Tomographic score (RAD-Covid Score) to assess the clinical severity of infection with the novel Coronavirus

2020 ◽  
Author(s):  
Tatiana Figueiredo Guimarães Ribeiro ◽  
Ricardo Arroyo Rstom ◽  
Paula Nicole Vieira Pinto Barbosa ◽  
Maria Fernanda Arruda Almeida ◽  
Affonso Bruno Binda de Nascimento ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Severity Score ◽  
Good Accuracy ◽  
Chest Ct ◽  
Clinical Severity ◽  
The Novel ◽  
Concordance Correlation ◽  
Single Center Study ◽  
Polymerase Chain ◽  
Novel Coronavirus

Abstract Objectives: The severity of pulmonary Covid-19 infection can be assessed by the pattern and extent of parenchymal involvement observed in computed tomography (CT), and it is important to standardize the analysis through objective, practical, and reproducible systems. We propose a method for stratifying the radiological severity of pulmonary disease, the Radiological Severity Score (RAD-Covid Score), in Covid-19 patients by quantifying infiltrate in chest CT, including assessment of its accuracy in predicting disease severity.Methods: This retrospective, single-center study analyzed patients with a confirmed diagnosis of Covid-19 infection by real-time reverse-transcriptase polymerase chain reaction, who underwent chest CT at hospital admission between March 6 and April 6, 2020. The CT scans were classified as positive, negative or equivocal, and a radiological severity score (RADCovid Score) was assigned. Clinical severity was assessed upon hospital admission, with mild cases considered suitable for home treatment, moderate cases for hospital admission and severe cases for intensive care unit admission.Results: 658 patients were included. Concordance correlation coefficient for the RAD-Covid Score was almost perfect among observers (0.833), with an overall agreement of 89.5%. The RAD-Covid Score was positively correlated with clinical severity and death, i.e., the higher the RAD-Covid Score, the greater the chance of a more severe clinical condition and mortality. This association proved independent of age and comorbidities. Accuracy of this score was 71%.Conclusions: The RAD-Covid Score showed good accuracy in predicting clinical severity at hospital admission and mortality in patients with confirmed Covid-19 infection and was an independent predictor of severity.

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

2020 ◽  
Vol 54 (4s) ◽  
pp. 97-99
Author(s):  
Benjamin D. Sarkodie ◽  
Yaw B. Mensah
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Chest Ct ◽  
The Novel ◽  
Chain Reaction ◽  
High Diagnostic Accuracy ◽  
Diagnostic Potential ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Chest Ct Scan

Computed Tomography (CT) scan of the chest plays an important role in the diagnosis and management of Coronavirus disease 2019 (COVID-19), the disease caused by the novel coronavirus SARS-CoV-2. COVID-19 pneumoniashows typical CT Scan features which can aid diagnoses and therefore help in the early detection and isolation of infected patients. CT scanners are readily available in many parts of Ghana. It is able to show findings typical for COVID-19 infection of the chest, even in instances where Reverse Transcription Polymerase Chain Reaction (RTPCR) misses the diagnosis. Little is known about the diagnostic potential of chest CT scan and COVID-19 among physicians even though CT scan offers a high diagnostic accuracy.

scholarly journals Persistent SARS-CoV-2-positive over 4 months in a COVID-19 patient with CHB

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 749-753
Author(s):  
Wenyuan Li ◽  
Beibei Huang ◽  
Qiang Shen ◽  
Shouwei Jiang ◽  
Kun Jin ◽  
...  
Keyword(s):  
The Novel ◽  
Chain Reaction ◽  
Health Crisis ◽  
Public Health Crisis ◽  
Oxygen Inhalation ◽  
New Strategy ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Specific Symptoms

Abstract In recent months, the novel coronavirus disease 2019 (COVID-19) pandemic has become a major public health crisis with takeover more than 1 million lives worldwide. The long-lasting existence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has not yet been reported. Herein, we report a case of SARS-CoV-2 infection with intermittent viral polymerase chain reaction (PCR)-positive for >4 months after clinical rehabilitation. A 35-year-old male was diagnosed with COVID-19 pneumonia with fever but without other specific symptoms. The treatment with lopinavir-ritonavir, oxygen inhalation, and other symptomatic supportive treatment facilitated recovery, and the patient was discharged. However, his viral PCR test was continually positive in oropharyngeal swabs for >4 months after that. At the end of June 2020, he was still under quarantine and observation. The contribution of current antivirus therapy might be limited. The prognosis of COVID-19 patients might be irrelevant to the virus status. Thus, further investigation to evaluate the contagiousness of convalescent patients and the mechanism underlying the persistent existence of SARS-CoV-2 after recovery is essential. A new strategy of disease control, especially extending the follow-up period for recovered COVID-19 patients, is necessary to adapt to the current situation of pandemic.

