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Lee JS, Baek CY, Kim HD, Kim DY. Effect of robot-assisted stair climbing training as part of a rehabilitation program to improve pulmonary function, gait performance, balance, and exercise capacity in a patient after severe coronavirus disease 2019: a case report. Physiother Theory Pract 2024; 40:1628-1634. [PMID: 36752656 DOI: 10.1080/09593985.2023.2175188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND Severe coronavirus disease 2019 (COVID-19) infection may decrease respiratory and physical functions. OBJECTIVE To evaluate whether robot-assisted stair climbing training (RASCT) would improve pulmonary and physical functions in a patient post-severe COVID-19 infection. CASE DESCRIPTION A 48-year-old woman who had experienced severe COVID-19 underwent a 6-week inpatient rehabilitation. She persistently exhibited impaired pulmonary and physical functions, including walking and balance impairment. We provided a 30-min outpatient RASCT biweekly for 6 weeks. OUTCOMES After training, maximal inspiratory and maximal expiratory pressures improved from 81 and 74 cmH2O to 104 and 81 cmH2O, respectively. The walking speed improved from 1.15 to 1.21 m/s. In balance ability, physical performance battery score and timed up-and-go test improved from 8 to 11 s and 10.89 to 9.95 s, respectively. Regarding exercise capacity, the 6-min walk test distance improved from 453 to 482 m, and the number of 1-min sit-to-stand test improved from 20 to 23, with improved pulse rate and saturation level. The physical and psychological domain scores of the World Health Organization Quality-of-Life Scale-BREF improved from 44 to 63 and 69 to 81, respectively; Falls Efficacy Scale-International scores improved from 38 to 21. CONCLUSION RASCT, as part of a rehabilitation plan, was feasible and effective for this patient after severe COVID-19 infection.
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Affiliation(s)
- June Sung Lee
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
| | - Chang Yoon Baek
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Hyeong Dong Kim
- Department of Physical Therapy, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Dong Yeong Kim
- Department of Rehabilitation Medicine, National Health Insurance Ilsan Hospital, Goyang-si, Republic of Korea
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2
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Ippolito D, Maino C, Vernuccio F, Cannella R, Inchingolo R, Dezio M, Faletti R, Bonaffini PA, Gatti M, Sironi S. Liver involvement in patients with COVID-19 infection: A comprehensive overview of diagnostic imaging features. World J Gastroenterol 2023; 29:834-850. [PMID: 36816623 PMCID: PMC9932422 DOI: 10.3748/wjg.v29.i5.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/06/2022] [Accepted: 01/20/2023] [Indexed: 02/06/2023] Open
Abstract
During the first wave of the pandemic, coronavirus disease 2019 (COVID-19) infection has been considered mainly as a pulmonary infection. However, different clinical and radiological manifestations were observed over time, including involvement of abdominal organs. Nowadays, the liver is considered one of the main affected abdominal organs. Hepatic involvement may be caused by either a direct damage by the virus or an indirect damage related to COVID-19 induced thrombosis or to the use of different drugs. After clinical assessment, radiology plays a key role in the evaluation of liver involvement. Ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) may be used to evaluate liver involvement. US is widely available and it is considered the first-line technique to assess liver involvement in COVID-19 infection, in particular liver steatosis and portal-vein thrombosis. CT and MRI are used as second- and third-line techniques, respectively, considering their higher sensitivity and specificity compared to US for assessment of both parenchyma and vascularization. This review aims to the spectrum of COVID-19 liver involvement and the most common imaging features of COVID-19 liver damage.
