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Zheng K, Chong AY, Mentzer AJ. How could our genetics impact COVID-19 vaccine response? Expert Rev Clin Immunol 2024; 20:1027-1039. [PMID: 38676712 DOI: 10.1080/1744666x.2024.2346584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/19/2024] [Indexed: 04/29/2024]
Abstract
INTRODUCTION The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed unprecedented global health challenges since its emergence in December 2019. The rapid availability of vaccines has been estimated to save millions of lives, but there is variation in how individuals respond to vaccines, influencing their effectiveness at an individual, and population level. AREAS COVERED This review focuses on human genetic factors influencing the immune response and effectiveness of vaccines, highlighting the importance of associations across the HLA locus. Genome-Wide Association Studies (GWAS) and other genetic association analyses have identified statistically significant associations between specific HLA alleles including HLA-DRB1*13, DBQ1*06, and A*03 impacting antibody responses and the risk of breakthrough infections post-vaccination. Relationships between these associations and potential mechanisms and links with risks of natural infection or disease are explored, and this review concludes by emphasizing how understanding the mechanisms of these genetic determinants may inform the development of tailored vaccination strategies. EXPERT OPINION Although complex, we believe these findings from the SARS-CoV2 pandemic offer a unique opportunity to understand the relationships between HLA and infection and vaccine response, with a goal of optimizing individual protection against COVID-19 in the ongoing pandemic, and possibly influencing wider vaccine development in the future.
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Affiliation(s)
- Keyi Zheng
- Centre for Human Genetics, University of Oxford, Oxford, UK
| | - Amanda Y Chong
- Centre for Human Genetics, University of Oxford, Oxford, UK
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Kadhim YA, Guzel MS, Mishra A. A Novel Hybrid Machine Learning-Based System Using Deep Learning Techniques and Meta-Heuristic Algorithms for Various Medical Datatypes Classification. Diagnostics (Basel) 2024; 14:1469. [PMID: 39061605 PMCID: PMC11275302 DOI: 10.3390/diagnostics14141469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/27/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Medicine is one of the fields where the advancement of computer science is making significant progress. Some diseases require an immediate diagnosis in order to improve patient outcomes. The usage of computers in medicine improves precision and accelerates data processing and diagnosis. In order to categorize biological images, hybrid machine learning, a combination of various deep learning approaches, was utilized, and a meta-heuristic algorithm was provided in this research. In addition, two different medical datasets were introduced, one covering the magnetic resonance imaging (MRI) of brain tumors and the other dealing with chest X-rays (CXRs) of COVID-19. These datasets were introduced to the combination network that contained deep learning techniques, which were based on a convolutional neural network (CNN) or autoencoder, to extract features and combine them with the next step of the meta-heuristic algorithm in order to select optimal features using the particle swarm optimization (PSO) algorithm. This combination sought to reduce the dimensionality of the datasets while maintaining the original performance of the data. This is considered an innovative method and ensures highly accurate classification results across various medical datasets. Several classifiers were employed to predict the diseases. The COVID-19 dataset found that the highest accuracy was 99.76% using the combination of CNN-PSO-SVM. In comparison, the brain tumor dataset obtained 99.51% accuracy, the highest accuracy derived using the combination method of autoencoder-PSO-KNN.
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Affiliation(s)
- Yezi Ali Kadhim
- College of Engineering, University of Baghdad, Jadriyah, Baghdad 10071, Iraq;
- Department of Modeling and Design of Engineering Systems (MODES), Atilim University, Ankara 06830, Turkey
- Department of Electrical and Electronics Engineering, Atilim University, Incek, Ankara 06830, Turkey
| | - Mehmet Serdar Guzel
- Department of Computer Engineering, Ankara University, Yenimahalle, Ankara 06100, Turkey;
| | - Alok Mishra
- Faculty of Engineering, Norwegian University of Science and Technology, 7034 Trondheim, Norway
- Department of Software Engineering, Atilim University, Incek, Ankara 06830, Turkey
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3
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Yang L, Zeng T, Li Y, Guo Q, Jiang D. Poor immune response to inactivated COVID-19 vaccine in patients with hypertension. Front Med (Lausanne) 2024; 11:1329607. [PMID: 38756945 PMCID: PMC11096495 DOI: 10.3389/fmed.2024.1329607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/03/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose The safety and efficacy of vaccination in people with hypertension (HTN) is important. There are currently a few data on the immunogenicity and safety of inactivated SARS-CoV-2 vaccinations in hypertension patients. Methods After receiving a two-dose immunization, 94 hypertension adult patients and 74 healthy controls (HCs) in this study, the evaluation included looking at antibodies (Abs) against receptor binding domain (RBD) IgG, SARS-CoV-2 neutralizing antibodies (NAbs), RBD-specific B cells, and memory B cells (MBCs). Results There was no discernible difference in the overall adverse events (AEs) over the course of 7 or 30 days between HTN patients and HCs. HTN patients had lower frequencies of RBD-specific memory B cells and the seropositivity rates and titers of Abs compared with HCs (all, p < 0.05). HTN patients with cardiovascular and cerebrovascular conditions (CCVD) have lower titers of CoV-2 NAb than in HCs. The titers of both Abs in HTN declined gradually over time. Conclusion Inactivated COVID-19 vaccinations were safe in hypertension patients; however humoral immune was limited, especially merged CCVD and declined gradually over time.
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Affiliation(s)
- Lei Yang
- Department of Respiratory Medicine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - TingTing Zeng
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yang Li
- Department of Respiratory Medicine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Qiao Guo
- Department of General and Practice, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - DePeng Jiang
- Department of Respiratory Medicine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
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Oraya DB, Militante SKN, Dans LF, Lozada MCH, Valle AOS, Cabaluna ITG. Chest CT Scan Findings in Children with COVID-19: A Systematic Review. ACTA MEDICA PHILIPPINA 2024; 58:110-128. [PMID: 38882921 PMCID: PMC11168958 DOI: 10.47895/amp.v58i7.6385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Objectives To gather, summarize, and appraise the available evidence on: 1) the accuracy of chest CT scan in diagnosing COVID-19 among children, and 2) the characteristic chest CT scan findings associated with COVID-19 pneumonia in children. Methods We comprehensively searched databases (MEDLINE, COCHRANE), clinical trial registries, bibliographic lists of selected studies, and unpublished data for relevant studies. Guide questions from the Painless Evidence Based Medicine and the National Institutes of Health Quality Assessment Tools were used to assess study quality. Results A poor quality study showed 86.0% (95% CI 73.8, 93.0) sensitivity and 75.9% (95% CI 67.1, 83.0) specificity of chest CT scan in diagnosing COVID-19 in children. Thirty-nine observational studies describing chest CT scan in children with COVID-19 showed abnormal findings in 717 of 1028 study subjects. Common chest CT scan findings in this population include: 1) ground glass opacities, patchy shadows, and consolidation, 2) lower lobe involvement, and 3) unilateral lung lesions. Conclusion Studies which investigate the accuracy of chest CT scan in the diagnosis of COVID-19 in children are limited by heterogeneous populations and small sample sizes. While chest CT scan findings such as patchy shadows, ground glass opacities, and consolidation are common in children with COVID-19, these may be similar to the imaging findings of other respiratory viral illnesses.
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Affiliation(s)
- Denisa B Oraya
- Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | | | - Leonila F Dans
- Division of Rheumatology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Maria Cristina H Lozada
- Division of Pulmonology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Andrea Orel S Valle
- Division of Cardiology, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Ian Theodore G Cabaluna
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines Manila
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Tajmirriahi M, Sami R, Mansourian M, Khademi N, Hosseini NS, Dehghan M, Soltaninejad F. The clinical manifestation and outcome of COVID-19 in patients with a history of ischemic heart disease; a retrospective case-control study. BMC Cardiovasc Disord 2023; 23:241. [PMID: 37149583 PMCID: PMC10163857 DOI: 10.1186/s12872-023-03256-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/21/2023] [Indexed: 05/08/2023] Open
Abstract
INTRODUCTION Coronary artery disease (CAD) is considered an independent risk factor for COVID-19. However, no study has specifically examined the clinical manifestations and outcomes of COVID-19 in patients with ischemic heart disease (IHD). METHODS In a retrospective case-control study between 20 March 2020 to 20 May 2020, the medical record of 1611 patients with laboratory-confirmed SARS-CoV-2 infection was reviewed. IHD was defined as a history of an abnormal coronary angiography, coronary angioplasty, coronary artery bypass graft (CABG), or chronic stable angina. Demographic data, past medical history, drug history, symptoms, vital signs, laboratory findings, outcome, and death were investigated from medical records. RESULTS 1518 Patients (882 men (58.1%)) with a mean age of 59.3 ± 15.5 years were included in the study. Patients with IHD (n = 300) were significantly less likely to have fever (OR: 0.170, 95% CI: 0.34-0.81, P < 0.001), and chills (OR: 0.74, 95% CI: 0.45-0.91, P < 0.001). Patients with IHD were 1.57 times more likely to have hypoxia (83.3% vs. 76%, OR: 1.57, 95% CI: 1.13-2.19, P = 0.007). There was no significant difference in terms of WBC, platelets, lymphocytes, LDH, AST, ALT, and CRP between the two groups (P > 0.05). After adjusting for demographic characteristics, comorbidities and vital signs, the risk factors for mortality of these patients were older age (OR: 1.04 and 1.07) and cancer (OR: 1.03, and 1.11) in both groups. In addition, in the patients without IHD, diabetes mellitus (OR: 1.50), CKD (OR: 1.21) and chronic respiratory diseases (OR: 1.48) have increased the odds of mortality. In addition, the use of anticoagulants (OR: 2.77) and calcium channel blockers (OR: 2.00) has increased the odds of mortality in two groups. CONCLUSION In comparison with non-IHD, the symptoms of SARS-CoV-2 infection such as fever, chills and diarrhea were less common among patients with a history of IHD. Also, older age, and comorbidities (including cancer, diabetes mellitus, CKD and chronic obstructive respiratory diseases) have been associated with a higher risk of mortality in patients with IHD. In addition, the use of anticoagulants and calcium channel blockers has increased the chance of death in two groups without and with IHD.
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Affiliation(s)
- Marzieh Tajmirriahi
- Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Sami
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Biology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Khademi
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mehrneagar Dehghan
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Forogh Soltaninejad
- Bamdad Respiratory and Sleep Research Center, Pulmonary ward, Isfahan University of Medical Sciences, Isfahan, Iran.
- Khorshid Hospital, Ostandari St, Isfahan, Iran.
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Saurabh A, Dey B, Raphael V, Barman B, Dev P, Tiewsoh I, Lyngdoh BS, Dutta K. Evaluation of Hematological Parameters in Predicting Intensive Care Unit Admission in COVID-19 Patients. SN COMPREHENSIVE CLINICAL MEDICINE 2022; 4:39. [PMID: 35071985 PMCID: PMC8761838 DOI: 10.1007/s42399-021-01115-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/28/2021] [Indexed: 01/03/2023]
Abstract
Hematological parameters like total leukocyte count (TLC), neutrophil, lymphocyte, and absolute eosinophil counts (AEC), and neutrophil-to-lymphocyte ratio (NLR) are known to predict the severity of novel coronavirus disease 2019 (COVID-19) patients. In the present study, we aimed to study the role of complete blood count parameters in triaging these patients requiring intensive care unit (ICU) admission. A retrospective study was done over a period of 2 months. Patients, who were ≥ 18 years of age with COVID-19 confirmed on SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) and whose routine hematology counts were sent within 24 h of admission, were included in the study. Cut-off values of 47.5 years for age, 11.3 × 109/L for TLC, and 9.1 for NLR were predictive of disease severity among COVID-19 patients. Relative neutrophilia ≥ 70% (p < 0.007), relative lymphopenia ≤ 20% (p < 0.002), AEC ≤ 40/cumm (p < 0.001), and NLR ≥ 9.1 (p < 0.001) were significantly associated with ICU admission. Routine hematological parameters are cost-effective and fast predictive markers for severe COVID-19 patients, especially in resource-constrained health care settings to utilize limited ICU resources more effectively.
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Affiliation(s)
- Animesh Saurabh
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, 793018 India
| | - Biswajit Dey
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, 793018 India
| | - Vandana Raphael
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, 793018 India
| | - Bhupen Barman
- Department of Internal Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Priyanka Dev
- Department of Anaesthesia and Critical Care, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Iadarilang Tiewsoh
- Department of Internal Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Bifica Sofia Lyngdoh
- Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, 793018 India
| | - Kaustuv Dutta
- Department of Anaesthesia and Critical Care, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
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Hao Z, Zhang M, Liu K, Zhang X, Jia H, Chen P. Where Is the Way Forward for New Media Empowering Public Health? Development Strategy Options Based on SWOT-AHP Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12813. [PMID: 36232111 PMCID: PMC9566796 DOI: 10.3390/ijerph191912813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
(1) Background: In recent years, new media and the integration of sport and medicine have promoted the rapid integration and development of the two fields of health and, to a certain extent, the pursuit of public health knowledge and the promotion of health concepts. However, the overall development process is at an early stage and the aim of this paper is to make an empirical analysis of its development through a SWOT-AHP model and give corresponding recommendations. (2) Methods: The SWOT-AHP model was constructed to quantitatively and qualitatively analyse the four dimensions of strengths, weaknesses, opportunities and threats obtained through the Delphi method, with regard to development and to determine the strategic direction of its development. (3) Results: The strategic azimuth θ is -13.243° and the strategic coefficient p is 0.53699, in the diversification zone. (4) Conclusions: New media, as a fast track to empowering the integration of sport and medicine for health, is a field with a bright future, but its own strengths and external threats coexist and should be maximised to overcome the disruptions caused by external threats through a variety of measures.
