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Burgos C, Mendez LM, Rodriguez MM, Martinez A, Sanchez P, Tovar C, Naranjo Vanegas M, Friedrich G, Vásquez-Hoyos P, Mesa-Rubio ML, Triana-Rodriguez GA, Royero-Arias M, Echeverry J, Gamo T, Moreno LÁ, Baquero OL, Mejía LM, Restrepo-Gualteros S, Navarro-Ramirez LM, Moreno-Lopez S, Piñeros JG, Álvarez-Moreno C, Díaz-Díaz A, Gutierrez IF, Galvis-Diaz C, Nieto JM, Gastesi I, Moraleda C, Tagarro García A, Ramirez Varela A. What to Look for in Chest X-Rays of Pediatric Patients With COVID-19: Insights From a Colombian Cohort. Pediatr Pulmonol 2025; 60:e27495. [PMID: 40018994 DOI: 10.1002/ppul.27495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/22/2024] [Accepted: 01/11/2025] [Indexed: 03/01/2025]
Abstract
BACKGROUND Despite advancements in vaccination and the transition from pandemic to endemic, SARS-CoV-2 continues to pose a medical challenge, particularly among children. In this context, imaging diagnostics, such as chest x-rays, are crucial to the initial treatment of patients. This study aims to characterize the radiological findings in pediatric patients with confirmed SARS-CoV-2 infection in Colombia between April 2020 and November 2021, as well as describe the clinical presentation, including those admission to intensive care. METHODS In Colombia, a multicenter cohort comprised patients aged 29 days to 17 years with confirmed SARS-CoV-2 infection and chest X-ray taken within 72 h of hospitalization. In two separate groups, four radiologists evaluated the images. A fifth radiologist reviewed all the X-rays; and subsequently, these readings were used to calculate the kappa coefficient and to solve discrepancies among the other radiologists. The results were compared from admission to intensive care. RESULTS Analysis was conducted on 392 patients with a median age of 2 years, the majority of whom (42%) were infants. Sixty-eight percent of the radiographs had normal results. Peribronchial thickening and interstitial opacity were the most common aberrant findings (59%), followed by alveolar opacity (12%). 88 percent of findings were bilateral. In our cohort, peribronchial thickening was the most common radiological pattern found in patients admitted the PICU and with ventilatory failure. Interobserver agreement was low for peribronchial thickening (kappa = 0.1), but higher for consolidations and alveolar opacities (kappa = 0.4 and 0.5, respectively). CONCLUSION In pediatric patients with SARS-CoV-2, radiological findings are nonspecific and interobserver agreement is minimal. Although consolidation and alveolar opacities demonstrated greater concordance, they did not appear to reflect the clinical presentation; therefore, our results can suggest chest radiography is not considered useful for determining the severity of COVID-19 in children. There is a need for more investigations.
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Affiliation(s)
- Claudia Burgos
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - Laura Melissa Mendez
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - María Margarita Rodriguez
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - Arianna Martinez
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - Paola Sanchez
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - Carolina Tovar
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | | | - Gabriela Friedrich
- School of Medicine, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - Pablo Vásquez-Hoyos
- Red Colaborativa Pediátrica de Latinoamérica (LARed Network), Montevideo, Uruguay
- School of Medicine, Universidad Nacional de Colombia, Bogotá, Bogotá D.C., Colombia
| | - María Lucía Mesa-Rubio
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | | | - Mónica Royero-Arias
- HOMI, Fundación Hospital Infantil de la Misericordia, Bogotá, Bogotá D.C., Colombia
| | | | - Tamara Gamo
- Clínica Infantil Colsubsidio, Bogotá, Bogotá D.C., Colombia
| | - Luz Ángela Moreno
- School of Medicine, Universidad Nacional de Colombia, Bogotá, Bogotá D.C., Colombia
- HOMI, Fundación Hospital Infantil de la Misericordia, Bogotá, Bogotá D.C., Colombia
| | | | - Luz Marina Mejía
- Instituto de Ortopedia Infantil Roosevelt, Bogotá, Bogotá D.C., Colombia
| | - Sonia Restrepo-Gualteros
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - Luis Miguel Navarro-Ramirez
- School of Medicine, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
- Cancer and Molecular Medicine Research Group (CAMMO), Bogotá, Bogotá D.C., Colombia
| | | | - Juan Gabriel Piñeros
- Department of Pediatrics, Fundación Santa Fe de Bogotá, Universidad de los Andes, Bogotá, Bogotá D.C., Colombia
| | - Carlos Álvarez-Moreno
- School of Medicine, Universidad Nacional de Colombia, Bogotá, Bogotá D.C., Colombia
- Clínica Universitaria Colombia, Bogotá, Bogotá D.C., Colombia
| | | | | | | | | | - Irati Gastesi
- Fundación Investigación Biomédica Hospital Universitario 12 de Octubre (FIBH12O), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Cinta Moraleda
- Fundación Investigación Biomédica Hospital Universitario 12 de Octubre (FIBH12O), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Alfredo Tagarro García
- Fundación Investigación Biomédica Hospital Universitario 12 de Octubre (FIBH12O), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - Andrea Ramirez Varela
- Department of Epidemiology, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
- Department of Pediatrics, McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, Texas, USA
- School of Public Health, Center for Health Equity, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Kumar I, Ansari MS, Verma A, Singh PK, Chakrabarti SS, Shukla RC. COVID-19 Vaccines: A Radiological Review of the Good, the Bad, and the Ugly. Indian J Radiol Imaging 2024; 34:714-725. [PMID: 39318578 PMCID: PMC11419762 DOI: 10.1055/s-0044-1785210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2024] Open
Abstract
The World Health Organization has declared "with great hope" an end to COVID-19 as a public health emergency. The vaccination drive that started in December 2020 played a crucial role in controlling the pandemic. However, the pace at which COVID-19 vaccines were developed and deployed for general population use led to vaccine hesitancy, largely owing to concerns regarding the safety and efficacy of the vaccines. Radiology has been instrumental in demonstrating the extent of pulmonary involvement and identification of the complications of COVID-19, and the same holds true for vaccine-related complications. This review summarizes the existing body of radiological literature regarding the efficacy, adverse events, and imaging pitfalls that accompany the global rollout of various COVID-19 vaccines.
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Affiliation(s)
- Ishan Kumar
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Mohammad Sharoon Ansari
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ashish Verma
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Pramod Kumar Singh
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Sankha Shubhra Chakrabarti
- Department of Geriatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ram Chandra Shukla
- Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Lee JE, Kim J, Hwang M, Kim YH, Chung MJ, Jeong WG, Jeong YJ. Clinical and Imaging Characteristics of SARS-CoV-2 Breakthrough Infection in Hospitalized Immunocompromised Patients. Korean J Radiol 2024; 25:481-492. [PMID: 38627873 PMCID: PMC11058431 DOI: 10.3348/kjr.2023.0992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 01/11/2024] [Accepted: 01/31/2024] [Indexed: 05/01/2024] Open
Abstract
OBJECTIVE To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. MATERIALS AND METHODS This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022. Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (≥ 25% of lung involvement), and typical CT pneumonia. RESULTS Of 2218 patients (mean age, 69.5 ± 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01-2.47], P = 0.042; and 3.12 [95% CI, 1.47-6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54-5.67], P = 0.001; and 2.87 [95% CI, 1.50-5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49-32.66], P < 0.001; and 4.18 [95% CI, 1.70-10.25], P = 0.002, respectively). CONCLUSION Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.
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Affiliation(s)
- Jong Eun Lee
- Department of Radiology, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jinwoo Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Minhee Hwang
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Republic of Korea
| | - Yun-Hyeon Kim
- Department of Radiology and Biomedical Engineering, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Myung Jin Chung
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Gi Jeong
- Department of Radiology, Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Hwasun, Republic of Korea
| | - Yeon Joo Jeong
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
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Zhu Z, Hu G, Ying Z, Wang J, Han W, Pan Z, Tian X, Song W, Sui X, Song L, Jin Z. Time-dependent CT score-based model for identifying severe/critical COVID-19 at a fever clinic after the emergence of Omicron variant. Heliyon 2024; 10:e27963. [PMID: 38586383 PMCID: PMC10998101 DOI: 10.1016/j.heliyon.2024.e27963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/22/2024] [Accepted: 03/08/2024] [Indexed: 04/09/2024] Open
Abstract
Rationale and objectives The computed tomography (CT) score has been used to evaluate the severity of COVID-19 during the pandemic; however, most studies have overlooked the impact of infection duration on the CT score. This study aimed to determine the optimal cutoff CT score value for identifying severe/critical COVID-19 during different stages of infection and to construct corresponding predictive models using radiological characteristics and clinical factors. Materials and methods This retrospective study collected consecutive baseline chest CT images of confirmed COVID-19 patients from a fever clinic at a tertiary referral hospital from November 28, 2022, to January 8, 2023. Cohorts were divided into three subcohorts according to the time interval from symptom onset to CT examination at the hospital: early phase (0-3 days), intermediate phase (4-7 days), and late phase (8-14 days). The binary endpoints were mild/moderate and severe/critical infection. The CT scores and qualitative CT features were manually evaluated. A logistic regression analysis was performed on the CT score as determined by a visual assessment to predict severe/critical infection. Receiver operating characteristic analysis was performed and the area under the curve (AUC) was calculated. The optimal cutoff value was determined by maximizing the Youden index in each subcohort. A radiology score and integrated models were then constructed by combining the qualitative CT features and clinical features, respectively, using multivariate logistic regression with stepwise elimination. Results A total of 962 patients (aged, 61.7 ± 19.6 years; 490 men) were included; 179 (18.6%) were classified as severe/critical COVID-19, while 344 (35.8%) had a typical Radiological Society of North America (RSNA) COVID-19 appearance. The AUCs of the CT score models reached 0.91 (95% confidence interval (CI) 0.88-0.94), 0.82 (95% CI 0.76-0.87), and 0.83 (95% CI 0.77-0.89) during the early, intermediate, and late phases, respectively. The best cutoff values of the CT scores during each phase were 1.5, 4.5, and 5.5. The predictive accuracies associated with the time-dependent cutoff values reached 88% (vs.78%), 73% (vs. 63%), and 87% (vs. 57%), which were greater than those associated with universal cutoff value (all P < 0.001). The radiology score models reached AUCs of 0.96 (95% CI 0.94-0.98), 0.90 (95% CI 0.87-0.94), and 0.89 (95% CI 0.84-0.94) during the early, intermediate, and late phases, respectively. The integrated models including demographic and clinical risk factors greatly enhanced the AUC during the intermediate and late phases compared with the values obtained with the radiology score models; however, an improvement in accuracy was not observed. Conclusion The time interval between symptom onset and CT examination should be tracked to determine the cutoff value for the CT score for identifying severe/critical COVID-19. The radiology score combining qualitative CT features and the CT score complements clinical factors for identifying severe/critical COVID-19 patients and facilitates timely hierarchical diagnoses and treatment.
