Mr. Dr. Health-Assistant Chatbot

Research says 60% of visits to a doctor are for simple small-scale diseases, 80% of which can be diagnosed at home using simple check-up. These diseases mostly include common cold and cough, headache, abdominal pains etc. Whereas, chat-bots in healthcare are highly in demand, which functioning can offer various services from symptom checking and appointment scheduling. Therefore, the purpose of the research aims to design, develop and evaluate a health-assistant Chat-bot Application entitled “MR.Dr.” that helps users to ask any personal query related to healthcare without physically available to the hospital. MR.Dr. is evaluated in term of usability. 30 respondents attended the survey of usability evaluation. In the system usability scale MR.Dr. achieved 87.6 % rating which means Grade A (excellent). User's feedback level was pretty satisfying where 24/7 service is the highest one.

Predicting SARS-CoV-2 infections for children and youth with single symptom screening

Symptom-based SARS-CoV-2 screening and testing decisions in children have important implications on daycare and school exclusion policies. Single symptoms account for a substantial volume of testing and disruption to in-person learning and childcare, yet their predictive value is unclear, given the clinical overlap with other circulating respiratory viruses and non-infectious etiologies. We aimed to determine the relative frequency and predictive value of single symptoms for paediatric SARS-CoV-2 infections from an Ottawa COVID-19 assessment centre from October 2020 through April 2021.Overall, 46.3% (n=10,688) of pediatric encounters were for single symptoms, and 2.7% of these tested positive. The most common presenting single symptoms were rhinorrhea (31.8%), cough (17.4%) and fever (14.0%). Among children with high-risk exposures children in each age group, the following single symptoms had a higher proportion of positive SARS-CoV-2 cases compared to no symptoms; fever and fatigue (0-4 years); fever, cough, headache, and rhinorrhea (5-12 years); fever, loss of taste or smell, headache, rhinorrhea, sore throat, and cough (13-17 years). There was no evidence that the single symptom of either rhinorrhea or cough predicted SARS-CoV-2 infections among 0-4 year olds, despite accounting for a large volume (61.1%) of single symptom presentations in the absence of high-risk exposures.Symptom-based screening needs to be responsive to changes in evidence and local factors, including the expected resurgence of other respiratory viruses following relaxation of social distancing/masking, to reduce infection-related risks in schools and daycare settings.

Symptoms that predict positive COVID-19 testing and hospitalization: an analysis of 9,000 patients

Purpose: To develop a reliable tool that predicts which patients are most likely to be COVID-19 positive and which ones have an increased risk of hospitalization. Methods: From February 2020 to April 2021, trained nurses recorded age, gender, and symptoms in an outpatient COVID-19 testing center. All positive patients were followed up by phone for 14 days or until symptom-free. We calculated the symptoms odds ratio for positive results and hospitalization and proposed a random forest machine-learning model to predict positive testing. Results: A total of 8,998 patients over 16 years old underwent COVID-19 RT-PCR, with 1,914 (21.3%) positives. Fifty patients needed hospitalization (2.6% of positives), and three died (0.15%). Most common symptoms were: cough, headache, sore throat, coryza, fever, myalgia (57%, 51%, 44%, 36%, 35%, 27%, respectively). Cough, fever, and myalgia predicted positive COVID-19 test, while others behaved as protective factors. The best predictors of positivity were fever plus anosmia/ageusia (OR=6.31), and cough plus anosmia/ageusia (OR=5.82), both p<0.0001. Our random forest model had an ROC-AUC of 0.72 (specificity=0.70, sensitivity=0.61, PPV=0.38, NPV=0.86). Having steady fever during the first days of infection and persistent dyspnea increased the risk of hospitalization (OR=6.66, p<0.0001 and OR=3.13, p=0.003, respectively), while anosmia-ageusia (OR=0.36, p=0.009) and coryza (OR=0.31, p=0.014) were protective. Conclusion: Present study and algorithm may help identify patients at higher risk of having SARS-COV-2 (online calculator http://wdchealth.covid-map.com/shiny/calculator/), and also disease severity and hospitalization based on symptoms presence, pattern, and duration, which can help physicians and health care providers.

Paradoxical low severity of COVID-19 in Prader-Willi syndrome: data from a French survey on 647 patients

Background Patients with Prader-Willi syndrome (PWS) often have comorbidities, especially obesity, that may constitute a risk factor for severe forms of COVID-19. We aimed to assess prevalence and medical course of SARS-CoV-2 infection in children and adults with PWS. From November 2020 to January 2021, we performed a detailed medical survey on 342 adults and 305 children with PWS followed in the French reference center. Results We obtained responses from 288 adults (84%) and 239 children (78%). From March 2020 to January 2021, 38 adults (13.2%) and 13 children (5.4%) with PWS had SARS-CoV-2 infection. Mean age of adults was 34.1 ± 11.9 years and mean body mass index was 40.6 ± 12.7 kg/m2; 82% had obesity and 37% had diabetes. Only 3 children (23%) had obesity and none had diabetes. Similar to the general population, the most frequent symptoms of COVID-19 were asthenia, fever, cough, headache and shortness of breath. All patients had a favorable outcome. Conclusion PWS itself is not a risk factor for severe COVID-19 in children and adults. On the contrary, evolution of SARS-CoV-2 infection in adults with PWS seems more favorable than expected, given their comorbidities.