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Affiliation(s)
- Zikang Hao
- Department of Physical Education, Laoshan Campus, Ocean University of China, 238 Song Ling Rd., Qingdao 266100, China
| | - Mengmeng Zhang
- Department of Competitive Sports Center, Taishan Campus, Taishan College of Science and Technology, 223 Dai Zong Rd., Taian 271000, China
| | - Kerui Liu
- Department of Sports Medicine, Daiyue Campus, Shandong First Medical University, 619 Chang Cheng Rd., Taian 271000, China
| | - Xiaodan Zhang
- Department of Physical Education, Laoshan Campus, Ocean University of China, 238 Song Ling Rd., Qingdao 266100, China
| | - Haoran Jia
- Department of Journalism, Minsk Oblast, Belarusian State University, 4 Nezavisimosti Street, 220071 Minsk, Belarus
| | - Ping Chen
- Department of Physical Education, Laoshan Campus, Ocean University of China, 238 Song Ling Rd., Qingdao 266100, China
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Hasan RR, Saleque AM, Anwar AB, Rahman MA, Tsang YH. Multiwalled Carbon Nanotube-Based On-Body Patch Antenna for Detecting COVID-19-Affected Lungs. ACS OMEGA 2022; 7:28265-28274. [PMID: 35983370 PMCID: PMC9380818 DOI: 10.1021/acsomega.2c02550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A novel rectangular patch antenna based on multiwall carbon nanotubes has been designed and developed for assisting the initial detection of COVID-19-affected lungs. Due to their highly conductive nature, each nanotube echoes electromagnetic waves in a unique manner, influencing the increase in bandwidth. The proposed antenna operates at 6.63, 7.291, 7.29, and 7.22 GHz with a higher bandwidth classified as an ultrawide band and can be used on a human body phantom model because of its flexibility and decreased radiation qualities. Flame retardant 4 is chosen as a substrate with a uniform thickness of 1.62 mm due to its inexpensive cost and excellent electrical properties. The maximum specific absorption rate of the proposed antenna is obtained as 1.77 W/kg for 10 g of tissues. For testing purposes, a model including all the known features of COVID-19-affected lungs is developed. The designed antenna exhibits excellent performance in free space, normal lungs, and affected lung environments. It might be utilized as a first screening device for COVID-19 patients, especially in resource-constrained areas where traditional medical equipment such as X-ray and computerized tomography scans are scarce.
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Affiliation(s)
- Raja Rashidul Hasan
- Department
of Electrical and Electronic Engineering, American International University-Bangladesh (AIUB), Dhaka 1229, Bangladesh
| | - Ahmed Mortuza Saleque
- Department
of Applied Physics and Materials Research Center, The Hong Kong Polytechnic University, Hung Hom, Kowloon 999077, Hong Kong
- Shenzhen
Research Institute, The Hong Kong Polytechnic
University, Shenzhen 518057, Guangdong, People’s
Republic of China
| | - Afrin Binte Anwar
- Department
of Electrical and Electronic Engineering, American International University-Bangladesh (AIUB), Dhaka 1229, Bangladesh
| | - Md. Abdur Rahman
- Department
of Electrical and Electronic Engineering, American International University-Bangladesh (AIUB), Dhaka 1229, Bangladesh
| | - Yuen Hong Tsang
- Department
of Applied Physics and Materials Research Center, The Hong Kong Polytechnic University, Hung Hom, Kowloon 999077, Hong Kong
- Shenzhen
Research Institute, The Hong Kong Polytechnic
University, Shenzhen 518057, Guangdong, People’s
Republic of China
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Karimabad MN, Hassanshahi G, Kounis NG, Mplani V, Roditis P, Gogos C, Lagadinou M, Assimakopoulos SF, Dousdampanis P, Koniari I. The Chemokines CXC, CC and C in the Pathogenesis of COVID-19 Disease and as Surrogates of Vaccine-Induced Innate and Adaptive Protective Responses. Vaccines (Basel) 2022; 10:vaccines10081299. [PMID: 36016187 PMCID: PMC9416781 DOI: 10.3390/vaccines10081299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 02/07/2023] Open
Abstract
COVID-19 is one of the progressive viral pandemics that originated from East Asia. COVID-19 or SARS-CoV-2 has been shown to be associated with a chain of physio-pathological mechanisms that are basically immunological in nature. In addition, chemokines have been proposed as a subgroup of chemotactic cytokines with different activities ranging from leukocyte recruitment to injury sites, irritation, and inflammation to angiostasis and angiogenesis. Therefore, researchers have categorized the chemotactic elements into four classes, including CX3C, CXC, CC, and C, based on the location of the cysteine motifs in their structures. Considering the severe cases of COVID-19, the hyperproduction of particular chemokines occurring in lung tissue as well as pro-inflammatory cytokines significantly worsen the disease prognosis. According to the studies conducted in the field documenting the changing expression of CXC and CC chemokines in COVID-19 cases, the CC and CXC chemokines contribute to this pandemic, and their impact could reflect the development of reasonable strategies for COVID-19 management. The CC and the CXC families of chemokines are important in host immunity to viral infections and along with other biomarkers can serve as the surrogates of vaccine-induced innate and adaptive protective responses, facilitating the improvement of vaccine efficacy. Furthermore, the immunogenicity elicited by the chemokine response to adenovirus vector vaccines may constitute the basis of vaccine-induced immune thrombotic thrombocytopaenia.
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Affiliation(s)
- Mojgan Noroozi Karimabad
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan 7717933777, Iran
| | - Gholamhossein Hassanshahi
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan 7717933777, Iran
| | - Nicholas G. Kounis
- Department of Internal Medicine, Division of Cardiology, University of Patras Medical School, 26500 Patras, Greece
- Correspondence:
| | - Virginia Mplani
- Intensive Care Unit, Patras University Hospital, 26500 Patras, Greece
| | - Pavlos Roditis
- Department of Cardiology, Mamatsio Kozanis General Hospital, 50100 Kozani, Greece
| | - Christos Gogos
- COVID-19 Unit, Papageorgiou General Hospital, 56403 Thessaloniki, Greece
| | - Maria Lagadinou
- Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, 26500 Patras, Greece
| | - Stelios F. Assimakopoulos
- Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, 26500 Patras, Greece
| | - Periklis Dousdampanis
- Department of Nephrology, Saint Andrews State General Hospital, 26221 Patras, Greece
| | - Ioanna Koniari
- Department of Cardiology, University Hospital of South Manchester, NHS Foundation Trust, Manchester M23 9LT, UK
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Aziz Alimul Hidayat A, Chen WL, Nor RM, Uliyah M, Badriyah FL, Ubudiyah M. The determinants of patient care manager role and the implementation of COVID-19 clinical pathway: a cross-sectional study. PeerJ 2022; 10:e13764. [PMID: 35910779 PMCID: PMC9332306 DOI: 10.7717/peerj.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/30/2022] [Indexed: 01/17/2023] Open
Abstract
Objective This study aims to determine the factors associated with patient care manager role and the implementation of the clinical pathway among nurses in private hospitals. Methods This study was conducted from January-July 2021 using the cross-sectional approach. The sample consisted of 168 nurses working in a private hospital in Surabaya City, East Java, Indonesia. Meanwhile, the data were collected using the Patient Care Manager Role Scale (PCMRS) and analyzed by multiple logistic regression to find the correlation between the variables. Results A higher percentage of nurses namely 64.3% had compliance in COVID-19 clinical pathways with an average PCMRS score of 27.81 ± 2.43. Nurses with a high-level patient care manager role level had a significant compliance risk with odds ratio [OR] 440.137, 95% confidence interval [CI] [51.850-3736.184], and p-value = 0.000 compared to those with a low role. Conclusion The role of patient care manager and compliance with COVID-19 clinical pathways correlated significantly. Based on the results, several actions are needed for the early identification of patient service managers' roles to ensure compliance with COVID-19 clinical pathways and reduce the number of cases in Indonesia.
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Affiliation(s)
| | - Wen-Ling Chen
- Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Kaohsiung, Taiwan
| | - Rahimah Mohd Nor
- Faculty of Health & Life Sciences, Management & Science University, Selangor, Selangor, Malaysia
| | - Musrifatul Uliyah
- Nursing, University Muhammadiyah of Surabaya, Surabaya, East Jawa, Indonesia
| | | | - Masunatul Ubudiyah
- Nursing, Universitas Muhammadiyah Lamongan, Lamongan, East Java, Indonesia
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11
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Majumder D. Development of a Fast Fourier Transform-based Analytical Method for COVID-19 Diagnosis from Chest X-Ray Images Using GNU Octave. J Med Phys 2022; 47:279-286. [PMID: 36684704 PMCID: PMC9846998 DOI: 10.4103/jmp.jmp_26_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/13/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
Purpose Many artificial intelligence-based computational procedures are developed to diagnose COVID-19 infection from chest X-ray (CXR) images, as diagnosis by CXR imaging is less time consuming and economically cheap compared to other detection procedures. Due to unavailability of skilled computer professionals and high computer architectural resource, majority of the employed methods are difficult to implement in rural and poor economic settings. Majority of such reports are devoid of codes and ignores related diseases (pneumonia). The absence of codes makes limitation in applying them widely. Hence, validation testing followed by evidence-based medical practice is difficult. The present work was aimed to develop a simple method that requires a less computational expertise and minimal level of computer resource, but with statistical inference. Materials and Methods A Fast Fourier Transform-based (FFT) method was developed with GNU Octave, a free and open-source platform. This was employed to the images of CXR for further analysis. For statistical inference, two variables, i.e., the highest peak and number of peaks in the FFT distribution plot were considered. Results The comparison of mean values among different groups (normal, COVID-19, viral, and bacterial pneumonia [BP]) showed statistical significance, especially when compared to normal, except between viral and BP groups. Conclusion Parametric statistical inference from our result showed high level of significance (P < 0.001). This is comparable to the available artificial intelligence-based methods (where accuracy is about 94%). Developed method is easy, availability with codes, and requires a minimal level of computer resource and can be tested with a small sample size in different demography, and hence, be implemented in a poor socioeconomic setting.
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Affiliation(s)
- Durjoy Majumder
- Department of Physiology, West Bengal State University, Kolkata, West Bengal, India
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12
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Zhou T, Wu J, Zeng Y, Li J, Yan J, Meng W, Han H, Feng F, He J, Zhao S, Zhou P, Wu Y, Yang Y, Han R, Jin W, Li X, Yang Y, Li X. SARS-CoV-2 triggered oxidative stress and abnormal energy metabolism in gut microbiota. MedComm (Beijing) 2022; 3:e112. [PMID: 35281785 PMCID: PMC8906553 DOI: 10.1002/mco2.112] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 12/19/2022] Open
Abstract
Specific roles of gut microbes in COVID-19 progression are critical. However, the circumstantial mechanism remains elusive. In this study, shotgun metagenomic or metatranscriptomic sequencing was performed on fecal samples collected from 13 COVID-19 patients and controls. We analyzed the structure of gut microbiota, identified the characteristic bacteria, and selected biomarkers. Further, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotations were employed to correlate the taxon alterations and corresponding functions. The gut microbiota of COVID-19 patients was characterized by the enrichment of opportunistic pathogens and depletion of commensals. The abundance of Bacteroides spp. displayed an inverse relationship with COVID-19 severity, whereas Actinomyces oris, Escherichia coli, and Streptococcus parasanguini were positively correlated with disease severity. The genes encoding oxidoreductase were significantly enriched in gut microbiome of COVID-19 group. KEGG annotation indicated that the expression of ABC transporter was upregulated, while the synthesis pathway of butyrate was aberrantly reduced. Furthermore, increased metabolism of lipopolysaccharide, polyketide sugar, sphingolipids, and neutral amino acids were found. These results suggested the gut microbiome of COVID-19 patients was in a state of oxidative stress. Healthy gut microbiota may enhance antiviral defenses via butyrate metabolism, whereas the accumulation of opportunistic and inflammatory bacteria may exacerbate COVID-19 progression.
