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B Gowda SG, Shekhar C, Gowda D, Chen Y, Chiba H, Hui SP. Mass spectrometric approaches in discovering lipid biomarkers for COVID-19 by lipidomics: Future challenges and perspectives. MASS SPECTROMETRY REVIEWS 2024; 43:1041-1065. [PMID: 37102760 DOI: 10.1002/mas.21848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 03/14/2023] [Accepted: 04/17/2023] [Indexed: 05/09/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has emerged as a global health threat and has rapidly spread worldwide. Significant changes in the lipid profile before and after COVID-19 confirmed the significance of lipid metabolism in regulating the response to viral infection. Therefore, understanding the role of lipid metabolism may facilitate the development of new therapeutics for COVID-19. Owing to their high sensitivity and accuracy, mass spectrometry (MS)-based methods are widely used for rapidly identifying and quantifying of thousands of lipid species present in a small amount of sample. To enhance the capabilities of MS for the qualitative and quantitative analysis of lipids, different platforms have been combined to cover a wide range of lipidomes with high sensitivity, specificity, and accuracy. Currently, MS-based technologies are being established as efficient methods for discovering potential diagnostic biomarkers for COVID-19 and related diseases. As the lipidome of the host cell is drastically affected by the viral replication process, investigating lipid profile alterations in patients with COVID-19 and targeting lipid metabolism pathways are considered to be crucial steps in host-directed drug targeting to develop better therapeutic strategies. This review summarizes various MS-based strategies that have been developed for lipidomic analyzes and biomarker discoveries to combat COVID-19 by integrating various other potential approaches using different human samples. Furthermore, this review discusses the challenges in using MS technologies and future perspectives in terms of drug discovery and diagnosis of COVID-19.
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Affiliation(s)
- Siddabasave Gowda B Gowda
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
- Graduate School of Global Food Resources, Hokkaido University, Sapporo, Japan
| | - Chandra Shekhar
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Divyavani Gowda
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yifan Chen
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Hitoshi Chiba
- Department of Nutrition, Sapporo University of Health Sciences, Sapporo, Japan
| | - Shu-Ping Hui
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Zhang B, Cong H, Shen Y, Sun M. Visual Perception and Convolutional Neural Network-Based Robotic Autonomous Lung Ultrasound Scanning Localization System. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:961-974. [PMID: 37015119 DOI: 10.1109/tuffc.2023.3263514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Under the situation of severe COVID-19 epidemic, lung ultrasound (LUS) has been proved to be an effective and convenient method to diagnose and evaluate the extent of respiratory disease. However, the traditional clinical ultrasound (US) scanning requires doctors not only to be in close contact with patients but also to have rich experience. In order to alleviate the shortage of medical resources and reduce the work stress and risk of infection for doctors, we propose a visual perception and convolutional neural network (CNN)-based robotic autonomous LUS scanning localization system to realize scanned target recognition, probe pose solution and movement, and the acquisition of US images. The LUS scanned targets are identified through the target segmentation and localization algorithm based on the improved CNN, which is using the depth camera to collect the image information; furthermore, the method based on multiscale compensation normal vector is used to solve the attitude of the probe; finally, a position control strategy based on force feedback is designed to optimize the position and attitude of the probe, which can not only obtain high-quality US images but also ensure the safety of patients and the system. The results of human LUS scanning experiment verify the accuracy and feasibility of the system. The positioning accuracy of the scanned targets is 15.63 ± 0.18 mm, and the distance accuracy and rotation angle accuracy of the probe position calculation are 6.38 ± 0.25 mm and 8.60° ±2.29° , respectively. More importantly, the obtained high-quality US images can clearly capture the main pathological features of the lung. The system is expected to be applied in clinical practice.
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Zhu T, Jin J, Chen M, Chen Y. The impact of infection with COVID-19 on the respiratory microbiome: A narrative review. Virulence 2022; 13:1076-1087. [PMID: 35763685 PMCID: PMC9794016 DOI: 10.1080/21505594.2022.2090071] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has affected millions of individuals with various implications. Consistent with the crucial role of the microbiome in determining health and disease in humans, various studies have investigated the gut and respiratory microbiome effect on the COVID-19. Microbiota dysbiosis might support the entry, replication, and establishment of SARS-CoV-2 infection by modulating various mechanisms. One of the main mechanisms that the modulation of respiratory microbiota composition during the COVID-19 infection affects the magnitude of the disease is changes in innate and acquired immune responses, including inflammatory markers and cytokines and B- and T-cells. The diversity of respiratory microbiota in COVID-19 patients is controversial; some studies reported low microbial diversity, while others found high diversity, suggesting the role of respiratory microbiota in this disease. Modulating microbiota diversity and profile by supplementations and nutrients can be applied prophylactic and therapeutic in combating COVID-19. Here, we discussed the lung microbiome dysbiosis during various lung diseases and its interaction with immune cells, focusing on COVID-19.
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Affiliation(s)
- Taiping Zhu
- Internal Medicine Department, Chun’an Maternal and Child Health Hospital, Hangzhou, Zhejiang, China
| | - Jun Jin
- Emergency and Critical Care Center, Intensive Care Unit, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital Hangzhou Medical College), Hangzhou, Zhejiang, China
| | - Minhua Chen
- Emergency and Critical Care Center, Intensive Care Unit, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital Hangzhou Medical College), Hangzhou, Zhejiang, China,CONTACT Minhua Chen
| | - Yingjun Chen
- Department of Infectious Diseases, Tiantai People’s Hospital of Zhejiang Province (Tiantai Branch of Zhejiang People’s Hospital), Taizhou, Zhejiang, China
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Park SH. KJR Honors The Most Impactful Article and Distinguished Reviewers for 2022. Korean J Radiol 2022; 23:937-938. [PMID: 36174998 PMCID: PMC9523234 DOI: 10.3348/kjr.2022.0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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Lin Q, Wu L, Lin W, Zhu L, Hu Y, Lin G, Lin J, Tu H. Correlation between chest CT severity score and laboratory indicators in patients with Coronavirus disease 2019 (COVID-19). Int J Clin Pract 2021; 75:e14907. [PMID: 34551174 PMCID: PMC8646716 DOI: 10.1111/ijcp.14907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/15/2021] [Accepted: 09/19/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The association between computed tomography (CT) and clinical severity of COVID-19 has been demonstrated. However, there are few studies on CT and laboratory indicators in patients in COVID-19. Our aim was to explore the correlation between chest CT images and laboratory indicators of patients with COVID-19 pneumonia. METHODS This was a retrospective study of patients with COVID-19 diagnosed and treated at the Affiliated Hospital of Putian University from 24 January 2020 to 6 March 2020. The correlation test between first chest CT score and blood cell analysis, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), blood biochemistry and T lymphocyte subsets (T-Ls) was investigated. RESULTS Among the 56 patients, there were 36 (64.3%) males and 20 (35.7%) females. The mean age of the patients was 46.54 ± 15.82 (range, 15-86) years. The CT score in the moderate group was higher than in the mild group (5.06 ± 0.77 vs 1.87 ± 0.88, P < .05), and higher in the severe group than in the moderate and mild groups (10.71 ± 4.21, P < .05). In addition, the ESR was significantly higher in the severe group than mild group (32.00 (26.04, 58.24) vs 11.00 (7.84, 24.70) mm/h, P < .05). The CD3, CD4, CD8 and CD4/CD8 cells were not different (all P > .05). The CT scores of all patients correlated positively with CRP, LDH and ESR (all P < .01). CONCLUSION The chest CT characteristics of patients with COVID-19 correlated positively with CRP, ESR and LDH, which may use one of the indicators for the assessment of disease severity.
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Affiliation(s)
- Qunying Lin
- Pulmonary and Critical Care MedicineAffiliated Hospital of Putian UniversityPutianChina
- Department of Clinical MedicineFujian Medical UniversityFuzhouFujianChina
| | - Liangning Wu
- Pulmonary and Critical Care MedicineAffiliated Hospital of Putian UniversityPutianChina
| | - Weihua Lin
- Pulmonary and Critical Care MedicineAffiliated Hospital of Putian UniversityPutianChina
- Department of Clinical MedicineFujian Medical UniversityFuzhouFujianChina
| | - Linjian Zhu
- Tuberculosis WardAffiliated Hospital of Putian UniversityPutianChina
| | - Yuxiong Hu
- Pulmonary and Critical Care MedicineAffiliated Hospital of Putian UniversityPutianChina
| | - Guosheng Lin
- Pulmonary and Critical Care MedicineAffiliated Hospital of Putian UniversityPutianChina
| | - Juan Lin
- Pulmonary and Critical Care MedicineAffiliated Hospital of Putian UniversityPutianChina
| | - Haijian Tu
- Clinical LaboratoryAffiliated Hospital of Putian UniversityPutianChina
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Wang Q, Cheng J, Shang J, Wang Y, Wan J, Yan YQ, Liu WB, Zhang HP, Wang JP, Wang XY, Li ZA, Lin J. Clinical value of laboratory indicators for predicting disease progression and death in patients with COVID-19: a retrospective cohort study. BMJ Open 2021; 11:e043790. [PMID: 34598979 PMCID: PMC8488281 DOI: 10.1136/bmjopen-2020-043790] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES As early prediction of severe illness and death for patients with coronavirus disease 2019 (COVID-19) is important, we aim to explore the clinical value of laboratory indicators in evaluating the progression and prognosis of patients with COVID-19. DESIGN Retrospective cohort study. SETTING Hospital-based study in China. PARTICIPANTS Adult patients with COVID-19 from December 15, 2019 to March 15, 2020. END POINT Disease severity and mortality. METHODS Clinical data of 638 patients with COVID-19 were collected and compared between severe and non-severe groups. The predictive ability of laboratory indicators in disease progression and prognosis of COVID-19 was analysed using the receiver operating characteristic curve. The survival differences of COVID-19 patients with different levels of laboratory indicators were analysed utilising Kaplan-Meier analysis. RESULTS 29.8% (190/638) of patients with COVID-19 progressed to severe. Compared with patients with no adverse events, C reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR) and D-dimer were significantly higher in severe patients with adverse events, such as acute myocardial injury, respiratory failure, acute kidney injury, mechanical ventilation, intensive care unit admission, multiple organ dysfunction syndromes and death (all p<0.05). The multivariate logistic analysis suggested that CRP, NLR and D-dimer were independent risk factors for the disease progression of COVID-19 (all p<0.05). The model combining all of them owned the highest area under the receiver operating characteristic curve (AUC) predicting disease progression and death of COVID-19, with AUC of 0.894 (95% CI 0.857 to 0.931) and 0.918 (95% CI 0.873 to 0.962), respectively. Survival analysis suggested that the patients with a high level of CRP, NLR or D-dimer performed shorter overall survival time (all p<0.05). CONCLUSIONS The combination of CRP, NLR and D-dimer could be an effective predictor for the aggravation and death in patients with COVID-19. The abnormal expression of these indicators might suggest a strong inflammatory response and multiple adverse events in patients with severe COVID-19.