scholarly journals Hypercoagulation and Antithrombotic Treatment in Coronavirus 2019: A New Challenge

2020 ◽  
Vol 120 (06) ◽  
pp. 949-956 ◽  
Author(s):  
Francesco Violi ◽  
Daniele Pastori ◽  
Roberto Cangemi ◽  
Pasquale Pignatelli ◽  
Lorenzo Loffredo
Keyword(s):  
Multiorgan Failure ◽  
Laboratory Data ◽  
Clinical Severity ◽  
The Novel ◽  
Antithrombotic Treatment ◽  
Clotting System ◽  
Thrombotic Risk ◽  
Number Of Patients ◽  
Coronary Ischemia ◽  
Novel Coronavirus

AbstractThe novel coronavirus 2019 (COVID-19) is clinically characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for a high number of patients needing mechanical ventilation or intensive care units treatment and for the elevated mortality risk. A link between COVID-19 and multiorgan failure may be dependent on the fact that most COVID-19 patients are complicated by pneumonia, which is known to be associated with early changes of clotting and platelet activation and artery dysfunction; these changes may implicate in thrombotic-related events such as myocardial infarction and ischemic stroke. Recent data showed that myocardial injury compatible with coronary ischemia may be detectable in SARS-CoV-2 patients and laboratory data exploring clotting system suggest the presence of a hypercoagulation state. Thus, we performed a systematic review of COVID-19 literature reporting measures of clotting activation to assess if changes are detectable in this setting and their relationship with clinical severity. Furthermore, we discussed the biologic plausibility of the thrombotic risk in SARS-CoV-2 and the potential use of an antithrombotic treatment.

scholarly journals An atypical case: RT-PCR-negative, sero-positive covid-19 patient

Pneumologia ◽  
2020 ◽  
Vol 69 (2) ◽  
pp. 107-114
Author(s):  
William Suriady ◽  
Andika Chandra Putra ◽  
Wiwien Heru Wiyono ◽  
Mohammad Fahmi Alatas ◽  
Bettia Bermawi ◽  
...  
Keyword(s):  
False Negative ◽  
Severe Pneumonia ◽  
World Health ◽  
Diagnostic Process ◽  
The Novel ◽  
Rt Pcr ◽  
Atypical Case ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Health Organization

Abstract The novel coronavirus disease-2019 (COVID-19), caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has become a public health emergency of international concern. The first confirmed COVID-19 case in Indonesia was announced on 2 March 2020, and later on, 11,192 confirmed cases were reported as of 3 May. The World Health Organization has stated that performing a real-time reverse transcription–polymerase chain reaction (RT-PCR) specific for SARS-CoV-2 on specimens from the upper and the lower respiratory tracts, especially nasopharyngeal and oropharyngeal swabs, is the standard diagnostic procedure for COVID-19. In Indonesia, we also use other diagnostic tests, such as rapid antibody tests specific for SARS-CoV-2. Herein, we report an atypical case of COVID-19 and describe the diagnostic process, the clinical course, with progression to severe pneumonia on Week 3 of illness and the case management. We also try to highlight the possibility of false-negative RT-PCR tests.

scholarly journals Multi-task Deep Learning Based CT Imaging Analysis For COVID-19: Classification and Segmentation

2020 ◽  
Author(s):  
A. Amyar ◽  
R. Modzelewski ◽  
S. Ruan
Keyword(s):  
Deep Learning ◽  
Ct Images ◽  
Ct Imaging ◽  
Chest Ct ◽  
The Novel ◽  
Imaging Analysis ◽  
Proposed Model ◽  
Fast Spreading ◽  
Novel Coronavirus ◽  
Deep Learning Model