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Affiliation(s)
- Zhenchen Zhu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ge Hu
- Medical Research Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhoumeng Ying
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jinhua Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Institute of Basic Medicine Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhengsong Pan
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- 4+4 Medical Doctor Program, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinlun Tian
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Sui
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lan Song
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhengyu Jin
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Ramya Sree A, Sethumadhavan K, Pullakanam ST, Usharani P. Evaluation of CoVid-19 infection among vaccinated and unvaccinated individuals using biochemical markers. Bioinformation 2024; 20:223-228. [PMID: 38712002 PMCID: PMC11069607 DOI: 10.6026/973206300200223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/31/2024] [Accepted: 03/31/2024] [Indexed: 05/08/2024] Open
Abstract
The evaluation of infection rate for CoVid-19 cases among vaccinated and unvaccinated individuals using haematological parameters is of interest. Data such as age, gender, occupation, location, signs and symptoms, length of symptoms, date of sample collection and report generation, status of vaccinations, and outcome available in the database was used in this analysis. Ferritin levels, D-dimer values, CRP, troponin-1 levels and platelet count of each CoVid-19 patient were recorded and analysed. Data shows that maximum number of cases was reported during the second wave 143 (51.07%). The common age group affected was 31-40 years 28.56%. The common symptom identified was weakness in arms and legs among the unvaccinated group of CoVid-19 positive group. However, common symptom identified was fatigue (87%) among those who received only the first dose of CoVid vaccine. Nonetheless, the symptom identified was hair loss (68%) among those who received both the doses of CoVid vaccine. Thus, data shows that people do experience severe and life-threatening COVID-19 infection despite receiving the vaccination. Nonetheless, the infection is mild and very few individuals require hospitalization. No deaths are reported in the group that received the vaccination. This is in contrast to the unvaccinated group, which had a severe CoVid-19 infection with few deaths reported.
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Affiliation(s)
- Allavarapu Ramya Sree
- Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation (VMRF-DU), Puducherry, Tamil Nadu, India
| | - K Sethumadhavan
- Department of Microbiology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission's Research Foundation (VMRF-DU), Puducherry, Tamil Nadu, India
| | - S.P. Tejaswi Pullakanam
- Department of Biochemistry, Gayatri Vidya Parishad Institute of Health Care and Medical Technology, Marikavalasa, Visakhapatnam, Andhra Pradesh, India
| | - Purimitla Usharani
- Department of Microbiology, Dr. Patnam Mahender Reddy Institute of Medical Sciences, Chevella, Ranga Reddy District, Telangana, India
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Vulturar DM, Moacă LȘ, Neag MA, Mitre AO, Alexescu TG, Gherman D, Făgărășan I, Chețan IM, Gherman CD, Melinte OE, Trofor AC, Todea DA. Delta Variant in the COVID-19 Pandemic: A Comparative Study on Clinical Outcomes Based on Vaccination Status. J Pers Med 2024; 14:358. [PMID: 38672984 PMCID: PMC11050903 DOI: 10.3390/jpm14040358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/17/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND As the global battle against the COVID-19 pandemic endures, the spread of the Delta variant has introduced nuanced challenges, prompting a nuanced examination. MATERIALS AND METHODS We performed a multilevel logistic regression analysis encompassing 197 patients, comprising 44 vaccinated individuals (V group) and 153 unvaccinated counterparts (UV). These patients, afflicted with the Delta variant of SARS-CoV-2, were hospitalized between October 2021 and February 2022 at the COVID-19 department of a University Centre in Cluj-Napoca, Romania. We compared patient characteristics, CT lung involvement, Padua score, oxygen saturation (O2 saturation), ventilation requirements, dynamics of arterial blood gas (ABG) parameters, ICU admission rates, and mortality rates between the two groups. RESULTS The UV group exhibited a statistically significant (p < 0.05) proclivity toward developing a more severe form of infection, marked by elevated rates of lung involvement, oxygen requirement, ICU admission, and mortality. CONCLUSION Our findings underscore the substantial efficacy of the vaccine in diminishing the incidence of severe disease, lowering the rates of ICU admissions, and mitigating mortality among hospitalized patients.
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Affiliation(s)
- Damiana-Maria Vulturar
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (D.-M.V.); (I.F.); (I.M.C.); (D.-A.T.)
| | - Liviu-Ștefan Moacă
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (D.-M.V.); (I.F.); (I.M.C.); (D.-A.T.)
| | - Maria Adriana Neag
- Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania;
| | - Andrei-Otto Mitre
- Department of Pathophysiology, Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
| | - Teodora-Gabriela Alexescu
- 4th Department Internal Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania;
| | - Diana Gherman
- Department of Radiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Iulia Făgărășan
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (D.-M.V.); (I.F.); (I.M.C.); (D.-A.T.)
| | - Ioana Maria Chețan
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (D.-M.V.); (I.F.); (I.M.C.); (D.-A.T.)
| | - Claudia Diana Gherman
- Department of Surgery-Practical Abilities,“Iuliu Hatieganu” University of Medicine and Pharmacy, Marinescu Street, No. 23, 400337 Cluj-Napoca, Romania;
| | - Oana-Elena Melinte
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.-E.M.); (A.C.T.)
| | - Antigona Carmen Trofor
- Discipline of Pneumology, III-rd Medical Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (O.-E.M.); (A.C.T.)
| | - Doina-Adina Todea
- Department of Pneumology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400332 Cluj-Napoca, Romania; (D.-M.V.); (I.F.); (I.M.C.); (D.-A.T.)
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Niu J, Samuels S, Sareli C, Mayer D, Visbal A, Sareli AE. Clinical Features and Outcomes of Hospitalized Adult Patients With Breakthrough COVID-19 Infections: A Propensity-Score-Matched Observational Study. Am J Epidemiol 2024; 193:285-295. [PMID: 37823271 DOI: 10.1093/aje/kwad199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 07/24/2023] [Accepted: 10/05/2023] [Indexed: 10/13/2023] Open
Abstract
In this study, we aimed to evaluate the impact of vaccination on intensive care unit (ICU) admission and in-hospital mortality among breakthrough coronavirus disease 2019 (COVID-19) infections. A total of 3,351 adult patients hospitalized with COVID-19 in the Memorial Healthcare System (Hollywood, Florida) between June 1 and September 20, 2021, were included; 284 (8.5%) were fully vaccinated. A propensity-score-matched analysis was conducted to compare fully vaccinated patients with unvaccinated controls. Propensity scores were calculated on the basis of variables associated with vaccination status. A 1:1 matching ratio was applied using logistic regression models, ensuring balanced characteristics between the two groups. The matched samples were then subjected to multivariate analysis. Among breakthrough infections, vaccinated patients demonstrated lower incidences of ICU admission (10.3% vs. 16.4%; P = 0.042) and death (12.2% vs. 18.7%; P = 0.041) than the matched controls. Risk-adjusted multivariate analysis demonstrated a significant inverse association between vaccination and ICU admission (odds ratio = 0.52, 95% confidence interval: 0.31, 0.89; P = 0.019) as well as in-hospital mortality (odds ratio = 0.57, 95% confidence interval: 0.34, 0.94; P = 0.027). Vaccinated individuals experiencing breakthrough infections had significantly lower risks of ICU admission and in-hospital mortality. These findings highlight the benefits of COVID-19 vaccines in reducing severe outcomes among patients with breakthrough infections.
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Shaw SY, Kindrachuk J, McKinnon L, Biegun JCS, Reimer JN, Loeppky C, Wei YJ, Bullard J, Van Caeseele P, Stein DR. The descriptive epidemiology of pre-omicron SARS-CoV-2 breakthrough infections and severe outcomes in Manitoba, Canada. FRONTIERS IN EPIDEMIOLOGY 2024; 3:1248847. [PMID: 38455896 PMCID: PMC10911002 DOI: 10.3389/fepid.2023.1248847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/12/2023] [Indexed: 03/09/2024]
Abstract
Introduction Vaccination plays a key role in curbing severe outcomes resulting from COVID-19 disease. With the Omicron variant and the relaxing of public health protections breakthrough infections are increasingly common, and certain groups remain at higher risk for severe outcomes from breakthrough infections. We analysed population-based public health data from Manitoba, Canada to understand characteristics of those experiencing breakthrough infections and severe outcomes from breakthrough infections. Data from previous pandemic stages can provide valuable information regarding severe outcomes associated with breakthrough infection in the Omicron and future phases. Methods Positive SARS-CoV-2 PCR tests from Cadham Provincial Laboratory were linked to case information from the population-based Public Health Information Management System. A retrospective design was used with time-to-event analyses to examine severe outcomes among those experiencing breakthrough infection. Results Breakthrough cases were more likely to have 2 + chronic conditions, compared to age-, sex-, and time-period matched unvaccinated cases (24% vs. 17%), with hypertension (30%), diabetes (17%), and asthma (14%) being the most prevalent chronic conditions amongst breakthrough cases. Severe outcomes resulting from breakthrough infection was associated with age and chronic conditions, with those with 2 + chronic conditions at higher risk of severe outcomes (adjusted hazard ratio: 3.6, 95% confidence intervals: 2.0-6.4). Risk of severe outcomes varied by age group, with those 70 + years at over 13 times the risk of severe outcomes (95% CI: 4.5-39.8), compared to those 18-29 years of age. Discussion Our results demonstrate the impact of chronic conditions on the likelihood of, and severity of outcomes from breakthrough infections. These findings underscore the importance of vaccination programs prioritizing vulnerable populations.