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Affiliation(s)
- Qian Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jie Cheng
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jian Shang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ying Wang
- Department of Teaching Office, Second Clinical Medical College of Wuhan University, Wuhan, Hubei, China
| | - Jing Wan
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - You-Qin Yan
- Department of Infectious Diseases and Hepatology, Wuhan No.7 hospital, Wuhan, Hubei, China
| | - Wen-Bin Liu
- Department of Surgery, Wuhan No.7 hospital, Wuhan, Hubei, China
| | - Hai-Ping Zhang
- Department of Gastroenterology, Zhongshan Hospital of Hubei Province, Wuhan, Hubei, China
| | - Jian-Ping Wang
- Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xiao-Yue Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Zi-Ang Li
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jun Lin
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
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Park SH. KJR Ways to Recognize Most Impactful Articles and Distinguished Reviewers. Korean J Radiol 2021; 22:1594-1596. [PMID: 34585541 PMCID: PMC8484148 DOI: 10.3348/kjr.2021.0681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Seong Ho Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
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RSNA-STR-ACR Consensus Statement for COVID-19 CT Patterns: Interreader Agreement in 240 Consecutive Patients and Association With RT-PCR Status. J Comput Assist Tomogr 2021; 45:485-489. [PMID: 33797444 DOI: 10.1097/rct.0000000000001162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to study interreader agreement of the RSNA-STR-ACR (Radiological Society of North America/Society of Thoracic Radiology/American College of Radiology) consensus statement on reporting chest computed tomography (CT) findings related to COVID-19 on a sample of consecutive patients confirmed with reverse transcriptase-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus 2. MATERIALS AND METHODS This institutional review board-approved retrospective study included 240 cases with a mean age of 47.6 ± 15.9 years, ranging from 20 to 90 years, who had a chest CT and RT-PCR performed. Computed tomography images were independently analyzed by 2 thoracic radiologists to identify patterns defined by the RSNA-STR-ACR consensus statement, and concordance was determined with weighted κ tests. Also, CT findings and CT severity scores were tabulated and compared. RESULTS Of the 240 cases, 118 had findings on CT. The most frequent on the RT-PCR-positive group were areas of ground-glass opacities (80.5%), crazy-paving pattern (32.2%), and rounded pseudonodular ground-glass opacities (22.9%). Regarding the CT patterns, the most frequent in the RT-PCR-positive group was typical in 75.9%, followed by negative in 17.1%. The interreader agreement was 0.90 (95% confidence interval, 0.80-0.96) in this group. The CT severity score had a mean difference of -0.07 (95% confidence interval, -0.48 to 0.34) among the readers, showing no significant differences regarding visual estimation. CONCLUSIONS The RSNA-STR-ACR consensus statement on reporting chest CT patterns for COVID-19 presents a high interreader agreement, with the typical pattern being more frequently associated with RT-PCR-positive examinations.
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Hoque MN, Akter S, Mishu ID, Islam MR, Rahman MS, Akhter M, Islam I, Hasan MM, Rahaman MM, Sultana M, Islam T, Hossain MA. Microbial co-infections in COVID-19: Associated microbiota and underlying mechanisms of pathogenesis. Microb Pathog 2021; 156:104941. [PMID: 33962007 PMCID: PMC8095020 DOI: 10.1016/j.micpath.2021.104941] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus infectious disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has traumatized the whole world with the ongoing devastating pandemic. A plethora of microbial domains including viruses (other than SARS-CoV-2), bacteria, archaea and fungi have evolved together, and interact in complex molecular pathogenesis along with SARS-CoV-2. However, the involvement of other microbial co-pathogens and underlying molecular mechanisms leading to extortionate ailment in critically ill COVID-19 patients has yet not been extensively reviewed. Although, the incidence of co-infections could be up to 94.2% in laboratory-confirmed COVID-19 cases, the fate of co-infections among SARS-CoV-2 infected hosts often depends on the balance between the host's protective immunity and immunopathology. Predominantly identified co-pathogens of SARS-CoV-2 are bacteria such as Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Acinetobacter baumannii, Legionella pneumophila and Clamydia pneumoniae followed by viruses including influenza, coronavirus, rhinovirus/enterovirus, parainfluenza, metapneumovirus, influenza B virus, and human immunodeficiency virus. The cross-talk between co-pathogens (especially lung microbiomes), SARS-CoV-2 and host is an important factor that ultimately increases the difficulty of diagnosis, treatment, and prognosis of COVID-19. Simultaneously, co-infecting microbiotas may use new strategies to escape host defense mechanisms by altering both innate and adaptive immune responses to further aggravate SARS-CoV-2 pathogenesis. Better understanding of co-infections in COVID-19 is critical for the effective patient management, treatment and containment of SARS-CoV-2. This review therefore necessitates the comprehensive investigation of commonly reported microbial co-pathogens amid COVID-19, their transmission pattern along with the possible mechanism of co-infections and outcomes. Thus, identifying the possible co-pathogens and their underlying molecular mechanisms during SARS-CoV-2 pathogenesis may shed light in developing diagnostics, appropriate curative and preventive interventions for suspected SARS-CoV-2 respiratory infections in the current pandemic.
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Affiliation(s)
- M Nazmul Hoque
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Gynecology, Obstetrics and Reproductive Health, Bangabandhu Sheikh Mujibur Rahman Agricultural University (BSMRAU), Gazipur, 1706, Bangladesh
| | - Salma Akter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | | | - M Rafiul Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - M Shaminur Rahman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Masuda Akhter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Israt Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mehedi Mahmudul Hasan
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Fisheries and Marine Science, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Md Mizanur Rahaman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Munawar Sultana
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Tofazzal Islam
- Institute of Biotechnology and Genetic Engineering (IBGE), BSMRAU, Gazipur, 1706, Bangladesh
| | - M Anwar Hossain
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Jashore University of Science and Technology, Jashore, 7408, Bangladesh.
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Xu S, Ilyas I, Little PJ, Li H, Kamato D, Zheng X, Luo S, Li Z, Liu P, Han J, Harding IC, Ebong EE, Cameron SJ, Stewart AG, Weng J. Endothelial Dysfunction in Atherosclerotic Cardiovascular Diseases and Beyond: From Mechanism to Pharmacotherapies. Pharmacol Rev 2021; 73:924-967. [PMID: 34088867 DOI: 10.1124/pharmrev.120.000096] [Citation(s) in RCA: 500] [Impact Index Per Article: 125.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The endothelium, a cellular monolayer lining the blood vessel wall, plays a critical role in maintaining multiorgan health and homeostasis. Endothelial functions in health include dynamic maintenance of vascular tone, angiogenesis, hemostasis, and the provision of an antioxidant, anti-inflammatory, and antithrombotic interface. Dysfunction of the vascular endothelium presents with impaired endothelium-dependent vasodilation, heightened oxidative stress, chronic inflammation, leukocyte adhesion and hyperpermeability, and endothelial cell senescence. Recent studies have implicated altered endothelial cell metabolism and endothelial-to-mesenchymal transition as new features of endothelial dysfunction. Endothelial dysfunction is regarded as a hallmark of many diverse human panvascular diseases, including atherosclerosis, hypertension, and diabetes. Endothelial dysfunction has also been implicated in severe coronavirus disease 2019. Many clinically used pharmacotherapies, ranging from traditional lipid-lowering drugs, antihypertensive drugs, and antidiabetic drugs to proprotein convertase subtilisin/kexin type 9 inhibitors and interleukin 1β monoclonal antibodies, counter endothelial dysfunction as part of their clinical benefits. The regulation of endothelial dysfunction by noncoding RNAs has provided novel insights into these newly described regulators of endothelial dysfunction, thus yielding potential new therapeutic approaches. Altogether, a better understanding of the versatile (dys)functions of endothelial cells will not only deepen our comprehension of human diseases but also accelerate effective therapeutic drug discovery. In this review, we provide a timely overview of the multiple layers of endothelial function, describe the consequences and mechanisms of endothelial dysfunction, and identify pathways to effective targeted therapies. SIGNIFICANCE STATEMENT: The endothelium was initially considered to be a semipermeable biomechanical barrier and gatekeeper of vascular health. In recent decades, a deepened understanding of the biological functions of the endothelium has led to its recognition as a ubiquitous tissue regulating vascular tone, cell behavior, innate immunity, cell-cell interactions, and cell metabolism in the vessel wall. Endothelial dysfunction is the hallmark of cardiovascular, metabolic, and emerging infectious diseases. Pharmacotherapies targeting endothelial dysfunction have potential for treatment of cardiovascular and many other diseases.
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Affiliation(s)
- Suowen Xu
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Iqra Ilyas
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Peter J Little
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Hong Li
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Danielle Kamato
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Sihui Luo
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Zhuoming Li
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Peiqing Liu
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Jihong Han
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Ian C Harding
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Eno E Ebong
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Scott J Cameron
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Alastair G Stewart
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China (S.X., I.I., X.Z., S.L., J.W.); Sunshine Coast Health Institute, University of the Sunshine Coast, Birtinya, Australia (P.J.L.); School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia (P.J.L., D.K.); Department of Medical Biotechnology, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); The Research Center of Basic Integrative Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China (H.L.); Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Laboratory of Druggability and New Drugs Evaluation, Guangzhou, China (Z.L., P.L.); College of Life Sciences, Key Laboratory of Bioactive Materials of Ministry of Education, State Key Laboratory of Medicinal Chemical Biology, Nankai University, Tianjin, China (J.H.); Department of Bioengineering, Northeastern University, Boston, Massachusetts (I.C.H., E.E.E.); Department of Chemical Engineering, Northeastern University, Boston, Massachusetts (E.E.E.); Department of Neuroscience, Albert Einstein College of Medicine, New York, New York (E.E.E.); Department of Cardiovascular and Metabolic Sciences, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (S.J.C.); and ARC Centre for Personalised Therapeutics Technologies, Department of Biochemistry and Pharmacology, School of Biomedical Science, University of Melbourne, Parkville, Victoria, Australia (A.G.S.)
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11
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Ceylan N, Çinkooğlu A, Bayraktaroğlu S, Savaş R. Atypical chest CT findings of COVID-19 pneumonia: a pictorial review. ACTA ACUST UNITED AC 2021; 27:344-349. [PMID: 33032981 DOI: 10.5152/dir.2020.20355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Coronavirus disease 2019 (COVID-19) first emerged in China and rapidly spread in the world causing a pandemic. Chest computed tomography (CT) continues to play an important role in the diagnosis and follow-up of the disease due to shortcomings of the real-time reverse transcription-polymerase chain reaction test, which is the gold standard in the diagnosis of this disease. Typical chest CT findings of COVID-19 pneumonia have been widely reported in the literature. However, atypical findings such as central involvement, peribronchovascular involvement, isolated upper lobe involvement, nodular involvement, lobar consolidation, solitary involvement, pleural and pericardial fluid, and subpleural sparing can also be seen. Knowing these atypical findings is important to avoid misdiagnosis. This review summarizes the atypical findings that can be seen in the course of the disease and may be confused with other diseases.
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Affiliation(s)
- Naim Ceylan
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Akın Çinkooğlu
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
| | | | - Recep Savaş
- Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey
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12
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Rao M, Rashid FA, Sabri FSAH, Jamil NN, Zain R, Hashim R, Amran F, Kok HT, Samad MAA, Ahmad N. Comparing Nasopharyngeal Swab and Early Morning Saliva for the Identification of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2021; 72:e352-e356. [PMID: 32761244 PMCID: PMC7454325 DOI: 10.1093/cid/ciaa1156] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/03/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The ideal severe acute respiratory syndrome coronavirus 2 (SARs-CoV-2) testing method would be accurate and also be patient-performed to reduce exposure to healthcare workers. The aim of this study was to compare patient-performed testing based on a morning saliva sample with the current standard testing method, healthcare worker-collected sampling via a nasopharyngeal swab (NPS). METHODS This was a prospective single center study which recruited 217 asymptomatic adult male participants in a coronavirus disease 2019 (COVID-19) quarantine center who had tested positive for SARS-CoV-2 8-10 days prior to isolation. Paired NPS and saliva specimens were collected and processed within 5 hours of sample collection. Real time reverse transcription polymerase chain reaction (RT-PCR) targeting Envelope (E) and RNA-dependent RNA polymerase (RdRp) genes was performed and the results were compared. RESULTS Overall, 160 of the 217 (74%) participants tested positive for COVID-19 based on saliva, NPS, or both testing methods. The detection rate for SARS-CoV-2 was higher in saliva compared to NPS testing (93.1%, 149/160 vs 52.5%, 84/160, P < .001). The concordance between the 2 tests was 45.6% (virus was detected in both saliva and NPS in 73/160), whereas 47.5% were discordant (87/160 tested positive for 1 whereas negative for the other). The cycle threshold (Ct) values for E and RdRp genes were significantly lower in saliva specimens compared to NP swab specimens. CONCLUSIONS Our findings demonstrate that saliva is a better alternative specimen for detection of SARS-CoV-2. Taking into consideration, the simplicity of specimen collection, shortage of PPE and the transmissibility of the virus, saliva could enable self-collection for an accurate SARS-CoV-2 surveillance testing.