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Affiliation(s)
- Davide Ippolito
- Milano Bicocca School of Medicine and Surgery, Milano 20126, Italy
- Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
| | - Cesare Maino
- Fondazione IRCCS San Gerardo dei Tintori, Monza 20900, Italy
| | - Federica Vernuccio
- Institute of Radiology (DIMED), University Hospital of Padova, Padova 35128, Italy
| | - Roberto Cannella
- Section of Radiology-Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo 90127, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo 90127, Italy
| | - Riccardo Inchingolo
- Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, Matera 75100, Italy
| | - Michele Dezio
- Division of Interventional Radiology, Department of Radiology, Madonna delle Grazie Hospital, Matera 75100, Italy
| | - Riccardo Faletti
- Department of Surgical Sciences, University of Turin, Turin 10126, Italy
| | - Pietro Andrea Bonaffini
- Milano Bicocca School of Medicine and Surgery, Milano 20126, Italy
- Department of Diagnostic Radiology, Papa Giovanni XXIII Hospital, Bergamo 24127, Italy
| | - Marco Gatti
- Department of Diagnostic Radiology, University of Turin, Turin 10126, Italy
| | - Sandro Sironi
- Milano Bicocca School of Medicine and Surgery, Milano 20126, Italy
- Department of Diagnostic Radiology, Papa Giovanni XXIII Hospital, Bergamo 24127, Italy
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3
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Accurso G, Vetrugno L, Pierucci P. Editorial: New advances in bedside assessment and monitoring of acute respiratory failure patients. Front Med (Lausanne) 2023; 10:1154289. [PMID: 36936218 PMCID: PMC10018187 DOI: 10.3389/fmed.2023.1154289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Giuseppe Accurso
- Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy
- *Correspondence: Giuseppe Accurso
| | - Luigi Vetrugno
- Department of Medical, Oral and Biotechnological Sciences University of Chieti-Pescara, Chieti, Italy
| | - Paola Pierucci
- Cardiothoracic Department, Respiratory and Critical Care Unit Bari Policlinico University Hospital, Bari, Italy
- Section of Respiratory Diseases, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
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Lo Bianco G, Misseri G, Stogicza AR, Cesare G, Li S, Day M, Kennedy DJ, Schatman ME. Radiofrequency Ablation for Chronic Lumbar Zygapophyseal Joint Pain Using a V-Shaped Active Tip Needle: An Observational Retrospective Study. J Pain Res 2023; 16:1243-1255. [PMID: 37069943 PMCID: PMC10105587 DOI: 10.2147/jpr.s406714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/04/2023] [Indexed: 04/19/2023] Open
Abstract
Background Lumbar zygapophyseal joint dysfunction represents one of the major sources of chronic low back pain. Radiofrequency ablation (RFA) using a V-shaped active tip needle may offer a larger lesion of the medial branch nerves, improving clinical outcome. The aim of our study is to evaluate the efficacy and the feasibility of RFA using V-shaped active tip needles. Methods This is a single-center observational retrospective study. Clinical records were screened and analyzed if they met the following inclusion criteria: adult patients (>18 years), diagnosis of chronic lumbar zygapophyseal joint pain, failure of conservative treatments, ability to provide informed consent for data analysis and publication. Exclusion criteria: lumbar pain not related to zygapophyseal joints, previous spinal/lumbar surgery, incomplete data, absence or withdrawal of informed consent. The primary outcome of the study was a change in pain intensity at follow-up. The secondary outcomes were the evaluation of quality-of-life improvement, the occurrence of adverse events and the impact on post-procedural analgesic consumption. For these purposes, pre- and post-treatment numeric rating scale (NRS), neuropathic pain 4 questions (DN4), EuroQoL - EQ-5D-3L, EQ-VAS, EQ-index and North American Spine Society (NASS) index were retrieved and analysed. Results Sixty-four patients were included. 7.8% of patients at 1-month (CI95% 0.026, 0.173), 37.5% at 3-month (CI95% 0.257, 0.505), 40.6% at 6-month (CI95% 0.285, 0.536) and 35.9% at 9-month (CI95% 0.243, 0.489) follow-up reported a reduction of more than 80% in NRS Statistical analysis indicated a significant change in NRS, DN4, EQ-index and EQ-5D-VAS (p-value <0.001) at the different time-points. Conclusion RFA using a V-shaped active tip needle might be a feasible and effective treatment for chronic lumbar zygapophyseal joint pain.