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Affiliation(s)
- Souradet Y. Shaw
- Department of CommunityHealth Sciences, University of Manitoba, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Jason Kindrachuk
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Lyle McKinnon
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Jeffery C. S. Biegun
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, MB, Canada
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Lee JE, Jin KN, Hong H, Jeong YJ, Yoon SH. Effectiveness of COVID-19 Vaccines Over Time Against Clinical and Radiologic Outcomes Related to Severe SARS-CoV-2 Infection. Radiology 2024; 310:e231928. [PMID: 38259210 DOI: 10.1148/radiol.231928] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Background The impact of waning vaccine effectiveness on the severity of COVID-19-related findings discovered with radiologic examinations remains underexplored. Purpose To evaluate the effectiveness of vaccines over time against severe clinical and radiologic outcomes related to SARS-CoV-2 infections. Materials and Methods This multicenter retrospective study included patients in the Korean Imaging Cohort of COVID-19 database who were hospitalized for COVID-19 between June 2021 and December 2022. Patients who had received at least one dose of a SARS-CoV-2 vaccine were categorized based on the time elapsed between diagnosis and their last vaccination. Adjusted multivariable logistic regression analysis was used to estimate vaccine effectiveness against a composite of severe clinical outcomes (invasive ventilation, extracorporeal membrane oxygenation, or in-hospital death) and severe radiologic pneumonia (≥25% of lung involvement), and odds ratios (ORs) were compared between patients vaccinated within 90 days of diagnosis and those vaccinated more than 90 days before diagnosis. Results Of 4196 patients with COVID-19 (mean age, 66 years ± 17 [SD]; 2132 [51%] women, 2064 [49%] men), the ratio of severe pneumonia since their most recent vaccination was as follows: 90 days or less, 18% (277 of 1527); between 91 and 120 days, 22% (172 of 783); between 121 and 180 days, 27% (274 of 1032); between 181 and 240 days, 32% (159 of 496); and more than 240 days, 31% (110 of 358). Patients vaccinated more than 240 days before diagnosis showed increased odds of severe clinical outcomes compared with patients vaccinated within 90 days (OR = 1.94 [95% CI: 1.16, 3.24]; P = .01). Similarly, patients vaccinated more than 240 days before diagnosis showed increased odds of severe pneumonia on chest radiographs compared with patients vaccinated within 90 days (OR = 1.65 [95% CI: 1.13, 2.40]; P = .009). No difference in odds of severe clinical outcomes (P = .13 to P = .68) or severe pneumonia (P = .15 to P = .86) were observed between patients vaccinated 91-240 days before diagnosis and those vaccinated within 90 days of diagnosis. Conclusion Vaccine effectiveness against severe clinical outcomes and severe pneumonia related to SARS-CoV-2 infection gradually declined, with increased odds of both observed in patients vaccinated more than 240 days before diagnosis. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Wells in this issue.
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Affiliation(s)
- Jong Eun Lee
- From the Department of Radiology, Chonnam National University Hospital, Gwangju, Korea (J.E.L.); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea (K.N.J.); Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (H.H.); Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.); and Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea (S.H.Y.)
| | - Kwang Nam Jin
- From the Department of Radiology, Chonnam National University Hospital, Gwangju, Korea (J.E.L.); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea (K.N.J.); Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (H.H.); Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.); and Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea (S.H.Y.)
| | - Hyunsook Hong
- From the Department of Radiology, Chonnam National University Hospital, Gwangju, Korea (J.E.L.); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea (K.N.J.); Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (H.H.); Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.); and Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea (S.H.Y.)
| | - Yeon Joo Jeong
- From the Department of Radiology, Chonnam National University Hospital, Gwangju, Korea (J.E.L.); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea (K.N.J.); Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (H.H.); Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.); and Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea (S.H.Y.)
| | - Soon Ho Yoon
- From the Department of Radiology, Chonnam National University Hospital, Gwangju, Korea (J.E.L.); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea (K.N.J.); Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea (H.H.); Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.); and Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea (S.H.Y.)
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Hammer MM, Sodickson AD, Marshall AD, Faust JS. Prevalence of Pneumonia Among Patients Who Died with COVID-19 Infection in Ancestral Versus Omicron Variant Eras. Acad Radiol 2024; 31:1-6. [PMID: 37271637 PMCID: PMC10172968 DOI: 10.1016/j.acra.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 06/06/2023]
Abstract
RATIONALE AND OBJECTIVES The Omicron variant of COVID-19 is less severe than the ancestral strain, leading to the potential for deaths in patients infected with the virus but who die of other causes. This study evaluated the difference in rates of pneumonia among patients who died with SARS-CoV-2 infection in the ancestral vs Omicron eras. MATERIALS AND METHODS We identified patients who died within 30days of a positive SARS-CoV-2 test, from March 2020 through December 2022; variants were assigned based on the prevalent variant in the US at that time. We also obtained a control group from patients who died within 30days of a negative SARS-CoV-2 test in January 2022. The first CT after the test was reviewed in a blinded fashion and assigned a category from the RSNA Consensus Reporting Guidelines. The primary outcome was the difference in rates of positive (typical or indeterminate) COVID-19 findings in the ancestral vs Omicron eras. RESULTS A total of 598 patients died during the ancestral era and 400 during the Omicron era, and 347 decedents comprised the control group. The rate of positive COVID-19 findings was 67/81 (83%) in the ancestral era and 43/81 (53%) in the Omicron era (P < .001), an absolute difference of 30% (95% CI 16%-43%). The rate of positive findings in the control group was 23/76 (30%). CONCLUSION During the Omicron era, 30% fewer SARS-CoV-2-associated deaths were associated with COVID-19 pneumonia and were caused either by nonpulmonary effects of the infection or were unrelated to the infection.
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Affiliation(s)
- Mark M Hammer
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, (M.M.H., A.D.S.).
| | - Aaron D Sodickson
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, (M.M.H., A.D.S.)
| | - Andrew D Marshall
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, (A.D.M., J.S.F.)
| | - Jeremy S Faust
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, (A.D.M., J.S.F.)
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11
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Borghesi A, Ciolli P, Antonelli E, Monti A, Scrimieri A, Ravanelli M, Maroldi R, Farina D. Residual Lung Abnormalities in Survivors of Severe or Critical COVID-19 at One-Year Follow-Up Computed Tomography: A Narrative Review Comparing the European and East Asian Experiences. Tomography 2023; 10:25-36. [PMID: 38250949 PMCID: PMC10819659 DOI: 10.3390/tomography10010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/14/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
The literature reports that there was a significant difference in the medical impact of the coronavirus disease (COVID-19) pandemic between European and East Asian countries; specifically, the mortality rate of COVID-19 in Europe was significantly higher than that in East Asia. Considering such a difference, our narrative review aimed to compare the prevalence and characteristics of residual lung abnormalities at one-year follow-up computed tomography (CT) after severe or critical COVID-19 in survivors of European and East Asian countries. A literature search was performed to identify articles focusing on the prevalence and characteristics of CT lung abnormalities in survivors of severe or critical COVID-19. Database analysis identified 16 research articles, 9 from Europe and 7 from East Asia (all from China). Our analysis found a higher prevalence of CT lung abnormalities in European than in Chinese studies (82% vs. 52%). While the most prevalent lung abnormalities in Chinese studies were ground-glass opacities (35%), the most prevalent lung abnormalities in European studies were linear (59%) and reticular opacities (55%), followed by bronchiectasis (46%). Although our findings required confirmation, the higher prevalence and severity of lung abnormalities in European than in Chinese survivors of COVID-19 may reflect a greater architectural distortion due to a more severe lung damage.
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Affiliation(s)
- Andrea Borghesi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili, 1, I-25123 Brescia, Italy; (P.C.); (E.A.); (A.M.); (A.S.); (M.R.); (R.M.); (D.F.)
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12
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DOGAN C, BILICI D, ARPINAR YIGITBAS B, ZENGIN O, ZOR O, AKMAN O, KOCABAG I, YALCIN GS, ERTAN YAZAR E. The Impact of Effective Vaccination on Clinical and Radiological Involvement in COVID-19 Patients. Medeni Med J 2023; 38:260-267. [PMID: 38148723 PMCID: PMC10759941 DOI: 10.4274/mmj.galenos.2023.88655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/04/2023] [Indexed: 12/28/2023] Open
Abstract
Objective We aimed to analyze clinical, radiological, and laboratory differences between vaccinated and unvaccinated patients admitted to hospital due to coronavirus disease-2019 (COVID-19) pneumonia. Methods Patients hospitalized in the COVID-19 clinic between February 2022 and August 2022 were included in the study. Demographic, clinical features, and treatment results. Furthermore, the COVID-19 vaccination status of the cases was recorded. The cases were divided into two groups as those with and without COVID vaccination and compared. Results A total of 215 patients were included in our study, and the patients were divided into 2 groups according to their vaccination status: those who were unvaccinated against COVID-19 (n=100) and those who vaccinated COVID-19 (n=115). The presence of comorbid chronic diseases and cancer was lower in the unvaccinated group. The duration of hospitalization was longer in the unvaccinated group than in the vaccinated group (9.6 and 7.1 days, respectively) (p<0.001). While there was no difference between the two groups in terms of the radiological involvement pattern, the number of involved segments was significantly higher in the unvaccinated group (p<0.05). The number of patients who received high-dose glucocorticoid therapy in the unvaccinated group was higher (28 cases vs. 11 cases; p<0.001). There was no statistically significant difference between the two groups in terms of transfer of patients to the intensive care unit (p>0.05). 11.3% (13/115) of the patients in the vaccinated group died, whereas 14% (14/100) died in the unvaccinated group. Conclusions The vaccinated cases who were infected with COVID-19 had a shorter duration of hospitalization and lower severity of radiological involvement. The requirement for pulse steroids was also less compared with unvaccinated individuals. Despite having chronic diseases and cancer, which is considered to have a significant effect on mortality in COVID-19 patients. In addition, although the vaccinated group was older, they had mortality rates similar to those of unvaccinated subjects.