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Affiliation(s)
- Tuoyu Zhou
- Ministry of Education Key Laboratory of Cell Activities and Stress AdaptationsSchool of Life SciencesLanzhou UniversityLanzhouP. R. China
| | - Jingyuan Wu
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Yufei Zeng
- State Key Joint Laboratory of Environment Simulation and Pollution ControlSchool of EnvironmentTsinghua UniversityBeijingP. R. China
| | - Junfeng Li
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Jun Yan
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Wenbo Meng
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Huawen Han
- Ministry of Education Key Laboratory of Cell Activities and Stress AdaptationsSchool of Life SciencesLanzhou UniversityLanzhouP. R. China
| | - Fengya Feng
- Ministry of Education Key Laboratory of Cell Activities and Stress AdaptationsSchool of Life SciencesLanzhou UniversityLanzhouP. R. China
| | - Jufang He
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Shuai Zhao
- Ministry of Education Key Laboratory of Cell Activities and Stress AdaptationsSchool of Life SciencesLanzhou UniversityLanzhouP. R. China
| | - Ping Zhou
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Ying Wu
- Ministry of Education Key Laboratory of Cell Activities and Stress AdaptationsSchool of Life SciencesLanzhou UniversityLanzhouP. R. China
| | - Yanlin Yang
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Rong Han
- Ministry of Education Key Laboratory of Cell Activities and Stress AdaptationsSchool of Life SciencesLanzhou UniversityLanzhouP. R. China
| | - Weilin Jin
- Medical Frontier Innovation Research CenterThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Xun Li
- Gansu Province Key Laboratory Biotherapy and Regenerative MedicineThe First Hospital of Lanzhou UniversityLanzhouP. R. China
| | - Yunfeng Yang
- State Key Joint Laboratory of Environment Simulation and Pollution ControlSchool of EnvironmentTsinghua UniversityBeijingP. R. China
| | - Xiangkai Li
- Ministry of Education Key Laboratory of Cell Activities and Stress AdaptationsSchool of Life SciencesLanzhou UniversityLanzhouP. R. China
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13
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Ning B, Youngquist BM, Li DD, Lyon CJ, Zelazny A, Maness NJ, Tian D, Hu TY. Rapid detection of multiple SARS-CoV-2 variants of concern by PAM-targeting mutations. CELL REPORTS METHODS 2022; 2:100173. [PMID: 35156077 PMCID: PMC8818353 DOI: 10.1016/j.crmeth.2022.100173] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/26/2021] [Accepted: 01/31/2022] [Indexed: 12/02/2022]
Abstract
SARS-CoV-2 variants of concern (VOCs) that increase transmission or disease severity or reduce diagnostic or vaccine efficacy continue to emerge across the world. Current methods available to rapidly detect these can be resource intensive and thus sub-optimal for large-scale deployment needed during a pandemic response. Here, we describe a CRISPR-based assay that detects mutations in spike gene CRISPR PAM motif or seed regions to identify a pan-specific VOC single-nucleotide polymorphism (SNP)) ((D614G) and Alpha- and Delta-specific (S982A and D950N) SNPs. This assay exhibits good diagnostic sensitivity and strain specificity with nasal swabs and is designed for use in laboratory and point-of-care settings. This should enable rapid, high-throughput VOC identification required for surveillance and characterization efforts to inform clinical and public health decisions. Furthermore, the assay can be adapted to target similar SNPs associated with emerging SARS-CoV-2 VOCs, or other rapidly evolving viruses.
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Affiliation(s)
- Bo Ning
- Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Brady M. Youngquist
- Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Diane D. Li
- Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Christopher J. Lyon
- Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Adrian Zelazny
- Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Di Tian
- The Molecular Pathology Laboratory, Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Tony Y. Hu
- Center for Cellular and Molecular Diagnostics, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, LA, USA
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Liu B, Liu H, Han B, Zhao T, Sun T, Tan X, Cui F. Trends and Factors Associated With Risk Perception, Anxiety, and Behavior From the Early Outbreak Period to the Controlled Period of COVID-19 Epidemic: Four Cross-Sectional Online Surveys in China in 2020. Front Public Health 2022; 9:768867. [PMID: 35118042 PMCID: PMC8805284 DOI: 10.3389/fpubh.2021.768867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/16/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The first wave of the COVID-19 epidemic in China was brought under with 3 months-from mid-January 2020 to the end of March 2020. Less studies examined dynamic psychological effect and behaviors during COVID-19 pandemic. This study aims to examine perceived risk, anxiety, and behavioral response of the general public related to the outbreak of COVID-19 in four cross-sectional surveys conducted throughout China. Methods: In 2020, four cross-sectional, population-based online survey were conducted from January 28 to February 3, from February 10 to 12, from February 20 to 22, and from March 1 to 10, respectively. Convenience sampling was used for easy recruiting survey participants under the long-term impact of the COVID-19 epidemic. The four independent online questionnaires were sent from the same approach (WeChat and MicroBlog), and anyone who receives the questionnaire on the Internet or mobile phone and meets the inclusion criteria could fill in it. The same questionnaires repeatedly used in the four surveys. Socio-demographic information and individual protective practice were collected and the state-trait anxiety inventory (STAI) was used for measuring anxiety. Propensity score matching was used to adjust for differences in baseline characteristics among the four surveys. Wilcoxon signed ranks test was used to compare people's perceived risk, anxiety and protective behaviors changes in four stages. General linear model was used to identify associations between some demographic factors and perceived risk, anxiety scores, and protective behaviors. Results: The proportion of high perceived risk has dropped from 24.7 to 4.7%. The proportion of severe anxiety has declined from 12.2 to 1.2%. The proportion of people wore masks when they went out has increased from 97.0 to 98.3%. Women were more likely to develop anxiety (OR = 1.5, 95%CI: 1.4-1.6) and more positively adopted recommended behaviors (OR = 2.1, 95%CI: 1.3-3.4) than men. People at age 30-39 years, with high-degree education, with married status, and accompanied with poor self-rated health status were prone to have higher risk perception and anxiety. Perceived risk was significantly associated with anxiety over the entire periods. Anxiety levels had stronger associations with adoption of protective behaviors (wearing mask and avoiding crowed place) in the early epidemic periods than in the late epidemic periods. Conclusions: The levels of perceived risk and anxiety showed a trend of rising first and then falling. Gradually upward trend on initiative preventive behaviors including wearing mask and avoiding visiting crowded places also was observed through scanning data at four stages. People at age 30-39 years, with high-degree education, and accompanied with poor self-rated health status were prone to have higher risk perception and anxiety. Our findings showed that people simultaneously presented both high-level risk perception and anxiety across the four wave surveys, leading to their positive self-prevention and protective behavior.
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Affiliation(s)
- Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Hanyu Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Bingfeng Han
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Tianshuo Zhao
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
| | - Tao Sun
- Department of Health Policy and Management, School of Medicine, Hangzhou Normal University, Hangzhou, China
| | - Xiaodong Tan
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing, China
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15
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Saminan S, Julisafrida L, Ridwan M, Fajri N. COVID-19 Pandemic: What Considerations Should Be Taken during the Assessment and Management of COPD Exacerbation? Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The on-going coronavirus disease 2019 (COVID-19) pandemic could contribute to higher mortality in population with underlying respiratory diseases, including chronic obstructive pulmonary disease (COPD). The aim of this review was to inform readers pertaining to the correlation of COPD exacerbation and severe acute respiratory syndrome-2 (SARS-CoV-2) infection along with considerations that could be taken in the clinical diagnosis and management. The literature search was conducted on Google Scholar, Scopus, and PubMed databases using related terms (such as, but not limited to, “COVID-19,” “SARS-CoV-2,” “COPD management,” “N-acetylcysteine,” and “corticosteroids”) on November 1–9, 2021. Recent studies suggest that COVID-19 and COPD are correlated through three pathways, namely, angiotensin-converting enzyme 2 expression, dysregulation of biological parameters, and occurrence of pneumonia. Early detection of COVID-19 in patients with underlying COPD is difficult because they share similar symptoms, attributed to advanced progression of the infection and subsequently deteriorates lung function. During COPD management, clinicians are expected to take consideration on the effect of systemic corticosteroids if patients develop COVID-19. In conclusion, COVID-19 and COPD and its management are potentially correlated, contributing to the worsening of the disease. There is a need of immediate research to reveal the true correlation between COVID-19 and COPD to improve the management.
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16
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Innovations and development of Covid-19 vaccines: A patent review. J Infect Public Health 2022; 15:123-131. [PMID: 34742639 PMCID: PMC8539827 DOI: 10.1016/j.jiph.2021.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/04/2021] [Accepted: 10/18/2021] [Indexed: 02/08/2023] Open
Abstract
More than 125 million confirmed cases of COVID-19 have been reported globally with rising cases in all countries since the first case was reported. A vaccine is the best measure for the effective prevention and control of COVID-19. There are more than 292 COVID-19 candidates' vaccines being developed as of July 2021 of which 184 are in human preclinical trials. A patent provides protection and a marketing monopoly to the inventor of an invention for a specified period. Therefore, vaccine developers, including Moderna, BioNTech, Janssen, Inovio, and Gamaleya also filed patent applications for the protection of their vaccines. This review aims to provide an insight into the patent literature of COVID-19 vaccines. The patent search was done using Patentscope and Espacenet databases. The results have revealed that most of the key players have patented their inventive COVID-19 vaccine. Many patent applications related to COVID-19 vaccines developed via different technologies (DNA, RNA, virus, bacteria, and protein subunit) have also been filed. The publication of a normal patent application takes place after 18 months of its filing. Therefore, many patents/patent applications related to the COVID-19 vaccine developed through different technology may come into the public domain in the coming days.
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17
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Smereka P, Anthopolos R, Latson LA, Kirsch P, Dane B. Using Lung Base Covid-19 Findings to Predict Future Disease Trends and New Variant Outbreaks: Study of First New York City (NYC) Outbreak. Acad Radiol 2021; 28:1645-1653. [PMID: 34740527 PMCID: PMC8484077 DOI: 10.1016/j.acra.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES Asymptomatic COVID-19 carriers and insufficient testing make containment of the virus difficult. The purpose of this study was to determine if unexpected lung base findings on abdominopelvic CTs concerning for COVID-19 infection could serve as a surrogate for the diagnosis of COVID-19 in the community. MATERIALS AND METHODS A database search of abdominopelvic CT reports from March 1,2020 to May 2,2020 was performed for keywords suggesting COVID-19 infection by lung base findings. COVID-19 status, respiratory symptoms, laboratory parameters and patient outcomes (hospitalization, ICU admission and/or intubation, and death) were recorded. The trend in cases of unexpected concerning lung base findings on abdominopelvic CT at our institution was compared to the total number of confirmed new cases in NYC over the same time period. RESULTS The trend in abnormal lung base findings on abdominopelvic CT at our institution correlated with the citywide number of confirmed new cases, including rise and subsequent fall in total cases. The trend was not mediated by COVID-19 testing status or number of tests performed. Patients with respiratory symptoms had significantly higher ferritin (median = 995ng/ml vs 500ng/ml, p = 0.027) and death rate (8/24, 33% vs 4/54, 9%, p = 0.018) compared to those without. CONCLUSION The rise and fall of unexpected lung base findings suggestive of COVID-19 infection on abdominopelvic CT in patients without COVID-19 symptoms correlated with the number of confirmed new cases throughout NYC from the same time period. A model using abdominopelvic CT lung base findings can serve as a surrogate for future COVID-19 outbreaks.
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Affiliation(s)
- Paul Smereka
- Department of Radiology (P.S., R.A., L.L., P.K., B.D.), NYU Langone Health, 660 1(st) Avenue, New York, NY 10016.
| | - Rebecca Anthopolos
- Department of Radiology (P.S., R.A., L.L., P.K., B.D.), NYU Langone Health, 660 1(st) Avenue, New York, NY 10016
| | - Larry A Latson
- Department of Radiology (P.S., R.A., L.L., P.K., B.D.), NYU Langone Health, 660 1(st) Avenue, New York, NY 10016
| | - Polly Kirsch
- Department of Radiology (P.S., R.A., L.L., P.K., B.D.), NYU Langone Health, 660 1(st) Avenue, New York, NY 10016
| | - Bari Dane
- Department of Radiology (P.S., R.A., L.L., P.K., B.D.), NYU Langone Health, 660 1(st) Avenue, New York, NY 10016
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18
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Nopour R, Kazemi-Arpanahi H, Shanbehzadeh M, Azizifar A. Performance analysis of data mining algorithms for diagnosing COVID-19. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:405. [PMID: 35071611 PMCID: PMC8719570 DOI: 10.4103/jehp.jehp_138_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/22/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND An outbreak of atypical pneumonia termed COVID-19 has widely spread all over the world since the beginning of 2020. In this regard, designing a prediction system for the early detection of COVID-19 is a critical issue in mitigating virus spread. In this study, we have applied selected machine learning techniques to select the best predictive models based on their performance. MATERIALS AND METHODS The data of 435 suspicious cases with COVID-19 which were recorded from the Imam Khomeini Hospital database between May 9, 2020 and December 20, 2020, have been taken into consideration. The Chi-square method was used to determine the most important features in diagnosing the COVID-19; eight selected data mining algorithms including multilayer perceptron (MLP), J-48, Bayesian Net (Bayes Net), logistic regression, K-star, random forest, Ada-boost, and sequential minimal optimization (SMO) were applied in data mining. Finally, the most appropriate diagnostic model for COVID-19 was obtained based on comparing the performance of the selected algorithms. RESULTS As the result of using the Chi-square method, 21 variables were identified as the most important diagnostic criteria in COVID-19. The results of evaluating the eight selected data mining algorithms showed that the J-48 with true-positive rate = 0.85, false-positive rate = 0.173, precision = 0.85, recall = 0.85, F-score = 0.85, Matthews Correlation Coefficient = 0.68, and area under the receiver operator characteristics = 0.68, respectively, had the higher performance than the other algorithms. CONCLUSION The results of evaluating the performance criteria showed that the J-48 can be considered as a suitable computational prediction model for diagnosing COVID-19 disease.
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Affiliation(s)
- Raoof Nopour
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Health Information Technology, Abadan University of Medical Sciences, Abadan, Iran
- Student Research Committee Department, Abadan University of Medical Sciences, Abadan, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Akbar Azizifar
- Department of English Language, School of Medicine, Ilam University of Medical Science, Ilam, Iran
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19
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Sadighbayan D, Minhas-Khan A, Ghafar-Zadeh E. Laser-Induced Graphene-Functionalized Field-Effect Transistor-Based Biosensing: A Potent Candidate for COVID-19 Detection. IEEE Trans Nanobioscience 2021; 21:232-245. [PMID: 34648455 PMCID: PMC9088816 DOI: 10.1109/tnb.2021.3119996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Speedy and on-time detection of coronavirus disease 2019 (COVID-19) is of high importance to control the pandemic effectively and stop its disastrous consequences. A widely available, reliable, label-free, and rapid test that can recognize tiny amounts of specific biomarkers might be the solution. Nanobiosensors are one of the most attractive candidates for this purpose. Integration of graphene with biosensing devices shifts the performance of these systems to an incomparable level. Between the various arrangements using this wonder material, field-effect transistors (FETs) display a precise detection even in complex samples. The emergence of pioneering biosensors for detecting a wide range of diseases especially COVID-19 created the incentive to prepare a review of the recent graphene-FET biosensing platforms. However, the graphene fabrication and transfer to the surface of the device is an imperative factor for researchers to take into account. Therefore, we also reviewed the common methods of manufacturing graphene for biosensing applications and discuss their advantages and disadvantages. One of the most recent synthesizing techniques - laser-induced graphene (LIG) - is attracting attention owing to its extraordinary benefits which are thoroughly explained in this article. Finally, a conclusion highlighting the current challenges is presented.