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Affiliation(s)
- Giuliano Lo Bianco
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Anesthesiology and Pain Department, Fondazione Istituto “G. Giglio”, Cefalù, Palermo, Italy
- Correspondence: Giuliano Lo Bianco, Anesthesia and Pain Medicine Department, Fondazione Giglio Cefalù, Contrada Pietrapollastra, Via Pisciotto, Cefalù, Palermo, 90015, Italy, Tel +393289682219, Email
| | - Giovanni Misseri
- Anesthesiology and Pain Department, Fondazione Istituto “G. Giglio”, Cefalù, Palermo, Italy
| | - Agnes R Stogicza
- Anesthesia and Pain, Saint Magdolna Private Hospital, Budapest, Hungary
| | - Gregoretti Cesare
- Anesthesiology and Pain Department, Fondazione Istituto “G. Giglio”, Cefalù, Palermo, Italy
- Department of Surgical, Oncological and Oral Science (Di.Chir.On.S.), University of Palermo, Palermo, Italy
| | - Sean Li
- National Spine and Pain Centers, Shrewsbury, NJ, USA
| | - Miles Day
- Pain Research, The Pain Center at Grace Clinic, Texas Tech University HSC, Lubbock, TX, USA
| | - David J Kennedy
- Department of PM&R, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health – Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
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Polilli E, Frattari A, Esposito JE, D’Amato M, Rapacchiale G, D’Intino A, Albani A, Di Iorio G, Carinci F, Parruti G. Reliability of predictive models to support early decision making in the emergency department for patients with confirmed diagnosis of COVID-19: the Pescara Covid Hospital score. BMC Health Serv Res 2022; 22:1062. [PMID: 35986291 PMCID: PMC9390116 DOI: 10.1186/s12913-022-08421-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 07/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background The hospital management of patients diagnosed with COVID-19 can be hampered by heterogeneous characteristics at entry into the emergency department. We aimed to identify demographic, clinical and laboratory parameters associated with higher risks of hospitalisation, oxygen support, admission to intensive care and death, to build a risk score for clinical decision making at presentation to the emergency department. Methods We carried out a retrospective study using linked administrative data and laboratory parameters available in the initial phase of the pandemic at the emergency department of the regional reference hospital of Pescara, Abruzzo, Italy, March–June 2020. Logistic regression and Cox modelling were used to identify independent predictors for risk stratification. Validation was carried out collecting data from an extended timeframe covering other variants of concern, including Alpha (December 2020–January 2021) and Delta/Omicron (January–March 2022). Results Several clinical and laboratory parameters were significantly associated to the outcomes of interest, independently from age and gender. The strongest predictors were: for hospitalisation, monocyte distribution width ≥ 22 (4.09; 2.21–7.72) and diabetes (OR = 3.04; 1.09–9.84); for oxygen support: saturation < 95% (OR = 11.01; 3.75–41.14), lactate dehydrogenase≥237 U/L (OR = 5.93; 2.40–15.39) and lymphocytes< 1.2 × 103/μL (OR = 4.49; 1.84–11.53); for intensive care, end stage renal disease (OR = 59.42; 2.43–2230.60), lactate dehydrogenase≥334 U/L (OR = 5.59; 2.46–13.84), D-dimer≥2.37 mg/L (OR = 5.18; 1.14–26.36), monocyte distribution width ≥ 25 (OR = 3.32; 1.39–8.50); for death, procalcitonin≥0.2 ng/mL (HR = 2.86; 1.95–4.19) and saturation < 96% (HR = 2.74; 1.76–4.28). Risk scores derived from predictive models using optimal thresholds achieved values of the area under the curve between 81 and 91%. Validation of the scoring algorithm for the evolving virus achieved accuracy between 65 and 84%. Conclusions A set of parameters that are normally available at emergency departments of any hospital can be used to stratify patients with COVID-19 at risk of severe conditions. The method shall be calibrated to support timely clinical decision during the first hours of admission with different variants of concern. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08421-4.
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Zakariaee SS, Salmanipour H, Naderi N, Kazemi-Arpanahi H, Shanbehzadeh M. Association of chest CT severity score with mortality of COVID-19 patients: a systematic review and meta-analysis. Clin Transl Imaging 2022; 10:663-676. [PMID: 35892066 PMCID: PMC9302953 DOI: 10.1007/s40336-022-00512-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/05/2022] [Indexed: 01/08/2023]
Abstract
Purpose Chest computed tomography (CT) is a high-sensitivity diagnostic tool for depicting interstitial pneumonia and may lay a critical role in the evaluation of the severity and extent of pulmonary involvement. In this study, we aimed to evaluate the association of chest CT severity score (CT-SS) with the mortality of COVID-19 patients using systematic review and meta-analysis. Methods Web of Science, PubMed, Embase, Scopus, and Google Scholar were used to search for primary articles. The meta-analysis was performed using the random-effects model, and odds ratios (ORs) with 95% confidence intervals (95%CIs) were calculated as the effect sizes. Results This meta-analysis retrieved a total number of 7106 COVID-19 patients. The pooled estimate for the association of CT-SS with mortality of COVID-19 patients was calculated as 1.244 (95% CI 1.157–1.337). The pooled estimate for the association of CT-SS with an optimal cutoff and mortality of COVID-19 patients was calculated as 7.124 (95% CI 5.307–9.563). There was no publication bias in the results of included studies. Radiologist experiences and study locations were not potential sources of between-study heterogeneity (both P > 0.2). The shapes of Begg’s funnel plots seemed symmetrical for studies evaluating the association of CT-SS with/without the optimal cutoffs and mortality of COVID-19 patients (Begg’s test P = 0.945 and 0.356, respectively). Conclusions The results of this study point to an association between CT-SS and mortality of COVID-19 patients. The odds of mortality for COVID-19 patients could be accurately predicted using an optimal CT-SS cutoff in visual scoring of lung involvement.