ABSTRACTThe fast spreading of the novel coronavirus COVID-19 has aroused worldwide interest and concern, and caused more than one million and a half confirmed cases to date. To combat this spread, medical imaging such as computed tomography (CT) images can be used for diagnostic. An automatic detection tools is necessary for helping screening COVID-19 pneumonia using chest CT imaging. In this work, we propose a multitask deep learning model to jointly identify COVID-19 patient and segment COVID-19 lesion from chest CT images. Our motivation is to leverage useful information contained in multiple related tasks to help improve both segmentation and classification performances. Our architecture is composed by an encoder and two decoders for reconstruction and segmentation, and a multi-layer perceptron for classification. The proposed model is evaluated and compared with other image segmentation and classification techniques using a dataset of 1044 patients including 449 patients with COVID-19, 100 normal ones, 98 with lung cancer and 397 of different kinds of pathology. The obtained results show very encouraging performance of our method with a dice coefficient higher than 0.78 for the segmentation and an area under the ROC curve higher than 93% for the classification.

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 A meta-analysis of the impact of COVID-19 on liver dysfunction

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Zeng-hong Wu ◽  
Dong‑liang Yang
Keyword(s):  
Liver Dysfunction ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Clinical Severity ◽  
The Novel ◽  
Significant Difference ◽  
Novel Coronavirus ◽  
The Impact ◽  
Review Manager ◽  
Different Levels

Abstract Background The novel coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is leading to a worldwide pandemic. Except representative manifestation of pneumonia and acute respiratory symptoms, COVID-19 patients have also shown different levels of liver injury or liver dysfunction. The aim of our study was to explore the probable clinical severity and mortality of COVID-19 patients and their liver dysfunction. Method A combination of computer and manual retrieval was used to search in Medline through PubMed, EMBASE and Web of Science. Review Manager 5.3 software was used to examine the heterogeneity among the studies and to calculate the combined effect value (OR, 95CI). Subgroup analysis, sensitivity analysis, and publication bias test were also performed. Results We found a significant connection between liver dysfunction and mortality of COVID-19 patients with a pooled OR of 1.98 (95% CI 1.39–2.82; P = 0.0002). There was a significant association between AST and severity of COVID-19 with a pooled OR of 4.48 (95% CI 3.24–7.21; P < 0.001), and a pooled WMD of 3.35 (95% CI, 2.07 to 4.64; P < 0.001). In addition, there was a significant difference between TBIL and severity of COVID-19, with a pooled OR of 1.91 (95% CI 1.40–2.60; P < 0.001), and with a pooled WMD of 1.18 (95% CI, 0.78 to 1.58; P < 0.001). Conclusion The mortality and severity of COVID-19 patients are significantly associated with liver dysfunction. The non-survivors and severe COVID-19 patients have elevated serum AST levels than the survivors and non-severe COVID-19 patients. The results of this study form a basis for better clinical liver management of patients with COVID-19.

scholarly journals Abnormal Liver Function Test in Patients Infected with Coronavirus (SARS-CoV-2): A Retrospective Single-Center Study from Spain

2021 ◽  
Vol 10 (5) ◽  
pp. 1039
Author(s):  
Raquel Benedé-Ubieto ◽  
Olga Estévez-Vázquez ◽  
Vicente Flores-Perojo ◽  
Ricardo U. Macías-Rodríguez ◽  
Astrid Ruiz-Margáin ◽  
...  
Keyword(s):  
Liver Injury ◽  
Serum Levels ◽  
Serum Markers ◽  
Disease Outcome ◽  
Abnormal Liver Function Test ◽  
The Novel ◽  
Clinical Indicators ◽  
Single Center Study ◽  
Function Test ◽  
Novel Coronavirus

The outbreak of the novel coronavirus SARS-CoV-2 epidemic has rapidly spread and still poses a serious threat to healthcare systems worldwide. In the present study, electronic medical records containing clinical indicators related to liver injury in 799 COVID-19-confirmed patients admitted to a hospital in Madrid (Spain) were extracted and analyzed. Correlation between liver injury and disease outcome was also evaluated. Serum levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Gamma-glutamyltransferase (GGT), Alkaline phosphatase (ALP), Lactate dehydrogenase (LDH) and AST/ALT ratio were elevated above the Upper Limit of Normal (ULN) in 25.73%, 49.17%, 34.62%, 24.21%, 55.84% and 75% of patients, respectively. Interestingly, significant positive correlation between LDH levels and the AST/ALT ratio with disease outcome was found. Our data showed that SARS-CoV-2 virus infection leads to mild, but significant changes in serum markers of liver injury. The upregulated LDH levels as well as AST/ALT ratios upon admission may be used as additional diagnostic characteristic for COVID-19 patients.