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20
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Khamis N, Saimy IS, Ibrahim NH, Badaruddin NK, Mohd Hassan NZA, Kusnin F, Sandhu SS, Mohamed M. Progression of the Pathway for Public Health Care during the COVID-19 Outbreak at District Health Office. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10533. [PMID: 34639833 PMCID: PMC8507755 DOI: 10.3390/ijerph181910533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022]
Abstract
Public health activities under district health offices (DHOs) play a major role in Malaysia's fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are familiar with DHO work settings was created in April 2020 for that purpose. Review of documents and the Ministry of Health's updates was carried out, followed by a series of discussions with stakeholders. Based on the steps in the outbreak investigation tasks, the flow of activities from January to May 2020 was listed in line with the phases of the country's National Movement Control Order 2020. Results show that the activities can be classified into three different sections-namely, the main action areas, category of cases, and level of care. The main process flow of activities comprised the case management and support activities. Case management flow was split into tasks for patients under investigation and persons under surveillance, while the support services existed throughout the phases. The pathways illustrate that the progression of the pandemic translated directly to changes in the pattern of activities, with additional subgroups of activities in accordance with all imposed guidelines.
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Affiliation(s)
- Noraziani Khamis
- Institute for Health Management, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (I.S.S.); (N.H.I.); (N.K.B.)
| | - Intan Syafinaz Saimy
- Institute for Health Management, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (I.S.S.); (N.H.I.); (N.K.B.)
| | - Nor Hayati Ibrahim
- Institute for Health Management, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (I.S.S.); (N.H.I.); (N.K.B.)
| | - Nur Khairah Badaruddin
- Institute for Health Management, Ministry of Health Malaysia, Shah Alam 40170, Malaysia; (I.S.S.); (N.H.I.); (N.K.B.)
| | | | - Faridah Kusnin
- Klang District Health Office, Selangor Health Department, Ministry of Health Malaysia, Klang 41200, Malaysia; (F.K.); (S.S.S.); (M.M.)
| | - Sukhvinder Singh Sandhu
- Klang District Health Office, Selangor Health Department, Ministry of Health Malaysia, Klang 41200, Malaysia; (F.K.); (S.S.S.); (M.M.)
| | - Masitah Mohamed
- Klang District Health Office, Selangor Health Department, Ministry of Health Malaysia, Klang 41200, Malaysia; (F.K.); (S.S.S.); (M.M.)
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21
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Azimzadeh M, Möhn N, Ghane Ezabadi S, Moghimi Esfandabadi Z, Soleimani A, Ranjbar E, Jahromi M, Seyedebrahimi R, Skripuletz T, Moharrami Kasmaie F. The Immunological Therapeutic Strategies for Controlling Multiple Sclerosis: Considerations during the COVID-19 Pandemic. Biomolecules 2021; 11:1372. [PMID: 34572585 PMCID: PMC8470206 DOI: 10.3390/biom11091372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022] Open
Abstract
A growing body of evidence initially suggested that patients with multiple sclerosis (MS) might be more susceptible to coronavirus disease 2019 (COVID-19). Moreover, it was speculated that patients with MS treated with immunosuppressive drugs might be at risk to develop a severe diseases course after infection with the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2). However, the recently published data have shown that MS patients do not have a higher risk for severe COVID-19. Although there is no indication that patients with MS and immunomodulatory/immunosuppressive therapy are generally at a higher risk of severe COVID-19, it is currently being emphasized that the hazards of poorly treated MS may outweigh the putative COVID-19 dangers. In this review, we discuss the challenges and considerations for MS patients in the COVID-19 pandemic.
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Affiliation(s)
- Maryam Azimzadeh
- Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran;
| | - Nora Möhn
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Sajjad Ghane Ezabadi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran;
| | | | - Alireza Soleimani
- Department of Medical Laboratory Sciences, Faculty of Paramedicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran;
| | - Elaheh Ranjbar
- Department of Paramedical Sciences, Gonabad University of Medical Sciences, Gonabad, Iran;
| | - Maliheh Jahromi
- Department of Anatomical Science, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran;
| | - Reihaneh Seyedebrahimi
- Department of Anatomical Sciences, School of Medicine, Qom University of Medical Sciences, Qom, Iran;
| | - Thomas Skripuletz
- Department of Neurology, Hannover Medical School, 30625 Hannover, Germany;
| | - Farshad Moharrami Kasmaie
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
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22
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Narin A. Accurate detection of COVID-19 using deep features based on X-Ray images and feature selection methods. Comput Biol Med 2021; 137:104771. [PMID: 34450381 PMCID: PMC8373589 DOI: 10.1016/j.compbiomed.2021.104771] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 01/19/2023]
Abstract
COVID-19 is a severe epidemic affecting the whole world. This epidemic, which has a high mortality rate, affects the health systems and the economies of countries significantly. Therefore, ending the epidemic is one of the most important priorities of all states. For this, automatic diagnosis and detection systems are very important to control the epidemic. In addition to the recommendation of the “reverse transcription-polymerase chain reaction (RT-PCR)” test, additional diagnosis and detection systems are required. Hence, based on the fact that the COVID-19 virus attacks the lungs, automatic diagnosis and detection systems developed using X-ray and CT images come to the fore. In this study, a high-performance detection system was implemented with three different CNN (ResNet50, ResNet101, InceptionResNetV2) models and X-ray images of three different classes (COVID-19, Normal, Pneumonia). The particle swarm optimization (PSO) algorithm and ant colony algorithm (ACO) was applied among the feature selection methods, and their performances were compared. The results were obtained using support vector machines (SVM) and a k-nearest neighbor (k-NN) classifier using the 10-fold cross-validation method. The highest overall accuracy performance was 99.83% with the SVM algorithm without feature selection. The highest performance was achieved after the feature selection process with the SVM + PSO method as 99.86%. As a result, higher performance with less computational load has been achieved by realizing the feature selection. Based on the high results obtained, it is thought that this study will benefit radiologists as a decision support system.
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Affiliation(s)
- Ali Narin
- Zonguldak Bulent Ecevit University, Faculty of Engineering, Department of Electrical and Electronics Engineering, Zonguldak, Turkey.
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Who Is the Most Vulnerable to Anxiety at the Beginning of the COVID-19 Outbreak in China? A Cross-Sectional Nationwide Survey. Healthcare (Basel) 2021; 9:healthcare9080970. [PMID: 34442107 PMCID: PMC8394659 DOI: 10.3390/healthcare9080970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/23/2022] Open
Abstract
(1) Background: The COVID-19 pandemic has not only changed people’s health behavior, but also induced a psychological reaction among the public. Research data is needed to develop scientific evidence-driven strategies to reduce adverse mental health effects. The aims of this study are to evaluate the anxiety reaction of Chinese people and the related determinants during the earliest phase of the COVID-19 outbreak in China. Evidence from this survey will contribute to a targeted reference on how to deliver psychological counseling service in the face of outbreaks. (2) Methods: A cross-sectional, population-based online survey was conducted from 28 January to 5 February 2020 using an open online questionnaire for people aged 18 years or above, residing in China and abroad. The socio-demographic information of the respondents was collected, and anxiety scores were calculated. A direct standardization method was used to standardize anxiety scores and a general linear model was used to identify associations between some factors (e.g., sex, age, education, etc.) and anxiety scores. (3) Results: A total of 10,946 eligible participants were recruited in this study, with a completion rate of 98.16% (10,946/11,151). The average anxiety score was 6.46 ± 4.12 (total score = 15); women (6.86 ± 4.11) scored higher than men (5.67 ± 4.04). The age variable was inversely and significantly associated with the anxiety score (β = −2.12, 95% CI: −2.47–−1.78). People possessing higher education (β = 1.15, 95% CI: 0.88–1.41) or a higher awareness of cognitive risk (β = 4.89, 95% CI: 4.33–5.46) reported higher levels of anxiety. There was a close association between poor subjective health and anxiety status (β = 2.83, 95% CI: 2.58–3.09). With the increase of confidence, the anxiety of the population exhibited a gradual decline (β = −2.45, 95% CI: −2.77–−2.13). (4) Conclusion: Most people were vulnerable to anxiety during the earliest phase of the COVID-19 outbreak in China. Younger women, individuals with high education, people with high cognitive risk and subjective poor health were vulnerable to anxiety during the epidemic. In addition, increasing confidence in resisting this pandemic is a protective determinant for individuals to develop anxiety. The findings suggest that policymakers adopt psychosocial interventions to reduce anxiety during the pandemic.
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Groot G, Baer S, Badea A, Dalidowicz M, Yasinian M, Ali A, Carr T, Reeder B. Developing a rapid evidence response to COVID-19: The collaborative approach of Saskatchewan, Canada. Learn Health Syst 2021; 6:e10280. [PMID: 34514125 PMCID: PMC8420570 DOI: 10.1002/lrh2.10280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction The COVID‐19 Evidence Support Team (CEST) was a provincial initiative that combined the support of policymakers, researchers, and clinical practitioners to initiate a new learning health cycle (LHS) in response to the pandemic. The primary aim of CEST was to produce and sustain the best available COVID‐19 evidence to facilitate decision‐making in Saskatchewan, Canada. To achieve this objective, four provincial organizations partnered to establish a single, data‐driven system. Methods The CEST partnership was driven by COVID‐19 questions from Emergency Operational Committee (EOC) of the Saskatchewan Health Authority. CEST included three processes: (a) clarifying the nature and priority of COVID‐19 policy and clinical questions; (b) providing Rapid Reviews (RRR) and Evidence Search Reports (ESR); and (c) seeking the requestors' evaluation of the product. A web‐based repository, including a dashboard and database, was designed to house ESRs and RRRs and offered a common platform for clinicians, academics, leaders, and policymakers to find COVID‐19 evidence. Results In CEST's first year, 114 clinical and policy questions have been posed resulting in 135 ESRs and 108 RRRs. While most questions (41.3%) originated with the EOC, several other teams were assembled to address a myriad of questions related to areas such as long‐term care, public health and prevention, infectious diseases, personal protective equipment, vulnerable populations, and Indigenous health. Initial challenges were mobilization of diverse partners and teams, remote work, lack of public access, and quality of emerging COVID‐19 literature. Current challenges indicate the need for institutional commitment for CEST sustainability. Despite these challenges, the CEST provided the Saskatchewan LHS with a template for successful collaboration. Conclusions The urgency of COVID‐19 pandemic and the implementation of the CEST served to catalyze collaboration between different levels of a Saskatchewan LHS.
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Affiliation(s)
- Gary Groot
- Department of Community Health and Epidemiology University of Saskatchewan Saskatoon Saskatchewan Canada.,Saskatchewan Health Authority Saskatoon Saskatchewan Canada
| | - Susan Baer
- Saskatchewan Health Authority Saskatoon Saskatchewan Canada
| | - Andreea Badea
- Department of Community Health and Epidemiology University of Saskatchewan Saskatoon Saskatchewan Canada
| | | | - Maryam Yasinian
- Department of Community Health and Epidemiology University of Saskatchewan Saskatoon Saskatchewan Canada
| | - Anum Ali
- Department of Community Health and Epidemiology University of Saskatchewan Saskatoon Saskatchewan Canada
| | - Tracey Carr
- Department of Community Health and Epidemiology University of Saskatchewan Saskatoon Saskatchewan Canada
| | - Bruce Reeder
- Department of Community Health and Epidemiology University of Saskatchewan Saskatoon Saskatchewan Canada
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Türkay Kunt A, Kozaci N, Torun E. Mortality Predictors in Patients Diagnosed with COVID-19 in the Emergency Department: ECG, Laboratory and CT. ACTA ACUST UNITED AC 2021; 57:medicina57060629. [PMID: 34204209 PMCID: PMC8233881 DOI: 10.3390/medicina57060629] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 01/15/2023]
Abstract
Background and Objectives: The aim of this study was to investigate parameters that can be used to predict mortality in patients diagnosed with COVID-19 in the emergency department (ED). Materials and Methods: Patients diagnosed with COVID-19 in the ED were included in this prospective study. The patients were divided into two groups. The surviving patients were included in Group 1 (survivors), and the patients who died were included in Group 2 (non-survivors). The electrocardiogram (ECG), laboratory results and chest computerized tomography (CCT) findings of the two groups were compared. The CCT images were classified according to the findings as normal, mild, moderate and severe. Results: Of the 419 patients included in the study, 347 (83%) survived (survivor) and 72 (17%) died (non-survivor). The heart rate and respiratory rate were found to be higher, and the peripheral oxygen saturation (SpO2) and diastolic blood pressure (DBP) were found to be lower in the non-survivor patients. QRS and corrected QT interval (QTc) were measured as longer in the non-survivor patients. In the CCT images, 79.2% of the non-survivor patients had severe findings, while 11.5% of the survivor patients had severe findings. WBC, neutrophil, NLR, lactate, D-dimer, fibrinogen, C- Reactive Protein (CRP), urea, creatinine, creatine kinase-MB (CK-MB) and hs-Troponin I levels were found to be higher and partial pressure of carbon dioxide (PCO2), base excess (BE), bicarbonate (HCO3), lymphocyte eosinophil levels were found to be lower in non-survivor patients. The highest AUC was calculated at the SpO2 level and the eosinophil level. Conclusions: COVID-19 is a fatal disease whose mortality risk can be estimated when the clinical, laboratory and imaging studies of the patients are evaluated together in the ED. SpO2 that is measured before starting oxygen therapy, the eosinophil levels and the CT findings are all important predictors of mortality risk.