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Affiliation(s)
- Seyed Salman Zakariaee
- Department of Medical Physics, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran
| | - Hossein Salmanipour
- Department of Radiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Negar Naderi
- Department of Midwifery, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Health Information Technology, School of Management and Medical Information Sciences, Abadan University of Medical Sciences, Abadan, Iran
| | - Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran
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7
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Ippolito D, Vernuccio F, Maino C, Cannella R, Giandola T, Ragusi M, Bigiogera V, Capodaglio C, Sironi S. Multiorgan Involvement in SARS-CoV-2 Infection: The Role of the Radiologist from Head to Toe. Diagnostics (Basel) 2022; 12:1188. [PMID: 35626344 PMCID: PMC9140872 DOI: 10.3390/diagnostics12051188] [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: 03/30/2022] [Revised: 04/29/2022] [Accepted: 05/05/2022] [Indexed: 01/08/2023] Open
Abstract
Radiology plays a crucial role for the diagnosis and management of COVID-19 patients during the different stages of the disease, allowing for early detection of manifestations and complications of COVID-19 in the different organs. Lungs are the most common organs involved by SARS-CoV-2 and chest computed tomography (CT) represents a reliable imaging-based tool in acute, subacute, and chronic settings for diagnosis, prognosis, and management of lung disease and the evaluation of acute and chronic complications. Cardiac involvement can be evaluated by using cardiac computed tomography angiography (CCTA), considered as the best choice to solve the differential diagnosis between the most common cardiac conditions: acute coronary syndrome, myocarditis, and cardiac dysrhythmia. By using compressive ultrasound it's possible to study the peripheral arteries and veins and to exclude the deep vein thrombosis, directly linked to the onset of pulmonary embolism. Moreover, CT and especially MRI can help to evaluate the gastrointestinal involvement and assess hepatic function, pancreas involvement, and exclude causes of lymphocytopenia, thrombocytopenia, and leukopenia, typical of COVID-19 patients. Finally, radiology plays a crucial role in the early identification of renal damage in COVID-19 patients, by using both CT and US. This narrative review aims to provide a comprehensive radiological analysis of commonly involved organs in patients with COVID-19 disease.
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Affiliation(s)
- Davide Ippolito
- Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, MB, Italy; (D.I.); (C.M.); (T.G.); (M.R.); (V.B.); (C.C.)
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB, Italy;
| | - Federica Vernuccio
- Department of Radiology, University Hospital of Padova, Via Nicolò Giustiniani, 2, 35128 Padova, PD, Italy
| | - Cesare Maino
- Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, MB, Italy; (D.I.); (C.M.); (T.G.); (M.R.); (V.B.); (C.C.)
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro, 129, 90127 Palermo, PA, Italy;
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Via del Vespro, 129, 90127 Palermo, PA, Italy
| | - Teresa Giandola
- Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, MB, Italy; (D.I.); (C.M.); (T.G.); (M.R.); (V.B.); (C.C.)
| | - Maria Ragusi
- Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, MB, Italy; (D.I.); (C.M.); (T.G.); (M.R.); (V.B.); (C.C.)
| | - Vittorio Bigiogera
- Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, MB, Italy; (D.I.); (C.M.); (T.G.); (M.R.); (V.B.); (C.C.)
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB, Italy;
| | - Carlo Capodaglio
- Department of Diagnostic Radiology, San Gerardo Hospital, Via Pergolesi 33, 20900 Monza, MB, Italy; (D.I.); (C.M.); (T.G.); (M.R.); (V.B.); (C.C.)