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Affiliation(s)
- Mohan Rao
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Fairuz A Rashid
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Fashihah S A H Sabri
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Nur Nadia Jamil
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Rozainanee Zain
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Rohaidah Hashim
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Fairuz Amran
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Huey Tean Kok
- Low Risk COVID-19 Quarantine and Treatment Centre, MAEPS, Selangor, Malaysia
| | - Md Anuar Abd Samad
- Low Risk COVID-19 Quarantine and Treatment Centre, MAEPS, Selangor, Malaysia
| | - Norazah Ahmad
- Infectious Disease Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, Kuala Lumpur, Malaysia
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13
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Song Q, Sun X, Dai Z, Gao Y, Gong X, Zhou B, Wu J, Wen W. Point-of-care testing detection methods for COVID-19. LAB ON A CHIP 2021; 21:1634-1660. [PMID: 33705507 DOI: 10.1039/d0lc01156h] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
COVID-19 is an acute respiratory disease caused by SARS-CoV-2, which has high transmissibility. People infected with SARS-CoV-2 can develop symptoms including cough, fever, pneumonia and other complications, which in severe cases could lead to death. In addition, a proportion of people infected with SARS-CoV-2 may be asymptomatic. At present, the primary diagnostic method for COVID-19 is reverse transcription-polymerase chain reaction (RT-PCR), which tests patient samples including nasopharyngeal swabs, sputum and other lower respiratory tract secretions. Other detection methods, e.g., isothermal nucleic acid amplification, CRISPR, immunochromatography, enzyme-linked immunosorbent assay (ELISA) and electrochemical sensors are also in use. As the current testing methods are mostly performed at central hospitals and third-party testing centres, the testing systems used mostly employ large, high-throughput, automated equipment. Given the current situation of the epidemic, point-of-care testing (POCT) is advantageous in terms of its ease of use, greater approachability on the user's end, more timely detection, and comparable accuracy and sensitivity, which could reduce the testing load on central hospitals. POCT is thus conducive to daily epidemic control and achieving early detection and treatment. This paper summarises the latest research advances in POCT-based SARS-CoV-2 detection methods, compares three categories of commercially available products, i.e., nucleic acid tests, immunoassays and novel sensors, and proposes the expectations for the development of POCT-based SARS-CoV-2 detection including greater accessibility, higher sensitivity and lower costs.
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Affiliation(s)
- Qi Song
- Department of Physics, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China. and Guangzhou HKUST Fok Ying Tung Research Institute, Guangzhou, Guangdong, China
| | - Xindi Sun
- Materials Genome Institute, Shanghai University, Shanghai, China.
| | - Ziyi Dai
- Joint Key Laboratory of the Ministry of Education, Institute of Applied Physics and Materials Engineering, University of Macau, Macau, China.
| | - Yibo Gao
- Shenzhen Shineway Technology Corporation, Shenzhen, Guangdong, China
| | - Xiuqing Gong
- Materials Genome Institute, Shanghai University, Shanghai, China.
| | - Bingpu Zhou
- Joint Key Laboratory of the Ministry of Education, Institute of Applied Physics and Materials Engineering, University of Macau, Macau, China.
| | - Jinbo Wu
- Materials Genome Institute, Shanghai University, Shanghai, China.
| | - Weijia Wen
- Department of Physics, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China.
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14
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Yasin R, Gomaa AAK, Ghazy T, Hassanein SA, Ibrahem RAL, Khalifa MH. Predicting lung fibrosis in post-COVID-19 patients after discharge with follow-up chest CT findings. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [PMCID: PMC8090913 DOI: 10.1186/s43055-021-00495-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background Coronavirus disease has spread widely all over the world since the beginning of 2020, and this required rapid adequate management. High-resolution computed tomography (HRCT) has become an initial valuable tool for screening, diagnosis, and assessment of disease severity. This study aimed to assess the clinical, radiographic, and laboratory findings of COVID-19 with HRCT follow-up in discharged patients to predict lung fibrosis after COVID-19 infection in survived patients. Results This study included two-hundred and ten patients who were tested positive for the novel coronavirus by nasopharyngeal swap, admitted to the hospital, and discharged after recovery. Patients with at least a one-time chest CT scan after discharge were enrolled. According to the presence of fibrosis on follow-up CT after discharge, patients were classified into two groups and assigned as the “non-fibrotic group” (without evident fibrosis) and “fibrotic group” (with evident fibrosis). We compared between these two groups based on the recorded clinical data, patient demographic information (i.e., sex and age), length of stay (LOS) in the hospital, admission to the ICU, laboratory results (peak C-reactive protein [CRP] level, lowest lymphocyte level, serum ferritin, high-sensitivity troponin, d-dimer, administration of steroid), and CT features (CT severity score and CT consolidation/crazy-paving score). CT score includes the CT during the hospital stay with peak opacification and follow-up CT after discharge. The average CT follow-up time after discharge is 41.5 days (range, 20 to 65 days). There was a statistically significant difference between both groups (p ˂0.001). Further, a multivariate analysis was performed and found that the age of the patients, initial CT severity score, consolidation/crazy-paving score, and ICU admission were independent risk factors associated with the presence of post-COVID-19 fibrosis (p<0.05). Chest CT severity score shows a sensitivity of 86.1%, a specificity of 78%, and an accuracy of 81.9% at a cutoff point of 10.5. Conclusion The residual pulmonary fibrosis in COVID-19 survivors after discharge depends on many factors with the patient’s age, CT severity, consolidation/crazy-paving scores, and ICU admission as independent risk factors associated with the presence of post-COVID-19 fibrosis.
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15
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Tamaskani N, Khandashpoor M, Livani S. Pneumothorax, Pneumomediastinum, and Subcutaneous Emphysema as Complications of COVID-19 Infection: A Case Series. TANAFFOS 2021; 20:368-372. [PMID: 36267925 PMCID: PMC9577210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 01/06/2021] [Indexed: 12/04/2022]
Abstract
The novel coronavirus infection is a global health concern in 2020. Computerized tomography (CT) scan has an important role in diagnosis and follow-up with the course of the disease. The most common radiologic findings in patients are bilateral peripheral patchy ground-glass opacities and consolidations. Although in a few cases, as we reported, we encountered some rare manifestations such as pneumothorax, pneumomediastinum, and subcutaneous emphysema, which imply distinct concerns about the management and outcome of the disease. Pulmonary interstitial emphysema develops due to an increase in alveolar pressure or because of alveolar rupture, secondary to alveolar membrane damage by the virus and proceed to such a complication. Therefore, it is crucial to be aware of the complications of novel coronavirus infection in the deterioration of the disease.
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Affiliation(s)
| | | | - Somayeh Livani
- Correspondence to: Livani S Address: Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran Email address:
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16
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Najafi-Ghalehlou N, Roudkenar MH, Langerodi HZ, Roushandeh AM. Taming of Covid-19: potential and emerging application of mesenchymal stem cells. Cytotechnology 2021; 73:253-298. [PMID: 33776206 PMCID: PMC7982879 DOI: 10.1007/s10616-021-00461-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 02/17/2021] [Indexed: 12/24/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has turned out to cause a pandemic, with a sky scraping mortality. The virus is thought to cause tissue injury by affecting the renin-angiotensin system. Also, the role of the over-activated immune system is noteworthy, leading to severe tissue injury via the cytokine storms. Thus it would be feasible to modulate the immune system response in order to attenuate the disease severity, as well as treating the patients. Today different medicines are being administered to the patients, but regardless of the efficacy of these treatments, adverse effects are pretty probable. Meanwhile, mesenchymal stem cells (MSCs) prove to be an effective candidate for treating the patients suffering from COVID-19 pneumonia, owing to their immunomodulatory and tissue-regenerative potentials. So far, several experiments have been conducted; transplanting MSCs and results are satisfying with no adverse effects being reported. This paper aims to review the recent findings regarding the novel coronavirus and the conducted experiments to treat patients suffering from COVID-19 pneumonia utilizing MSCs.
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Affiliation(s)
- Nima Najafi-Ghalehlou
- Department of Medical Laboratory Sciences, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehryar Habibi Roudkenar
- Burn and Regenerative Medicine Research Center, Velayat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Medical Biotechnology Department, Paramedicine Faculty, Guilan University of Medical Sciences, Rasht, Iran
| | - Habib Zayeni Langerodi
- Guilan Rheumatology Research Center (GRRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Amaneh Mohammadi Roushandeh
- Burn and Regenerative Medicine Research Center, Velayat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
- Anatomical Sciences Department, Medicine Faculty, Guilan University of Medical Sciences, Rasht, Iran
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17
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Wolfskeil M, Devriendt Y, Dumoulin A, Lormans P. Spontaneous pneumomediastinum in Covid-19 : a case of complete resolution despite invasive positive pressure ventilation. ACTA ANAESTHESIOLOGICA BELGICA 2021. [DOI: 10.56126/72.1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We present the case of a 65-year-old patient who was admitted to the intensive care unit (ICU) due to Covid-19 respiratory failure. During his hospital stay, he developed a spontaneous pneumomediastinum (SP). To date, there have been few reports of SP associated with Covid-19 and even less is known about the impact of positive pressure ventilation on these patients.
Our patient was first treated with high-flow nasal cannula oxygen therapy (HFNC). Because of further respiratory deterioration, he was supported with non-invasive ventilation (NIV). Later, he required intubation and ventilation with invasive positive pressure ventilation. Despite this, a complete spontaneous resolution of the pneumomediastinum was observed 13 days after the initial diagnosis.
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18
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Bayraktaroğlu S, Çinkooğlu A, Ceylan N, Savaş R. The novel coronavirus pneumonia (COVID-19): a pictorial review of chest CT features. Diagn Interv Radiol 2021; 27:188-194. [PMID: 32815523 PMCID: PMC7963373 DOI: 10.5152/dir.2020.20304] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/28/2020] [Accepted: 05/30/2020] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first reported in Wuhan, China. The infection rapidly spread to more than 200 countries around the world. The clinical presentation of the disease may vary from mild illness to severe pneumonia such as acute respiratory distress syndrome (ARDS). The chest computed tomography (CT) has an important complementary role in diagnosis of the disease. The predominant CT findings of the disease are ground glass opacities and consolidations located in subpleural areas of lower lobes. Widespread ground-glass opacities, consolidation, air bronchograms, central involvement of lung parenchyma, mediastinal lymphadenopathy are more common in patients with the severe form of the disease. CT imaging also guides in differentiation of alternative diagnosis or in assessment of associated pulmonary embolism during the course of the disease. In this pictorial review we aim to review the CT features of COVID-19 pneumonia and mention the changes throughout the disease process.
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Affiliation(s)
- Selen Bayraktaroğlu
- From the Department of Radiology (S.B. , Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Akın Çinkooğlu
- From the Department of Radiology (S.B. , Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Naim Ceylan
- From the Department of Radiology (S.B. , Ege University Faculty of Medicine, Bornova, Izmir, Turkey
| | - Recep Savaş
- From the Department of Radiology (S.B. , Ege University Faculty of Medicine, Bornova, Izmir, Turkey
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Zhang JF, Liu J, Ma HN, Feng K, Chen ZW, Yang LS, Mei B, Zhang JJ. RT-PCR Combined with CT Examination in the Diagnosis and Prognosis Evaluation of COVID-19 Patients in Fangcang Hospital: A Case Series. J Multidiscip Healthc 2021; 14:145-149. [PMID: 33500623 PMCID: PMC7826067 DOI: 10.2147/jmdh.s293601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 12/22/2020] [Indexed: 01/19/2023] Open
Abstract
Rationale Currently, the "gold standard" is real-time reverse transcriptase-polymerase chain reaction (RT-PCR) amplification of the viral DNA for diagnosis of COVID-19 infection. However, early reports of test performance in the Wuhan outbreak showed variable sensitivities. Therefore, the simple use of RT-PCR as a discharge standard for COVID-19 patients may be risky. Early discussions suggested that CT should be the preferred modality for the diagnosis of COVID-19. However, the use of CT for COVID-19 discharge is controversial. In the Fangcang hospital, we performed multiple nucleic acid tests and chest CT examinations in all patients. For discharged patients, we performed multiple nucleic acid tests and chest CT scans on the basis of discharge standards to minimize the incidence of false negatives in nucleic acid tests. Patient Concerns Two 42-year-old male patients with mild to moderate COVID-19 were treated in the Fangcang Hospital According to the treatment, one patient was cured and discharged, while the other patient was sent to a higher-level hospital for further treatment. Diagnoses Real-time reverse transcriptase-polymerase chain reaction amplification of the viral DNA for diagnosis of COVID-19 infection. Interventions The patients received Chinese medicine and antiviral treatment in the Fangcang Hospital. Outcomes At follow-up, both patients were cured after treatment and returned to normal life after 2 weeks of home isolation and a negative nucleic acid test. Lessons The use of nucleic acid testing combined with chest CT examination can quickly diagnose patients with COVID-19 infection and evaluate their treatment in the Fangcang Hospital.