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Affiliation(s)
- Coskun DOGAN
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
| | - Deniz BILICI
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
| | - Burcu ARPINAR YIGITBAS
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
| | - Omer ZENGIN
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
| | - Orhan ZOR
- Istanbul Medeniyet University Faculty of Medicine, Department of Family Medicine, Istanbul, Turkey
| | - Oguzhan AKMAN
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
| | - Ilyas KOCABAG
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
| | - Gonul Seven YALCIN
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
| | - Esra ERTAN YAZAR
- Istanbul Medeniyet University Faculty of Medicine, Department of Chest Diseases, Istanbul, Turkey
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13
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Giraudo C, Guarnieri G, Molena B, Caminati M, Stramare R, Vianello A. The lung-protective effect of prior mRNA vaccination on breakthrough COVID-19 patients receiving high flow nasal oxygen for hypoxemic acute respiratory failure. Pulmonology 2023; 29:421-423. [PMID: 35963831 PMCID: PMC9304153 DOI: 10.1016/j.pulmoe.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- C Giraudo
- Department of Medicine DIMED, University of Padova, Padova, Italy
| | - G Guarnieri
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - B Molena
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - M Caminati
- Department of Medicine, University of Verona
| | - R Stramare
- Department of Medicine DIMED, University of Padova, Padova, Italy
| | - A Vianello
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
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14
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Ravichandran S, Vijayakumar K, G V V, P M S. Vaccination Can Prevent Severe Pulmonary Disease in COVID-19 Positive Patients: A Case-Control Study. Cureus 2023; 15:e45638. [PMID: 37868424 PMCID: PMC10589065 DOI: 10.7759/cureus.45638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic was a global health emergency, which brought lives to a standstill. To combat this deadly virus, two vaccines were deployed widely: COVISHIELD (ChAdOx1 nCoV-19) and COVAXIN (BBV152). These were approved based on the immunological response they elicit in standardized conditions; however, the real-life scenario after deployment was completely different. Only in such situations can the true effectiveness of vaccines be assessed. The primary objective was to assess the effectiveness (VE) of COVAXIN/COVISHIELD in preventing severe pulmonary disease in RT-PCR-positive COVID-19 patients greater than 18 years of age. MATERIALS AND METHODS A case-control study was conducted among 260 subjects aged above 18 years, positive for COVID-19 through RT-PCR. 130 cases and 130 controls were enrolled. Radiological findings were obtained and subjects with >50% lung involvement were considered as cases. Subjects were interviewed about their vaccination status. Odds ratio was calculated, and the adjusted odds ratio was estimated for vaccine effectiveness, using the formula (1-adjusted ODDS ratio)*100. RESULTS The vaccine effectiveness for a single dose of vaccine was 55.2% (95% C.I. 11.0%-77.5%) and with two doses was 98.0% (95% C.I. 85.0%-99.7%). Hence two doses are highly effective than a single dose of vaccine in reducing lung involvement. CONCLUSION Two doses of vaccine are more effective than a single dose vaccine in reducing lung involvement. Since sporadic cases of COVID-19 still persist, it is important to emphasize the role of vaccination in preventing severe COVID-19 infections, particularly in the elderly and those with comorbidities.
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Affiliation(s)
| | | | - Vishwajit G V
- Community Medicine, Coimbatore Medical College, Coimbatore, IND
| | - Siva P M
- Community Medicine, Government Medical College, Tiruppur, IND
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15
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Whittaker R, Toikkanen S, Dean K, Lyngstad TM, Buanes EA, Kløvstad H, Paulsen TH, Seppälä E. A comparison of two registry-based systems for the surveillance of persons hospitalised with COVID-19 in Norway, February 2020 to May 2022. Euro Surveill 2023; 28:2200888. [PMID: 37589591 PMCID: PMC10436689 DOI: 10.2807/1560-7917.es.2023.28.33.2200888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/05/2023] [Indexed: 08/18/2023] Open
Abstract
BackgroundThe surveillance of persons hospitalised with COVID-19 has been essential to ensure timely and appropriate public health response. Ideally, surveillance systems should distinguish persons hospitalised with COVID-19 from those hospitalised due to COVID-19.AimWe compared data in two national electronic health registries in Norway to critically appraise and inform the further development of the surveillance of persons hospitalised with COVID-19.MethodWe included hospitalised COVID-19 patients registered in the Norwegian Patient Registry (NPR) or the Norwegian Pandemic Registry (NoPaR) with admission dates between 17 February 2020 and 1 May 2022. We linked patients, identified overlapping hospitalisation periods and described the overlap between the registries. We described the prevalence of International Classification of Diseases (ICD-10) diagnosis codes and their combinations by main cause of admission (clinically assessed as COVID-19 or other), age and time.ResultsIn the study period, 19,486 admissions with laboratory-confirmed COVID-19 were registered in NoPaR and 21,035 with the corresponding ICD-10 code U07.1 in NPR. Up to late 2021, there was a 90-100% overlap between the registries, which thereafter decreased to < 75%. The prevalence of ICD-10 codes varied by reported main cause, age and time.ConclusionChanges in patient cohorts, virus characteristics and the management of COVID-19 patients from late 2021 impacted the registration of patients and coding practices in the registries. Using ICD-10 codes for the surveillance of persons hospitalised due to COVID-19 requires age- and time-specific definitions and ongoing validation to consider temporal changes in patient cohorts and virus characteristics.
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Affiliation(s)
- Robert Whittaker
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Salla Toikkanen
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Katharine Dean
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Trude Marie Lyngstad
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | - Eirik Alnes Buanes
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
- Norwegian Intensive Care and Pandemic Registry, Haukeland University Hosspital, Bergen, Norway
| | - Hilde Kløvstad
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Trine Hessevik Paulsen
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Elina Seppälä
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
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Brogna B, Bignardi E, Megliola A, Laporta A, La Rocca A, Volpe M, Musto LA. A Pictorial Essay Describing the CT Imaging Features of COVID-19 Cases throughout the Pandemic with a Special Focus on Lung Manifestations and Extrapulmonary Vascular Abdominal Complications. Biomedicines 2023; 11:2113. [PMID: 37626610 PMCID: PMC10452395 DOI: 10.3390/biomedicines11082113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023] Open
Abstract
With the Omicron wave, SARS-CoV-2 infections improved, with less lung involvement and few cases of severe manifestations. In this pictorial review, there is a summary of the pathogenesis with particular focus on the interaction of the immune system and gut and lung axis in both pulmonary and extrapulmonary manifestations of COVID-19 and the computed tomography (CT) imaging features of COVID-19 pneumonia from the beginning of the pandemic, describing the typical features of COVID-19 pneumonia following the Delta variant and the atypical features appearing during the Omicron wave. There is also an outline of the typical features of COVID-19 pneumonia in cases of breakthrough infection, including secondary lung complications such as acute respiratory distress disease (ARDS), pneumomediastinum, pneumothorax, and lung pulmonary thromboembolism, which were more frequent during the first waves of the pandemic. Finally, there is a description of vascular extrapulmonary complications, including both ischemic and hemorrhagic abdominal complications.
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Affiliation(s)
- Barbara Brogna
- Department of Interventional and Emergency Radiology, San Giuseppe Moscati Hospital, 83100 Avellino, Italy; (A.L.); (A.L.R.); (L.A.M.)
| | - Elio Bignardi
- Department of Radiology, Francesco Ferrari Hospital, ASL Lecce, 73042 Casarano, Italy;
| | - Antonia Megliola
- Radiology Unit, “Frangipane” Hospital, ASL Avellino, 83031 Ariano Irpino, Italy; (A.M.); (M.V.)
| | - Antonietta Laporta
- Department of Interventional and Emergency Radiology, San Giuseppe Moscati Hospital, 83100 Avellino, Italy; (A.L.); (A.L.R.); (L.A.M.)
| | - Andrea La Rocca
- Department of Interventional and Emergency Radiology, San Giuseppe Moscati Hospital, 83100 Avellino, Italy; (A.L.); (A.L.R.); (L.A.M.)
| | - Mena Volpe
- Radiology Unit, “Frangipane” Hospital, ASL Avellino, 83031 Ariano Irpino, Italy; (A.M.); (M.V.)
| | - Lanfranco Aquilino Musto
- Department of Interventional and Emergency Radiology, San Giuseppe Moscati Hospital, 83100 Avellino, Italy; (A.L.); (A.L.R.); (L.A.M.)
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Lee JE, Hwang M, Kim YH, Chung MJ, Jeong WG, Sim BH, Jeong YJ. Comparison of Clinical Outcomes and Imaging Features in Hospitalized Patients with SARS-CoV-2 Omicron Subvariants. Radiology 2023; 308:e230653. [PMID: 37462497 DOI: 10.1148/radiol.230653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Background Differences in the clinical and radiological characteristics of SARS-CoV-2 Omicron subvariants have not been well studied. Purpose To compare clinical disease severity and radiologically severe pneumonia in patients with COVID-19 hospitalized during a period of either Omicron BA.1/BA.2 or Omicron BA.5 subvariant predominance. Materials and Methods This multicenter retrospective study, included patients registered in the Korean Imaging Cohort of COVID-19 database who were hospitalized for COVID-19 between January and December 2022. Publicly available relative variant genome frequency data were used to determine the dominant periods of Omicron BA.1/BA.2 subvariants (January 17 to June 20, 2022) and the Omicron BA.5 subvariant (July 4 to December 5, 2022). Clinical outcomes and imaging pneumonia outcomes based on chest radiography and CT were compared among predominant subvariants using multivariable analyses adjusted for covariates. Results Of 1916 confirmed patients with COVID-19 (mean age, 72 years ± 16 [SD]; 1019 males), 1269 were registered during the Omicron BA.1/BA.2 subvariant dominant period and 647 during the Omicron BA.5 subvariant dominant period. Patients in the BA.5 group showed lower odds of high-flow O2 requirement (adjusted odds ratio [OR], 0.75 [95% CI: 0.57, 0.99]; P = .04), mechanical ventilation (adjusted OR, 0.49 [95% CI: 0.34, 0.72]; P < .001]), and death (adjusted OR, 0.47 [95% CI: 0.33, 0.68]; P <.001) than those in the BA.1/BA.2 group. Additionally, the BA.5 group had lower odds of severe pneumonia on chest radiographs (adjusted OR, 0.68 [95% CI: 0.53, 0.88]; P = .004) and higher odds of atypical pattern pneumonia on CT images (adjusted OR, 1.81 [95% CI: 1.26, 2.58]; P = .001) than the BA.1/BA.2 group. Conclusions Patients hospitalized during the period of Omicron BA.5 subvariant predominance had lower odds of clinical and pneumonia severity than those hospitalized during the period of Omicron BA.1/BA.2 predominance, even after adjusting for covariates. See also the editorial by Hammer in this issue.