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB, Italy;
| | - Sandro Sironi
- School of Medicine, University of Milano-Bicocca, Via Cadore 48, 20900 Monza, MB, Italy;
- Department of Diagnostic Radiology, H Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, BG, Italy
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Brandi N, Ciccarese F, Rimondi MR, Balacchi C, Modolon C, Sportoletti C, Renzulli M, Coppola F, Golfieri R. An Imaging Overview of COVID-19 ARDS in ICU Patients and Its Complications: A Pictorial Review. Diagnostics (Basel) 2022; 12:846. [PMID: 35453894 PMCID: PMC9032937 DOI: 10.3390/diagnostics12040846] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 01/08/2023] Open
Abstract
A significant proportion of patients with COVID-19 pneumonia could develop acute respiratory distress syndrome (ARDS), thus requiring mechanical ventilation, and resulting in a high rate of intensive care unit (ICU) admission. Several complications can arise during an ICU stay, from both COVID-19 infection and the respiratory supporting system, including barotraumas (pneumothorax and pneumomediastinum), superimposed pneumonia, coagulation disorders (pulmonary embolism, venous thromboembolism, hemorrhages and acute ischemic stroke), abdominal involvement (acute mesenteric ischemia, pancreatitis and acute kidney injury) and sarcopenia. Imaging plays a pivotal role in the detection and monitoring of ICU complications and is expanding even to prognosis prediction. The present pictorial review describes the clinicopathological and radiological findings of COVID-19 ARDS in ICU patients and discusses the imaging features of complications related to invasive ventilation support, as well as those of COVID-19 itself in this particularly fragile population. Radiologists need to be familiar with COVID-19's possible extra-pulmonary complications and, through reliable and constant monitoring, guide therapeutic decisions. Moreover, as more research is pursued and the pathophysiology of COVID-19 is increasingly understood, the role of imaging must evolve accordingly, expanding from the diagnosis and subsequent management of patients to prognosis prediction.
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Affiliation(s)
- Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Federica Ciccarese
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Maria Rita Rimondi
- Cardio-Thoracic Radiology Unit, University Hospital S.Orsola-Malpighi, 40138 Bologna, Italy; (M.R.R.); (C.M.); (C.S.)
| | - Caterina Balacchi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Cecilia Modolon
- Cardio-Thoracic Radiology Unit, University Hospital S.Orsola-Malpighi, 40138 Bologna, Italy; (M.R.R.); (C.M.); (C.S.)
| | - Camilla Sportoletti
- Cardio-Thoracic Radiology Unit, University Hospital S.Orsola-Malpighi, 40138 Bologna, Italy; (M.R.R.); (C.M.); (C.S.)
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
| | - Francesca Coppola
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
- Italian Society of Medical and Interventional Radiology, SIRM Foundation, Via della Signora 2, 20122 Milano, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy; (F.C.); (C.B.); (M.R.); (F.C.); (R.G.)
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9
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Gosangi B, Rubinowitz AN, Irugu D, Gange C, Bader A, Cortopassi I. COVID-19 ARDS: a review of imaging features and overview of mechanical ventilation and its complications. Emerg Radiol 2021; 29:23-34. [PMID: 34698956 PMCID: PMC8545770 DOI: 10.1007/s10140-021-01976-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022]
Abstract
The first cluster of cases of COVID-19 pneumonia was reported on December 31, 2019. Since then, this disease has spread rapidly across the world, and as of September 17, 2021, there are 226,844,344 cases of COVID-19 worldwide with 4,666,334 deaths related to COVID-19. While most COVID-19 cases are mild, some cases are severe with patients developing acute respiratory distress syndrome (ARDS). The pathophysiology of ARDS includes damage to the alveolar epithelium that leads to increased permeability of the alveolar epithelial barrier causing hyaline membrane formation, interstitial edema, and alveolar edema that results in severe hypoxia. Patients with COVID-19 ARDS are supported by non-invasive or invasive mechanical ventilation with an aim to improve oxygenation and maintain adequate blood oxygen levels. Increased intra-alveolar pressure while on mechanical ventilation may lead to alveolar rupture and thus barotrauma-related injuries such as lung tension cysts, pulmonary interstitial emphysema (PIE), pneumomediastinum, pneumopericardium, and pneumothorax. Recent studies have shown that the rate of barotrauma-related events is higher in patients with COVID-19 ARDS compared to patients with ARDS secondary to other etiologies. Radiologists should be aware of the imaging features of COVID-19 ARDS as well as the complications of mechanical ventilation. This educational manuscript will review the features of COVID-19 ARDS, discuss imaging of patients on mechanical ventilation, and review the imaging features of complications related to mechanical ventilation, including ventilator-associated lung injuries.
