scholarly journals MO846THE SPECTRUM OF CLINICAL AND SEROLOGICAL FEATURES OF COVID-19 IN URBAN HEMODIALYSIS PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Elena Gomá-Garcés ◽  
Teresa Stock da Cunha ◽  
Alejandro Avello ◽  
Monica Pereira ◽  
Sebastian Mas-Fontao ◽  
...  
Keyword(s):  
Troponin I ◽  
Hemodialysis Patients ◽  
Limited Evidence ◽  
Chain Reaction ◽  
X Ray ◽  
Asymptomatic Patients ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Treatment Responses ◽  
Overall Mortality

Abstract Background and Aims The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. Method Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units. Results In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status. Conclusion COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies.

scholarly journals The Spectrum of Clinical and Serological Features of COVID-19 in Urban Hemodialysis Patients

2020 ◽  
Vol 9 (7) ◽  
pp. 2264
Author(s):  
Teresa Stock da Cunha ◽  
Elena Gomá-Garcés ◽  
Alejandro Avello ◽  
Mónica Pereira-García ◽  
Sebastian Mas-Fontao ◽  
...  
Keyword(s):  
Troponin I ◽  
Hemodialysis Patients ◽  
Limited Evidence ◽  
Chain Reaction ◽  
X Ray ◽  
Asymptomatic Patients ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Treatment Responses ◽  
Overall Mortality

Introduction: The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized. Material and Methods: Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units. Results: In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status. Conclusions: COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies.

scholarly journals Hoarseness of Voice as a Rare Presentation of Tuberculosis: A Case Report Study

2019 ◽  
Vol 7 (19) ◽  
pp. 3262-3264
Author(s):  
Taher Felemban ◽  
Abdullah Ashi ◽  
Abdullah Sindi ◽  
Mohannad Rajab ◽  
Zuhair Al Jehani
Keyword(s):  
Laryngeal Carcinoma ◽  
Incidental Finding ◽  
Chain Reaction ◽  
Rare Presentation ◽  
Case Presentation ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Laryngeal Tuberculosis

BACKGROUND: Having hoarseness of voice as the first clinical manifestation of tuberculosis is rare. This atypical presentation causes some confusion since other more common conditions, such as laryngeal carcinoma, present similarly and might require more invasive tests to confirm the diagnosis. CASE PRESENTATION: A 38-year-old male presented to the otorhinolaryngology clinic with a four-month history of change in voice. Laryngoscopy demonstrated a right glottic mass, raising suspicion of laryngeal cancer. The computed tomography showed a mass and incidental finding of opacities in lung apices. Chest x-ray demonstrated findings suggestive of tuberculosis. Polymerase chain reaction and culture of sputum samples confirmed the diagnosis and the patient was started on anti-tuberculosis treatment. CONCLUSION: Despite accounting for only 1% of pulmonary tuberculosis cases and having a similar presentation to laryngeal carcinoma, we recommend considering laryngeal tuberculosis when evaluating hoarseness of voice in endemic areas.

scholarly journals The use of lung ultrasound during the COVID-19 pandemic

2020 ◽  
Vol 27 (SP1) ◽  
pp. e64-e75
Author(s):  
Aly Youssef ◽  
Marta Cavalera ◽  
Carlotta Azzarone ◽  
Carla Serra ◽  
Elena Brunelli ◽  
...  
Keyword(s):  
Health System ◽  
Pulmonary Infection ◽  
Lung Ultrasound ◽  
The Novel ◽  
Chain Reaction ◽  
X Ray ◽  
Rapid Learning ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Novel Coronavirus