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Affiliation(s)
- Aslı Türkay Kunt
- Department of Emergency Medicine, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya 07450, Turkey;
- Correspondence: ; Tel.: +90-(533)-939-2717
| | - Nalan Kozaci
- Department of Emergency Medicine, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya 07450, Turkey;
| | - Ebru Torun
- Department of Radiology, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya 07450, Turkey;
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Liu TY, Rai A, Ditkofsky N, Deva DP, Dowdell TR, Ackery AD, Mathur S. Cost benefit analysis of portable chest radiography through glass: Initial experience at a tertiary care centre during COVID-19 pandemic. J Med Imaging Radiat Sci 2021; 52:186-190. [PMID: 33875400 PMCID: PMC8026266 DOI: 10.1016/j.jmir.2021.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/12/2021] [Accepted: 03/29/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Portable chest radiography through glass (TG-CXR) is a novel technique, particularly useful during the COVID-19 (Coronavirus disease 2019) pandemic. The purpose of this study was to understand the cost and benefit of adopting TG-CXR in quantifiable terms. METHODS Portable or bedside radiographs are typically performed by a team of two technologists. The TG-CXR method has the benefit of allowing one technologist to stay outside of the patient room while operating the portable radiography machine, reducing PPE use, decreasing the frequency of radiography machine sanitization and decreasing technologists' exposures to potentially infectious patients. The cost of implementing this technique during the current COVID-19 pandemic was obtained from our department's operational database. The direct cost of routinely used PPE and sanitization materials and the cost of the time taken by the technologists to clean the machine was used to form a quantitative picture of the benefit associated with TG-CXR technique. RESULTS Technologists were trained on the TG-CXR method during a 15 min shift change briefing. This translated to a one-time cost of $424.88 USD. There was an average reduction of portable radiography machine downtime of 4 min and 48 s per study. The benefit of adopting the TG-CXR technique was $9.87 USD per patient imaged. This will result in a projected net cost savings of $51,451.84 USD per annum. CONCLUSION Adoption of the TG-CXR technique during the COVID-19 pandemic involved minimal one-time cost, but is projected to result in a net-benefit of over $51,000 USD per annum in our emergency department.
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Affiliation(s)
- Tian Yang Liu
- Department of Radiology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada. M5B 1W8.
| | - Archana Rai
- Department of Radiology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada. M5B 1W8
| | - Noah Ditkofsky
- Department of Radiology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada. M5B 1W8
| | - Djeven P Deva
- Department of Radiology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada. M5B 1W8; Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, 209 Victoria Street, Toronto, ON, Canada. M5B 1T8
| | - Timothy R Dowdell
- Department of Radiology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada. M5B 1W8
| | - Alun Duncan Ackery
- Department of Emergency Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Shobhit Mathur
- Department of Radiology, St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada. M5B 1W8
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Lin Y, Rong J, Zhang Z. Silent existence of eosinopenia in sepsis: a systematic review and meta-analysis. BMC Infect Dis 2021; 21:471. [PMID: 34030641 PMCID: PMC8142617 DOI: 10.1186/s12879-021-06150-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 05/06/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Sepsis is a life-threatening and time-critical medical emergency; therefore, the early diagnosis of sepsis is essential to timely treatment and favorable outcomes for patients susceptible to sepsis. Eosinopenia has been identified as a potential biomarker of sepsis in the past decade. However, its clinical application progress is slow and its recognition is low. Recent studies have again focused on the potential association between Eosinopenia and severe infections. This study analyzed the efficacy of Eosinopenia as a biomarker for diagnosis of sepsis and its correlation with pathophysiology of sepsis. METHOD The protocol for this meta-analysis is available in PROSPERO (CRD42020197664). We searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials CENTRAL databases to identify studies that met the inclusion criteria. Two authors performed data extraction independently. The pooled outcomes were calculated by TP (true positive), FP (false positive), FN (false negative), TN (true negative) by using bivariate meta-analysis model in STATA 14.0 software. Meanwhile, possible mechanisms of sepsis induced Eosinopenia was also analyzed. RESULTS Seven studies were included in the present study with a total number of 3842 subjects. The incidence of Eosinopenia based on the enrolled studies varied from 23.2 to 92.7%. For diagnosis of sepsis, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of Eosinopenia were 0.66 (95%CI [0.53-0.77]), 0.68 (95%CI [0.56-0.79]), 2.09 (95%CI [1.44-3.02]), 0.49 (95%CI [0.34-0.71]) and 4.23 (95%CI [2.15-8.31]), respectively. The area under the summary receiver operator characteristic curve (SROC) was 0.73 (95%CI [0.68-0.76]). Meta-regression analysis revealed that no single parameter accounted for the heterogeneity of pooled outcomes. For each subgroup of different eosinopenia cutoff values (50, 40, ≤25, 100), the sensitivity was 0.61, 0.79, 0.57, 0.54, and the specificity was 0.61, 0.75, 0.83, 0.51, respectively. CONCLUSIONS Our findings suggested that Eosinopenia has a high incidence in sepsis but has no superiority in comparison with conventional biomarkers for diagnosis of sepsis. However, eosinopenia can still be used in clinical diagnosis for sepsis as a simple, convenient, fast and inexpensive biomarker. Therefore, further large clinical trials are still needed to re-evaluate eosinopenia as a biomarker of sepsis.
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Affiliation(s)
- Yao Lin
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiabing Rong
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhaocai Zhang
- Department of Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Exploring the potential of novel phenolic compounds as potential therapeutic candidates against SARS-CoV-2, using quantum chemistry, molecular docking and dynamic studies. Bioorg Med Chem Lett 2021; 43:128079. [PMID: 33940136 PMCID: PMC8087859 DOI: 10.1016/j.bmcl.2021.128079] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 12/23/2022]
Abstract
In the current study, the interaction of SARS-CoV-2 protein (A and B chains of nsp13) with different recently synthesized phenolic compounds (Sreenivasulu et al., Synthetic Communications, 2020, 112-122) has been studied. The interactions have been investigated by using molecular docking, quantum chemical and molecular dynamics simulations methods. The molecular structures of all the ligands are studied quantum chemically in terms of their optimized structures, 3-D orbital distributions, global chemical descriptors, molecular electrostatic potential plots and HOMO-LUMO orbital energies. All the ligands show reasonably good binding affinities with nsp-13 protein. The ligand L2 shows to have better binding affinities to Chain A and Chain B of nsp13 protein, which are -6.7 and -6.4 kcal/mol. The study of intermolecular interactions indicates that L2 shows different hydrophobic and hydrogen bond interactions with both chains. Furthermore, molecular dynamic simulations of the nsp13-L2 complex are obtained over a time scale of 60 ns, which indicates its stability and flexibility behavior as assessed in terms of its RMSD and RMSF graphs. The ADMET analysis also shows no violation of Lipinski rule (RO5) by studied phenolic compounds. We believe that the current findings will be further confirmed by in vitro and in vivo studies of these recent phenolic compounds for their potential as inhibitors for SARS-Co-V-2 virus.
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de Oliveira LC, Rosa KSDC, Durante AL, Ramadas Rodrigues LDO, da Cunha DADO, de Oliveira LAF, de Freitas R, Borsatto AZ, Esteves EMFL, Sampaio SGDSM. Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center. Am J Hosp Palliat Care 2021; 38:512-520. [PMID: 33455418 PMCID: PMC7983337 DOI: 10.1177/1049909120986962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Advanced cancer patients are part of a group likely to be more susceptible to COVID-19. AIMS To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases. DESIGN Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI). RESULTS One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome. CONCLUSION Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.
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Affiliation(s)
- Livia Costa de Oliveira
- Palliative Care Unit, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
| | - Karla Santos da Costa Rosa
- Palliative Care Unit, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
| | - Ana Luísa Durante
- Palliative Care Unit, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
| | | | | | | | - Renata de Freitas
- Palliative Care Unit, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
| | - Alessandra Zanei Borsatto
- Palliative Care Unit, National Cancer Institute José Alencar Gomes da Silva (INCA), Rio de Janeiro, Brazil
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Atta H, Hasan HA, Elmorshedy R, Gabr A, Abbas WA, El-Barody MM. Validation of imaging reporting and data system of coronavirus disease 2019 lexicons CO-RADS and COVID-RADS with radiologists’ preference: a multicentric study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [PMCID: PMC8048342 DOI: 10.1186/s43055-021-00485-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Abstract
Background
A retrospective multicentric study gathered 1439 CT chest studies with suspected coronavirus disease 2019 (COVID-19) affection. Three radiologists, blinded to other results, interpreted all studies using both lexicons with documentation of applicability and preferred score in assessing every case. The purpose of the study is to assess COVID-19 standardized assessment schemes’ (CO-RADS and COVID-RADS lexicons) applicability and diagnostic efficacy.
Results
This study included 991 RT-PCR-confirmed CT studies. An almost perfect agreement was found in COVID-RADS among the three observers (Fleiss Kappa = 0.82), opposed by a substantial agreement in CO-RADS (Κ = 0.78). The preference records favor COVID-RADS/CO-RADS in 78.5%/12.5%, 75.5%/24.5%, and 73.4%/24.5% regarding the three radiologists’ records, respectively. The distinguishability between positive and negative RT-PCR cases was 0.92 for COVID-RADS, while it was 0.85 for CO-RADS. On the other hand, both lexicons’ performance regarding clinical diagnosis and clinical suspicion index was 0.93 for COVID-RADS and 0.94 for CO-RADS. A very high to excellent agreement between the three observers for COVID-RADS/CO-RADS preference was concluded (Fleiss Kappa = 0.80 to 0.94). These results were statistically significant (p < 0.001).
Conclusion
Both lexicon scores (CO-RADS and COVID-RADS) were found to be applicable in the COVID-19 structured report with the preference of COVID-RADS in more than 50% of cases. The diagnostic accuracy of COVID-RADS against RT-PCR was higher than that of CO-RADS.
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Karimi F, Vaezi AA, Qorbani M, Moghadasi F, Gelsfid SH, Maghoul A, Mahmoodi N, Eskandari Z, Gholami H, Mokhames Z, Saleh M. Clinical and laboratory findings in COVID-19 adult hospitalized patients from Alborz province / Iran: comparison of rRT-PCR positive and negative. BMC Infect Dis 2021; 21:256. [PMID: 33706699 PMCID: PMC7948661 DOI: 10.1186/s12879-021-05948-5] [Citation(s) in RCA: 6] [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: 07/08/2020] [Accepted: 03/02/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) was emergency turned into global public health after the first patients were detected in Wuhan, China, in December 2019. The disease rapidly expanded and led to an epidemic throughout China, followed by the rising number of cases worldwide. Given the high prevalence of COVID-19, rapid and accurate diagnostic methods are immediately needed to identify, isolate and treat the patients as soon as possible, decreasing mortality rates and the risk of public contamination by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). METHODS This case-control study was conducted in two hospitals in Alborz Province in Iran. All recruited cases in this study were symptomatic adults hospitalized as COVID-19 patients with compatible Computed tomographic (CT) scan findings and available rRT-PCR results. The patients were recruited in this study. The patients were categorized into positive and negative rRT-PCR groups and evaluated for symptoms, initial vital signs, comorbidity, clinical and laboratory findings. Finally, the results were assessed by SPSS software. RESULTS Between March 5 to April 5, 2020, 164 symptomatic COVID-19 patients were studied. In total, there were 111 rRT-PCR positive (67.6%) and 53 rRT-PCR negative patients (32.4%). In terms of statistics, the frequency of symptoms revealed no difference, except for cough (P.V:0.008), dizziness (PV: 0.048), and weakness (P.V:0.022). Among initial vital signs, PR (P.V:0.041) and O2 Saturation (PV: 0.014) were statistically different between the two groups. Evaluation of comorbidities revealed no difference except for hyperlipidemia (P.V:0.024). In the comparison of laboratory findings, only WBC count (PV: 0.001), lymphocyte count (PV: 0.001), and Hb (P.V:0.008) were statistically different between the two groups. CONCLUSION In case of the negative rRT-PCR result, it is necessary to take a logical approach, and we recommended that the physician decides according to clinical manifestations, laboratory findings, and positive CT results.
