department of Radiology, Rajagiri Hospital, Kochi 683112, Kerala, India
| | - Paul Joy
- Department of Radiology, Rajagiri Hospital, Kochi 683112, Kerala, India
| | - Danny George
- Department of Radiology, Rajagiri Hospital, Kochi 683112, Kerala, India
| | - Maria Joseph
- Department of Radiology, Rajagiri Hospital, Kochi 683112, Kerala, India
| | - Teena Sleeba
- Department of Radiology, Rajagiri Hospital, Kochi 683112, Kerala, India
| | - Ajith Toms
- Department of Radiology, Rajagiri Hospital, Kochi 683112, Kerala, India
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Fields BKK, Demirjian NL, Gholamrezanezhad A. Coronavirus Disease 2019 (COVID-19) diagnostic technologies: A country-based retrospective analysis of screening and containment procedures during the first wave of the pandemic. Clin Imaging 2020; 67:219-225. [PMID: 32871426 PMCID: PMC7448874 DOI: 10.1016/j.clinimag.2020.08.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/02/2020] [Accepted: 08/24/2020] [Indexed: 02/06/2023]
Abstract
Since first report of a novel coronavirus in December of 2019, the Coronavirus Disease 2019 (COVID-19) pandemic has crippled healthcare systems around the world. While many initial screening protocols centered around laboratory detection of the virus, early testing assays were thought to be poorly sensitive in comparison to chest computed tomography, especially in asymptomatic disease. Coupled with shortages of reverse transcription polymerase chain reaction (RT-PCR) testing kits in many parts of the world, these regions instead turned to the use of advanced imaging as a first-line screening modality. However, in contrast to previous Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome coronavirus epidemics, chest X-ray has not demonstrated optimal sensitivity to be of much utility in first-line screening protocols. Though current national and international guidelines recommend for the use of RT-PCR as the primary screening tool for suspected cases of COVID-19, institutional and regional protocols must consider local availability of resources when issuing universal recommendations. Successful containment and social mitigation strategies worldwide have been thus far predicated on unified governmental responses, though the underlying ideologies of these practices may not be widely applicable in many Western nations. As the strain on the radiology workforce continues to mount, early results indicate a promising role for the use of machine-learning algorithms as risk stratification schema in the months to come.
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Affiliation(s)
- Brandon K K Fields
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America
| | - Natalie L Demirjian
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America; Department of Integrative Anatomical Sciences, University of Southern California, Los Angeles, CA 90033, United States of America
| | - Ali Gholamrezanezhad
- Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, United States of America; Department of Radiology, University of Southern California, Los Angeles, CA 90033, United States of America.
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Abstract
PURPOSE The novel coronavirus disease (COVID-19) pandemic has swept the globe, with a domino effect on medical education and training. In this study, we surveyed Canadian radiology residents to understand the impact of the pandemic on their residency training, strategies utilized by the residency programs in mitigating those impacts, and factors important to residents in the selection of educational resources on COVID-19. METHODS A 10-item questionnaire was distributed to 460 resident members of the Canadian Association of Radiologists. The survey was open for 2 weeks, with a reminder sent at half-way mark. RESULTS We received 96 responses (response rate: 20.9%). The 4 highest affected domains of training were daytime case volumes (92.4%), daytime schedules (87.4%), internal and external assessments (86.5%), and vacation/travel (83.3%). Virtual teaching rounds (91.7%), change in schedules to allow staying home (78.1%), and virtual/phone readouts (72.9%) were the most utilized strategies by the Canadian radiology residency programs. Overall stress of exposure to the disease was moderate to low (86.5%). A minority of the residents were redeployed (6.2%), although most (68.8%) were on standby for redeployment. Residents preferred published society guidelines (92.3%), review papers (79.3%), video lectures (79.3%), and web tools (76.9%) for learning about COVID-19 imaging manifestations. CONCLUSION The COVID-19 pandemic has had a significant impact on various domains of the Canadian radiology residency programs, which has been mitigated by several strategies employed by the training programs.