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Affiliation(s)
- Jun-Fei Zhang
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People's Republic of China
| | - Jia Liu
- Medical Experiment Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People's Republic of China
| | - Han-Ning Ma
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People's Republic of China
| | - Ke Feng
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People's Republic of China
| | - Zhong-Wei Chen
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People's Republic of China
| | - Li-Shan Yang
- Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People's Republic of China
| | - Bin Mei
- Department of Social Medical Development, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, People's Republic of China
| | - Jun-Jian Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, People's Republic of China
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20
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Grygiel-Górniak B, Oduah MT. COVID-19: What Should the General Practitioner Know? Clin Interv Aging 2021; 16:43-56. [PMID: 33442244 PMCID: PMC7800435 DOI: 10.2147/cia.s268607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 08/25/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 infection is currently the most significant public health challenge. Its presentation ranges from mild to severe respiratory failure and septic shock. Rapid transmission of the virus is dangerous with a high possibility of life-threatening complications. Lack of treatment standards for SARS-CoV-2 is responsible for the current dilemma in clinical medicine. METHODS An electronic literature search was done using PubMed to gather information on the pathogenesis, transmission of infection, clinical symptoms, diagnosis, and therapeutic options for COVID-19. Search items included "SARS-CoV-2", "COVID-19" and "coronavirus infection". RESULTS In light of the current global crisis caused by SARS-CoV-2, the exchange of information within the scientific community should be quick and extremely transparent. Thus, this review presents the available information necessary for a general practitioner. Such presentation of data should allow the reader quick access to basic and crucial information related to epidemiology, viral transmission, clinical symptoms, diagnostics, treatment, and complications that may occur in the course of COVID-19. CONCLUSION Rapidly increasing amounts of information about the diagnosis and treatment of patients with SARS-CoV-2 allow a better understanding of the etiology and course of the infection. In the current epidemiological situation, readily accessible information helps minimize the time to acquire knowledge and focus on prevention methods, diagnostic and treatment options. Thus, this review highlights key issues related to SARS-CoV-2 infection and contains the most useful data for daily medical practice.
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Affiliation(s)
- Bogna Grygiel-Górniak
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Mary-Tiffany Oduah
- Department of Rheumatology, Rehabilitation and Internal Diseases, Poznan University of Medical Sciences, Poznan, Poland
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21
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Li X, Li T, Wang H. Treatment and prognosis of COVID-19: Current scenario and prospects (Review). Exp Ther Med 2021; 21:3. [PMID: 33235612 PMCID: PMC7678645 DOI: 10.3892/etm.2020.9435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/22/2020] [Indexed: 12/24/2022] Open
Abstract
SARS-CoV-2 is the seventh member of the family of coronaviruses that can cause infections in humans, termed as COVID-19, which is now a global pandemic. Because it is a novel virus, considerable efforts and extensive studies are needed to fully understand its characteristics. Its symptoms and severity range from mild to critical, depending on several factors, such as host susceptibility to the virus and their immune system, with the most common symptoms being fever, fatigue, sore throat and runny nose. There is no clear treatment available yet, though several options are being explored, with research for vaccines being at the forefront. Traditional Chinese Medicine may also be used as a treatment option. Since this virus is similar to the SARS-CoV and MERS viruses, considerable insight can be gained from previous studies. Although many patients recover completely, there are several factors that lead to poor prognosis. This review summarizes the research carried out so far in terms of treatment options and prognosis factors associated with COVID-19.
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Affiliation(s)
- Xuemei Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, P.R. China
| | - Tao Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, P.R. China
- Institute of Clinical Pharmacology, Anhui Medical University, Key Laboratory of Anti-Inflammatory and Immune Medicine, Ministry of Education, Anhui Collaborative Innovation Center of Anti-Inflammatory and Immune Medicine, Anhui Anti-Inflammatory and Immune Medicine Innovation Team, Hefei, Anhui 230032, P.R. China
| | - Huihui Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230032, P.R. China
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22
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Bano N, Batool F, Bin-Jumah MN. Introduction to COVID-19. ALTERNATIVE MEDICINE INTERVENTIONS FOR COVID-19 2021:1-32. [DOI: 10.1007/978-3-030-67989-7_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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23
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Khatami F, Saatchi M, Zadeh SST, Aghamir ZS, Shabestari AN, Reis LO, Aghamir SMK. A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis. Sci Rep 2020; 10:22402. [PMID: 33372194 PMCID: PMC7769992 DOI: 10.1038/s41598-020-80061-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022] Open
Abstract
Nowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85-90%), 46% (95% CI 29-63%), 69% (95% CI 56-72%), and 89% (95% CI 82-96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.
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Affiliation(s)
- Fatemeh Khatami
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saatchi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Leonardo Oliveira Reis
- UroScience and Department of Surgery (Urology), School of Medical Sciences, University of Campinas, Unicamp, and Pontifical Catholic University of Campinas, PUC-Campinas, Campinas, São Paulo, Brazil
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24
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Çardaközü T, Çınar Ö, Eliçora A, Sezer F. Modified Closed Chest Drainage System for Safe Anaesthesia in Patients with COVID-19 Suspicion. Turk J Anaesthesiol Reanim 2020; 49:74-77. [PMID: 33718911 PMCID: PMC7932711 DOI: 10.5152/tjar.2020.1043] [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: 08/07/2020] [Accepted: 09/29/2020] [Indexed: 11/22/2022] Open
Abstract
An emergency operation was planned for a patient who developed pneumothorax, subcutaneous emphysema and pneumomediastinum, which was thought to develop secondary to acute diverticulitis. Polymerase chain reaction (PCR) test for coronavirus disease 2019 (COVID-19) diagnosis could not be performed before the operation. In COVID-19 infection, it has been reported that pneumonia, pneumomediastinum and subcutaneous emphysema could be seen in thoracic computed tomography (CT) scan in addition to classic ground-glass opacities. In this study, a modified closed chest drainage system (CCDS) is presented to prevent COVID-19 aerosolisation in a patient undergoing intraoperative tube thoracostomy.
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Affiliation(s)
- Tülay Çardaközü
- Department of Anaesthesiology and Reanimation, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Özge Çınar
- Department of Anaesthesiology and Reanimation, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Aykut Eliçora
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Fatih Sezer
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
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25
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Fang X, Li X, Bian Y, Ji X, Lu J. Radiomics nomogram for the prediction of 2019 novel coronavirus pneumonia caused by SARS-CoV-2. Eur Radiol 2020; 30:6888-6901. [PMID: 32621237 PMCID: PMC7332742 DOI: 10.1007/s00330-020-07032-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/30/2020] [Accepted: 06/12/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To develop and validate a radiomics model for predicting 2019 novel coronavirus (COVID-19) pneumonia. METHODS For this retrospective study, a radiomics model was developed on the basis of a training set consisting of 136 patients with COVID-19 pneumonia and 103 patients with other types of viral pneumonia. Radiomics features were extracted from the lung parenchyma window. A radiomics signature was built on the basis of reproducible features, using the least absolute shrinkage and selection operator method (LASSO). Multivariable logistic regression model was adopted to establish a radiomics nomogram. Nomogram performance was determined by its discrimination, calibration, and clinical usefulness. The model was validated in 90 consecutive patients, of which 56 patients had COVID-19 pneumonia and 34 patients had other types of viral pneumonia. RESULTS The radiomics signature, consisting of 3 selected features, was significantly associated with COVID-19 pneumonia (p < 0.05) in both training and validation sets. The multivariable logistic regression model included the radiomics signature and distribution; maximum lesion, hilar, and mediastinal lymph node enlargement; and pleural effusion. The individualized prediction nomogram showed good discrimination in the training sample (area under the receiver operating characteristic curve [AUC], 0.959; 95% confidence interval [CI], 0.933-0.985) and in the validation sample (AUC, 0.955; 95% CI, 0.899-0.995) and good calibration. The mixed model achieved better predictive efficacy than the clinical model. Decision curve analysis demonstrated that the radiomics nomogram was clinically useful. CONCLUSIONS The radiomics model derived has good performance for predicting COVID-19 pneumonia and may help in clinical decision-making. KEY POINTS • A radiomics model showed good performance for prediction 2019 novel coronavirus pneumonia and favorable discrimination for other types of pneumonia on CT images. • A central or peripheral distribution, a maximum lesion range > 10 cm, the involvement of all five lobes, hilar and mediastinal lymph node enlargement, and no pleural effusion is associated with an increased risk of 2019 novel coronavirus pneumonia. • A radiomics model was superior to a clinical model in predicting 2019 novel coronavirus pneumonia.
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Affiliation(s)
- Xu Fang
- Department of Radiology, Changhai Hospital, The Navy Military Medical University, Changhai road 168, Shanghai, 200434, China
| | - Xiao Li
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China
- Department of Radiology, Wuhan Huoshenshan Hospital, Wuhan, 430000, Hubei, China
| | - Yun Bian
- Department of Radiology, Changhai Hospital, The Navy Military Medical University, Changhai road 168, Shanghai, 200434, China.
| | - Xiang Ji
- Shanghai United Imaging Intelligence Healthcare, Shanghai, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital, The Navy Military Medical University, Changhai road 168, Shanghai, 200434, China
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26
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Sk MF, Jonniya NA, Roy R, Poddar S, Kar P. Computational Investigation of Structural Dynamics of SARS-CoV-2 Methyltransferase-Stimulatory Factor Heterodimer nsp16/nsp10 Bound to the Cofactor SAM. Front Mol Biosci 2020; 7:590165. [PMID: 33330626 PMCID: PMC7732651 DOI: 10.3389/fmolb.2020.590165] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/23/2020] [Indexed: 01/08/2023] Open
Abstract
Recently, a highly contagious novel coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has emerged, posing a global threat to public health. Identifying a potential target and developing vaccines or antiviral drugs is an urgent demand in the absence of approved therapeutic agents. The 5'-capping mechanism of eukaryotic mRNA and some viruses such as coronaviruses (CoVs) are essential for maintaining the RNA stability and protein translation in the virus. SARS-CoV-2 encodes S-adenosyl-L-methionine (SAM) dependent methyltransferase (MTase) enzyme characterized by nsp16 (2'-O-MTase) for generating the capped structure. The present study highlights the binding mechanism of nsp16 and nsp10 to identify the role of nsp10 in MTase activity. Furthermore, we investigated the conformational dynamics and energetics behind the binding of SAM to nsp16 and nsp16/nsp10 heterodimer by employing molecular dynamics simulations in conjunction with the Molecular Mechanics Poisson-Boltzmann Surface Area (MM/PBSA) method. We observed from our simulations that the presence of nsp10 increases the favorable van der Waals and electrostatic interactions between SAM and nsp16. Thus, nsp10 acts as a stimulator for the strong binding of SAM to nsp16. The hydrophobic interactions were predominately identified for the nsp16-nsp10 interactions. Also, the stable hydrogen bonds between Ala83 (nsp16) and Tyr96 (nsp10), and between Gln87 (nsp16) and Leu45 (nsp10) play a vital role in the dimerization of nsp16 and nsp10. Besides, Computational Alanine Scanning (CAS) mutagenesis was performed, which revealed hotspot mutants, namely I40A, V104A, and R86A for the dimer association. Hence, the dimer interface of nsp16/nsp10 could also be a potential target in retarding the 2'-O-MTase activity in SARS-CoV-2. Overall, our study provides a comprehensive understanding of the dynamic and thermodynamic process of binding nsp16 and nsp10 that will contribute to the novel design of peptide inhibitors based on nsp16.