The novel coronavirus disease (COVID-19) is a challenge to every health system. Unfortunately, it is unlikely that this pandemic will disappear soon. No health system, with its present resources and workflow, is capable enough to deal with a full-blown wave of this pandemic. Acquisition of specific new skills may be fundamental in delivering appropriate health care for our patients. The gold standard for diagnosis of the COVID-19 infection is real-time reverse transcription polymerase chain reaction. Radiological investigations (chest X-ray or high-resolution computerized tomography [CT]) can be helpful both for diagnosis and management, but they have many limitations. Ultrasound has been suggested as a reliable and accurate tool for assessing the lungs in COVID-19 patients. Lung ultrasound (LUS) can show specific signs of inter-stitial pneumonia, which is characteristic of COVID-19 pulmonary infection. In addition, nonradiologist specialists with experience in ultrasound can be trained on LUS with a relatively rapid learning curve. In pregnancy, LUS can be particularly useful due to the avoidance of exposure to ionizing radiation. In this review, we present the advantages, techniques, and limitations of the use of LUS during the COVID-19 pandemic, with specific focus on pregnancy.

scholarly journals Clinical Features of Asymptomatic SARS-CoV-2 Infection in Hemodialysis Patients

2021 ◽  
pp. 1-9
Author(s):  
Maria Soledad Pizarro-Sánchez ◽  
Alejandro Avello ◽  
Sebastian Mas-Fontao ◽  
Teresa Stock da Cunha ◽  
Elena Goma-Garcés ◽  
...  
Keyword(s):  
Risk Factor ◽  
Observational Study ◽  
Ace Inhibitors ◽  
Troponin I ◽  
Hemodialysis Patients ◽  
Blood Analysis ◽  
Clinical Spectrum ◽  
Nasopharyngeal Swab ◽  
Asymptomatic Patients ◽  
Overall Mortality

<b><i>Background:</i></b> CKD is a risk factor for severe COVID-19. However, the clinical spectrum of COVID-19 in hemodialysis patients is still poorly characterized. <b><i>Objective:</i></b> To analyze the clinical spectrum of COVID-19 on hemodialysis patients. <b><i>Method:</i></b> A retrospective observational study was conducted on 66 hemodialysis patients. Nasopharyngeal swab PCR and serology for SARS-CoV-2, blood analysis, chest radiography, treatment, and outcomes were assessed. <b><i>Results:</i></b> COVID-19 was diagnosed in 50 patients: 38 (76%) were PCR-positive and 12 (24%) were PCR-negative but developed anti-SARS-CoV-2 antibodies. By contrast, 17% of PCR-positive patients failed to develop detectable antibodies against SARS-CoV-2. Among PCR-positive patients, 5/38 (13%) were asymptomatic, while among PCR-negative patients 7/12 (58%) were asymptomatic (<i>p</i> = 0.005) for a total of 12/50 (24%) asymptomatic patients. No other differences were found between PCR-positive and PCR-negative patients. No differences in potential predisposing factors were found between asymptomatic and symptomatic patients except for a lower use of ACE inhibitors among asymptomatic patients. Asymptomatic patients had laboratory evidence of milder disease such as higher lymphocyte counts and oxygen saturation and lower troponin I and interleukin-6 levels than symptomatic patients. Overall mortality was 7/50 (14%) and occurred only in symptomatic PCR-positive patients in whom mortality was 7/33 (21%). <b><i>Conclusions:</i></b> Asymptomatic SARS-CoV-2 infection is common in hemodialysis patients, especially among patients with initial negative PCR that later seroconvert. Thus COVID-19 mortality in hemodialysis patients may be lower than previously estimated based on PCR tests alone.

scholarly journals Autoimmune Hemolytic Anemia as a Novel Complication of COVID-19 Infection in Sanglah General Hospital Bali, Indonesia

2020 ◽  
Vol 8 (T1) ◽  
pp. 509-513
Author(s):  
I. Putu Surya Sujana ◽  
Ni Putu Ayu Widiasari ◽  
Ni Luh Putu Eka Arisanti ◽  
Ida Bagus Ngurah Rai ◽  
Ni Made Renny Anggreni Rena
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Polymerase Chain Reaction Test ◽  
Laboratory Studies ◽  
Chain Reaction ◽  
X Ray ◽  
Reaction Test ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Chain Reaction Test