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Affiliation(s)
- Devang Odedra
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Baljot S. Chahal
- Department of Radiology and Diagnostic Imaging, University of Alberta, WC Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada
| | - Michael N. Patlas
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
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Precautions in dentistry against the outbreak of corona virus disease 2019. J Infect Public Health 2020; 13:1805-1810. [PMID: 33069661 PMCID: PMC7539802 DOI: 10.1016/j.jiph.2020.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/27/2020] [Accepted: 09/21/2020] [Indexed: 12/23/2022] Open
Abstract
The outbreak of Coronavirus Disease 2019 (COVID-19) has become a severe global acute respiratory pandemic around the world in just a few months with an increasing number of infections and deaths. COVID-19 is a highly contagious and fatal disease. Almost everyone in the population is susceptible, and the incubation period is 1–14 days, mostly 3–7 days. The clinical symptoms of the COVID-19 are fever, dry cough and fatigue. Some patients are accompanied by symptoms such as nasal congestion, runny nose, sore throat, myalgia and diarrhea. Severe patients could even develop acute respiratory distress syndrome, septic shocks, metabolic acidosis and multifunctional organ failure, etc. Due to the relatively closed environment of dental clinics and the unique nature of dental procedures, both dental personnel and patients are easy to get infection through currently known respiratory droplet transmission, aerosol transmission, close contact transmission and other ways, inducing mutual cross-infection. Dental practitioners are facing unprecedented challenges due to the high risk of exposure to droplets and aerosols from saliva and other body fluids during dental procedures. Based on our experience and relevant research, this article introduces the basic knowledge about COVID-19 and the corresponding protective measures for dental practitioners, includes the risk of infection during dental procedures, the precautions related to the patients, infection control measures during dental treatment in clinics, protection measures at different levels for dental practitioners, and emergency dental treatment for confirmed COVID-19. It is the responsibility of every dental practitioner to fully understand the characteristics of the new coronavirus and strictly implement the most appropriate protective measures to reduce and control the risk of cross infection in dental procedures.
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H’ng MWC, Tan BP, Punamiya S. Setting Up an Interventional Radiology Suite in an Infectious Diseases Centre: Lessons from the Novel Coronavirus (COVID-19) Outbreak. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2020177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Rousan LA, Elobeid E, Karrar M, Khader Y. Chest x-ray findings and temporal lung changes in patients with COVID-19 pneumonia. BMC Pulm Med 2020; 20:245. [PMID: 32933519 PMCID: PMC7491017 DOI: 10.1186/s12890-020-01286-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients. METHODS From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients' demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients' symptoms. RESULTS A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19. Their age ranged from 3 to 80 years (35.2 ± 18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6-11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P = 0.005). CONCLUSION Almost half of patients with COVID-19 have abnormal chest x-ray findings with peripheral GGO affecting the lower lobes being the most common finding. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.
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Affiliation(s)
- Liqa A. Rousan
- Department of Diagnostic Radiology and Nuclear Medicine, Jordan University of Science and Technology, PO BOX 3030, Irbid, 21100 Jordan
| | - Eyhab Elobeid
- Department of Diagnostic Radiology and Nuclear Medicine, Jordan University of Science and Technology, PO BOX 3030, Irbid, 21100 Jordan
| | - Musaab Karrar
- Department of Emergency, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Department of Public Health, Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
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13
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Yu J, Ding N, Chen H, Liu XJ, Pu ZH, Xu HJ, Lei Y, Zhang HW. Loopholes in Current Infection Control and Prevention Practices Against COVID-19 in Radiology Department and Improvement Suggestions. Can Assoc Radiol J 2020; 72:215-221. [PMID: 32281391 DOI: 10.1177/0846537120916852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To improve the infection control and prevention practices against coronavirus disease 2019 (COVID-19) in radiology department through loophole identification and providing rectifying measurements. METHODS Retrospective analysis of 2 cases of health-care-associated COVID-19 transmission in 2 radiology departments and comparing the infection control and prevention practices against COVID-19 with the practices of our department, where no COVID-19 transmission has occurred. RESULTS Several loopholes have been identified in the infection control and prevention practices against COVID-19 of the 2 radiology departments. Loopholes were in large part due to our limited understanding of the highly contagious coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is characterized by features not observed in other SARS viruses. We recommend to set up an isolation zone for handling patients who do not meet the diagnostic criteria of COVID-19 but are not completely cleared of the possibility of infection. CONCLUSIONS Loopholes in the infection control and prevention practices against COVID-19 of the 2 radiology departments are due to poor understanding of the emerging disease which can be fixed by establishing an isolation zone for patients not completely cleared of SARS-CoV-2 infection.
