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Vieira WDB, Franco KMVDS, Dias ARN, Falcão ASC, Falcão LFM, Quaresma JAS, de Sousa RCM. Chest Computed Tomography Is an Efficient Method for Initial Diagnosis of COVID-19: An Observational Study. Front Med (Lausanne) 2022; 9:848656. [PMID: 35492320 PMCID: PMC9039662 DOI: 10.3389/fmed.2022.848656] [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: 01/04/2022] [Accepted: 03/14/2022] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease (COVID-19) is an infectious disease that can lead to pneumonia, pulmonary oedema, acute respiratory distress syndrome, multiple organ and system dysfunction, and death. This study aimed to verify the efficacy of chest computed tomography (CT) for the initial diagnosis of COVID-19. This observational, retrospective, cross-sectional study included 259 individuals who underwent clinical evaluation, blood collection, chest CT, and a reverse transcription polymerase chain reaction (RT-PCR) diagnostic test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during their course of treatment at a reference hospital in Belém, Pará, Brazil between April and June 2020. Inclusion criteria were flu-like symptoms in adults of both sexes. Individuals with an inconclusive COVID-19 molecular test or who had artifacts in the chest CT images were excluded. Parametric data were analyzed using Student-t-test and non-parametric data were analyzed using average test and Fisher exact test. Participants were divided into two groups: Group 1 (COVID-19 positive), n = 211 (124 males, 87 females), 51.8 ± 17.9 years old and Group 2 (COVID-19 negative), n = 48 (22 males, 26 females), 47.6 ± 18.6 years old. Most frequent symptoms were cough [Group 1 n = 199 (94%)/Group 2 n = 46 (95%)], fever [Group 1 n = 154 (72%)/Group 2 n = 28 (58%)], myalgia [Group 1 n = 172 (81%)/Group 2 n = 38 (79%)], dyspnoea [Group 1 n = 169 (80%) / Group 2 n = 37 (77%)], headache [Group 1 n = 163 (77%)/Group 2 n = 32 (66%)], and anosmia [Group 1 n = 154 (73%)/Group 2 n = 29 (60%)]. Group 1 had a higher proportion of ground-glass opacity [Group 1 n = 175 (83%)/Group 2 n = 24 (50%), 0.00], vascular enhancement sign [Group 1 n = 128 (60%)/Group 2 n = 15 (31%), 0.00], septal thickening [Group 1 n = 99 (47%)/Group 2 n = 13 (27%), 0.01], crazy-paving pattern [Group 1 n = 98 (46%) / Group 2 n = 13 (27%), 0.01], consolidations [Group 1 n = 92 (43%)/Group 2 n = 8 (16%), 0.00], and CO-RADS 4 and 5 [Group 1 n = 163 (77.25%)/Group 2 n = 24 (50%), 0.00] categories in chest CT. Chest CT, when available, was found to be an efficient method for the initial diagnosis and better management of individuals with COVID-19.
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Affiliation(s)
| | | | - Apio Ricardo Nazareth Dias
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil.,Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará, Belém, Brazil
| | | | | | - Juarez Antonio Simões Quaresma
- Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil.,Centro de Ciências Biológicas e da Saúde, Universidade do Estado do Pará, Belém, Brazil
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Hung DT, Ghula S, Aziz JMA, Makram AM, Tawfik GM, Abozaid AAF, Pancharatnam RA, Ibrahim AM, Shabouk MB, Turnage M, Nakhare S, Karmally Z, Kouz B, Le TN, Alhijazeen S, Phuong NQ, Ads AM, Abdelaal AH, Nam NH, Iiyama T, Kita K, Hirayama K, Huy NT. The efficacy and adverse effects of favipiravir on patients with COVID-19: A systematic review and meta-analysis of published clinical trials and observational studies. Int J Infect Dis 2022; 120:217-227. [PMID: 35470021 PMCID: PMC9023375 DOI: 10.1016/j.ijid.2022.04.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives This study aimed to evaluate the efficacy and adverse events of favipiravir in patients with COVID-19. Methods Our protocol was registered on PROSPERO (CRD42020206305). Fourteen databases were searched until February 8th, 2021. An update search for new RCTs was done on March 2nd, 2022. Meta-analysis was done for randomized controlled trials (RCTs) and non-RCTs. Results Overall, 157 studies (24 RCTs, 1 non-RCT, 21 observational studies, 2 case series, and 106 case reports) were included. On hospitalized patients, in comparison to standard of care, favipiravir showed a higher rate of viral clearance at day 5 (RR = 1.60, p = 0.02), defervescence at day 3–4 (RR = 1.99, p <0.01), chest radiological improvement (RR = 1.33, p <0.01), hospital discharge at day 10–11 (RR = 1.19, p <0.01), and shorter clinical improvement time (MD = –1.18, p = 0.05). Regarding adverse events, favipiravir groups had higher rates of hyperuricemia (RR = 9.42, p <0.01), increased alanine aminotransferase (RR = 1.35, p <0.01) but lower rates of nausea (RR = 0.42, p <0.01) and vomiting (R R= 0.19, p=0.02). There were no differences regarding mortality (RR=1.19, p=0.32), and increased aspartate aminotransferase (RR = 1.11, p = 0.25). On nonhospitalized patients, no significant differences were reported. Conclusions Adding favipiravir to the standard of care provides better outcomes for hospitalized patients with COVID-19. Pregnant, lactating women, and patients with a history of hyperuricemia should avoid using favipiravir.