BACKGROUND: Clinical manifestation of coronavirus disease (COVID-19) could be asymptomatic, mild to severe, even mortality. Although various hematological complications associated with COVID-19 infection have been reported, the finding of autoimmune hemolytic anemia (AIHA) is a novel case. CASE REPORT: A 59-year-old woman was admitted to our emergency room because of a 5-day period of fever with cough and shortness of breath. At admission, she was takipnea, jaundice, and had an oxygen saturation of 60% on room air. Laboratory studies showed hemoglobin (Hb) 3.68 g/dL, high reticulocyte (14.4%), and hyperbilirubinemia. Chest X-ray showed bilateral pneumonia with positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test. Although she got packed red cell (PRC) transfusions in 7 days, her Hb remained low and bilateral infiltrate still increased. That’s why we considered direct Coombs test and it returned positive. AIHA was diagnosed and treatment with hydrocortisone 100 mg IV twice daily was given for the first 72 h. The maintenance dose with methylprednisolone 16 mg twice daily was continued for 7 days admission. Then, Hb value increased to 11.03 g/dL and she was discharged home without any compliments. CONCLUSION: In the current epidemiological situation, AIHA needs to be considered as a complication of COVID-19 infection in a patient who presents with jaundice and severe anemia without any underlying chronic disease, which is need blood transfusions, steroid medication use, or blood cancer.

Un empiema pleurico, una occasione per fare il punto sulla vaccinazione antipneumococcica

2020 ◽  
Vol 23 (10) ◽  
pp. 240-244
Author(s):  
Giuliana Ferrante ◽  
Luca Alessi ◽  
Mario Giuffrè ◽  
Giovanni Corsello
Keyword(s):  
Pneumococcal Disease ◽  
Pleural Empyema ◽  
Chain Reaction ◽  
X Ray ◽  
Full Remission ◽  
Serotype Replacement ◽  
Chest X Ray ◽  
Genetic Sequences ◽  
Polymerase Chain ◽  
Type 3

The article describes the case of a 4-year-old girl present-ing with fever and dyspnea. Blood tests showed neutrophilic leukocytosis and a significant increase in inflammation markers. The antibiotic therapy (macrolide and amoxicillin) did not produce any clinical improvement. A chest X-ray and CT showed a pleural empyema associated to trilobar right pneumonia. An evacuative videothoracoscopy was then performed. Clinical evolution was positive with full remission. The real-time polymerase chain reaction enabled to isolate genetic sequences of Streptococcus pneumoniae type 3, one of the serotypes involved in the invasive pneumococcal disease and contained in the pneumococcal 13-valent conjugate vaccine (PCV13). The patient had completed a full PCV13 vaccination before two years of age. Despite antibiotic treatment and the spread of vaccinations, pleural empyema is still a frequent complication of pneumonia to date. Several studies suggest a poor effective-ness of the pneumococcal vaccine against the serotype 3. Moreover, the implementation of PCV13 may have influenced the distribution of serotypes of S. pneumoniae not included in this vaccine and the phenomenon of serotype replacement. Nonetheless, the phenomenon of serotype replacement does not seem to be exclusively due to the effect of vaccination programmes.

scholarly journals Basic approach: Chest X-ray and CT-scan imaging in coronavirus disease 2019

2021 ◽  
Vol 2 ◽  
pp. 35-40
Author(s):  
Ricky Suryamin
Keyword(s):  
Ct Scan ◽  
Chain Reaction ◽  
Basic Approach ◽  
X Ray ◽  
Long Time ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Short Time ◽  
Reaction Result ◽  
Screening And Diagnosis