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Affiliation(s)
| | | | | | | | - Parimal Kar
- Discipline of Biosciences and Biomedical Engineering, Indian Institute of Technology Indore, Khandwa, India
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27
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Hong L, Ye E, Sun G, Wang X, Zhang S, Wu Y, Xie X, Xia S, Zheng X, Dong L, Cai F, Lou X, Zhao R, Hu Y, Ruan Z, Ding J, Sun Q. Clinical and radiographic characteristics, management and short-term outcomes of patients with COVID-19 in Wenzhou, China. BMC Infect Dis 2020; 20:841. [PMID: 33187475 PMCID: PMC7662018 DOI: 10.1186/s12879-020-05528-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 10/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is an emerging viral disease. Here, we report the clinical features, management, and short-term outcomes of COVID-19 patients in Wenzhou, China, an area outside Wuhan. METHODS Patients admitted to the Infectious Diseases Department of Ruian People's Hospital in Wenzhou, from January 21 to February 7, 2020, were recruited. Medical data on epidemiological history, demographics, clinical characteristics, laboratory tests, chest computerized tomography (CT) examination, treatment, and short-term outcomes were retrospectively reviewed. Blood biochemistry and routine tests were examined using standard methods and automatic machines. CT examination was performed several times during hospitalization as necessary. RESULTS A total of 67 confirmed COVID-19 cases were diagnosed; 64 (95.4%) were common cases and three (4.5%) were severe cases. The most common symptoms at admission were fever (86.6%), cough (77.6%), productive cough (52.2%), chest distress (17.9%), and sore throat (11.9%), followed by diarrhea (7.4%), headache (7.4%), shortness of breath (6.0%), dizziness (4.5%), muscular soreness (4.5%), and running nose (4.5%). Thirty patients (47.8%) had increased C-reactive protein levels. The CT radiographs at admission showed abnormal findings in 54 (80.6%) patients. The patients were treated mainly by oxygen therapy and antiviral drugs. By March 3, 2020, all 67 patients completely recovered and had negative nucleic acid tests. The patients were discharged from the hospital and transferred to a medical observation isolation center for further observation. CONCLUSION Cases of COVID-19 in Wenzhou are milder and have a better prognosis, compared to those in Wuhan. Timely and appropriate screening, diagnosis, and treatment are the key to achieve good outcomes.
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Affiliation(s)
- Liang Hong
- Department of Infectious diseases, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), 108 Wansong Road, Ruian, Wenzhou, 325200, Zhejiang Province, China
| | - Enling Ye
- Endocrinology Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Gangqiang Sun
- Department of Biology, Gordon College, Wenham, MA, 01984, USA
| | - Xiaoyang Wang
- Radiography Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Shengguo Zhang
- Department of Infectious diseases, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), 108 Wansong Road, Ruian, Wenzhou, 325200, Zhejiang Province, China
| | - Yanghe Wu
- Department of Infectious diseases, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), 108 Wansong Road, Ruian, Wenzhou, 325200, Zhejiang Province, China
| | - Xiangao Xie
- Health bureau of Ruian City, 333 Ruihu Road, Ruian, Wenzhou, 325200, Zhejiang Province, China
| | - Shichun Xia
- Hospital Office, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Xudong Zheng
- The Emergency Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Ling Dong
- Pneumology Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Fujing Cai
- Department of Infectious diseases, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), 108 Wansong Road, Ruian, Wenzhou, 325200, Zhejiang Province, China
| | - Xixian Lou
- Pneumology Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Renguo Zhao
- Pneumology Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Yongqi Hu
- The Emergency Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Zhanwei Ruan
- The Emergency Department, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), Ruian City, Zhejiang Province, 325200, China
| | - Jiguang Ding
- Department of Infectious diseases, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), 108 Wansong Road, Ruian, Wenzhou, 325200, Zhejiang Province, China.
| | - Qingfeng Sun
- Department of Infectious diseases, the Third Affiliated Hospital to Wenzhou Medical University (Ruian People's Hospital), 108 Wansong Road, Ruian, Wenzhou, 325200, Zhejiang Province, China.
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Cellina M, Orsi M, Valenti Pittino C, Toluian T, Oliva G. Chest computed tomography findings of COVID-19 pneumonia: pictorial essay with literature review. Jpn J Radiol 2020; 38:1012-1019. [PMID: 32588277 PMCID: PMC7315402 DOI: 10.1007/s11604-020-01010-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/19/2020] [Indexed: 12/21/2022]
Abstract
Available information on chest Computed Tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) is constantly evolving. Ground glass opacities and consolidation with bilateral and peripheral distribution were reported as the most common CT findings, but also less typical features could be identified. All radiologists should be aware of the imaging spectrum of the COVID-19 pneumonia and imaging changes in the course of the disease. Our aim is to display the chest CT findings at first assessment and follow-up through a pictorial essay, to help in the recognition of these features for an accurate diagnosis.
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Affiliation(s)
- Michaela Cellina
- Department of Radiology, ASST Fatebenefratelli Sacco, Milano, Ospedale Fatebenefratelli, Piazza Principessa Clotilde 3, 20121, Milan, Italy.
| | - Marcello Orsi
- Department of Radiology, ASST Fatebenefratelli Sacco, Milano, Ospedale Fatebenefratelli, Piazza Principessa Clotilde 3, 20121, Milan, Italy
| | - Carlo Valenti Pittino
- Scuola Di Specializzazione in Radiodiagnostica, Università Degli Studi Di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Tahereh Toluian
- Scuola Di Specializzazione in Radiodiagnostica, Università Degli Studi Di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Giancarlo Oliva
- Department of Radiology, ASST Fatebenefratelli Sacco, Milano, Ospedale Fatebenefratelli, Piazza Principessa Clotilde 3, 20121, Milan, Italy
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Cao Y, Han X, Gu J, Li Y, Liu J, Alwalid O, Cui Y, Zhang X, Zheng C, Fan Y, Wu H, Shi H. Prognostic value of baseline clinical and HRCT findings in 101 patients with severe COVID-19 in Wuhan, China. Sci Rep 2020; 10:17543. [PMID: 33067524 PMCID: PMC7567846 DOI: 10.1038/s41598-020-74497-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/25/2020] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to assess the prognostic value of baseline clinical and high resolution CT (HRCT) findings in patients with severe COVID-19. In this retrospective, two-center study, we included two groups of inpatients with severe COVID-19 who had been discharged or died in Jin Yin-tan hospital and Wuhan union hospital between January 5, 2020, and February 22, 2020. Cases were confirmed by real-time polymerase chain reaction. Demographic, clinical, and laboratory data, and HRCT imaging were collected and compared between discharged and deceased patients. Univariable and multivariable logistic regression models were used to assess predictors of mortality risk in these patients. 101 patients were included in this study, of whom 66 were discharged and 35 died in the hospital. The mean age was 56.6 ± 15.1 years and 67 (66.3%) were men. Of the 101 patients, hypertension (38, 37.6%), cardiovascular disease (21,20.8%), diabetes (18,17.8%), and chronic pulmonary disease (16,15.8%) were the most common coexisting conditions. The multivariable regression analysis showed older age (OR: 1.142, 95% CI 1.059-1.231, p < 0.001), acute respiratory distress syndrome (ARDS) (OR: 10.142, 95% CI 1.611-63.853, p = 0.014), reduced lymphocyte count (OR: 0.004, 95% CI 0.001-0.306, p = 0.013), and elevated HRCT score (OR: 1.276, 95% CI 1.002-1.625, p = 0.049) to be independent predictors of mortality risk on admission in severe COVID-19 patients. These findings may have important clinical implications for decision-making based on risk stratification of severe COVID-19 patients.
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Affiliation(s)
- Yukun Cao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xiaoyu Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jin Gu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yumin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Jia Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Osamah Alwalid
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yue Cui
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xin Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yanqing Fan
- Department of Radiology, Wuhan Jinyintan Hospital, No.1 Yintan Road, Dongxihu District, Wuhan, 430022, China.
| | - Hanping Wu
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - Heshui Shi
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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Yang C, Lu Y, Wan M, Xu D, Yang X, Yang L, Wang S, Sun G. Efficacy of High-Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta-Analysis of Randomized Controlled Studies. Nutr Clin Pract 2020; 36:368-384. [PMID: 33037694 DOI: 10.1002/ncp.10585] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this meta-analysis was to summarize randomized controlled trial (RCT) evidence and evaluate the efficacy and safety of vitamin D (VD) supplementation as an adjunct to antibiotics for the treatment of pneumonia. Data sources published from the inception dates up to January 2020 were searched. RCTs of VD supplementation of any duration, age, and dosing regimen type were eligible for inclusion if data on pneumonia were collected. Thirteen studies (4786 randomized participants) fulfilled eligibility criteria. VD supplementation significantly increased levels of serum 25(OH)D (mean difference = 15.97; 95% CI, 7.49-24.44; P = .002) and reduced incidence of repeat episodes of pneumonia (risk ratio [RR] = 0.68; 95% CI, 0.50-0.93; P = .02). Subgroup analysis revealed VD supplementation had more reducing effects on repeat episodes of pneumonia among participants in trials in which the population were children (RR = 0.66; 95% CI, 0.48-0.90), duration <3 months (RR = 0.55; 95% CI, 0.33-0.91), or dose of VD <300,000 IU (RR = 0.51; 95% CI, 0.29-0.89). Although our results suggested that VD supplementation had a positive effect on recovery rate of pneumonia (RR = 1.28; 95% CI, 0.94-1.74; I2 = 13%), there was no statistical difference (P = .12). High-dose VD intervention may have an effect on reducing the incidence rate of repeat episodes of pneumonia by enhancing immune efficacy, although more population studies are needed to support that VD supplementation has therapeutic effects on pneumonia itself.
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Affiliation(s)
- Chao Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
| | - Yifei Lu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
| | - Min Wan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
| | - Dengfeng Xu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
| | - Xian Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
| | - Ligang Yang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
| | - Shaokang Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, P. R. China
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Chen X, Zhang G, Hao SY, Bai L, Lu JJ. Similarities and Differences of Early Pulmonary CT Features of Pneumonia Caused by SARS-CoV-2, SARS-CoV and MERS-CoV: Comparison Based on a Systemic Review. ACTA ACUST UNITED AC 2020; 35:254-261. [PMID: 32972503 PMCID: PMC7521866 DOI: 10.24920/003727] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
To compare the similarities and differences of early CT manifestations of three types of viral pneumonia induced by SARS-CoV-2 (COVED-19), SARS-CoV (SARS) and MERS-CoV (MERS) using a systemic review. Methods Electronic database were searched to identify all original articles and case reports presenting chest CT features for adult patients with COVID-19, SARS and MERS pneumonia respectively. Quality of literature and completeness of presented data were evaluated by consensus reached by three radiologists. Vote-counting method was employed to include cases of each group. Data of patients' manifestations in early chest CT including lesion patterns, distribution of lesions and specific imaging signs for the three groups were extracted and recorded. Data were compared and analyzed using SPSS 22.0. Results A total of 24 studies were included, composing of 10 studies of COVED-19, 5 studies of MERS and 9 studies of SARS. The included CT exams were 147, 40, and 122 respectively. For the early CT features of the 3 pneumonias, the basic lesion pattern with respect to “mixed ground glass opacity (GGO) and consolidation, GGO mainly, or consolidation mainly” was similar among the 3 groups (χ2 = 7.966, p > 0.05). There were no significant differences on the lesion distribution (χ2= 13.053, p > 0.05) and predominate involvement of the subpleural area of bilateral lower lobes (χ2 = 4.809, p > 0.05) among the 3 groups. The lesions appeared more focal in COVID-19 pneumonia at early phase (χ2= 23.509, p < 0.05). The proportions of crazy-paving pattern (χ2 = 23.037, p < 0.001), organizing pneumonia pattern (p < 0.05) and pleural effusions (p < 0.001) in COVID-19 pneumonia were significantly lower than the other two. Although rarely shown in the early CT findings of all three viral pneumonias, the fibrotic changes were more frequent in SAKS than COVID-19 and MERS (χ2 = 6.275, P<0.05). For other imaging signs, only the MERS pneumonia demonstrated tree-in-buds, cavitation, and its incidence rate of interlobular or intralobular septal thickening presented significantly increased as compared to the other two pneumonia (χ2 = 22.412, p < 0.05). No pneumothorax, pneumomediastinum and lymphadenopathy was present for each group. Conclusions Imaging findings on early stage of these three coronavirus pneumonias showed similar basic lesion patterns, including GGO and consolidation, bilateral distribution, and predominant involvement of the subpleural area and the lower lobes. Early signs of COVID-19 pneumonia showed less severity of inflammation. Early fibrotic changes appeared in SAKS only, MERS had more severe inflammatory changes including cavitation and pleural effusion. The differences may indicate the specific pathophysiological processes for each coronavirus pneumonia.