COVID-19 and Malaria Co-infection; Same coin but different faces?

Background: As the COVID-19 pandemic spreads rapidly around the world, urgent action is needed to combat the new coronavirus, while other deadly diseases such as malaria cannot be ignored. The impact of the coronavirus on countries affected by malaria and, where possible, contribute to a successful response to COVID19. Our aim is to assess the possible link between Malaria and COVID-19 .Methods: This is a descriptive retrospective cross sectional study which was conducted among adult Sudanese COVID-19 patients admitted to the Universal and Ombada hospitals in the period (4th of April 2020 to the 15th of January, 2020). A total number of 87 patients were included. Results: Among the 87 patients 64.9 % were males while 35.6 were females. 27.6 % had a positive blood film. 64.7% of the malaria patients had p.falciparum while 35.3% had p.vivax. 52.9% of the patients showed positive RT-PCR for COVID-19 with 52.9 % showed positive CT findings . Generalized fatigability was observed in 52.9 % of the patients with malaria followed by headache, nausea, fever with chills, fever with shivering, vomiting and diarrhea in 42.5%, 36.8%, 20.7%, 12.6%, 9.2% and 9.2% respectively. In COVID-19 patients 85.1% had fever and generalized fatigability, followed by cough, headache, SOB , sore throat ,myalgia, chest pain and diarrhea. 13.79 % of malaria patients had malarial pneumonitis, followed by pulmonary edema, choleric malaria, thrombocytopenia and malaria induced hepatitis in 10.39 %, 9.2 %, 9.19 % and 6.9% respectively. 8.4% had cerebral malaria while 1.1% had cerebellar syndromes. 44.8 % had acute respiratory distress syndrome, 17.2% had heart failure, 8% had pulmonary embolism, 8% had stroke, 3.9% had encephalitis and 1.1% had convulsions.Conclusion: Malaria and COVID-19 have a possible link that they both share similar presentations and complications.

Paediatric primary cough headache with internal jugular phlebectasia

Primary cough headaches (PCHs) are mainly observed in people aged >40 years, but cough-induced headaches are potentially symptomatic in children. We report a case of a child diagnosed with PCH without an intracranial disease. A 7-year-old boy presented with cough due to pertussis and powerful cough-induced headaches. No brain abnormalities were detected, but the right side of his neck was observed to swell. Echo examination confirmed right internal jugular vein dilatation during a Valsalva manoeuvre, and the patient was diagnosed with PCH with internal jugular phlebectasia. PCHs are normally reported in adults, but they can also occur in children. PCHs and internal jugular vein abnormalities may be related. Thus, tests assessing internal jugular vein morphology and function should be considered for PCH cases.

Tuberculosis miliar, hallazgo clínico-radiológico. Sobre un caso

Tuberculosis is a granulomatous disease with a variable clinical spectrum. The objective is to present a case with miliar tuberculosis, one of the least frequent clinical forms of the disease, and the use of the clinical method provided an accurate diagnosis. We present a 54-year-old male, non-smoker, alcoholic who attended in the Ameijeiras Brothers Surgical Clinical Hospital for referring to a history of unproductive cough, headache, fever, loss of appetite, and weight two months of evolution. Chest X-ray and CT showed a miliar pattern and direct bacilloscopy confirmed the presence of Mycobacterium tuberculosis. Miliar TB is very rare but can be suspected by a miliar radiological pattern and confirmed by microbiological analysis.

Why Traditional Chinese Medicine can not be a new approach to alleviate the symptoms of COVID-19 ?

Traditional Chinese Medicine (TCM) has a unique set of therapeutic methods for plagues. COVID-19 is a severe type of pneumonia caused by a new coronavirus, which manifests in fever, cough, headache, fatigue, difficulty breathing, and other symptoms. TCM has fully displayed its advantages of various approaches in this epidemic, including herbal decoction, patent herbs, aroma packets, acupuncture, massage, etc. These methods have played an essential role in the prevention, treatment, and nursing of COVID-19, not only in alleviating the early clinical symptoms of patients but reducing the progression from mild to severe symptoms. Thanks to the advantages of treating the pandemic, we should pay more attention to TCM modalities.

Symptomatic manifestations of the disease caused by coronavirus (COVID-19) in adults: systematic review

ABSTRACT Objective To identify symptoms of COVID-19 in adults in the scientific literature. Method Systematic review of studies published from December 1, 2019 to April 21, 2020 from the Scopus, Web of Science and PubMed databases, in order to answer the following research question: “What are the symptoms caused by COVID-19 in adults?” using the keywords “Symptoms”, “Clinical Manifestations”, “Coronavirus”, “COVID-19”. Results Of the total 105 references, 13 references that addressed the symptoms of COVID-19 were selected. Fever and normal or dry cough were symptoms present in all studies. Conclusion The symptoms identified in adult patients were fever, normal or dry cough, headache, pharyngalgia, dyspnea, diarrhea, myalgia, vomiting, sputum or expectoration, anxiety or chest pain, fatigue, nausea, anorexia, abdominal pain, rhinorrhea, runny nose or nasal congestion, dizziness, chills, systemic pain, mental confusion, hemoptysis, asthma, taste disorder, smell disorder, belching and tachycardia.