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Affiliation(s)
- Juan Yu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, 499778Shenzhen Second People's Hospital, Shenzhen, People's Republic of China
| | - Ning Ding
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Huan Chen
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, 499778Shenzhen Second People's Hospital, Shenzhen, People's Republic of China
| | - Xia-Jing Liu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, 499778Shenzhen Second People's Hospital, Shenzhen, People's Republic of China
| | - Zu-Hui Pu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, 499778Shenzhen Second People's Hospital, Shenzhen, People's Republic of China
| | - Hua-Jian Xu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, 499778Shenzhen Second People's Hospital, Shenzhen, People's Republic of China
| | - Yi Lei
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, 499778Shenzhen Second People's Hospital, Shenzhen, People's Republic of China
| | - Han-Wen Zhang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, 499778Shenzhen Second People's Hospital, Shenzhen, People's Republic of China
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14
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Redmond CE, Gibney B, Nicolaou S, Patlas MN. Emergency Radiology in 2020: Moving Forward Together. Can Assoc Radiol J 2020; 71:249-250. [DOI: 10.1177/0846537120918954] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Ciaran E. Redmond
- Division of Emergency Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Brian Gibney
- Division of Emergency Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Savvas Nicolaou
- Division of Emergency Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Michael N. Patlas
- Department of Radiology, McMaster University, Hamilton, Ontario, Canada
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Liu X, Lv J, Gan L, Zhang Y, Sun F, Meng B, Jheon A, Yan F, Li B, Xuan Z, Ma X, Wulasihana M. Comparative analysis of clinical characteristics, imaging and laboratory findings of different age groups with COVID-19. Indian J Med Microbiol 2020; 38:87-93. [PMID: 32719214 PMCID: PMC7706422 DOI: 10.4103/ijmm.ijmm_20_133] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/27/2020] [Accepted: 06/07/2020] [Indexed: 12/18/2022]
Abstract
Objective This study aims to provide scientific basis for rapid screening and early diagnosis of the coronavirus disease 2019 (COVID-19) through analysing the clinical characteristics and early imaging/laboratory findings of the inpatients. Methods Three hundred and three patients with laboratory-confirmed COVID-19 from the East Hospital of People's Hospital of Wuhan University (Wuhan, China) were selected and divided into four groups: youth (20-40 years, n = 64), middle-aged (41-60 years, n = 89), older (61-80 years, n = 118) and elderly (81-100 years, n = 32). The clinical characteristics and imaging/laboratory findings including chest computed tomography (CT), initial blood count, C-reactive protein [CRP]), procalcitonin (PCT) and serum total IgE were captured and analysed. Results (1) The first symptoms of all age groups were primarily fever (76%), followed by cough (12%) and dyspnoea (5%). Beside fever, the most common initial symptom of elderly patients was fatigue (13%). (2) Fever was the most common clinical manifestation (80%), with moderate fever being the most common (40%), followed by low fever in patients above 40 years old and high fever in those under 40 years (35%). Cough was the second most common clinical manifestation and was most common (80%) in the middle-aged. Diarrhoea was more common in the middle-aged (21%) and the older (19%). Muscle ache was more common in the middle-aged (15%). Chest pain was more common in the youth (13%), and 13% of the youth had no symptoms. (3) The proportion of patients with comorbidities increased with age. (4) Seventy-one per cent of the patients had positive reverse transcription-polymerase chain reaction results and 29% had positive chest CT scans before admission to the hospital. (5) Lesions in all lobes of the lung were observed as the main chest CT findings (76%). (6) Decrease in lymphocytes and increase in monocytes were common in the patients over 40 years old but rare in the youth. Eosinophils (50%), red blood cells (39%) and haemoglobin (40%) decreased in all age groups. (7) The proportion of patients with CRP and PCT elevation increased with age. (8) Thirty-nine per cent of the patients had elevated IgE, with the highest proportion in the old (49%). Conclusion The clinical characteristics and imaging/laboratory findings of COVID-19 patients vary in different age groups. Personalised criteria should be formulated according to different age groups in the early screening and diagnosis stage.
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Affiliation(s)
- Xuemei Liu
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Jie Lv
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Lin Gan
- Faculty of Medicine and Health Sciences, Macquarie University, New South Wales, Australia
| | - Ying Zhang
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Feng Sun
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Bo Meng
- School of Dental Medicine, University of California San Francisco, San Francisco, USA
| | - Andrew Jheon
- School of Dental Medicine, University of California San Francisco, San Francisco, USA
| | - Fang Yan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Bin Li
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Zhou Xuan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiumin Ma
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Clinical Laboratory Center, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi, China
| | - Muhuyati Wulasihana
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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