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Affiliation(s)
- Xu Chen
- Department of Radiology, Beijing United Family Hospital, Beijing 100015, China
| | - Gang Zhang
- Department of Radiology, Beijing United Family Hospital, Beijing 100015, China
| | - Shuai Ying Hao
- Department of Radiology, Beijing United Family Hospital, Beijing 100015, China
| | - Lin Bai
- Department of Radiology, Beijing United Family Hospital, Beijing 100015, China
| | - Jing Jing Lu
- Department of Radiology, Beijing United Family Hospital, Beijing 100015, China
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Hoque MN, Chaudhury A, Akanda MAM, Hossain MA, Islam MT. Genomic diversity and evolution, diagnosis, prevention, and therapeutics of the pandemic COVID-19 disease. PeerJ 2020; 8:e9689. [PMID: 33005486 PMCID: PMC7510477 DOI: 10.7717/peerj.9689] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/19/2020] [Indexed: 12/14/2022] Open
Abstract
The coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection caused by a novel evolutionarily divergent RNA virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus first emerged in Wuhan, China in December 2019, and subsequently spreaded around the world. Genomic analyses revealed that this zoonotic virus may be evolved naturally but not a purposefully manipulated laboratory construct. However, currently available data are not sufficient to precisely conclude the origin of this fearsome virus. Comprehensive annotations of the whole-genomes revealed hundreds of nucleotides, and amino acids mutations, substitutions and/or deletions at different positions of the ever changing SARS-CoV-2 genome. The spike (S) glycoprotein of SARS-CoV-2 possesses a functional polybasic (furin) cleavage site at the S1-S2 boundary through the insertion of 12 nucleotides. It leads to the predicted acquisition of 3-O-linked glycan around the cleavage site. Although real-time RT-PCR methods targeting specific gene(s) have widely been used to diagnose the COVID-19 patients, however, recently developed more convenient, cheap, rapid, and specific diagnostic tools targeting antigens or CRISPR-Cas-mediated method or a newly developed plug and play method should be available for the resource-poor developing countries. A large number of candidate drugs, vaccines and therapies have shown great promise in early trials, however, these candidates of preventive or therapeutic agents have to pass a long path of trials before being released for the practical application against COVID-19. This review updates current knowledge on origin, genomic evolution, development of the diagnostic tools, and the preventive or therapeutic remedies of the COVID-19. We also discussed the future scopes for research, effective management, and surveillance of the newly emerged COVID-19 disease.
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Affiliation(s)
- M. Nazmul Hoque
- Department of Gynecology, Obstetrics and Reproductive Health, Bangabandhu Sheikh Mujibur Rahman Agricultural University (BSMRAU), Gazipur, Bangladesh
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh
| | | | - Md Abdul Mannan Akanda
- Department of Plant Pathology, Bangabandhu Sheikh Mujibur Rahman Agricultural University (BSMRAU), Gazipur, Bangladesh
| | - M. Anwar Hossain
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh
- Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Tofazzal Islam
- Institute of Biotechnology and Genetic Engineering (IBGE), Bangabandhu Sheikh Mujibur Rahman Agricultural University (BSMRAU), Gazipur, Bangladesh
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Jutzeler CR, Bourguignon L, Weis CV, Tong B, Wong C, Rieck B, Pargger H, Tschudin-Sutter S, Egli A, Borgwardt K, Walter M. Comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatment strategies, and outcomes in adult and pediatric patients with COVID-19: A systematic review and meta-analysis. Travel Med Infect Dis 2020; 37:101825. [PMID: 32763496 PMCID: PMC7402237 DOI: 10.1016/j.tmaid.2020.101825] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/09/2020] [Accepted: 07/27/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Since December 2019, a novel coronavirus (SARS-CoV-2) has triggered a world-wide pandemic with an enormous medical and societal-economic toll. Thus, our aim was to gather all available information regarding comorbidities, clinical signs and symptoms, outcomes, laboratory findings, imaging features, and treatments in patients with coronavirus disease 2019 (COVID-19). METHODS EMBASE, PubMed/Medline, Scopus, and Web of Science were searched for studies published in any language between December 1st, 2019 and March 28th, 2020. Original studies were included if the exposure of interest was an infection with SARS-CoV-2 or confirmed COVID-19. The primary outcome was the risk ratio of comorbidities, clinical signs and symptoms, laboratory findings, imaging features, treatments, outcomes, and complications associated with COVID-19 morbidity and mortality. We performed random-effects pairwise meta-analyses for proportions and relative risks, I2, T2, and Cochrane Q, sensitivity analyses, and assessed publication bias. RESULTS 148 studies met the inclusion criteria for the systematic review and meta-analysis with 12'149 patients (5'739 female) and a median age of 47.0 [35.0-64.6] years. 617 patients died from COVID-19 and its complication. 297 patients were reported as asymptomatic. Older age (SMD: 1.25 [0.78-1.72]; p < 0.001), being male (RR = 1.32 [1.13-1.54], p = 0.005) and pre-existing comorbidity (RR = 1.69 [1.48-1.94]; p < 0.001) were identified as risk factors of in-hospital mortality. The heterogeneity between studies varied substantially (I2; range: 1.5-98.2%). Publication bias was only found in eight studies (Egger's test: p < 0.05). CONCLUSIONS Our meta-analyses revealed important risk factors that are associated with severity and mortality of COVID-19.
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Affiliation(s)
- Catherine R Jutzeler
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland; Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
| | - Lucie Bourguignon
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Caroline V Weis
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Bobo Tong
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada
| | - Cyrus Wong
- Simon Fraser University, Vancouver, Canada
| | - Bastian Rieck
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Hans Pargger
- Intensive Care Unit, University Hospital Basel, University Basel, Basel, Switzerland
| | - Sarah Tschudin-Sutter
- Division of Infectious Diseases & Hospital Epidemiology, University Hospital Basel and University of Basel, Switzerland; Department of Clinical Research, University Hospital Basel and University of Basel, Switzerland
| | - Adrian Egli
- Division of Clinical Bacteriology & Mycology, University Hospital Basel, Basel, Switzerland; Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Karsten Borgwardt
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Matthias Walter
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Swiss Paraplegic Center, Nottwil, Switzerland
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Khoubnasabjafari M, Jouyban-Gharamaleki V, Ghanbari R, Jouyban A. Exhaled breath condensate as a potential specimen for diagnosing COVID-19. Bioanalysis 2020; 12:1195-1197. [PMID: 32290684 PMCID: PMC7370802 DOI: 10.4155/bio-2020-0083] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Maryam Khoubnasabjafari
- Tuberculosis & Lung Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Jouyban-Gharamaleki
- Pharmaceutical Analysis Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ghanbari
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abolghasem Jouyban
- Pharmaceutical Analysis Research Center & Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Liu N, He G, Yang X, Chen J, Wu J, Ma M, Lu W, Li Q, Cheng T, Huang X. Dynamic changes of Chest CT follow-up in Coronavirus Disease-19 (COVID-19) pneumonia: relationship to clinical typing. BMC Med Imaging 2020; 20:92. [PMID: 32758155 PMCID: PMC7403785 DOI: 10.1186/s12880-020-00491-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To investigate the CT changes of different clinical types of COVID-19 pneumonia. METHODS This retrospective study included 50 patients with COVID-19 from 16 January 2020 to 25 February 2020. We analyzed the clinical characteristics, CT characteristics and the pneumonia involvement of the patients between the moderate group and the severe and critical group, and the dynamic changes of severity with the CT follow-up time. RESULTS There were differences in the CT severity score of the right lung in the initial CT, and total CT severity score in the initial and follow-up CT between the moderate group and the severe and critical group (all p < 0.05). There was a quadratic relationship between total CT severity score and CT follow-up time in the severe and critical group (r2 = 0.137, p = 0.008), the total CT severity score peaked at the second follow-up CT. There was no correlation between total CT severity score and CT follow-up time in the moderate group (p > 0.05). There were no differences in the occurrence rate of CT characteristics in the initial CT between the two groups (all p > 0.05). There were differences in the occurrence rate of ground-glass opacity and crazy-paving pattern in the second follow-up CT, and pleural thickening or adhesion in the third follow-up CT between the two groups (all p < 0.05). CONCLUSIONS The CT changes of COVID-19 pneumonia with different severity were different, and the extent of pneumonia involvement by CT can help to assess the severity of COVID-19 pneumonia rather than the initial CT characteristics.
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Affiliation(s)
- Nian Liu
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No.63 Wenhua Road, Shunqing District, Nanchong, 637000, China
| | - Guanghong He
- Department of Radiology, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, 637000, China
| | - Xiongxiong Yang
- Department of Radiology, Nanchong Hospital of Traditional Chinese Medicine, Nanchong, 637000, China
| | - Jianxin Chen
- Department of Radiology, West China-Guang'an Hospital, Sichuan University, Guangan, 638000, China
| | - Jie Wu
- Department of CT/MRI, Nanchong Central Hospital, Nanchong, 637000, China
| | - Min Ma
- Department of Radiology, Wusheng People's Hospital, Guangan, 638000, China
| | - Wenying Lu
- Department of Radiology, Langzhong People's Hospital, Nanchong, 637000, China
| | - Qiang Li
- Department of Radiology, Yuechi People's Hospital, Guangan, 638000, China
| | - Tao Cheng
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No.63 Wenhua Road, Shunqing District, Nanchong, 637000, China
| | - Xiaohua Huang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, No.63 Wenhua Road, Shunqing District, Nanchong, 637000, China.
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Alsuliman T, Sulaiman R, Ismail S, Srour M, Alrstom A. COVID-19 paraclinical diagnostic tools: Updates and future trends. Curr Res Transl Med 2020; 68:83-91. [PMID: 32576508 PMCID: PMC7305905 DOI: 10.1016/j.retram.2020.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/24/2020] [Accepted: 06/15/2020] [Indexed: 02/08/2023]
Abstract
MOTIVATION COVID-19 is one of the most widely affecting pandemics. As for many respiratory viruses-caused diseases, diagnosis of COVID-19 relies on two main compartments: clinical and paraclinical diagnostic criteria. Rapid and accurate diagnosis is vital in such a pandemic. On one side, rapidity may enhance management effectiveness, while on the other, coupling efficiency and less costly procedures may permit more effective community-scale management. METHODOLOGY AND MAIN STRUCTURE In this review, we shed light on the most used and the most validated diagnostic tools. Furthermore, we intend to include few under-development techniques that may be potentially useful in this context. The practical intent of our work is to provide clinicians with a realistic summarized review of the essential elements in the applied paraclinical diagnosis of COVID-19.
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Affiliation(s)
- Tamim Alsuliman
- Service d'hématologie, hôpital Saint-Antoine, AP-HP Sorbonne Université, 75012, Paris, France.
| | - Rand Sulaiman
- Department of Genetics, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Sawsan Ismail
- Department of Pathology, Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Micha Srour
- Service maladie du sang, centre hospitalier universitaire de Lille, 59000, Lille, France
| | - Ali Alrstom
- Department of Infectious Diseases, Faculty of Medicine, Damascus University, Damascus, Syria
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Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, Zhang LJ. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology 2020; 296:E15-E25. [PMID: 32083985 PMCID: PMC7233368 DOI: 10.1148/radiol.2020200490] [Citation(s) in RCA: 943] [Impact Index Per Article: 188.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In December 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 infection occurred in Wuhan, Hubei Province, China, and spread across China and beyond. On February 12, 2020, the World Health Organization officially named the disease caused by the novel coronavirus as coronavirus disease 2019 (COVID-19). Because most patients infected with COVID-19 had pneumonia and characteristic CT imaging patterns, radiologic examinations have become vital in early diagnosis and the assessment of disease course. To date, CT findings have been recommended as major evidence for clinical diagnosis of COVID-19 in Hubei, China. This review focuses on the etiology, epidemiology, and clinical symptoms of COVID-19 while highlighting the role of chest CT in prevention and disease control.