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Affiliation(s)
- Babina Gosangi
- Department of Radiology & Biomedical Imaging, Yale School of Medicine; Thoracic Imaging section, Yale-New Haven Hospital, Yale New Haven Health, New Haven, CT, USA.
| | - Ami N Rubinowitz
- Department of Radiology & Biomedical Imaging, Yale School of Medicine; Thoracic Imaging section, Yale-New Haven Hospital, Yale New Haven Health, New Haven, CT, USA
| | | | - Christopher Gange
- Department of Radiology & Biomedical Imaging, Yale School of Medicine; Thoracic Imaging section, Yale-New Haven Hospital, Yale New Haven Health, New Haven, CT, USA
| | - Anna Bader
- Department of Radiology & Biomedical Imaging, Yale School of Medicine; Thoracic Imaging section, Yale-New Haven Hospital, Yale New Haven Health, New Haven, CT, USA
| | - Isabel Cortopassi
- Department of Radiology & Biomedical Imaging, Yale School of Medicine; Thoracic Imaging section, Yale-New Haven Hospital, Yale New Haven Health, New Haven, CT, USA
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Yayehrad AT, Siraj EA, Yimenu DK, Ambaye AS, Derseh MT, Tamene AA, Yayeh TG. Multidisciplinary Effort and Integrative Preparedness: A Lesson for the Foreseen Multivariate COVID-19 Pandemic Flare-Up. J Multidiscip Healthc 2021; 14:2905-2921. [PMID: 34703243 PMCID: PMC8524181 DOI: 10.2147/jmdh.s332049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 09/14/2021] [Indexed: 12/15/2022] Open
Abstract
It has been a year and a half since the world suffered the horrific COVID-19 pandemic which has still continued becoming a prominent headache for the whole world. Recently, we are facing the second and third wave of multivariate outbreaks with great intensity of transmission which renders huge disaster. Presently, new strains of the virus are emerging that are predicted to be resistant for the current vaccines and other management approaches. It needs collaborative and coordinated role at professional, facility, regional, and global levels to ameliorate the pandemic by monitoring the existing and emerging variants. This review addressed the multidisciplinary roles in patient screening and detection, emergency management, moderate and critical care, vaccination, complication prevention, comorbidity management, psychological therapy, and digital health care. The inevitable roles of academicians, researchers, private health sectors, policy makers, regulatory bodies, and partners are also discussed.
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Affiliation(s)
- Ashagrachew Tewabe Yayehrad
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Ebrahim Abdela Siraj
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmacy, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Dawit Kumilachew Yimenu
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abyou Seyfu Ambaye
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Manaye Tamrie Derseh
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Andargachew Almaw Tamene
- Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Bahloul M, Kharrat S, Chtara K, Hafdhi M, Turki O, Baccouche N, Ammar R, Kallel N, Hsairi M, Chakroun-Walha O, Hamida CB, Chelly H, Mahfoudh KB, Karoui A, Karray H, Rekik N, Bouaziz M. Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia. Acute Crit Care 2021; 37:84-93. [PMID: 34380191 PMCID: PMC8918704 DOI: 10.4266/acc.2021.00129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/11/2021] [Indexed: 12/15/2022] Open
Abstract
Background Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.
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Affiliation(s)
- Mabrouk Bahloul
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Sana Kharrat
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Kamilia Chtara
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Malek Hafdhi
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Turki
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Najeh Baccouche
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Rania Ammar
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Nozha Kallel
- Department of Radiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Majdi Hsairi
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Olfa Chakroun-Walha
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Chokri Ben Hamida
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hedi Chelly
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | | | - Abelhamid Karoui
- Department of Anesthesiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Hela Karray
- Department of Microbiology, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Noureddine Rekik
- Department of Emergency Medicine, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
| | - Mounir Bouaziz
- Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Karimi E, Azari H, Yari M, Tahmasebi A, Hassani Azad M, Mousavi P. Interplay between SARS-CoV-2-derived miRNAs, immune system, vitamin D pathway and respiratory system. J Cell Mol Med 2021; 25:7825-7839. [PMID: 34159729 PMCID: PMC8358877 DOI: 10.1111/jcmm.16694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/29/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
The new coronavirus pandemic started in China in 2019. The intensity of the disease can range from mild to severe, leading to death in many cases. Despite extensive research in this area, the exact molecular nature of virus is not fully recognized; however, according to pieces of evidence, one of the mechanisms of virus pathogenesis is through the function of viral miRNAs. So, we hypothesized that SARS-CoV-2 pathogenesis may be due to targeting important genes in the host with its miRNAs, which involved in the respiratory system, immune pathways and vitamin D pathways, thus possibly contributing to disease progression and virus survival. Potential miRNA precursors and mature miRNA were predicted and confirmed based on the virus genome. The next step was to predict and identify their target genes and perform functional enrichment analysis to recognize the biological processes connected with these genes in the three pathways mentioned above through several comprehensive databases. Finally, cis-acting regulatory elements in 5' regulatory regions were analysed, and the analysis of available RNAseq data determined the expression level of genes. We revealed that thirty-nine mature miRNAs could theoretically derive from the SARS-CoV-2 genome. Functional enrichment analysis elucidated three highlighted pathways involved in SARS-CoV-2 pathogenesis: vitamin D, immune system and respiratory system. Our finding highlighted genes' involvement in three crucial molecular pathways and may help develop new therapeutic targets related to SARS-CoV-2.