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Affiliation(s)
- Farnaz Karimi
- Department of Pathology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Amir Abbas Vaezi
- Department of Internal Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Chronic Diseases Research Center, Tehran University of Medical Sciences Endocrinology and Metabolism Research Institute, Tehran, Iran
| | - Fatemeh Moghadasi
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Arman Maghoul
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Neda Mahmoodi
- Imam Jafar Sadegh hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Zahra Eskandari
- Department of Health in emergencies and disasters, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Gholami
- Imam Ali hospital, Alborz University of Medical Sciences, Karaj, Iran
| | - Zakiye Mokhames
- Department of molecular diagnostics, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahshid Saleh
- Department of Applied Cell Sciences, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Tu YH, Guo Y, Ji S, Shen JL, Fei GH. The Influenza A Virus H3N2 Triggers the Hypersusceptibility of Airway Inflammatory Response via Activating the lncRNA TUG1/miR-145-5p/NF-κB Pathway in COPD. Front Pharmacol 2021; 12:604590. [PMID: 33841139 PMCID: PMC8029562 DOI: 10.3389/fphar.2021.604590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 01/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with chronic obstructive pulmonary disease (COPD) are more susceptible to influenza A virus (IAV) with more severe symptoms, yet the underlying molecular mechanisms of the hypersusceptibility of airway inflammatory response remain unclear. Methods: The primary human bronchial epithelial cells (pHBECs) were isolated from normal and COPD bronchial tissues (NHBE and DHBE) and cultured with/without IAV infection in vitro. DHBE cells were exposed to IAV for 24 h after knockdown of lncRNA TUG1 with short hairpin RNA (shRNA). Gain-of-function assays were performed with the miR-145-5p inhibitor and NF-κBp65 transfection. The expressions of lncRNA TUG1, miR-145-5p, phospho-NF-κBp65, NF-κBp65, TNF-α, and (Interleukin) IL-1β were examined with qRT-PCR, Western blotting, and ELISA. The interactions of lncRNA TUG1, miR-145-5p, and NF-κB were verified with luciferase reporter assay. Results: The expressions of lncRNA TUG1, phospho-NF-κBp65, TNF-α, and IL-1β were increased significantly in pHBECs after being infected with IAV for 24 h (all p0.05). The detailed time analysis revealed that the NF-κBp65 in DHBE was activated earlier than that in NHBE by Western blotting and immunofluorescence. Knockdown of lncRNA TUG1 and miR-145-5p mimic attenuated the expressions of NF-κBp65, TNF-α, and IL-1β significantly. The miR-145-5p inhibitor and NF-κBp65 transfection reversed the attenuated expressions of NF-κBp65, TNF-α, and IL-1β. Conclusion: The IAV causes the hypersusceptibility of airway inflammatory response, which may be closely associated with more severe symptoms in AECOPD patients. The lncRNA TUG1 inhibitor may be a promising therapeutic strategy for AECOPD caused by IAV.
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Affiliation(s)
- You-Hui Tu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yan Guo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shuang Ji
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ji-Long Shen
- Department of Pathogen Biology and Provincial Laboratories of Pathogen Biology and Zoonoses, Anhui Medical University, Hefei, China
| | - Guang-He Fei
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Key Laboratory of Respiratory Disease Research and Medical Transformation of Anhui Province, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Tur-Kaspa I, Tur-Kaspa T, Hildebrand G, Cohen D. COVID-19 may affect male fertility but is not sexually transmitted: a systematic review. ACTA ACUST UNITED AC 2021; 2:140-149. [PMID: 33558864 PMCID: PMC7857030 DOI: 10.1016/j.xfnr.2021.01.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 12/12/2022]
Abstract
Objective To determine if SARS-CoV-2, which has led to the rapidly spreading COVID-19 global pandemic, is sexually transmitted. Since the putative receptor for the virus is identified in reproductive organs, it is also important to examine if COVID-19 may affect human fertility. Evidence Review A systematic review of English publications was conducted up to December 11, 2020 in PubMed, NIH iCite COVID-19 portfolio, Cochrane Library, and Google Scholar databases, searching for SARS-CoV-2 in the testes; seminal, prostatic, and vaginal fluids; and cervical smears. A total of 1,997 records were identified, duplicates were removed, and 1,490 records were reviewed for eligibility by examining titles and abstracts. Subsequently, 202 full-text relevant articles were reviewed by 2 independent reviewers. Forty-seven studies (literature reviews, editorials, and guidelines) were assessed qualitatively, and 23 studies that tested the male and female reproductive tracts of patients with COVID-19 for SARS-CoV-2 were quantitatively analyzed. Results No epidemiological investigations to date have described evidence suggesting that COVID-19 is an STD. While angiotensin-converting enzyme 2 receptor is found in the reproductive organs, the lack of co-expression of the TMPRSS2 modulatory protein, required for SARS-CoV-2 cell entry, in testicular cells, sperm, or oocytes, argues against the hypothesis that gametes transmit SARS-CoV-2. Molecular detection studies of SARS-CoV-2 RNA in the male and female reproductive tracts were summarized: 98.0% (293/299) of the seminal fluids, 16/17 testicular biopsies, all 89 prostatic fluids, 98.3% (57/58) of the vaginal fluids, all 35 cervical smears, and all 16 oocyte samples tested negative for SARS-CoV-2. None of the studies confirmed sexual transmission of SARS-CoV-2. Nonetheless, COVID-19 may have detrimental effects on male reproduction by inducing orchitis and/or decreasing testosterone levels, sperm counts, and motility. Conclusion On the basis of the current worldwide published information, COVID-19 is not an STD. This information is important for clinicians, proposed guidelines for public health, U.S. Food and Drug Administration guidelines for gamete and tissue donor eligibility, and fertility treatments. Universal precautions, currently practiced worldwide, are adequate and sufficient at this time to prevent the transmission of known or unknown viral infections. We suggest that recovered patients of COVID-19, especially those with infertility, should be evaluated for their ovarian and testicular function.
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Affiliation(s)
- Ilan Tur-Kaspa
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana
| | - Tomer Tur-Kaspa
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana.,Wesleyan University, Middletown, Connecticut
| | - Grace Hildebrand
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana
| | - David Cohen
- Institute for Human Reproduction (IHR), Chicago and Oak Brook, Illinois, and Valparaiso, Indiana
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Abstract
PURPOSE OF REVIEW The recent COVID-19 outbreak has clearly shown how epidemics/pandemics can challenge developed countries' healthcare systems. Proper management of equipment and human resources is critical to provide adequate medical care to all patients admitted to the hospital and the ICU for both pandemic-related and unrelated reasons. RECENT FINDINGS Appropriate separate paths for infected and noninfected patients and prompt isolation of infected critical patients in dedicated ICUs play a pivotal role in limiting the contagions and optimizing resources during pandemics. The key to handle these challenging events is to learn from past experiences and to be prepared for future occurrences. Hospital space should be redesigned to quickly increase medical and critical care capacity, and healthcare workers (critical and noncritical) should be trained in advance. SUMMARY A targeted improvement of hospital and ICU protocols will increase medical care quality for patients admitted to the hospital for any clinical reasons during a pandemic.
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Affiliation(s)
- Gaetano Florio
- Department of Pathophysiology and Transplantation, University of Milan
| | - Alberto Zanella
- Department of Pathophysiology and Transplantation, University of Milan
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Pesenti
- Department of Pathophysiology and Transplantation, University of Milan
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Gómez Antúnez M, Muiño Míguez A, Bendala Estrada AD, Maestro de la Calle G, Monge Monge D, Boixeda R, Ena J, Mella Pérez C, Anton Santos JM, Lumbreras Bermejo C. Clinical Characteristics and Prognosis of COPD Patients Hospitalized with SARS-CoV-2. Int J Chron Obstruct Pulmon Dis 2021; 15:3433-3445. [PMID: 33447021 PMCID: PMC7801905 DOI: 10.2147/copd.s276692] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/26/2020] [Indexed: 01/08/2023] Open
Abstract
Objective To describe the characteristics and prognosis of patients with COPD admitted to the hospital due to SARS-CoV-2 infection. Methods The SEMI-COVID registry is an ongoing retrospective cohort comprising consecutive COVID-19 patients hospitalized in Spain since the beginning of the pandemic in March 2020. Data on demographics, clinical characteristics, comorbidities, laboratory tests, radiology, treatment, and progress are collected. Patients with COPD were selected and compared to patients without COPD. Factors associated with a poor prognosis were analyzed. Results Of the 10,420 patients included in the SEMI-COVID registry as of May 21, 2020, 746 (7.16%) had a diagnosis of COPD. Patients with COPD are older than those without COPD (77 years vs 68 years) and more frequently male. They have more comorbidities (hypertension, hyperlipidemia, diabetes mellitus, atrial fibrillation, heart failure, ischemic heart disease, peripheral vascular disease, kidney failure) and a higher Charlson Comorbidity Index (2 vs 1, p<0.001). The mortality rate in COPD patients was 38.3% compared to 19.2% in patients without COPD (p<0.001). Male sex, a history of hypertension, heart failure, moderate-severe chronic kidney disease, presence of cerebrovascular disease with sequelae, degenerative neurological disease, dementia, functional dependence, and a higher Charlson Comorbidity Index have been associated with increased mortality due to COVID-19 in COPD patients. Survival was higher among patients with COPD who were treated with hydroxychloroquine (87.1% vs 74.9%, p<0.001) and with macrolides (57.9% vs 50%, p<0.037). Neither prone positioning nor non-invasive mechanical ventilation, high-flow nasal cannula, or invasive mechanical ventilation were associated with a better prognosis. Conclusion COPD patients admitted to the hospital with SARS-CoV-2 infection have more severe disease and a worse prognosis than non-COPD patients.
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Affiliation(s)
- María Gómez Antúnez
- Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain
| | - Antonio Muiño Míguez
- Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain
| | | | | | | | - Ramón Boixeda
- Internal Medicine Department, Mataró Hospital, Mataró, Barcelona, Spain
| | - Javier Ena
- Internal Medicine Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
| | - Carmen Mella Pérez
- Internal Medicine Department, Ferrol University Hospital Complex, Ferrol, A Coruña, Spain
| | | | | | - On behalf of the SEMI-COVID-19 Network
- Internal Medicine Department, Gregorio Marañón University Hospital, Madrid, Spain
- Internal Medicine Department, 12 de Octubre University Hospital, Madrid, Spain
- Internal Medicine Department, Segovia Hospital Complex, Segovia, Spain
- Internal Medicine Department, Mataró Hospital, Mataró, Barcelona, Spain
- Internal Medicine Department, Marina Baixa Hospital, Villajoyosa, Alicante, Spain
- Internal Medicine Department, Ferrol University Hospital Complex, Ferrol, A Coruña, Spain
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, Madrid, Spain
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George JA, Mayne ES. The Novel Coronavirus and Inflammation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1321:127-138. [PMID: 33656719 DOI: 10.1007/978-3-030-59261-5_11] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The SARS-CoV-2 virus which causes COVID-19 disease was initially described in the Hubei Province of China and has since spread to more than 200 countries and territories of the world. Severe cases of the disease are characterised by release of high levels of pro-inflammatory cytokines and other inflammatory mediators in a process characterised as a cytokine storm. These inflammatory mediators are associated with pathological leukocyte activation states with tissue damage. Here, we review these effects with a focus on their potential use in diagnosis, patient stratification and prognosis, as well as new drug targets.
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Affiliation(s)
- J A George
- Department of Chemical Pathology, National Health Laboratory Services and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - E S Mayne
- Department of Immunology, National Health Laboratory Services and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Carcaterra M, Caruso C. Alveolar epithelial cell type II as main target of SARS-CoV-2 virus and COVID-19 development via NF-Kb pathway deregulation: A physio-pathological theory. Med Hypotheses 2021; 146:110412. [PMID: 33308936 PMCID: PMC7681037 DOI: 10.1016/j.mehy.2020.110412] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/19/2020] [Indexed: 02/08/2023]
Abstract
The Corona Virus Disease (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) requires a rapid solution and global collaborative efforts in order to define preventive and treatment strategies. One of the major challenges of this disease is the high number of patients needing advanced respiratory support due to the Acute Respiratory Distress Syndrome (ARDS) as the lung is the major - although not exclusive - target of the virus. The molecular mechanisms, pathogenic drivers and the target cell type(s) in SARS-CoV-2 infection are still poorly understood, but the development of a "hyperactive" immune response is proposed to play a role in the evolution of the disease and it is envisioned as a major cause of morbidity and mortality. Here we propose a theory by which the main targets for SARS-CoV-2 are the Type II Alveolar Epithelial Cells and the clinical manifestations of the syndrome are a direct consequence of their involvement. We propose the existence of a vicious cycle by which once alveolar damage starts in AEC II cells, the inflammatory state is supported by macrophage pro-inflammatory polarization (M1), cytokines release and by the activation of the NF-κB pathway. If this theory is confirmed, future therapeutic efforts can be directed to target Type 2 alveolar cells and the molecular pathogenic drivers associated with their dysfunction with currently available therapeutic strategies.
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Affiliation(s)
| | - Cristina Caruso
- Radiation Oncology, San Giovanni Addolorata Hospital, Rome, Italy
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Bouazza B, Hadj-Said D, Pescatore KA, Chahed R. Are Patients with Asthma and Chronic Obstructive Pulmonary Disease Preferred Targets of COVID-19? Tuberc Respir Dis (Seoul) 2021; 84:22-34. [PMID: 33099990 PMCID: PMC7801803 DOI: 10.4046/trd.2020.0101] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/30/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
The coronavirus pandemic, known as coronavirus disease 2019 (COVID-19), is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus first identified in patients from Wuhan, China. Since December 2019, SARS-CoV-2 has spread swiftly around the world, infected more than 25 million people, and caused more than 800,000 deaths in 188 countries. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) appear to be risk factors for COVID-19, however, their prevalence remains controversial. In fact, studies in China reported lower rates of chronic respiratory conditions in patients with COVID-19 than in the general population, while the trend is reversed in the United States and Europe. Although the underlying molecular mechanisms of a possible interaction between COVID-19 and chronic respiratory diseases remain unknown, some observations can help to elucidate them. Indeed, physiological changes, immune response, or medications used against SARS-CoV-2 may have a greater impact on patients with chronic respiratory conditions already debilitated by chronic inflammation, dyspnea, and the use of immunosuppressant drugs like corticosteroids. In this review, we discuss importance and the impact of COVID-19 on asthma and COPD patients, the possible available treatments, and patient management during the pandemic.