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Affiliation(s)
- Dang The Hung
- Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan.
| | - Suhaib Ghula
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK.
| | - Jeza Muhamad Abdul Aziz
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Department of Medical Laboratory Science, College Health Science, University of Human Development, Sulaimani, Iraq; Baxshin Research centre, Baxshin Hospital, Sulaimani, Kurdistan, Iraq.
| | - Abdelrahman M Makram
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Public Health, Imperial College London, London, United Kingdom; Faculty of Medicine, October 6 University, Giza, Egypt.
| | - Gehad Mohamed Tawfik
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Ali Ahmed-Fouad Abozaid
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Ain Shams University, Cairo, Egypt.
| | - Rohan Andrew Pancharatnam
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK.
| | - Amr Mohamed Ibrahim
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, South Valley University, Qena, Egypt.
| | - Muhammad Besher Shabouk
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, University of Aleppo, Aleppo, Syria.
| | - Morgan Turnage
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Einstein Medical Center Montgomery, East Norriton, Pennsylvania, USA; American University of the Caribbean, School of Medicine, Cupecoy, Sint Maarten.
| | - Saloni Nakhare
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK.
| | - Zahra Karmally
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; School of Medicine, The University of Buckingham, Buckingham, UK.
| | - Basel Kouz
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Damascus University, Damascus, Damascus Governorate, Syria.
| | - Tran Nhat Le
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Hue University of Medicine and Pharmacy, Hue, Vietnam.
| | - Suleiman Alhijazeen
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Graduate of Faculty of Medicine, Mutah University, Karak, Jordan.
| | - Nguyen Quoc Phuong
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Biology - Biotechnology, University of Science, Vietnam National University, Ho Chi Minh city, Vietnam.
| | - Alaa Mohamed Ads
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Tanta University, Tanta, Egypt.
| | - Ali Hussein Abdelaal
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Faculty of Medicine, Aswan University, Aswan, Egypt.
| | - Nguyen Hai Nam
- Online Research Club (http://www.onlineresearchclub.org), Nagasaki, Japan; Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Harvard Medical School, Global Clinical Scholars Research Training Program, Boston, Massachusetts, United States of America.
| | - Tatsuo Iiyama
- Department of International Trials, Center of Clinical Sciences, National Center for Global Health and Medicine (NCGM), Tokyo, Japan.
| | - Kyoshi Kita
- Department of International Trials, Center of Clinical Sciences, National Center for Global Health and Medicine (NCGM), Tokyo, Japan.
| | - Kenji Hirayama
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
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Dighe K, Moitra P, Alafeef M, Gunaseelan N, Pan D. A rapid RNA extraction-free lateral flow assay for molecular point-of-care detection of SARS-CoV-2 augmented by chemical probes. Biosens Bioelectron 2022; 200:113900. [PMID: 34959185 PMCID: PMC8684225 DOI: 10.1016/j.bios.2021.113900] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 12/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has highlighted the major shortcoming of healthcare systems globally in their inability to diagnose the disease rapidly and accurately. At present, the molecular approaches for diagnosing COVID-19 primarily use reverse transcriptase polymerase chain reaction (RT-PCR) to create and amplify cDNA from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA. Although molecular tests are reported to be specific, false negatives are quite common. Furthermore, literally all these tests require a step involving RNA isolation which does not make them point-of-care (POC) in the true sense. Here, we report a lateral flow strip-based RNA extraction and amplification-free nucleic acid test (NAT) for rapid diagnosis of positive COVID-19 cases at POC. The assay uses highly specific 6-carboxyfluorescein (6-FAM) and biotin labeled antisense oligonucleotides (ASOs) as probes those are designed to target N-gene sequence of SARS-CoV-2. Additionally, we utilized cysteamine capped gold-nanoparticles (Cyst-AuNPs) to augment the signal further for enhanced sensitivity. Without any large-stationary equipment and highly trained staffers, the entire sample-to-answer approach in our case would take less than 30 min from a patient swab sample collection to final diagnostic result. Moreover, when evaluated with 60 clinical samples and verified with an FDA-approved TaqPath RT-PCR kit for COVID-19 diagnosis, the assay obtained almost 99.99% accuracy and specificity. We anticipate that the newly established low-cost amplification-free detection of SARS-CoV-2 RNA will aid in the development of a platform technology for rapid and POC diagnosis of COVID-19 and other pathogens.