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Affiliation(s)
| | | | - Peng Peng Xu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China (Z.Y.Z., M.D.J., P.P.X., Q.Q.N., G.M.L., L.J.Z); Department of Medical Imaging, Taihe Hospital, Shiyan, Hubei, 442000, China (W.C)
| | - Wen Chen
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China (Z.Y.Z., M.D.J., P.P.X., Q.Q.N., G.M.L., L.J.Z); Department of Medical Imaging, Taihe Hospital, Shiyan, Hubei, 442000, China (W.C)
| | - Qian Qian Ni
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China (Z.Y.Z., M.D.J., P.P.X., Q.Q.N., G.M.L., L.J.Z); Department of Medical Imaging, Taihe Hospital, Shiyan, Hubei, 442000, China (W.C)
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China (Z.Y.Z., M.D.J., P.P.X., Q.Q.N., G.M.L., L.J.Z); Department of Medical Imaging, Taihe Hospital, Shiyan, Hubei, 442000, China (W.C)
| | - Long Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China (Z.Y.Z., M.D.J., P.P.X., Q.Q.N., G.M.L., L.J.Z); Department of Medical Imaging, Taihe Hospital, Shiyan, Hubei, 442000, China (W.C)
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Bertolino L, Vitrone M, Durante-Mangoni E. Does this patient have COVID-19? A practical guide for the internist. Intern Emerg Med 2020; 15:791-800. [PMID: 32445165 PMCID: PMC7244400 DOI: 10.1007/s11739-020-02377-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/12/2020] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is currently causing a pandemic and will likely persist in endemic form in the foreseeable future. Physicians need to correctly approach this new disease, often representing a challenge in terms of differential diagnosis. Although COVID-19 lacks specific signs and symptoms, we believe internists should develop specific skills to recognize the disease, learning its 'semeiotic'. In this review article, we summarize the key clinical features that may guide in differentiating a COVID-19 case, requiring specific testing, from upper respiratory and/or influenza-like illnesses of other aetiology. We consider two different clinical settings, where availability of the different diagnostic strategies differs widely: outpatient and inpatient. Our reasoning highlights how challenging a balanced approach to a patient with fever and flu-like symptoms can be. At present, clinical workup of COVID-19 remains a hard task to accomplish. However, knowledge of the natural history of the disease may aid the internist in putting common and unspecific symptoms into the correct clinical context.
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Affiliation(s)
- Lorenzo Bertolino
- Department of Precision Medicine, Section of Internal Medicine, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - Martina Vitrone
- Department of Precision Medicine, Section of Internal Medicine, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - Emanuele Durante-Mangoni
- Department of Precision Medicine, Section of Internal Medicine, University of Campania 'L. Vanvitelli', Napoli, Italy.
- Unit of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale E. Ruggieri, 80131, Naples, Italy.
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Suchá D, van Hamersvelt RW, van den Hoven AF, de Jong PA, Verkooijen HM. Suboptimal Quality and High Risk of Bias in Diagnostic Test Accuracy Studies at Chest Radiography and CT in the Acute Setting of the COVID-19 Pandemic: A Systematic Review. Radiol Cardiothorac Imaging 2020; 2:e200342. [PMID: 33778613 PMCID: PMC7393956 DOI: 10.1148/ryct.2020200342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/07/2020] [Accepted: 07/20/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To synthesize the literature on diagnostic test accuracy of chest radiography, CT, and US for the diagnosis of coronavirus disease 2019 (COVID-19) in patients suspected of having COVID-19 in a hospital setting and evaluate the extent of suboptimal reporting and risk of bias. MATERIALS AND METHODS A systematic search was performed (April 26, 2020) in EMBASE, PubMed, and Cochrane to identify chest radiographic, CT, or US studies in adult patients suspected of having COVID-19, using reverse-transcription polymerase chain reaction test or clinical consensus as the standard of reference. Two × two contingency tables were reconstructed, and test sensitivity, specificity, positive predictive values, and negative predictive values were recalculated. Reporting quality was evaluated by adherence to the Standards for Reporting of Diagnostic Accuracy Studies (STARD), and risk of bias was evaluated by adherence to the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). RESULTS Thirteen studies were eligible (CT = 12; chest radiography = 1; US = 0). Recalculated CT sensitivity and specificity ranged between 0.57 and 0.97, and 0.37 and 0.94, respectively, and positive predictive values and negative predictive values ranged between 0.59 and 0.92 and 0.57 and 0.96, respectively. On average, studies complied with only 35% of the STARD-guideline items. No study scored low risk of bias for all QUADAS-2 domains (patient selection, index test, reference test, and flow and timing). High risk of bias in more than one domain was scored in 10 of 13 studies (77%). CONCLUSION Reported CT test accuracy for COVID-19 diagnosis varies substantially. The validity and generalizability of these findings is complicated by poor adherence to reporting guidelines and high risk of bias, which are most likely due to the need for urgent publication of findings in the first months of the COVID-19 pandemic.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Dominika Suchá
- From the Department of Radiology (D.S., R.W.v.H., A.F.v.d.H., P.A.d.J., H.M.V.) and Imaging Division (H.M.V.), University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, the Netherlands
| | - Robbert W. van Hamersvelt
- From the Department of Radiology (D.S., R.W.v.H., A.F.v.d.H., P.A.d.J., H.M.V.) and Imaging Division (H.M.V.), University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, the Netherlands
| | - Andor F. van den Hoven
- From the Department of Radiology (D.S., R.W.v.H., A.F.v.d.H., P.A.d.J., H.M.V.) and Imaging Division (H.M.V.), University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, the Netherlands
| | - Pim A. de Jong
- From the Department of Radiology (D.S., R.W.v.H., A.F.v.d.H., P.A.d.J., H.M.V.) and Imaging Division (H.M.V.), University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, the Netherlands
| | - Helena M. Verkooijen
- From the Department of Radiology (D.S., R.W.v.H., A.F.v.d.H., P.A.d.J., H.M.V.) and Imaging Division (H.M.V.), University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, the Netherlands
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George A, Ganti L. A Less Virulent COVID-19 Pneumonia. Cureus 2020; 12:e9426. [PMID: 32864252 PMCID: PMC7450893 DOI: 10.7759/cureus.9426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Pan F, Zheng C, Ye T, Li L, Liu D, Li L, Hesketh RL, Yang L. Different computed tomography patterns of Coronavirus Disease 2019 (COVID-19) between survivors and non-survivors. Sci Rep 2020; 10:11336. [PMID: 32647307 PMCID: PMC7347874 DOI: 10.1038/s41598-020-68057-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023] Open
Abstract
This study aimed to compare the chest computed tomography (CT) findings between survivors and non-survivors with Coronavirus Disease 2019 (COVID-19). Between 12 January 2020 and 20 February 2020, the records of 124 consecutive patients diagnosed with COVID-19 were retrospectively reviewed and divided into survivor (83/124) and non-survivor (41/124) groups. Chest CT findings were qualitatively compared on admission and serial chest CT scans were semi-quantitively evaluated between two groups using curve estimations. On admission, significantly more bilateral (97.6% vs. 73.5%, p = 0.001) and diffuse lesions (39.0% vs. 8.4%, p < 0.001) with higher total CT score (median 10 vs. 4, p < 0.001) were observed in non-survivor group compared with survivor group. Besides, crazy-paving pattern was more predominant in non-survivor group than survivor group (39.0% vs. 12.0%, p < 0.001). From the prediction of curve estimation, in survivor group total CT score increased in the first 20 days reaching a peak of 6 points and then gradually decreased for more than other 40 days (R2 = 0.545, p < 0.001). In non-survivor group, total CT score rapidly increased over 10 points in the first 10 days and gradually increased afterwards until ARDS occurred with following death events (R2 = 0.711, p < 0.001). In conclusion, persistent progression with predominant crazy-paving pattern was the major manifestation of COVID-19 in non-survivors. Understanding this CT feature could help the clinical physician to predict the prognosis of the patients.
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Affiliation(s)
- Feng Pan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Tianhe Ye
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Lingli Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Dehan Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Lin Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Richard L Hesketh
- Department of Radiology, University College London Hospital, 235, Euston Road, London, NW1 2BU, UK
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1277#, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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Tulchinsky M, Fotos JS, Slonimsky E. Incidental CT Findings Suspicious for COVID-19-Associated Pneumonia on Nuclear Medicine Examinations: Recognition and Management Plan. Clin Nucl Med 2020; 45:531-533. [PMID: 32502091 PMCID: PMC7217125 DOI: 10.1097/rlu.0000000000003100] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/03/2020] [Accepted: 04/03/2020] [Indexed: 12/19/2022]
Abstract
Some patients undergoing routine SPECT/CT and PET/CT examinations during the COVID-19 pandemic may incidentally reveal findings of COVID-19-associated pneumonia (C-19AP) on localizing CT. It is critical for nuclear medicine physicians to develop diagnostic skills for timely recognition of typical findings of C-19AP on a localizing CT. Furthermore, it is our responsibility to know the optimal practices for safely isolating and managing such patients while protecting the staff, other patients at the facility, family and/or friend accompanying the patients, and the public in general from risky exposure to COVID-19 sources. We offer several steps following an encounter suspicious of C-19AP.
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Affiliation(s)
- Mark Tulchinsky
- From the Section of Nuclear Medicine, Department of Radiology, Milton S. Hershey Medical Center, Penn State Health, Hershey, PA
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Güneyli S, Atçeken Z, Doğan H, Altınmakas E, Atasoy KÇ. Radiological approach to COVID-19 pneumonia with an emphasis on chest CT. Diagn Interv Radiol 2020; 26:323-332. [PMID: 32352917 PMCID: PMC7360081 DOI: 10.5152/dir.2020.20260] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has recently become a worldwide outbreak with several millions of people infected and more than 160.000 deaths. A fast and accurate diagnosis in this outbreak is critical to isolate and treat patients. Radiology plays an important role in the diagnosis and management of the patients. Among various imaging modalities, chest CT has received attention with its higher sensitivity and specificity rates. Shortcomings of the real-time reverse transcriptase-polymerase chain reaction test, including inappropriate sample collection and analysis methods, initial false negative results, and limited availability has led to widespread use of chest CT in the diagnostic algorithm. This review summarizes the role of radiology in COVID-19 pneumonia, diagnostic accuracy of imaging, and chest CT findings of the disease.
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Affiliation(s)
- Serkan Güneyli
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Zeynep Atçeken
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Hakan Doğan
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Emre Altınmakas
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Kayhan Çetin Atasoy
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
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Khalili M, Karamouzian M, Nasiri N, Javadi S, Mirzazadeh A, Sharifi H. Epidemiological characteristics of COVID-19: a systematic review and meta-analysis. Epidemiol Infect 2020; 148:e130. [PMID: 32594937 PMCID: PMC7343974 DOI: 10.1017/s0950268820001430] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/13/2020] [Accepted: 06/10/2020] [Indexed: 12/23/2022] Open
Abstract
Our understanding of the Coronavirus disease 2019 (COVID-19) continues to evolve and there are many unknowns about its epidemiology. This study aims to synthesise case fatality rate (CFR) among confirmed COVID-19 patients, incubation period and time from onset of COVID-19 symptoms to first medical visit, intensive care unit (ICU) admission, recovery, and death. We searched MEDLINE, Embase, Google Scholar, and bibliographies of relevant articles from 01 December 2019 to 11 March 2020 without any language restrictions. Quantitative studies that recruited people with confirmed COVID-19 diagnosis were included. Two independent reviewers extracted the data. Out of 1675 non-duplicate studies, 43 were included in the meta-analysis. The pooled mean incubation period was 5.68 (99% confidence interval [CI]: 4.78, 6.59) days. The pooled mean number of days from the onset of COVID-19 symptoms to first clinical visit was 4.92 (95% CI: 3.95, 5.90), ICU admission was 9.84 (95% CI: 8.78, 10.90), recovery was 18.55 (95% CI: 13.69, 23.41), and death was 15.93 (95% CI: 13.07, 18.79). Pooled CFR among confirmed COVID-19 patients was 0.02 (95% CI: 0.02, 0.03). We found that the incubation period and lag between the onset of symptoms and first clinical visit for COVID-19 are longer than other respiratory viral infections including Middle East respiratory syndrome and severe acute respiratory syndrome; however, the current policy of 14 days of mandatory quarantine for everyone potentially exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be too conservative. Longer quarantine periods might be more justified for extreme cases.