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Affiliation(s)
- Belaid Bouazza
- Department of Biochemistry and Microbiology, Faculty of Biological and Agricultural Sciences, Mouloud Mammeri University, Tizi-Ouzou, Algeria
| | - Dihia Hadj-Said
- Department of Biochemistry and Microbiology, Faculty of Biological and Agricultural Sciences, Mouloud Mammeri University, Tizi-Ouzou, Algeria
| | | | - Rachid Chahed
- Cabinet Médical Privé, Spécialité de Pneumologie, Tizi-Ouzou, Algeria
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Floriani ID, Borgmann AV, Barreto MR, Ribeiro ER. EXPOSURE OF PEDIATRIC EMERGENCY PATIENTS TO IMAGING EXAMS, NOWADAYS AND IN TIMES OF COVID-19: AN INTEGRATIVE REVIEW. REVISTA PAULISTA DE PEDIATRIA 2020; 40:e2020302. [PMID: 33331510 PMCID: PMC7747787 DOI: 10.1590/1984-0462/2022/40/2020302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/12/2020] [Indexed: 11/22/2022]
Abstract
Objective: To analyze literature data about unnecessary exposure of pediatric emergency patients to ionizing agents from imaging examinations, nowadays and during times of COVID-19. Data sources: Between April and July 2020, articles were selected using the databases: Virtual Health Library, PubMed and Scientific Electronic Library Online. The following descriptors were used: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] and [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Inclusion criteria were articles available in full, in Portuguese or English, published from 2016 to 2020 or from 2019 to 2020, and articles that covered the theme. Articles without adherence to the theme and duplicate texts in the databases were excluded. Data synthesis: 61 publications were identified, of which 17 were comprised in this review. Some imaging tests used in pediatric emergency departments increase the possibility of developing future malignancies in patients, since they emit ionizing radiation. There are clinical decision instruments that allow reducing unnecessary exam requests, avoiding over-medicalization, and hospital expenses. Moreover, with the COVID-19 pandemic, there was a growing concern about the overuse of imaging exams in the pediatric population, which highlights the problems pointed out by this review. Conclusions: It is necessary to improve hospital staff training, use clinical decision instruments and develop guidelines to reduce the number of exams required, allowing hospital cost savings; and reducing children’s exposure to ionizing agents.
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Mahmoud H, Taha MS, Askoura A, Aleem M, Omran A, Aboelela S. Can chest CT improve sensitivity of COVID-19 diagnosis in comparison to PCR? A meta-analysis study. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2020. [PMCID: PMC7649892 DOI: 10.1186/s43163-020-00039-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Abstract Background In December 2019, SARS-CoV-2 was identified as the causative agent of pneumonia cases in China. This virus is spread by coughing or sneezing and can infect other persons by on contacting mucous membranes. SARS-Cov-2 most frequent serious manifestation is pneumonia. Chest computed tomography in COVID-19 patients usually shows ground-glass opacities that may be accompanied by consolidation lesions. Early diagnosis of the disease and rapid isolation of the patient is of great importance. So far, confirmation of COVID-19 infection is made by RT-PCR of nasopharyngeal or respiratory specimens. Recent research reported that the sensitivity of computed tomography in diagnosing COVID-19 is 98% while RT-PCR sensitivity is 71%. Herein, we compare the sensitivity of both chest CT and RT-PCR in diagnosing COVID-19 at initial patient presentation through a meta-analysis study. Main body Using MEDLINE database a systematic literature search was conducted to identify relevant published studies within from November 2019 to April 2020. Only articles with full text were examined to determine eligibility and extract data by two reviewers. It was decided to include studies mentioning sensitivity of chest CT scan and sensitivity of RT-PCR and both done at the same time. Results Potentially relevant 15,300 studies were identified in our search in MEDLINE whose titles were quickly reviewed. Potentially eligible studies missing any of the forementioned inclusion criteria were excluded. This process left 7 eligible articles that fulfilled the inclusion criteria and were thus included in the meta-analysis and used for further analyses. Conclusion The meta-analysis study showed that chest CT may be beneficial in early detection of cases of COVID-19. Imaging, in adjunct to clinical and laboratory findings, should be used for monitoring of disease course, until further evidence is available.
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Khourssaji M, Chapelle V, Evenepoel A, Belkhir L, Yombi JC, van Dievoet MA, Saussoy P, Coche E, Fillée C, Constantinescu SN, Rodriguez-Villalobos H, Defour JP, Gruson D. A biological profile for diagnosis and outcome of COVID-19 patients. Clin Chem Lab Med 2020; 58:2141-2150. [PMID: 33064667 DOI: 10.1515/cclm-2020-0626] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/02/2020] [Indexed: 12/13/2022]
Abstract
Objectives As severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) pandemic is increasing its victims on a global scale with recurring outbreaks, it remains of outmost importance to rapidly identify people requiring an intensive care unit (ICU) hospitalization. The aim of this study was to identify Coronavirus Disease 2019 (COVID-19) biomarkers, to investigate their correlation with disease severity and to evaluate their usefulness for follow-up. Methods Fifty patients diagnosed with SARS-Cov-2 were included in March 2020. Clinical and biological data were collected at admission, during hospitalization and one month after discharge. Patients were divided into two severity groups: non-ICU (28) and ICU and/or death (22) to stratify the risk. Results Blood parameters in COVID-19 patients at admission showed increased C-reactive protein (CRP) (100%), ferritin (92%), lactate dehydrogenase (LDH) (80%), white blood cell (WBC) count (26%) with lymphopenia (52%) and eosinopenia (98%). There were significant differences in levels of CRP, ferritin, D-dimers, fibrinogen, lymphocyte count, neutrophil count and neutrophil-to-lymphocyte ratio (NLR) among the two severity groups. Mapping of biomarker's kinetics distinguished early and late parameters. CRP, ferritin, LDH, lymphopenia and eosinopenia were present upon admission with a peak at the first week. Late biomarkers such as anemia, neutrophilia and elevated liver biomarkers appeared after one week with a peak at three weeks of hospitalization. Conclusions We confirmed that high-values of CRP, NLR, D-dimers, ferritin as well as lymphopenia and eosinopenia were consistently found and are good markers for risk stratification. Kinetics of these biomarkers correlate well with COVID-19 severity. Close monitoring of early and late biomarkers is crucial in the management of critical patients to avoid preventable deaths.
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Affiliation(s)
- Mehdi Khourssaji
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Virginie Chapelle
- Department of Hematology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Anton Evenepoel
- Department of Hematology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Leila Belkhir
- Department of Infectious Diseases, Cliniques Universitaires St-Luc and Université catholique de Louvain, Brussels, Belgium
| | - Jean Cyr Yombi
- Department of Infectious Diseases, Cliniques Universitaires St-Luc and Université catholique de Louvain, Brussels, Belgium
| | - Marie-Astrid van Dievoet
- Department of Hematology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Pascale Saussoy
- Department of Hematology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Emmanuel Coche
- Department of Radiology, Cliniques Universitaires St-Luc and Université catholique de Louvain, Brussels, Belgium
| | - Catherine Fillée
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | | | - Hector Rodriguez-Villalobos
- Department of Microbiology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Jean-Philippe Defour
- Department of Hematology, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Damien Gruson
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium.,Pôle de recherche en Endocrinologie, Diabète et Nutrition, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St-Luc and Université catholique de Louvain, Brussels, Belgium
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Associations of procalcitonin, C-reaction protein and neutrophil-to-lymphocyte ratio with mortality in hospitalized COVID-19 patients in China. Sci Rep 2020; 10:15058. [PMID: 32929124 PMCID: PMC7490259 DOI: 10.1038/s41598-020-72164-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 08/20/2020] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an important and urgent threat to global health. Inflammation factors are important for COVID-19 mortality, and we aim to explore whether the baseline levels of procalcitonin (PCT), C-reaction protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) are associated with an increased risk of mortality in patients with COVID-19. A retrospective study was conducted and a total of 76 patients with confirmed COVID-19 were included between January 17, 2020 to March 2, 2020, of these cases, 17 patients were dead. After adjusting covariates, PCT (≥ 0.10 ng/mL) and CRP (≥ 52.14 mg/L) exhibited independent increasing risks of mortality were used hazard ratio (HR) of 52.68 (95% confidence interval [CI]: 1.77–1571.66) and 5.47 (95% CI: 1.04–28.72), respectively. However, NRL (≥ 3.59) was not found to be an independent risk factor for death in our study. Furthermore, the elevated PCT levels were still associated with increasing risk of mortality in the old age group (age ≥ 60 y), and in the critically severe and severe patients after adjustment for complications. Thu Baseline levels of PCT and CRP have been addressed as independent predictors of mortality in patients with COVID-19.
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Munteanu C, PĂUN DL, ȘUȚĂ AM, FLORESCU SA, ONOSE G. Diabetes mellitus and COVID-19 in the post-acute phase patients - possible links with physical and rehabilitation medicine and balneotherapy. BALNEO RESEARCH JOURNAL 2020; 11:350-367. [DOI: 10.12680/balneo.2020.363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Background. The outbreak of COVID-19 - COronaVIrus Disease 2019 - has become a significant threat to public health worldwide, with high contagious capacity and varied mortality in different countries. Diabetes mellitus (DM/ diabetes) is among the most frequently reported comorbidities in patients with COVID-19. In the field of physical and rehabilitation medicine and balneotherapy, specific rehabilitation procedures, natural therapeutic factors, and physical activity are known to be contributive to mitigating some of the DM clinical-patho-biological consequences. Objective. This systematic review aims to rigorously select related articles and identify within their content, the main possible interferences between DM and COVID-19’s pathological mechanisms, and to discuss the value of physical and rehabilitation medicine and balneotherapy in the post-acute COVID-19 recovery of the surviving patients. Methods. This systematic review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searched for open-access articles published in English, between January and May 2020, from the following databases: Cochrane, Elsevier, PubMed and Web of Science. The contextually searched syntax used was ”DIABETES AND COVID-19”. The selected articles were analyzed in detail regarding both pathologies: COVID-19 and DM. The meta-analysis proceeded was designated to estimate the prevalence of DM among COVID-19 patients. Results. Our search has been conducted on five stages, described by a PRISMA adapted flow diagram. Within the first stage, using the syntax mentioned above resulted in 1,133 articles. After eliminating, in the second stage, all the inevitable redundancies remained 1,058 articles. In the third stage, we performed a PEDro qualitative analysis score weighted selection of all the papers and were kept 91 articles. In the fourth stage, were selected relevant issues for a meta-analysis regarding the prevalence of DM diabetes among COVID-19 cases, resulting 32 papers. The fifth stage of the PRISMA adapted flow diagram was dedicated to the analysis of the data regarding the use of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM, and COVID-19 patients in rehabilitation wards. For enhancing the bibliographical sources pool, we added from external, free found sources, another 15 articles. Discussion/ Limitation. COVID-19 is an acute illness condition and DM is a chronic one. Therefore, it is difficult for now, to have enough data enabling us to see all the repercussions of COVID-19 and to completely understand the significance of physical and rehabilitation medicine and balneotherapy, which applies in COVID-19 post-acute DM patients. Conclusions. This paper overviews the current state-of-the-art knowledge in the approach of DM /diabetes as COVID-19 comorbidity, with a focal point on the roles of natural therapeutic factors, physical exercises within the ensemble of case-specific indicated procedures used for DM and COVID-19 patients in rehabilitation wards, for possible actual and future connexions with the comprehensive management/ rehabilitation of such both chronic and post-acute survivors.
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Affiliation(s)
- Constantin Munteanu
- 1. Romanian Association of Balneology, Bucharest, Romania 2. Teaching Emergency Hospital “Bagdasar-Arseni”, Bucharest, Romania
| | - Diana-Loreta PĂUN
- 3. University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
| | - Alina-Maria ȘUȚĂ
- 4. Clinical Hospital of Psychiatry Prof. Dr. Alexandru Obregia, Endocrinological and Diabetes Department, Bucharest, Romania
| | - Simin Aysel FLORESCU
- 3. University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania, 5. Clinical Hospital of Infectious and Tropical Diseases ”Dr. Victor Babeș”, Bucharest, Romania
| | - Gelu ONOSE
- 2. Teaching Emergency Hospital “Bagdasar-Arseni”, Bucharest, Romania 3. University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
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Rachel JB, Gururaj N, Smitha T, Daniel TD, Harishini BS, Rosaian AS. Innovative diagnostic approach and investigation trends in COVID19-A systematic review. J Oral Maxillofac Pathol 2020; 24:421-436. [PMID: 33967476 PMCID: PMC8083432 DOI: 10.4103/jomfp.jomfp_395_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/14/2020] [Accepted: 10/20/2020] [Indexed: 01/19/2023] Open
Abstract
A highly contagious viral infection emerged in Wuhan city; China had increased mortality with uncertain pathogenesis spreads throughout the world to become a pandemic. It is reported to be caused by a member of β coronaviruses and named it as COVID-19 by the World Health Organization (WHO). The disease is caused by a mutant strain of coronavirus SARS-COV-2 that affects the respiratory tract causing mild to severe respiratory tract illness. The clinical manifestation ranges from mild, moderate, severe and very severe signs and symptoms result in death due to severe hypoxia or multi-organ dysfunction. Also, the affected persons were capable of infecting others through various modes of transmission through respiratory droplets (aerosol spread). A definite investigation protocol has followed to diagnose COVID 19 disease but mainly confirmed with reverse transcription polymerase chain reaction. Computerized tomography scan plays a significant role in the diagnosis and prognosis of affected individuals. The major problem with COVID-19 is due to its novelty and lack of vaccination or treatment. This review focuses on the mutation, pathogenesis, various diagnostic tests adopted and autopsy findings in patients affected with COVID-19.