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Affiliation(s)
- Jong Eun Lee
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Minhee Hwang
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Biomedical Research Institute, Busan, Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Jin Chung
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Won Gi Jeong
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Byeong Hak Sim
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Yeon Joo Jeong
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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Masci GM, Izzo A, Bonito G, Marchitelli L, Guiducci E, Ciaglia S, Lucchese S, Corso L, Valenti A, Malzone L, Pasculli P, Ciardi MR, La Torre G, Galardo G, Alessandri F, Vullo F, Manganaro L, Iafrate F, Catalano C, Ricci P. Chest CT features of COVID-19 in vaccinated versus unvaccinated patients: use of CT severity score and outcome analysis. LA RADIOLOGIA MEDICA 2023:10.1007/s11547-023-01664-z. [PMID: 37354309 DOI: 10.1007/s11547-023-01664-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES To evaluate the impact of vaccination on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and moreover on coronavirus disease 2019 (COVID-19) pneumonia, by assessing the extent of lung disease using the CT severity score (CTSS). METHODS Between September 2021 and February 2022, SARS-CoV-2 positive patients who underwent chest CT were retrospectively enrolled. Anamnestic and clinical data, including vaccination status, were obtained. All CT scans were evaluated by two readers using the CTSS, based on a 25-point scale. Univariate and multivariate logistic regression analyses were performed to evaluate the associations between CTSS and clinical or demographic variables. An outcome analysis was used to differentiate clinical outcome between vaccinated and unvaccinated patients. RESULTS Of the 1040 patients (537 males, 503 females; median age 58 years), 678 (65.2%) were vaccinated and 362 (34.8%) unvaccinated. Vaccinated patients showed significantly lower CTSS compared to unvaccinated patients (p < 0.001), also when patients without lung involvement (CTSS = 0) were excluded (p < 0.001). Older age, male gender and lower number of doses administered were associated with higher CTSS, however, in the multivariate analysis, vaccination status resulted to be the variable with the strongest association with CTSS. Clinical outcomes were significantly worse in unvaccinated patients, including higher number of ICU admissions and higher mortality rates. CONCLUSIONS Lung involvement during COVID-19 was significantly less severe in vaccinated patients compared with unvaccinated patients, who also showed worse clinical outcomes. Vaccination status was the strongest variable associated to the severity of COVID-related, more than age, gender, and number of doses administered.
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Affiliation(s)
- Giorgio Maria Masci
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Antonella Izzo
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Giacomo Bonito
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
- Unit of Emergency Radiology, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Livia Marchitelli
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Elisa Guiducci
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Simone Ciaglia
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Sonia Lucchese
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Laura Corso
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Alessandra Valenti
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Lucia Malzone
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Patrizia Pasculli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Maria Rosa Ciardi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - Gioacchino Galardo
- Medical Emergency Unit, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Francesco Alessandri
- Department of Anaesthesiology Critical Care Medicine and Pain Therapy, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Francesco Vullo
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
- Unit of Emergency Radiology, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Lucia Manganaro
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Franco Iafrate
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Carlo Catalano
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Paolo Ricci
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
- Unit of Emergency Radiology, Policlinico Umberto I, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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19
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Nukovic JA, Opancina V, Zdravkovic N, Prodanovic N, Pejcic A, Opancina M, Nukovic JJ, Vojinovic R, Dulovic D, Jukovic F, Hamzagic N, Nukovic M, Markovic NV. Brixia Chest X-ray Score, Laboratory Parameters and Vaccination Status for Prediction of Mortality in COVID-19 Hospitalized Patients. Diagnostics (Basel) 2023; 13:2122. [PMID: 37371019 DOI: 10.3390/diagnostics13122122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/23/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Chest X-ray has verified its role as a crucial tool in COVID-19 assessment due to its practicability, especially in emergency units, and Brixia score has proven as a useful tool for COVID-19 pneumonia grading. The aim of our study was to investigate correlations between main laboratory parameters, vaccination status, and Brixia score, as well as to confirm if Brixia score is a significant independent predictor of unfavorable outcome (death) in COVID-19 patients. The study was designed as a cross-sectional multicentric study. It included patients with a diagnosed COVID-19 infection who were hospitalized. This study included a total of 279 patients with a median age of 62 years. The only significant predictor of unfavorable outcome (death) was Brixia score (adjusted odds ratio 1.148, p = 0.022). In addition, the results of the multiple linear regression analysis (R2 = 0.334, F = 19.424, p < 0.001) have shown that male gender (B = 0.903, p = 0.046), severe COVID-19 (B = 1.970, p < 0.001), and lactate dehydrogenase (B = 0.002, p < 0.001) were significant positive predictors, while albumin level (B = -0.211, p < 0.001) was a significant negative predictor of Brixia score. Our results provide important information about factors influencing Brixia score and its usefulness in predicting the unfavorable outcome (death) of COVID-19 patients. These findings have clinical relevance, especially in epidemic circumstances.
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Affiliation(s)
- Jusuf A Nukovic
- Faculty of Pharmacy and Health Travnik, University of Travnik, 72270 Travnik, Bosnia and Herzegovina
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | - Valentina Opancina
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
| | - Nebojsa Zdravkovic
- Department of Medical Statistics and Informatics, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Nikola Prodanovic
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Ana Pejcic
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
| | - Miljan Opancina
- Department of Medical Statistics and Informatics, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- Military Medical Academy, Faculty of Medicine, University of Defense, 11000 Belgrade, Serbia
| | - Jasmin J Nukovic
- Faculty of Pharmacy and Health Travnik, University of Travnik, 72270 Travnik, Bosnia and Herzegovina
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | - Radisa Vojinovic
- Department of Radiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
| | - Dragan Dulovic
- Military Medical Academy, Faculty of Medicine, University of Defense, 11000 Belgrade, Serbia
| | - Fehim Jukovic
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | | | - Merisa Nukovic
- Department of Radiology, General Hospital Novi Pazar, 36300 Novi Pazar, Serbia
| | - Nenad V Markovic
- University Clinical Center Kragujevac, 34000 Kragujevac, Serbia
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia
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20
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Crombé A, Bensid L, Seux M, Fadli D, Arnaud F, Benhamed A, Banaste N, Gorincour G. Impact of Vaccination and the Omicron Variant on COVID-19-related Chest CT Findings: A Multicenter Study. Radiology 2023. [PMID: 36880948 DOI: 10.1148/radiol.222730:222730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Background The SARS-CoV-2 Omicron variant has a higher infection rate than previous variants but results in less severe disease. However, the effects of Omicron and vaccination on chest CT findings are difficult to evaluate. Purpose To investigate the effect of vaccination status and predominant variant on chest CT findings, diagnostic scores, and severity scores in a multicenter sample of consecutive patients referred to emergency departments for proven COVID-19. Materials and Methods This retrospective multicenter study included adults referred to 93 emergency departments with SARS-CoV-2 infection according to a reverse-transcriptase polymerase chain reaction test and known vaccination status between July 2021 and March 2022. Clinical data and structured chest CT reports, including semiquantitative diagnostic and severity scores following the French Society of Radiology-Thoracic Imaging Society guidelines, were extracted from a teleradiology database. Observations were divided into Delta-predominant, transition, and Omicron-predominant periods. Associations between scores and variant and vaccination status were investigated with χ2 tests and ordinal regressions. Multivariable analyses evaluated the influence of Omicron variant and vaccination status on the diagnostic and severity scores. Results Overall, 3876 patients were included (median age, 68 years [quartile 1 to quartile 3 range, 54-80]; 1695 women). Diagnostic and severity scores were associated with the predominant variant (Delta vs Omicron, χ2 = 112.4 and 33.7, respectively; both P < .001) and vaccination status (χ2 = 243.6 and 210.1; both P < .001) and their interaction (χ2 = 4.3 [P = .04] and 28.7 [P < .001], respectively). In multivariable analyses, Omicron variant was associated with lower odds of typical CT findings than was Delta variant (odds ratio [OR], 0.46; P < .001). Two and three vaccine doses were associated with lower odds of demonstrating typical CT findings (OR, 0.32 and 0.20, respectively; both P < .001) and of having high severity score (OR, 0.47 and 0.33, respectively; both P < .001), compared with unvaccinated patients. Conclusion Both the Omicron variant and vaccination were associated with less typical chest CT manifestations of COVID-19 and lesser extent of disease. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Yoon and Goo in this issue.
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Affiliation(s)
- Amandine Crombé
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
| | - Lounès Bensid
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
| | - Mylène Seux
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
| | - David Fadli
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
| | - François Arnaud
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
| | - Axel Benhamed
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
| | - Nathan Banaste
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
| | - Guillaume Gorincour
- From IMADIS, 48 rue Quivogne, Lyon 69002, France (A.C., L.B., M.S., D.F., F.A., N.B., G.G.); Department of Radiology, Pellegrin University Hospital and Bordeaux University, Bordeaux, France (A.C., D.F.); Ramsay Generale de Sante, Hopital Prive Clairval, Marseille, France (F.A.); Service SAMU-Urgences, Centre Hospitalier Universitaire Edouard Herriot, Hospices Civils de Lyon, Lyon, France (A.B.); Ramsay Generale de Sante, Clinique Convert, Bourg-en-Bresse, France (N.B.); and ELSAN, Clinique Bouchard, Marseille, France (G.G.)
