CT scan chest findings in symptomatic COVID-19 patients: a reliable alternative for diagnosis

The Ambivalence of Post COVID-19 Vaccination Responses in Humans

The Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has prompted a massive global vaccination campaign, leading to the rapid development and deployment of several vaccines. Various COVID-19 vaccines are under different phases of clinical trials and include the whole virus or its parts like DNA, mRNA, or protein subunits administered directly or through vectors. Beginning in 2020, a few mRNA (Pfizer-BioNTech BNT162b2 and Moderna mRNA-1273) and adenovirus-based (AstraZeneca ChAdOx1-S and the Janssen Ad26.COV2.S) vaccines were recommended by WHO for emergency use before the completion of the phase 3 and 4 trials. These vaccines were mostly administered in two or three doses at a defined frequency between the two doses. While these vaccines, mainly based on viral nucleic acids or protein conferred protection against the progression of SARS-CoV-2 infection into severe COVID-19, and prevented death due to the disease, their use has also been accompanied by a plethora of side effects. Common side effects include localized reactions such as pain at the injection site, as well as systemic reactions like fever, fatigue, and headache. These symptoms are generally mild to moderate and resolve within a few days. However, rare but more serious side effects have been reported, including allergic reactions such as anaphylaxis and, in some cases, myocarditis or pericarditis, particularly in younger males. Ongoing surveillance and research efforts continue to refine the understanding of these adverse effects, providing critical insights into the risk-benefit profile of COVID-19 vaccines. Nonetheless, the overall safety profile supports the continued use of these vaccines in combating the pandemic, with regulatory agencies and health organizations emphasizing the importance of vaccination in preventing COVID-19's severe outcomes. In this review, we describe different types of COVID-19 vaccines and summarize various adverse effects due to autoimmune and inflammatory response(s) manifesting predominantly as cardiac, hematological, neurological, and psychological dysfunctions. The incidence, clinical presentation, risk factors, diagnosis, and management of different adverse effects and possible mechanisms contributing to these effects are discussed. The review highlights the potential ambivalence of human response post-COVID-19 vaccination and necessitates the need to mitigate the adverse side effects.

Review of COVID-19 testing and diagnostic methods

More than six billion tests for COVID-19 has been already performed in the world. The testing for SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) virus and corresponding human antibodies is essential not only for diagnostics and treatment of the infection by medical institutions, but also as a pre-requisite for major semi-normal economic and social activities such as international flights, off line work and study in offices, access to malls, sport and social events. Accuracy, sensitivity, specificity, time to results and cost per test are essential parameters of those tests and even minimal improvement in any of them may have noticeable impact on life in the many countries of the world. We described, analyzed and compared methods of COVID-19 detection, while representing their parameters in 22 tables. Also, we compared test performance of some FDA approved test kits with clinical performance of some non-FDA approved methods just described in scientific literature. RT-PCR still remains a golden standard in detection of the virus, but a pressing need for alternative less expensive, more rapid, point of care methods is evident. Those methods that may eventually get developed to satisfy this need are explained, discussed, quantitatively compared. The review has a bioanalytical chemistry prospective, but it may be interesting for a broader circle of readers who are interested in understanding and improvement of COVID-19 testing, helping eventually to leave COVID-19 pandemic in the past.

The human-AI scoring system: A new method for CT-based assessment of COVID-19 severity

BACKGROUND

Chest computed tomography (CT) plays an important role in the diagnosis and assessment of coronavirus disease 2019 (COVID-19).

OBJECTIVE

To evaluate the value of an artificial intelligence (AI) scoring system for radiologically assessing the severity of COVID-19.

MATERIALS AND METHODS

Chest CT images of 81 patients (61 of normal type and 20 of severe type) with confirmed COVID-19 were used. The test data were anonymized. The scores achieved by four methods (junior radiologists; AI scoring system; human-AI segmentation system; human-AI scoring system) were compared with that by two experienced radiologists (reference score). The mean absolute errors (MAEs) between the four methods and experienced radiologists were calculated separately. The Wilcoxon test is used to predict the significance of the severity of COVID-19. Then use Spearman correlation analysis ROC analysis was used to evaluate the performance of different scores.

RESULTS

The AI score had a relatively low MAE (1.67-2.21). Score of human-AI scoring system had the lowest MAE (1.67), a diagnostic value almost equal to reference score (r= 0.97), and a strongest correlation with clinical severity (r= 0.59, p< 0.001). The AUCs of reference score, score of junior radiologists, AI score, score of human-AI segmentation system, and score of human-AI scoring system were 0.874, 0.841, 0.852, 0.857 and 0.865, respectively.

CONCLUSION

The human-AI scoring system can help radiologists to improve the accuracy of COVID-19 severity assessment.