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Affiliation(s)
- J Beryl Rachel
- Department of Oral Pathology and Microbiology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - N Gururaj
- Department of Oral Pathology and Microbiology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - T Smitha
- Department of Oral Pathology and Microbiology, Vokkaligara Sangha Dental College and Hosipital, Bengaluru, Karnataka, India
| | - T Divyna Daniel
- Department of Oral Pathology and Microbiology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - B S Harishini
- Department of Oral Pathology and Microbiology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Adlin Saroja Rosaian
- Department of Oral Pathology and Microbiology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Zare-Zardini H, Soltaninejad H, Ferdosian F, Hamidieh AA, Memarpoor-Yazdi M. Coronavirus Disease 2019 (COVID-19) in Children: Prevalence, Diagnosis, Clinical Symptoms, and Treatment. Int J Gen Med 2020; 13:477-482. [PMID: 32848446 PMCID: PMC7425102 DOI: 10.2147/ijgm.s262098] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022] Open
Abstract
In this article, we have reviewed the prevalence, diagnosis, symptoms, and treatment of COVID-19 in children. The incidence of COVID-19 among children under 18 years was 2.1% based on the reported studies, where the mortality rate in the same age group was 0.2%. No death has been reported in children under 9-years old. There are some articles that report children with COVID-19 having symptoms similar to Kawasaki's disease. In these cases, heart complications were observed. The best markers for diagnosing the severity of the disease in children are the levels of bilirubin and hepatic enzymes. Large number of angiotensin converting enzyme 2 (ACE2) receptors on cell surfaces, effective innate immune system, and high level of blood lymphocyte have been reported to be the potent reasons for lower incidence of severe symptoms of COVID-19 among children. Children can very well be the carriers of this virus. Children with severe COVID-19 clinical symptoms, especially those suffering from pneumonia, must be hospitalized similar to adults, while quarantine is required for those having mild symptoms. Antiviral medication (lopinavir, darunavir, favipiravir, remdesivir, ribavirin, oseltamivir, tocilizumab, and umifenovir), ACE inhibitors, interferon-α2b, co-therapy with azithromycin, inhaling iNO, and oxygen therapy can be used for treatment. For the treatment of children without any clinical and infection symptoms, home isolation protocol has been recommended.
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Affiliation(s)
- Hadi Zare-Zardini
- Department of Sciences, Farhangian University, Isfahan, Iran.,Hematology and Oncology Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Soltaninejad
- Stem Cell and Regenerative Medicine Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Ferdosian
- Department of Pediatrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Ali Hamidieh
- Pediatric Cell Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran
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46
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Sieńko J, Kotowski M, Bogacz A, Lechowicz K, Drożdżal S, Rosik J, Sietnicki M, Sieńko M, Kotfis K. COVID-19: The Influence of ACE Genotype and ACE-I and ARBs on the Course of SARS-CoV-2 Infection in Elderly Patients. Clin Interv Aging 2020; 15:1231-1240. [PMID: 32764907 PMCID: PMC7382582 DOI: 10.2147/cia.s261516] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/19/2020] [Indexed: 12/23/2022] Open
Abstract
Since the beginning of 2020, the whole world has been struggling with the pandemic of Coronavirus Disease 2019 (COVID-19) caused by a novel coronavirus SARS-CoV-2. The SARS-CoV-2 infection depends on ACE2, TMPRSS2, and CD147, which are expressed on host cells. Several studies suggest that some single nucleotide polymorphisms (SNPs) of ACE2 might be a risk factor of COVID-19 infection. Genotypes affect ACE2 structure, its serum concentration, and levels of circulating angiotensin (1-7). Moreover, there is evidence that ACE genotype affects the outcomes of acute respiratory distress syndrome (ARDS) treatment, the most severe consequence of SARS-CoV-2 infection. COVID-19 morbidity, infection course, and mortality might depend on ACE D allele frequency. The aim of this narrative review was to analyze and identify the mechanisms of ACE-I and ARBs with particular emphasis on angiotensin receptors and their polymorphism in the light of COVID-19 pandemic as these medications are commonly prescribed to elderly patients. There is no direct evidence yet for ACE-I or ARBs in the treatment of COVID-19. However, for those already taking these medications, both the European Society of Cardiology and the American College of Cardiology recommend continuing the treatment, because at present, there is no clear clinical or scientific evidence to justify the discontinuation of ACE-I or ARBs. Individualized treatment decisions should be based on the clinical condition and co-morbidities of each patient.
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Affiliation(s)
- Jerzy Sieńko
- Department of General Surgery and Transplantology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Maciej Kotowski
- Department of General Surgery and Transplantology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anna Bogacz
- Department of Pharmacology and Phytochemistry, Institute of Natural Fibers and Medicinal Plants, Poznan, Poland
| | - Kacper Lechowicz
- Department of Anaesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Sylwester Drożdżal
- Department of Pharmacokinetics and Monitored Therapy, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jakub Rosik
- Department of Physiology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marek Sietnicki
- Department of Civil Engineering and Architecture, West Pomeranian University of Technology in Szczecin, Szczecin, Poland
| | - Magdalena Sieńko
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Katarzyna Kotfis
- Department of Anaesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Du Y, Wang X, Chang C, Zhu P, Tu L, Hu Q, Jin Y, Xu G. Reply to Tsolaki and Zakynthinos: Are Patients with COVID-19 Dying of or with Cardiac Injury? Am J Respir Crit Care Med 2020; 202:301-303. [PMID: 32432898 PMCID: PMC7365382 DOI: 10.1164/rccm.202004-1156le] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
| | - Xi Wang
- Chinese PLA General HospitalBeijing, China
| | - Christopher Chang
- University of CaliforniaDavis, California.,Joe DiMaggio Children's HospitalHollywood, Florida
| | | | - Lei Tu
- Huazhong University of Science and TechnologyWuhan, China
| | - Qinyong Hu
- Renmin Hospital of Wuhan UniversityWuhan, Chinaand.,Wuhan Hannan HospitalWuhan, China
| | - Yang Jin
- Huazhong University of Science and TechnologyWuhan, China
| | - Guogang Xu
- Chinese PLA General HospitalBeijing, China
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48
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Oliviero A, de Castro F, Coperchini F, Chiovato L, Rotondi M. COVID-19 Pulmonary and Olfactory Dysfunctions: Is the Chemokine CXCL10 the Common Denominator? Neuroscientist 2020; 27:214-221. [PMID: 32659199 DOI: 10.1177/1073858420939033] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
COVID-19 is an ongoing viral pandemic that emerged from East Asia and quickly spread to the rest of the world. SARS-CoV-2 is the virus causing COVID-19. Acute respiratory distress syndrome (ARDS) is definitely one of the main clinically relevant consequences in patients with COVID-19. Starting from the earliest reports of the COVID-19 pandemic, two peculiar neurological manifestations (namely, hyposmia/anosmia and dysgeusia) were reported in a relevant proportion of patients infected by SARS-CoV-2. At present, the physiopathologic mechanisms accounting for the onset of these symptoms are not yet clarified. CXCL10 is a pro-inflammatory chemokine with a well-established role in the COVID-19-related cytokine storm and in subsequent development of ARDS. CXCL10 is also known to be involved in coronavirus-induced demyelination. On these bases, a role for CXCL10 as the common denominator between pulmonary and olfactory dysfunctions could be envisaged. The aim of the present report will be to hypothesize a role for CXCL10 in COVID-19 olfactory dysfunctions. Previous evidences supporting our hypothesis, with special emphasis to the role of CXCL10 in coronavirus-induced demyelination, the anatomical and physiological peculiarity of the olfactory system, and the available data supporting their link during COVID-19 infections, will be overviewed.
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Affiliation(s)
- Antonio Oliviero
- Hospital Nacional de Parapléjicos, FENNSI Group, SESCAM, Toledo, Spain
| | - Fernando de Castro
- Instituto Cajal-CSIC, Spanish Research Council/Consejo Superior de Investigaciones Científicas-CSIC, Madrid, Spain
| | - Francesca Coperchini
- Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Luca Chiovato
- Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Mario Rotondi
- Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Pavia, Italy.,Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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Wang J, Zhu X, Xu Z, Yang G, Mao G, Jia Y, Xie Z, Wang J, Ao W. Clinical and CT findings of COVID-19: differences among three age groups. BMC Infect Dis 2020; 20:434. [PMID: 32571228 PMCID: PMC7306933 DOI: 10.1186/s12879-020-05154-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/12/2020] [Indexed: 01/08/2023] Open
Abstract
Background The novel coronavirus pneumonia (coronavirus disease 2019, COVID-19) has spread around the world. We aimed to recapitulate the clinical and CT imaging features of COVID-19 and their differences in three age groups. Methods The clinical and CT data of patients with COVID-19 (n = 307) that had been divided into three groups (Group 1: < 40 years old; Group 2: 40 ≤ age < 60 years old; Group 3: ≥ 60 years old) according to age were analyzed retrospectively. Results Of all patients, 114 (37.1%) had histories of epidemiological exposure, 48 (15.6%) were severe/critical cases, 31 had hypertension (10.1%), 15 had diabetes mellitus (4.9%), 3 had chronic obstructive pulmonary disease (COPD, 1%). Among the three groups, severe/critical type, hypertension and diabetes occurred more commonly in the elderly group compared with Group 1&2 (P < 0.05, respectively). Cough and chest tightness/pain were more commonly appeared in Group 2&3 compared with Group 1 (P < 0.05, respectively). Compared with Group 1 and 2, there were more abnormal laboratory examination indexes (including CRP increase, abnormal percentage of lymphocytes, neutrophils and monocytes) in Group 3 (P < 0.05, respectively). CT images revealed that more lobes were affected and more subpleural lesions were involved in the elderly group, besides, crazy paving sign, bronchodilatation and pleural thickening were more commonly seen in the elderly group, with significant difference between Group 1&2, Group 2&3 (P < 0.05, respectively). Conclusions COVID-19 presented representative clinical manifestations, laboratory examinations and CT findings, but three age groups possessed their own specific characteristics. Grasping the clinical and CT features stratified by age will be helpful for early definite diagnosis of COVID-19.
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Affiliation(s)
- Jian Wang
- Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, 310012, Zhejiang Province, China
| | - Xiandi Zhu
- Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, 310012, Zhejiang Province, China
| | - Zhihua Xu
- Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, 310012, Zhejiang Province, China
| | - Guangzhao Yang
- Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, 310012, Zhejiang Province, China
| | - Guoqun Mao
- Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, 310012, Zhejiang Province, China
| | - Yuzhu Jia
- Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, 310012, Zhejiang Province, China
| | - Zongyu Xie
- Department of Radiology, The First Affliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Jing Wang
- Department of Radiology, XiXi Hospital of Hangzhou, Hangzhou, Zhejiang Province, China
| | - Weiqun Ao
- Department of Radiology, Tongde Hospital of Zhejiang Province, No. 234, Gucui Road, Hangzhou, 310012, Zhejiang Province, China.
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50
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Liu ZM, Li JP, Wang SP, Chen DY, Zeng W, Chen SC, Huang YH, Huang JL, Long W, Li M, Gao RF, Guo L, Wu XH. Association of procalcitonin levels with the progression and prognosis of hospitalized patients with COVID-19. Int J Med Sci 2020; 17:2468-2476. [PMID: 33029089 PMCID: PMC7532477 DOI: 10.7150/ijms.48396] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/15/2020] [Indexed: 02/06/2023] Open
Abstract
Rationale: Coronavirus disease 2019 (COVID-19) was first announced in Wuhan, and has rapidly evolved into a pandemic. However, the risk factors associated with the severity and mortality of COVID-19 are yet to be described in detail. Methods: We retrospectively reviewed the information of 1525 cases from the Leishenshan Hospital in Wuhan. Univariate and multivariate Cox regression analyses were generated to explore the relationship between procalcitonin (PCT) level and the progression and prognosis of COVID-19. Univariate and multivariate logistic regression analyses were performed to explore the relationship between disease severity in hospitalized patients and their PCT levels. Survival curves and the cumulative hazard function for COVID-19 progression were conducted in the two groups. To further detect the relationship between the computed tomography score and survival days, curve-fitting analyses were performed. Results: Patients in the elevated PCT group had a higher incidence of severe and critical severity conditions (P < 0.001), death, and higher computed tomography (CT) scores. There was an association between elevated PCT levels and mortality in the univariate ((hazard ratio [1], 3.377; 95% confidence interval [2], 1.012-10.344; P = 0.033) and multivariate Cox regression analysis (HR, 4.933; 95% CI, 1.170-20.788; P = 0.030). Similarly, patients with elevated PCT were more likely to have critically severe disease conditions in the univariate (odds ratio [2], 7.247; 95% CI, 3.559-14.757; P < 0.001) and multivariate logistic regression analysis (OR, 10.679; 95% CI, 4.562-25.000; P < 0.001). Kaplan-Meier curves showed poorer prognosis for patients with elevated PCT (P = 0.024). The CT score 1 for patients with elevated PCT peaked at day 40 following the onset of symptoms then decreased gradually, while their total CT score was relatively stable. Conclusion: PCT level was shown as an independent risk factor of in-hospital mortality among COVID-19 patients. Compared with inpatients with normal PCT levels, inpatients with elevated PCT levels had a higher risk for overall mortality and critically severe disease. These findings may provide guidance for improving the prognosis of patients with critically severe COVID-19.
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Affiliation(s)
- Ze-Ming Liu
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Jin-Peng Li
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Shi-Pei Wang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Dan-Yang Chen
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Wen Zeng
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Si-Chao Chen
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yi-Hui Huang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Jiang-Long Huang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Wei Long
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Man Li
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Rong-Fen Gao
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liang Guo
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Xiao-Hui Wu
- Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
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