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21
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Askani E, Mueller-Peltzer K, Madrid J, Knoke M, Hasic D, Schlett CL, Bamberg F, Agarwal P. Pulmonary computed tomographic manifestations of COVID-19 in vaccinated and non-vaccinated patients. Sci Rep 2023; 13:6884. [PMID: 37105996 PMCID: PMC10134716 DOI: 10.1038/s41598-023-33942-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/21/2023] [Indexed: 04/29/2023] Open
Abstract
This study aimed to analyze computed tomographic (CT) imaging features of vaccinated and non-vaccinated COVID-19 patients. The study population of this retrospective single-center cohort study consisted of hospitalized COVID-19 patients who received a chest CT at the study site between July 2021 and February 2022. Qualitative scoring systems (RSNA, CO-RADS, COV-RADS), imaging pattern analysis and semi-quantitative scoring of lung changes were assessed. 105 patients (70,47% male, 62.1 ± 16.79 years, 53.3% fully vaccinated) were included in the data analysis. A significant association between vaccination status and the presence of the crazy-paving pattern was observed in univariate analysis and persisted after step-wise adjustment for possible confounders in multivariate analysis (RR: 2.19, 95% CI: [1.23, 2.62], P = 0.024). Scoring systems for probability assessment of the presence of COVID-19 infection showed a significant correlation with the vaccination status in univariate analysis; however, the associations were attenuated after adjustment for virus variant and stage of infection. Semi-quantitative assessment of lung changes due to COVID-19 infection revealed no association with vaccination status. Non-vaccinated patients showed a two-fold higher probability of the crazy-paving pattern compared to vaccinated patients. COVID-19 variants could have a significant impact on the CT-graphic appearance of COVID-19.
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Affiliation(s)
- Esther Askani
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany.
| | - Katharina Mueller-Peltzer
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Julian Madrid
- Department of Cardiology, Pneumology, Angiology and Intensive Care, Ortenau Klinikum, Lahr, Germany
| | - Marvin Knoke
- Department of Protestant Theology, Faculty of Theology, University of Heidelberg, Heidelberg, Germany
| | - Dunja Hasic
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Christopher L Schlett
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
| | - Prerana Agarwal
- Department of Diagnostic and Interventional Radiology, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg im Breisgau, Freiburg, Germany
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22
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Huang H, Zheng J, Liu Y, Zhou Q, Peng D. Effect of vitamin D status on adult COVID-19 pneumonia induced by Delta variant: A longitudinal, real-world cohort study. Front Med (Lausanne) 2023; 10:1121256. [PMID: 37035323 PMCID: PMC10080157 DOI: 10.3389/fmed.2023.1121256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
OBJECTIVE The effect of vitamin D status on adult COVID-19 pneumonia induced by Delta variant remains to be further explored. METHODS A longitudinal, real-world cohort study was performed. Artificial intelligence (AI) was used to identify and measure pneumonia lesions. All cases with pneumonia were divided into the vitamin D deficiency (VDD) and control groups according to serum 25-hydroxyvitamin D concentration. Lesion dynamics were observed within six time periods after the onset of pneumonia. RESULTS A total of 161 cases were included, of which 101 (63%) were male and 46 (29%) presented with pneumonia. The median age and baseline 25-hydroxyvitamin D concentrations were 37 years and 21 ng/ml, respectively. Age, fibrinogen, and SARS-CoV-2 IgG titer on admission were independent predictors for the onset of pneumonia. After the onset of pneumonia, patients in the VDD group (n = 18) had higher percentage of fever (33 vs. 7.1%; p = 0.04) than those in the control group (n = 28); the interval of pneumonia resolution was longer (28 vs. 21 days; p = 0.02); lesions progressed more rapidly (p = 0.01) within 3 to 7 days and improved more slowly (p = 0.007) within more than 28 days; notably, simultaneous interleukin-6 (18.7 vs. 14.6 pg/ml; p = 0.04) levels were higher, and cycle thresholds for N gene (22.8 vs. 31.3; p = 0.04) and ORF1ab gene (20.9 vs. 28.7; p = 0.03) were lower within 3 to 7 days. CONCLUSION Vitamin D status may have effects on the progression and resolution, but not the onset of Delta variant-induced pneumonia in adults. Computed tomography image diagnosis system based on AI may have promising applications in the surveillance and diagnosis of novel SARS-CoV-2 variant-induced pneumonia.
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Affiliation(s)
- Hua Huang
- Department of Radiology, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Jiawei Zheng
- Department of Emergency Medicine, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Yan Liu
- Department of Emergency Medicine, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Qunhe Zhou
- Department of General Practice, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Denggao Peng
- Department of Emergency Medicine, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
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23
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Yoon SH, Goo JM. Changes in COVID-19 CT Manifestations with Vaccination and the Omicron Variant. Radiology 2023; 307:e230454. [PMID: 36880953 PMCID: PMC10031569 DOI: 10.1148/radiol.230454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Soon Ho Yoon
- Department of Radiology, Seoul National University Hospital, Seoul
National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul,
03080, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University Hospital, Seoul
National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul,
03080, Korea
- Institute of Radiation Medicine, Seoul National University Medical
Research Center, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Korea
- Cancer Research Institute, Seoul National University, 101, Daehak-ro,
Jongno-gu, Seoul, 03080, Korea
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24
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Lee JE, Hwang M, Kim YH, Chung MJ, Sim BH, Jeong WG, Jeong YJ. SARS-CoV-2 Variants Infection in Relationship to Imaging-based Pneumonia and Clinical Outcomes. Radiology 2023; 306:e221795. [PMID: 36165791 PMCID: PMC9527969 DOI: 10.1148/radiol.221795] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/03/2022] [Accepted: 09/13/2022] [Indexed: 11/11/2022]
Abstract
Background Few reports have evaluated the effect of the SARS-CoV-2 variant and vaccination on the clinical and imaging features of COVID-19. Purpose To evaluate and compare the effect of vaccination and variant prevalence on the clinical and imaging features of infections by the SARS-CoV-2. Materials and Methods Consecutive adults hospitalized for confirmed COVID-19 at three centers (two academic medical centers and one community hospital) and registered in a nationwide open data repository for COVID-19 between August 2021 and March 2022 were retrospectively included. All patients had available chest radiographs or CT images. Patients were divided into two groups according to predominant variant type over the study period. Differences between clinical and imaging features were analyzed with use of the Pearson χ2 test, Fisher exact test, or the independent t test. Multivariable logistic regression analyses were used to evaluate the effect of variant predominance and vaccination status on imaging features of pneumonia and clinical severity. Results Of the 2180 patients (mean age, 57 years ± 21; 1171 women), 1022 patients (47%) were treated during the Delta variant predominant period and 1158 (53%) during the Omicron period. The Omicron variant prevalence was associated with lower pneumonia severity based on CT scores (odds ratio [OR], 0.71 [95% CI: 0.51, 0.99; P = .04]) and lower clinical severity based on intensive care unit (ICU) admission or in-hospital death (OR, 0.43 [95% CI: 0.24, 0.77; P = .004]) than the Delta variant prevalence. Vaccination was associated with the lowest odds of severe pneumonia based on CT scores (OR, 0.05 [95% CI: 0.03, 0.13; P < .001]) and clinical severity based on ICU admission or in-hospital death (OR, 0.15 [95% CI: 0.07, 0.31; P < .001]) relative to no vaccination. Conclusion The SARS-CoV-2 Omicron variant prevalence and vaccination were associated with better clinical outcomes and lower severe pneumonia risk relative to Delta variant prevalence. © RSNA, 2022 Supplemental material is available for this article. See also the editorial by Little in this issue.
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Affiliation(s)
- Jong Eun Lee
- From the Department of Radiology, Chonnam National University
Hospital, Gwangju, Korea (J.E.L., Y.H.K.); Department of Radiology, Pusan
National University Hospital, Pusan National University School of Medicine and
Biomedical Research Institute, Busan, Korea (M.H.); Department of Radiology and
Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea (M.J.C.); Department of Radiology, Namwon
Medical Center, Namwon, Korea (B.H.S.); Department of Radiology, Chonnam
National University Hwasun Hospital, Chonnam National University Medical School,
Hwasun, Korea (W.G.J.); and Department of Radiology, Research Institute for
Convergence of Biomedical Science and Technology, Pusan National University
Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro,
Mulgeum-eup, Yangsan 50612, Korea (Y.J.J.)
| | - Minhee Hwang
- From the Department of Radiology, Chonnam National University
Hospital, Gwangju, Korea (J.E.L., Y.H.K.); Department of Radiology, Pusan
National University Hospital, Pusan National University School of Medicine and
Biomedical Research Institute, Busan, Korea (M.H.); Department of Radiology and
Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea (M.J.C.); Department of Radiology, Namwon
Medical Center, Namwon, Korea (B.H.S.); Department of Radiology, Chonnam
National University Hwasun Hospital, Chonnam National University Medical School,
Hwasun, Korea (W.G.J.); and Department of Radiology, Research Institute for
Convergence of Biomedical Science and Technology, Pusan National University
Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro,
Mulgeum-eup, Yangsan 50612, Korea (Y.J.J.)
| | - Yun-Hyeon Kim
- From the Department of Radiology, Chonnam National University
Hospital, Gwangju, Korea (J.E.L., Y.H.K.); Department of Radiology, Pusan
National University Hospital, Pusan National University School of Medicine and
Biomedical Research Institute, Busan, Korea (M.H.); Department of Radiology and
Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea (M.J.C.); Department of Radiology, Namwon
Medical Center, Namwon, Korea (B.H.S.); Department of Radiology, Chonnam
National University Hwasun Hospital, Chonnam National University Medical School,
Hwasun, Korea (W.G.J.); and Department of Radiology, Research Institute for
Convergence of Biomedical Science and Technology, Pusan National University
Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro,
Mulgeum-eup, Yangsan 50612, Korea (Y.J.J.)