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Affiliation(s)
- Malahat Khalili
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Naser Nasiri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Javadi
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
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Kazemi-Arpanahi H, Moulaei K, Shanbehzadeh M. Design and development of a web-based registry for Coronavirus (COVID-19) disease. Med J Islam Repub Iran 2020; 34:68. [PMID: 32974234 PMCID: PMC7500427 DOI: 10.34171/mjiri.34.68] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 12/16/2022] Open
Abstract
Background: The 2019 coronavirus (COVID-19) is a highly contagious disease associated with a high morbidity and mortality worldwide. The accumulation of data through a prospective clinical registry enables public health authorities to make informed decisions based on real evidence obtained from surveillance of COVID-19. This registry is also fundamental to providing robust infrastructure for future research surveys. The purpose of this study was to design a registry and its minimum data set (MDS), as a valid and reliable data source for reporting and benchmarking COVID-19. Methods: This cross sectional and descriptive study provides a template for the required MDS to be included in COVID-19 registry. This was done by an extensive literature review and 2 round Delphi survey to validate the content, which resulted in a web-based registry created by Visual Studio 2019 and a database designed by Structured Query Language (SQL). Results: The MDS of COVID-19 registry was categorized into the administrative part with 3 sections, including 30 data elements, and the clinical part with 4 sections, including 26 data elements. Furthermore, a web-based registry with modular and layered architecture was designed based on final data classes and elements. Conclusion: To the best of our knowledge, COVID-19 registry is the first designed instrument from information management perspectives in Iran and can become a homogenous and reliable infrastructure for collecting data on COVID-19. We hope this approach will facilitate epidemiological surveys and support policymakers to better plan for monitoring patients with COVID-19.
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Affiliation(s)
- Hadi Kazemi-Arpanahi
- Department of Health Information Technology, Abadan Faculty of Medical Sciences, Abadan, Iran
| | - Khadijeh Moulaei
- Department of Health Information Management, School of Health Management and Information Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
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Patel RS, Patel N, Baksh M, Zaidi A, Patel J. Clinical Perspective on 2019 Novel Coronavirus Pneumonia: A Systematic Review of Published Case Reports. Cureus 2020; 12:e8488. [PMID: 32656006 PMCID: PMC7343316 DOI: 10.7759/cureus.8488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 06/06/2020] [Indexed: 01/19/2023] Open
Abstract
The ongoing pandemic of 2019 novel coronavirus (2019-nCoV), which originated from Wuhan, China, has led to 68,279 deaths due to 2019-nCoV pneumonia as of May 5, 2020. We conducted a systematic review and included 16 case reports to summarize the transmission and pathology of 2019-nCoV, and clinical presentation, laboratory and imaging findings, and treatment in 2019-nCoV pneumonia. The disease is mild in most people; in some, it may progress to severe pneumonia with acute respiratory distress syndrome (ARDS). Patients with mild illness usually recover at home, with supportive care and isolation in accordance with guidelines. Patients who have moderate to severe pneumonia are usually monitored in the hospital. Although there is no definitive treatment for 2019-nCoV pneumonia so far, some antiviral drugs have shown promising results. The use of lopinavir/ritonavir and remdesivir was associated with significant clinical improvement in severe pneumonia. Nonetheless, we need more randomized clinical trials (RCTs) and treatment guidelines for developing effective management of the 2019-nCoV and improve patient outcomes by reducing mortality in high-risk patients. We also need more clinical trials and management guidelines for the effective management of 2019-nCoV pneumonia.
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Affiliation(s)
| | - Neev Patel
- Medicine, Byramjee Jeejeebhoy Medical College, Ahmedabad, IND
| | - Mizba Baksh
- Internal Medicine, Dr. Nandamuri Taraka Rama Rao University of Health Sciences, Vijayawada, IND
| | - Annam Zaidi
- Medicine, Dow University of Health Sciences, Karachi, PAK
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Chen X, Zou XJ, Xu Z. Serial computed tomographic findings and specific clinical features of pediatric COVID-19 pneumonia: A case report. World J Clin Cases 2020; 8:2345-2349. [PMID: 32548166 PMCID: PMC7281042 DOI: 10.12998/wjcc.v8.i11.2345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/26/2020] [Accepted: 05/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A series of recent cases of pneumonia in Wuhan, Hubei Province, China, was caused by the 2019 novel coronavirus [2019-nCoV, also called severe acute respiratory syndrome (SARS)-CoV-2]. The World Health Organization officially named the disease as coronavirus disease 2019 (COVID-19). With the global spread of COVID-19, similar cases have appeared in other areas of China, and there are a few reports of pediatric patients with COVID-19 pneumonia.
CASE SUMMARY A 7-year-old girl was diagnosed with COVID-19 and presented with irregular fever, sore throat and diarrhea. Chest computed tomography revealed patchy consolidation and ground-glass opacities in multiple areas. The lesions were mainly distributed in the bronchial bundles or subpleural areas of both lungs, particularly in the right lower lobe. The patient also presented with diarrhea, mild kidney injury, and live coronavirus was found in her feces. She was given antiviral agents (lopinavir and ritonavir), and follow-up detection showed that these abnormalities were markedly decreased within 3 d.
CONCLUSION The clinical symptoms and prognosis of COVID-19 in pediatric patients may be different from those in adult patients, and the fecal–oral transmission of SARS-CoV-2 should be considered.
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Affiliation(s)
- Xing Chen
- Department of Pediatrics, Huzhou Central Hospital, Affiliated Cent Hospital HuZhou University, Huzhou 313000, Zhejiang Province, China
| | - Xiao-Jie Zou
- Department of Pediatrics, Huzhou Central Hospital, Affiliated Cent Hospital HuZhou University, Huzhou 313000, Zhejiang Province, China
| | - Zhen Xu
- Department of Pediatrics, Huzhou Central Hospital, Affiliated Cent Hospital HuZhou University, Huzhou 313000, Zhejiang Province, China
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Zhou H, Xu K, Shen Y, Fang Q, Chen F, Sheng J, Zhao F, Lou H. Coronavirus disease 2019 (COVID-19): chest CT characteristics benefit to early disease recognition and patient classification-a single center experience. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:679. [PMID: 32617299 PMCID: PMC7327362 DOI: 10.21037/atm-20-2119a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background The current outbreak of coronavirus disease 2019 (COVID-19), epi-centered in Wuhan, Hubei Province of the China, has become a global health emergency. Several studies from China have recently provided the evidence of epidemiological, clinical, laboratory, and outcomes of COVID-19 patients. Investigation on the role of chest CT in patient screening and management course in a large cohort remains paucity. Methods This was a retrospective observational study based on the data collected between January 19 and 2020 to February 15, 2020. A clinic workflow using chest CT and RT-PCR assay to screen suspected patient was reviewed. Clinical data were evaluated and patients were classified to mild, common, severe and critical group. Chest CT characteristics of each patient were evaluated and a CT scoring system was applied to grade the lung involvement. Results Of 98 enrolled patients, 1, 29, 51 and 17 were clinically classified into mild, common, severe and critical group, respectively. Eighty-three patients (84.7%) demonstrated ground-glass opacity (GGO), 76 patients (77.5%) demonstrated consolidation and 18 patients (18.4%) demonstrated crazy-paving pattern on chest CT. Based on the CT scoring, 2, 35, 55 and 6 patients were categorized to grade 0, grade 1, grade 2 and grade 3, respectively, which significantly consistent with clinical classification (kappa =0.638, P﹤0.05). Twenty-nine patients admitted from fever clinic, with an average interval of 1.2 days (range, 0-4 days) between CT examination and onset of symptom. Three of these patients had negative initial RT-PCR result while abnormalities displayed on the initial chest CT. Conclusions Peripheral lung distributed GGO and consolidation, without subpleural sparing, are the most common manifestations on chest CT of COVID-19. Abnormalities on chest CT can occur in an early stage of COVID-19, even when RT-PCR assay negative, which may help to early recognition and rapid diagnosis of this disease.
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Affiliation(s)
- Hua Zhou
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaijin Xu
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihong Shen
- Department of Respiration, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qiang Fang
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Chen
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jifang Sheng
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Feng Zhao
- Department of Radiation Oncology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiyan Lou
- Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Docea AO, Tsatsakis A, Albulescu D, Cristea O, Zlatian O, Vinceti M, Moschos SA, Tsoukalas D, Goumenou M, Drakoulis N, Dumanov JM, Tutelyan VA, Onischenko GG, Aschner M, Spandidos DA, Calina D. A new threat from an old enemy: Re‑emergence of coronavirus (Review). Int J Mol Med 2020; 45:1631-1643. [PMID: 32236624 PMCID: PMC7169834 DOI: 10.3892/ijmm.2020.4555] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/27/2020] [Indexed: 02/07/2023] Open
Abstract
The new outbreak of coronavirus from December 2019 has brought attention to an old viral enemy and has raised concerns as to the ability of current protection measures and the healthcare system to handle such a threat. It has been known since the 1960s that coronaviruses can cause respiratory infections in humans; however, their epidemic potential was understood only during the past two decades. In the present review, we address current knowledge on coronaviruses from a short history to epidemiology, pathogenesis, clinical manifestation of the disease, as well as treatment and prevention strategies. Although a great amount of research and efforts have been made worldwide to prevent further outbreaks of coronavirus‑associated disease, the spread and lethality of the 2019 outbreak (COVID‑19) is proving to be higher than previous epidemics on account of international travel density and immune naivety of the population. Only strong, joint and coordinated efforts of worldwide healthcare systems, researchers, and pharmaceutical companies and receptive national leaders will succeed in suppressing an outbreak of this scale.
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Affiliation(s)
- Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
- Russian Academy of Sciences, 119991 Moscow
- The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation, 119992 Moscow, Russia
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA
| | | | - Oana Cristea
- Department of Microbiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ovidiu Zlatian
- Department of Microbiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Marco Vinceti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, I-41125 Modena, Italy
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
| | - Sterghios A. Moschos
- Department of Applied Sciences, Faculty of Health and Life Sciences, Northumbria University
- PulmoBioMed Ltd., Newcastle-Upon-Tyne NE1 8ST, UK
| | - Dimitris Tsoukalas
- Metabolomic Medicine, Health Clinics for Autoimmune and Chronic Diseases, 10674 Athens
| | - Marina Goumenou
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771 Athens, Greece
| | - Josef M. Dumanov
- Mycological Institute US EU, Subclinical Research Group, Sparta, NJ 07871, USA
| | - Victor A. Tutelyan
- Russian Academy of Sciences, 119991 Moscow
- Federal Research Centre of Nutrition and Biotechnology, 109240 Moscow, Russia
| | - Gennadii G. Onischenko
- Russian Academy of Sciences, 119991 Moscow
- The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation, 119992 Moscow, Russia
| | - Michael Aschner
- The State Education Institution of Higher Professional Training, The First Sechenov Moscow State Medical University under Ministry of Health of the Russian Federation, 119992 Moscow, Russia
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, New York, NY 10461, USA
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Li L, Yang L, Gui S, Pan F, Ye T, Liang B, Hu Y, Zheng C. Association of clinical and radiographic findings with the outcomes of 93 patients with COVID-19 in Wuhan, China. Theranostics 2020; 10:6113-6121. [PMID: 32483442 PMCID: PMC7255034 DOI: 10.7150/thno.46569] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 01/08/2023] Open
Abstract
Rationale: To retrospectively analyze serial chest CT and clinical features in patients with coronavirus disease 2019 (COVID-19) for the assessment of temporal changes and to investigate how the changes differ in survivors and nonsurvivors. Methods: The consecutive records of 93 patients with confirmed COVID-19 who were admitted to Wuhan Union Hospital from January 10, 2020, to February 22, 2020, were retrospectively reviewed. A series of chest CT findings and clinical data were collected and analyzed. The serial chest CT scans were scored on a semiquantitative basis according to the extent of pulmonary abnormalities. Chest CT scores in different periods (0 - 5 days, 6 - 10 days, 11 - 15 days, 16 - 20 days, and > 20 days) since symptom onset were compared between survivors and nonsurvivors, and the temporal trend of the radiographic-clinical features was analyzed. Results: The final cohort consisted of 93 patients: 68 survivors and 25 nonsurvivors. Nonsurvivors were significantly older than survivors. For both survivors and nonsurvivors, the chest CT scores were not different in the first period (0 - 5 days) but diverged afterwards. The mortality rate of COVID-19 monotonously increased with chest CT scores, which positively correlated with the neutrophil-to-lymphocyte ratio, neutrophil percentage, D-dimer level, lactate dehydrogenase level and erythrocyte sedimentation rate, while negatively correlated with the lymphocyte percentage and lymphocyte count. Conclusions: Chest CT scores correlate well with risk factors for mortality over periods, thus they may be used as a prognostic indicator in COVID-19. While higher chest CT scores are associated with a higher mortality rate, CT images taken at least 6 days since symptom onset may contain more prognostic information than images taken at an earlier period.
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Affiliation(s)
- Lingli Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Shan Gui
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Feng Pan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Tianhe Ye
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Bo Liang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
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