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Affiliation(s)
- Elham Karimi
- Student Research CommitteeFaculty of MedicineHormozgan University of Medical SciencesBandar AbbasIran
| | - Hanieh Azari
- Student Research CommitteeFaculty of MedicineHormozgan University of Medical SciencesBandar AbbasIran
| | - Maryam Yari
- Department of Medical BiotechnologySchool of Advanced Medical Sciences and TechnologiesShiraz University of Medical SciencesShirazIran
| | | | - Mehdi Hassani Azad
- Infectious and Tropical Diseases Research CenterHormozgan Health InstituteHormozgan University of Medical SciencesBandar AbbasIran
| | - Pegah Mousavi
- Infectious and Tropical Diseases Research CenterHormozgan Health InstituteHormozgan University of Medical SciencesBandar AbbasIran
- Department of Medical GeneticsFaculty of MedicineHormozgan University of Medical SciencesBandar AbbasIran
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Lo Bianco G, Papa A, Schatman ME, Tinnirello A, Terranova G, Leoni MLG, Shapiro H, Mercadante S. Practical Advices for Treating Chronic Pain in the Time of COVID-19: A Narrative Review Focusing on Interventional Techniques. J Clin Med 2021; 10:2303. [PMID: 34070601 PMCID: PMC8198659 DOI: 10.3390/jcm10112303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/24/2021] [Accepted: 05/20/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Since the management of chronic pain has become even more challenging secondary to the occurrence of SARS-CoV-2 outbreaks, we developed an exhaustive narrative review of the scientific literature, providing practical advices regarding the management of chronic pain in patients with suspected, presumed, or confirmed SARS-CoV-2 infection. We focused particularly on interventional procedures, where physicians are in closer contact with patients. METHODS Narrative Review of the most relevant articles published between June and December of 2020 that focused on the treatment of chronic pain in COVID-19 patients. RESULTS Careful triage of patients is mandatory in order to avoid overcrowding of hospital spaces. Telemedicine could represent a promising tool to replace in-person visits and as a screening tool prior to admitting patients to hospitals. Opioid medications can affect the immune response, and therefore, care should be taken prior to initiating new treatments and increasing dosages. Epidural steroids should be avoided or limited to the lowest effective dose. Non urgent interventional procedures such as spinal cord stimulation and intrathecal pumps should be postponed. The use of personal protective equipment and disinfectants represent an important component of the strategy to prevent viral spread to operators and cross-infection between patients due to the SARS-CoV-2 outbreaks.
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Affiliation(s)
- Giuliano Lo Bianco
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy;
- Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, 90015 Cefalù, Italy
| | - Alfonso Papa
- Pain Department, AO “Ospedali dei Colli”, Monaldi Hospital, 80131 Naples, Italy;
| | - Michael E. Schatman
- Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, MA 02111, USA;
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Andrea Tinnirello
- Anesthesiology and Pain Management Unit, Azienda Socio Sanitaria Territoriale della Franciacorta, 25032 Chiari, Italy
| | - Gaetano Terranova
- Anaesthesia and Intensive Care Department, Asst Gaetano Pini, 20122 Milano, Italy;
| | | | - Hannah Shapiro
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Sebastiano Mercadante
- Pain Relief and Supportive Care, Private Hospital La Maddalena, 90100 Palermo, Italy;
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