| | - Myung Jin Chung
- From the Department of Radiology, Chonnam National University
Hospital, Gwangju, Korea (J.E.L., Y.H.K.); Department of Radiology, Pusan
National University Hospital, Pusan National University School of Medicine and
Biomedical Research Institute, Busan, Korea (M.H.); Department of Radiology and
Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea (M.J.C.); Department of Radiology, Namwon
Medical Center, Namwon, Korea (B.H.S.); Department of Radiology, Chonnam
National University Hwasun Hospital, Chonnam National University Medical School,
Hwasun, Korea (W.G.J.); and Department of Radiology, Research Institute for
Convergence of Biomedical Science and Technology, Pusan National University
Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro,
Mulgeum-eup, Yangsan 50612, Korea (Y.J.J.)
| | - Byeong Hak Sim
- From the Department of Radiology, Chonnam National University
Hospital, Gwangju, Korea (J.E.L., Y.H.K.); Department of Radiology, Pusan
National University Hospital, Pusan National University School of Medicine and
Biomedical Research Institute, Busan, Korea (M.H.); Department of Radiology and
Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea (M.J.C.); Department of Radiology, Namwon
Medical Center, Namwon, Korea (B.H.S.); Department of Radiology, Chonnam
National University Hwasun Hospital, Chonnam National University Medical School,
Hwasun, Korea (W.G.J.); and Department of Radiology, Research Institute for
Convergence of Biomedical Science and Technology, Pusan National University
Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro,
Mulgeum-eup, Yangsan 50612, Korea (Y.J.J.)
| | - Won Gi Jeong
- From the Department of Radiology, Chonnam National University
Hospital, Gwangju, Korea (J.E.L., Y.H.K.); Department of Radiology, Pusan
National University Hospital, Pusan National University School of Medicine and
Biomedical Research Institute, Busan, Korea (M.H.); Department of Radiology and
Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea (M.J.C.); Department of Radiology, Namwon
Medical Center, Namwon, Korea (B.H.S.); Department of Radiology, Chonnam
National University Hwasun Hospital, Chonnam National University Medical School,
Hwasun, Korea (W.G.J.); and Department of Radiology, Research Institute for
Convergence of Biomedical Science and Technology, Pusan National University
Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro,
Mulgeum-eup, Yangsan 50612, Korea (Y.J.J.)
| | - Yeon Joo Jeong
- From the Department of Radiology, Chonnam National University
Hospital, Gwangju, Korea (J.E.L., Y.H.K.); Department of Radiology, Pusan
National University Hospital, Pusan National University School of Medicine and
Biomedical Research Institute, Busan, Korea (M.H.); Department of Radiology and
Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea (M.J.C.); Department of Radiology, Namwon
Medical Center, Namwon, Korea (B.H.S.); Department of Radiology, Chonnam
National University Hwasun Hospital, Chonnam National University Medical School,
Hwasun, Korea (W.G.J.); and Department of Radiology, Research Institute for
Convergence of Biomedical Science and Technology, Pusan National University
Yangsan Hospital, Pusan National University School of Medicine, 20 Geumo-ro,
Mulgeum-eup, Yangsan 50612, Korea (Y.J.J.)
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Little BP. Variants and Vaccination of COVID-19: New Complexities for Chest Imaging Research and Clinical Practice. Radiology 2023; 306:e222478. [PMID: 36255314 PMCID: PMC9623732 DOI: 10.1148/radiol.222478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Brent P Little
- From the Department of Radiology, Division of Cardiothoracic Imaging, Mayo Clinic Florida, 4500 San Pablo Rd, Jacksonville, FL 32224
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26
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Jeong YJ, Wi YM, Park H, Lee JE, Kim SH, Lee KS. Current and Emerging Knowledge in COVID-19. Radiology 2023; 306:e222462. [PMID: 36625747 PMCID: PMC9846833 DOI: 10.1148/radiol.222462] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 01/11/2023]
Abstract
COVID-19 has emerged as a pandemic leading to a global public health crisis of unprecedented morbidity. A comprehensive insight into the imaging of COVID-19 has enabled early diagnosis, stratification of disease severity, and identification of potential sequelae. The evolution of COVID-19 can be divided into early infectious, pulmonary, and hyperinflammatory phases. Clinical features, imaging features, and management are different among the three phases. In the early stage, peripheral ground-glass opacities are predominant CT findings, and therapy directly targeting SARS-CoV-2 is effective. In the later stage, organizing pneumonia or diffuse alveolar damage pattern are predominant CT findings and anti-inflammatory therapies are more beneficial. The risk of severe disease or hospitalization is lower in breakthrough or Omicron variant infection compared with nonimmunized or Delta variant infections. The protection rates of the fourth dose of mRNA vaccination were 34% and 67% against overall infection and hospitalizations for severe illness, respectively. After acute COVID-19 pneumonia, most residual CT abnormalities gradually decreased in extent, but they may remain as linear or multifocal reticular or cystic lesions. Advanced insights into the pathophysiologic and imaging features of COVID-19 along with vaccine benefits have improved patient care, but emerging knowledge of post-COVID-19 condition, or long COVID, also presents radiology with new challenges.
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Affiliation(s)
- Yeon Joo Jeong
- From the Department of Radiology, Research Institute for Convergence
of Biomedical Science and Technology, Pusan National University Yangsan
Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.);
Division of Infectious Diseases, Department of Internal Medicine (Y.M.W.,
S.H.K.) and Department of Radiology (K.S.L.), Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon 51353, Korea;
Department of Electrical and Computer Engineering, Sungkyunkwan University,
Suwon, Korea (H.P.); Center for Neuroscience Imaging Research, Institute for
Basic Science, Suwon, Korea (H.P.); and Department of Radiology, Chonnam
National University Hospital, Gwangju, Korea (J.E.L.)
| | - Yu Mi Wi
- From the Department of Radiology, Research Institute for Convergence
of Biomedical Science and Technology, Pusan National University Yangsan
Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.);
Division of Infectious Diseases, Department of Internal Medicine (Y.M.W.,
S.H.K.) and Department of Radiology (K.S.L.), Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon 51353, Korea;
Department of Electrical and Computer Engineering, Sungkyunkwan University,
Suwon, Korea (H.P.); Center for Neuroscience Imaging Research, Institute for
Basic Science, Suwon, Korea (H.P.); and Department of Radiology, Chonnam
National University Hospital, Gwangju, Korea (J.E.L.)
| | - Hyunjin Park
- From the Department of Radiology, Research Institute for Convergence
of Biomedical Science and Technology, Pusan National University Yangsan
Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.);
Division of Infectious Diseases, Department of Internal Medicine (Y.M.W.,
S.H.K.) and Department of Radiology (K.S.L.), Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon 51353, Korea;
Department of Electrical and Computer Engineering, Sungkyunkwan University,
Suwon, Korea (H.P.); Center for Neuroscience Imaging Research, Institute for
Basic Science, Suwon, Korea (H.P.); and Department of Radiology, Chonnam
National University Hospital, Gwangju, Korea (J.E.L.)
| | - Jong Eun Lee
- From the Department of Radiology, Research Institute for Convergence
of Biomedical Science and Technology, Pusan National University Yangsan
Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.);
Division of Infectious Diseases, Department of Internal Medicine (Y.M.W.,
S.H.K.) and Department of Radiology (K.S.L.), Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon 51353, Korea;
Department of Electrical and Computer Engineering, Sungkyunkwan University,
Suwon, Korea (H.P.); Center for Neuroscience Imaging Research, Institute for
Basic Science, Suwon, Korea (H.P.); and Department of Radiology, Chonnam
National University Hospital, Gwangju, Korea (J.E.L.)
| | - Si-Ho Kim
- From the Department of Radiology, Research Institute for Convergence
of Biomedical Science and Technology, Pusan National University Yangsan
Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.);
Division of Infectious Diseases, Department of Internal Medicine (Y.M.W.,
S.H.K.) and Department of Radiology (K.S.L.), Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon 51353, Korea;
Department of Electrical and Computer Engineering, Sungkyunkwan University,
Suwon, Korea (H.P.); Center for Neuroscience Imaging Research, Institute for
Basic Science, Suwon, Korea (H.P.); and Department of Radiology, Chonnam
National University Hospital, Gwangju, Korea (J.E.L.)
| | - Kyung Soo Lee
- From the Department of Radiology, Research Institute for Convergence
of Biomedical Science and Technology, Pusan National University Yangsan
Hospital, Pusan National University School of Medicine, Yangsan, Korea (Y.J.J.);
Division of Infectious Diseases, Department of Internal Medicine (Y.M.W.,
S.H.K.) and Department of Radiology (K.S.L.), Samsung Changwon Hospital,
Sungkyunkwan University School of Medicine (SKKU-SOM), Changwon 51353, Korea;
Department of Electrical and Computer Engineering, Sungkyunkwan University,
Suwon, Korea (H.P.); Center for Neuroscience Imaging Research, Institute for
Basic Science, Suwon, Korea (H.P.); and Department of Radiology, Chonnam
National University Hospital, Gwangju, Korea (J.E.L.)