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Affiliation(s)
- Ketan Dighe
- Department of Chemical, Biochemical and Environmental Engineering, University of Maryland Baltimore County, Interdisciplinary Health Sciences Facility, 1000 Hilltop Circle, Baltimore, MD, 21250, United States; Departments of Diagnostic Radiology and Nuclear Medicine and Pediatrics, Center for Blood Oxygen Transport and Hemostasis, University of Maryland Baltimore School of Medicine, Health Sciences Research Facility III, 670 W Baltimore St., Baltimore, MD, 21201, United States
| | - Parikshit Moitra
- Departments of Diagnostic Radiology and Nuclear Medicine and Pediatrics, Center for Blood Oxygen Transport and Hemostasis, University of Maryland Baltimore School of Medicine, Health Sciences Research Facility III, 670 W Baltimore St., Baltimore, MD, 21201, United States
| | - Maha Alafeef
- Department of Chemical, Biochemical and Environmental Engineering, University of Maryland Baltimore County, Interdisciplinary Health Sciences Facility, 1000 Hilltop Circle, Baltimore, MD, 21250, United States; Departments of Diagnostic Radiology and Nuclear Medicine and Pediatrics, Center for Blood Oxygen Transport and Hemostasis, University of Maryland Baltimore School of Medicine, Health Sciences Research Facility III, 670 W Baltimore St., Baltimore, MD, 21201, United States; Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States; Biomedical Engineering Department, Jordan University of Science and Technology, Irbid, 22110, Jordan
| | - Nivetha Gunaseelan
- Departments of Diagnostic Radiology and Nuclear Medicine and Pediatrics, Center for Blood Oxygen Transport and Hemostasis, University of Maryland Baltimore School of Medicine, Health Sciences Research Facility III, 670 W Baltimore St., Baltimore, MD, 21201, United States
| | - Dipanjan Pan
- Department of Chemical, Biochemical and Environmental Engineering, University of Maryland Baltimore County, Interdisciplinary Health Sciences Facility, 1000 Hilltop Circle, Baltimore, MD, 21250, United States; Departments of Diagnostic Radiology and Nuclear Medicine and Pediatrics, Center for Blood Oxygen Transport and Hemostasis, University of Maryland Baltimore School of Medicine, Health Sciences Research Facility III, 670 W Baltimore St., Baltimore, MD, 21201, United States; Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, United States.
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Iversen KK, Afzal S, Ahlström MG, Nordestgaard BG, Schneider UV, Nielsen L, Kofoed K, Benfield T, Ronit A. Lung function decline in relation to COVID-19 in the general population: a matched cohort study with pre-pandemic assessment of lung function. J Infect Dis 2022; 225:1308-1316. [PMID: 34979029 PMCID: PMC8755346 DOI: 10.1093/infdis/jiab636] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/02/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To quantify the potential decline in dynamic lung volumes following coronavirus disease 2019 (COVID-19) in the general population. METHODS A prospective matched cohort study of adult Copenhagen General Population Study (CGPS) participants with a pre-pandemic spirometry available. CGPS individuals with a positive SARS-CoV-2 polymerase chain reaction (PCR) test performed a repeat spirometry, a questionnaire regarding respiratory symptoms and a diffusing capacity test for carbon monoxide. A matched uninfected CGPS control sample was used, and simple regression and linear mixed effect models were computed to study lung function decline. RESULTS A total of 606 were included. 92/107 (85.9%) of individuals with a positive SARS-CoV-2 PCR test experienced COVID-19 symptoms and 12 (11.2%) were hospitalized. Spirometry was performed at a median (interquartile range) of 5.6 (3.9-12.8) months after positive SARS-CoV-2 PCR test. COVID-19 was associated with an adjusted 7.3 mL (95%CI: 0.3-14.3) and 22.6 mL (95%CI: 13.1-32.0) steeper decline in annual FEV1 and FVC or a total of 113.8 and 301.3 ml lower FEV1 and FVC from baseline to follow up. Results were robust in analyses restricted to individuals not requiring hospitalization. CONCLUSION COVID-19 related decline of dynamic lung volumes in the general population not requiring hospitalization were small but measurable.
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Affiliation(s)
- Katrine K Iversen
- Department of Infectious Diseases 144, Copenhagen University Hospital - Amager Hvidovre; Hvidovre, Denmark
| | - Shoaib Afzal
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Magnus G Ahlström
- Department of Clinical Microbiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.,The Copenhagen General Population Study, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Uffe V Schneider
- Department of Clinical Microbiology, Copenhagen University Hospital - Amager Hvidovre, Hvidovre, Denmark
| | - Lene Nielsen
- Department of Clinical Microbiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Klaus Kofoed
- Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Thomas Benfield
- Department of Infectious Diseases 144, Copenhagen University Hospital - Amager Hvidovre; Hvidovre, Denmark
| | - Andreas Ronit
- Department of Infectious Diseases 144, Copenhagen University Hospital - Amager Hvidovre; Hvidovre, Denmark
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