scholarly journals Vitamin D Levels Are Reduced at the Time of Hospital Admission in Sicilian SARS-CoV-2-Positive Patients

2021 ◽  
Vol 18 (7) ◽  
pp. 3491
Author(s):  
Agostino Gaudio ◽  
Andrea Murabito ◽  
Antonella Agodi ◽  
Arturo Montineri ◽  
Pietro Castellino ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hospital Admission ◽  
Clinical Course ◽  
Deep Understanding ◽  
Clinical Severity ◽  
Chain Reaction ◽  
Positive Polymerase Chain Reaction ◽  
Vitamin D Levels ◽  
Polymerase Chain ◽  
Low Levels

The coronavirus disease 2019 (COVID-19) pandemic poses a worldwide healthcare challenge that needs an efficient response. Unfortunately, to date there is no highly effective treatment, so a deep understanding of COVID-19 risk factors could be an important step in treating the disease. Vitamin D affects the immune system in many different ways, and other authors already found that COVID-19 patients have low levels of vitamin D. In our retrospective study, we evaluated the vitamin D status at the time of hospital admission in 50 COVID-19 patients in Sicily, which is the southernmost region of Italy, and compared them with 100 control subjects matched for age and sex. Our data showed markedly low levels of vitamin D in patients with a positive polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but no association was found with inflammation markers or clinical severity. Vitamin D levels were reduced at the time of hospital admission in Sicilian SARS-CoV-2-positive patients, but it is not clear whether this condition has an impact on the clinical course of COVID-19.

scholarly journals 1126. Learner Driven Call Center to increase Convalescent Plasma Donation in COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S593-S593
Author(s):  
Nancy M Joyner ◽  
Michael Deaney ◽  
Caroline Derrick ◽  
Jeannette Bouchard ◽  
Hannah G Brown ◽  
...  
Keyword(s):  
Call Center ◽  
Closed Loop ◽  
The Novel ◽  
Test Results ◽  
Inclusion Criteria ◽  
Eligibility Criteria ◽  
Successful Model ◽  
Plasma Donation ◽  
Polymerase Chain ◽  
Novel Coronavirus

Abstract Background Convalescent plasma (CP) may be obtained from patients who have recovered from the novel coronavirus disease, COVID-19, caused by the virus SARS-CoV-2. Although not FDA approved, preliminary data suggests patients who receive convalescent plasma from recovered donors may have shortened recovery time and symptom reduction. The purpose of the study is to detail learner recruitment of convalescent plasma donation (CPD) for treating hospitalized COVID-19 patients. Methods Prisma Health Midlands formed a multidisciplinary CP donation team, consisting of seven COVID-19-certified pharmacy learner volunteers, two pharmacists, and two providers. Primary eligibility criteria were SARS-CoV-2 polymerase chain reaction (PCR) positivity at least 28 days prior to donation and asymptomatic for a minimum of 14 days. Donors were excluded based on FDA guidelines for CPD, limiting ineligible contact. Team learners were trained on call techniques and subsequently contacted, educated, and requested candidates donate through this program. Willing donors were then linked to The Blood Connection to circulate CP back into the Prisma Health System, creating a self-sustaining and closed-loop donation cycle. Results In total, 253 recovered adult patients with positive SARS-CoV-2 PCR test results were evaluated. 195 patients met baseline inclusion criteria for contact. This pre-screen reduced call and travel time for ineligible candidates. 108 patients were successfully reached. Of the 108, n=79 (73.14%) accepted referral to The Blood Connection, and n=29 (26.85%) were no longer candidates primarily due to patient communicated new exclusionary factors, such as active COVID-19 symptoms. The program allowed for rapid, internal access to CP for patients hospitalized with COVID-19 at Prisma Health Midlands. Conclusion Interest and awareness in COVID-19 CPD was successfully increased upon direct communication from the team and was felt to represent a personnel intense but successful model for recruiting potential CP donors. This program educated and utilized learners during this pandemic to enhance Prisma Health’s ability to obtain CP for hospitalized patients using a closed system. Disclosures All Authors: No reported disclosures

Sign in / Sign up

Export Citation Format

Share Document