This study aims to provide an overview of how to interpreting coronavirus disease 2019 (COVID-19). This study reviewed various sources then reviewed as a literature review. COVID-19 is an infectious disease caused by the coronavirus species, namely, severe acute respiratory syndrome coronavirus 2. Radiology has an important role in screening and diagnosis of general pneumonia, including COVID-19 pneumonia. In some countries, reverse transcription polymerase chain reaction result can take a long time while physician need to diagnose and treat patients as soon as possible. Chest X-ray and CT-scan can be done in short time that can help physician but there is a possibility that can mimic other diseases. Radiologist need to determine the imaging into the categorized characteristic in COVID-19.

scholarly journals Transfer Learning Based Multiclass Classification For Covid-19 Detection Using Chest X-Rays

2021 ◽  
Author(s):  
Japman Singh Monga ◽  
Yuvraj Singh Champawat ◽  
Seema Kharb
Keyword(s):  
Deep Learning ◽  
Transfer Learning ◽  
X Rays ◽  
Performance Parameters ◽  
Chain Reaction ◽  
X Ray ◽  
Proposed Model ◽  
Chest X Ray ◽  
Polymerase Chain ◽  
Deep Learning Model

Abstract In the year 2020 world came to a halt due to spread of Covid-19 or SARS-CoV2 which was first identified in Wuhan, China. Since then, it has caused plethora of problems around the globe such as loss of millions of lives, economic instability etc. Less effectiveness of detection through Reverse Transcription Polymerase Chain Reaction and also prolonged time needed for detection through the same calls for a substitute for Covid-19 detection. Hence, in this study, we aim to develop a transfer learning based multi-class classifier using Chest X-Ray images which will classify the X-Ray images in 3 classes (Covid-19, Pneumonia, Normal). Further, the proposed model has been trained with deep learning classifiers namely: DenseNet201, Xception, ResNet50V2, VGG16, VGG-19, InceptionResNetV2 .These are evaluated on the basis of accuracy, precision and recall as performance parameters. It has been observed that DenseNet201 is the best deep learning model with 82.2% accuracy.

scholarly journals Chest X-Ray Findings in COVID-19 Patients Presenting to Primary Care during the Peak of the First Wave of the Pandemic in Qatar: Their Association with Clinical and Laboratory Findings

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Abdelwahed Abougazia ◽  
Ahmed Alnuaimi ◽  
Amal Mahran ◽  
Tamer Ali ◽  
Ahmed Khedr ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Reverse Transcription ◽  
Chest Radiography ◽  
Cross Sectional Study ◽  
Chain Reaction ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
X Ray ◽  
Chest X Ray ◽  
Polymerase Chain

When managing coronavirus disease 2019 (COVID-19) patients, radiological imaging complements clinical evaluation and laboratory parameters. We aimed to assess the sensitivity of chest radiography findings in detecting COVID-19, describe those findings, and assess the association of positive chest radiography findings with clinical and laboratory findings. A multicentre, cross-sectional study was conducted involving all primary health care corporation-registered patients (2485 patients) enrolled over a 1-month period during the peak of the 2020 pandemic wave in Qatar. These patients had reverse transcription-polymerase chain reaction-confirmed COVID-19 and underwent chest radiography within 72 hours of the swab test. A positive result on reverse transcription-polymerase chain reaction was the gold standard for diagnosing COVID-19. The sensitivity of chest radiography was calculated. The airspace opacities were mostly distributed in the peripheral and lower lung zones, and most of the patients had bilateral involvement. Pleural effusion was detected in some cases. The risk of having positive chest X-ray findings increased with age, Southeast Asian nationality, fever, or a history of fever and diarrhoea. Patients with cardiac disease, obesity, hypertension, diabetes, and chronic kidney disease were at a higher risk of having positive chest X-ray findings. There was a statistically significant increase in the mean serum albumin, white blood cell count, neutrophil count, and serum C-reactive protein, hepatic enzymes, and total bilirubin with an increase in the radiographic severity score.

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