Automated lung sound analysis using the LungPass platform: A sensitive and specific tool for identifying lower respiratory tract involvement in COVID-19.

Background: Lower respiratory tract (LRT) involvement, observed in about 20% of patients suffering from coronavirus disease 2019 (COVID-19) is associated with a more severe clinical course, adverse outcomes and long-term sequelae. Early identification of LRT involvement could facilitated targeted and timely interventions that could alter the short- and long-term disease outcomes. The LungPass is an automated lung sound analysis platform developed using neural network technology and previously trained. We hypothesised that the LungPass could be used as a screening tool for LRT involvement in patients with COVID-19. Methods: In a prospective observational study involving 282 individuals with presenting in the emergency department with a strong clinical suspicion of COVID-19 and imaging findings consistent with COVID-19 LRT involvement (25.5% had concomitant hypoxia), and 32 healthy controls, we assessed the sensitivity and specificity of the LungPass in identifying LRT involvement in COVID-19. We also compared the auscultatory findings of the LungPass compared to a chest physician using a traditional, high-quality stethoscope. Results: Among individuals with COVID-19 LRT involvement, the LungPass identified crackles in at least one auscultation site in 93.6% and in two or more points in 84%. Moreover, the LungPass identified any abnormal lung sound (crackles or wheeze) in at least one auscultation site in 98.6% and in at least two points in 94% of the participants. The respective percentages for the respiratory physicians were lower. Considering the presence of any added abnormal sound (crackles or wheeze) in at least two auscultation points as evidence of LRT involvement, LungPass demonstrated a sensitivity of 98.6% (95% confidence intervals [CI]: 96.4%-99.6%) and a specificity of 96.9% (95% CI: 83.8%-99.9%) in identifying COVID-19 LRT involvement. Conclusion: This exploratory study suggests the LungPass is a sensitive and specific platform for identifying LRT involvement due to COVID-19, even before the development of hypoxia.

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Automated lung sound analysis using the LungPass platform: a sensitive and specific tool for identifying lower respiratory tract involvement in COVID-19

European Respiratory Journal ◽

10.1183/13993003.01907-2021 ◽

2021 ◽

pp. 2101907

Author(s):

Elena A. Lapteva ◽

Olga N. Kharevich ◽

Victoria V. Khatsko ◽

Natalia A. Voronova ◽

Maksim V. Chamko ◽

...

Keyword(s):

Respiratory Tract ◽

Lower Respiratory Tract ◽

Lung Sound ◽

Sound Analysis ◽

Tract Involvement

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Faculty Opinions recommendation of Long-term use of thiazolidinediones and the associated risk of pneumonia or lower respiratory tract infection: systematic review and meta-analysis.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.13491993.14870098 ◽

2012 ◽

Author(s):

Antonio R Anzueto ◽

Diego J Maselli

Keyword(s):

Systematic Review ◽

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Lower Respiratory Tract Infection ◽

Lower Respiratory Tract ◽

Meta Analysis

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Glucocorticosteroids effects on brain development in the preterm infants: a role for microglia?

Current Neuropharmacology ◽

10.2174/1570159x19666210517112913 ◽

2021 ◽

Vol 19 ◽

Author(s):

Zinni Manuela ◽

Pansiot Julien ◽

Elodie Billion ◽

Baud Olivier ◽

Mairesse Jérôme

Keyword(s):

Brain Development ◽

Preterm Infants ◽

Adverse Outcomes ◽

Mortality And Morbidity ◽

Respiratory Problems ◽

Neurodevelopmental Impairment ◽

Short And Long Term ◽

Abnormal Brain

: Prematurity, observed in 15 million births worldwide each year, is a clinical condition that is a major cause of neonatal mortality and morbidity in short and long term. Preterm infants are at high risk for developing respiratory problems, sepsis, and other morbidities leading to neurodevelopmental impairment and neurobehavioral disorders. Perinatal glucocorticosteroids have been widely used for the prevention and treatment of adverse outcomes linked to prematurity. However, despite their shortterm benefits due to their maturational properties, some clinical trials have shown an association between steroids exposure and abnormal brain development in infants born preterm. Neuroinflammation has emerged as a preeminent factor for brain injury in preterm infants, and the major role of microglia, the brain resident immune cells, has been recently highlighted. Considering the role of microglia in the modulation of brain development, the aim of this review is to summarize the effects of endogenous and exogenous glucocorticosteroids on brain development and discuss the possible role of microglia as a mediator of these effects.

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Renal Protection in Critically Ill Patients

Kidney Protection ◽

10.1093/med/9780190611620.003.0016 ◽

2019 ◽

pp. 163-174

Author(s):

Ryan W. Haines ◽

John R. Prowle

Keyword(s):

Chronic Kidney Disease ◽

Intensive Care Unit ◽

Kidney Injury ◽

Adverse Outcomes ◽

Renal Protection ◽

High Quality ◽

Hemodynamic Stability ◽

Secondary Sources ◽

Short And Long Term

Acute kidney injury complicates over 50% of critical care admissions and is associated with both increased short and long-term mortality and the development or acceleration of chronic kidney disease. While in certain settings, such as cardiac surgery, primary prevention of AKI is possible, in most cases AKI is present or evolving at intensive care unit admission and the main clinical focus is secondary prevention of further kidney injury. In the absence of evidence for specific AKI-targeted therapies, high quality supportive care to maximize hemodynamic stability and avoidance of secondary sources of kidney injury are the cornerstones of renal protection. Fluid overload is particularly associated with adverse outcomes in critical illness complicated by AKI. Continuous methods of renal replacement therapy may promote hemodynamic stability and have been associated with better longer term renal outcomes.

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