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Rizzetto F, Gnocchi G, Travaglini F, Di Rocco G, Rizzo A, Carbonaro LA, Vanzulli A. Impact of COVID-19 Pandemic on the Workload of Diagnostic Radiology: A 2-Year Observational Study in a Tertiary Referral Hospital. Acad Radiol 2023; 30:276-284. [PMID: 35781400 PMCID: PMC9186449 DOI: 10.1016/j.acra.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate the impact of COVID-19 pandemic on diagnostic imaging workload in a tertiary referral hospital. MATERIALS AND METHODS Radiological examinations performed in pre-pandemic period (2015-2019) and in pandemic period (2020-2021) were retrospectively included. Based on epidemiological data and restriction measures, four pandemic waves were identified. For each of them, the relative change (RC) in workload was calculated and compared to the 5-year averaged workload in the corresponding pre-COVID-19 periods. Workload variations were also assessed according to technique (radiographs, CT, MRI, ultrasounds), body district (chest, abdomen, breast, musculoskeletal, head/neck, brain/spine, cardiovascular) and care setting (inpatient, outpatient, emergency imaging, pre-admission imaging). RESULTS A total of 1384380 examinations were included. In 2020 imaging workload decreased (RC = -11%) compared to the average of the previous 5 years, while in 2021 only a minimal variation (RC = +1%) was observed. During first wave, workload was reduced for all modalities, body regions and types of care setting (RC from -86% to -10%), except for CT (RC = +3%). In subsequent waves, workload increased only for CT (mean RC = +18%) and, regarding body districts, for breast (mean RC = +23%) and cardiovascular imaging (mean RC = +23%). For all other categories, a workload comparable to pre-pandemic period was almost only restored in the fourth wave. In all pandemics periods workload decrease was mainly due to reduced outpatient activity (p < 0.001), while inpatient and emergency imaging was increased (p < 0.001). CONCLUSION Evaluating imaging workload changes throughout COVID-19 pandemic helps to understand the response dynamics of radiological services and to improve institutional preparedness to face extreme contingency.
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Affiliation(s)
- Francesco Rizzetto
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy.
| | - Giulia Gnocchi
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Francesca Travaglini
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Gabriella Di Rocco
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Aldo Rizzo
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Luca Alessandro Carbonaro
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Angelo Vanzulli
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
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Zorzi G, Berta L, Rizzetto F, De Mattia C, Felisi MMJ, Carrazza S, Nerini Molteni S, Vismara C, Scaglione F, Vanzulli A, Torresin A, Colombo PE. Artificial intelligence for differentiating COVID-19 from other viral pneumonias on CT: comparative analysis of different models based on quantitative and radiomic approaches. Eur Radiol Exp 2023; 7:3. [PMID: 36690869 PMCID: PMC9870776 DOI: 10.1186/s41747-022-00317-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/15/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND To develop a pipeline for automatic extraction of quantitative metrics and radiomic features from lung computed tomography (CT) and develop artificial intelligence (AI) models supporting differential diagnosis between coronavirus disease 2019 (COVID-19) and other viral pneumonia (non-COVID-19). METHODS Chest CT of 1,031 patients (811 for model building; 220 as independent validation set (IVS) with positive swab for severe acute respiratory syndrome coronavirus-2 (647 COVID-19) or other respiratory viruses (384 non-COVID-19) were segmented automatically. A Gaussian model, based on the HU histogram distribution describing well-aerated and ill portions, was optimised to calculate quantitative metrics (QM, n = 20) in both lungs (2L) and four geometrical subdivisions (GS) (upper front, lower front, upper dorsal, lower dorsal; n = 80). Radiomic features (RF) of first (RF1, n = 18) and second (RF2, n = 120) order were extracted from 2L using PyRadiomics tool. Extracted metrics were used to develop four multilayer-perceptron classifiers, built with different combinations of QM and RF: Model1 (RF1-2L); Model2 (QM-2L, QM-GS); Model3 (RF1-2L, RF2-2L); Model4 (RF1-2L, QM-2L, GS-2L, RF2-2L). RESULTS The classifiers showed accuracy from 0.71 to 0.80 and area under the receiving operating characteristic curve (AUC) from 0.77 to 0.87 in differentiating COVID-19 versus non-COVID-19 pneumonia. Best results were associated with Model3 (AUC 0.867 ± 0.008) and Model4 (AUC 0.870 ± 0.011. For the IVS, the AUC values were 0.834 ± 0.008 for Model3 and 0.828 ± 0.011 for Model4. CONCLUSIONS Four AI-based models for classifying patients as COVID-19 or non-COVID-19 viral pneumonia showed good diagnostic performances that could support clinical decisions.
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Affiliation(s)
- Giulia Zorzi
- Postgraduate School of Medical Physics, Università degli Studi di Milano, via Giovanni Celoria 16, 20133, Milan, Italy
- Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
- Department of Physics, INFN Sezione di Milano, via Giovanni Celoria 16, 20133, Milan, Italy
| | - Luca Berta
- Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
| | - Francesco Rizzetto
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milan, Italy.
- Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
| | - Cristina De Mattia
- Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Marco Maria Jacopo Felisi
- Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Stefano Carrazza
- Department of Physics, INFN Sezione di Milano, via Giovanni Celoria 16, 20133, Milan, Italy
- Department of Physics, Università degli Studi di Milano, via Giovanni Celoria 16, 20133, Milan, Italy
| | - Silvia Nerini Molteni
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Chiara Vismara
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Francesco Scaglione
- Chemical-Clinical and Microbiological Analyses, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milan, Italy
| | - Angelo Vanzulli
- Department of Radiology, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, via Festa del Perdono 7, 20122, Milan, Italy
| | - Alberto Torresin
- Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
- Department of Physics, INFN Sezione di Milano, via Giovanni Celoria 16, 20133, Milan, Italy
- Department of Physics, Università degli Studi di Milano, via Giovanni Celoria 16, 20133, Milan, Italy
| | - Paola Enrica Colombo
- Department of Medical Physics, ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
- Department of Physics, Università degli Studi di Milano, via Giovanni Celoria 16, 20133, Milan, Italy
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Abstract
A patient with severe COVID-19 pneumonia requiring ICU admission and prolonged hospital stay is presented. The infection resulted in long term morbidity, functional decline and abnormal chest CT findings. Mechanisms for long term lung injury post COVID-19 infection, imaging appearances and role of imaging in follow-up are discussed.
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Affiliation(s)
- Mark C. Murphy
- Fellow in Cardiothoracic Imaging and Intervention Massachusetts
General Hospital, Boston
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Topal Ü, Yılmaz G, Şahin AS. Are the thorax Computed Tomography findings of ICU patients diagnosed with COVID-19 pneumonia related to the duration of hospital stay and mortality? J Infect Chemother 2023; 29:495-501. [PMID: 36627082 PMCID: PMC9825141 DOI: 10.1016/j.jiac.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/06/2022] [Accepted: 12/31/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Quantitative thorax Computed Tomography (CT) is used to determine the severity of COVID-19 pneumonia. With a new approach, quantitative thoracic CT is to contribute to the triage of patients with severe COVID-19 pneumonia in the ICU and to evaluate its relation with mortality by taking into account the vaccination status. METHODS Fifty-six patients who had a diagnosis of COVID-19 pneumonia confirmed in the adult ICU were evaluated retrospectively. To evaluate the degree of parenchymal involvement, the quantitative CT "craniocaudal diameter of the thorax/craniocaudal largest lesion diameter (CCDT/CCDL)" ratio and semi-quantitative total CT severity scores (TCTSS) (0:0%; 1:1-25%; 2:26-50%; 3:51-75% and 4:76-100%) were calculated. Both methods were analyzed with comparative ROC curves for predicting mortality. The effects of vaccines on thorax CT findings and laboratory parameters were also investigated. RESULTS The sensitivities and specificities were found to be 72.5%, 75.61%, and 80%, 73.33% when CCDT/CCDL and TCTSS cutoff value was taken <1.4, and >9, respectively, to predict mortality in COVID-19 pneumonia (Area Under the Curve = AUC = 0.797 and 0.752). Both methods predicted mortality well and no statistical differences were detected between them (p = 0.3618). In vaccinated patients, CRP was higher (p = 0.045), and LDH and ferritin were lower (p = 0.049, p = 0.004). The number of lobes involved was lower in the vaccinated group (p = 0.001). CONCLUSIONS The quantitative CT score (CCDT/CCDL) may play as important a role as TCTSS in diagnosing COVID-19 pneumonia, determining the severity of the disease, and predicting the related mortality. COVID-19 vaccines may affect laboratory parameters and cause less pneumonia on thoracic CT than in unvaccinated individuals.
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Affiliation(s)
- Ümmihan Topal
- Department of Radiology, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, 34303, Turkey,Corresponding author
| | - Gülseren Yılmaz
- Department of Anesthesiology and Reanimation, HSU, Kanuni Sultan Suleyman Education and Training Hospital, Istanbul, Turkey
| | - Ayça Sultan Şahin
- Department of Anesthesiology and Reanimation, HSU, Kanuni Sultan Suleyman Education and Training Hospital, Istanbul, Turkey
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Samir A, Altarawy D, Sweed RA, Abdel-Kerim AA. "Sinopharm", "Oxford-AstraZeneca", and "Pfizer-BioNTech" COVID-19 vaccinations: testing efficacy using lung CT-volumetry with comparative analysis of variance (ANOVA). THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2023. [PMCID: PMC9987394 DOI: 10.1186/s43055-023-00999-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Background Several clinical studies tested the efficacy of the different COVID-19 vaccinations while very few radiological researches targeted this issue before.
Aim of the work To verify the additive role of lung CT-Volumetry in testing the efficacy of three widely distributed COVID-19 vaccinations; namely the "Sinopharm", "Oxford-AstraZeneca", and "Pfizer-BioNTech" vaccinations, with comparative analysis of variance (ANOVA).
Results This study was retrospectively conducted on 341 COVID-19 patients during the period between June/2021 and March/2022. Based on the immunization status, they were divided into four groups; group (A) included 156/341 (46%) patients who did not receive any vaccination (control group), group (B) included 92/341 (27%) patients who received "Sinopharm" vaccine, group (C) included 55/341 (16%) patients who received "Oxford-AstraZeneca" vaccine, group (D) included 38/341 (11%) patients who received "Pfizer-BioNTech" vaccine. Every group was subdivided based on the medical history into three groups; group (1) patients without comorbidities, group (2) patients with comorbidities, and group (3) immunocompromised patients. Automated CT volumetry was calculated for the pathological lung parenchyma. Five CT-severity scores were provided (score 0 = 0%, score 1 = 1–25%, score 2 = 25–50%, score 3 = 51–75%, and score 4 = 76–100%). Analysis of variance (ANOVA) including Tukey HSD testing was utilized in comparison to the non-immunized patients. The "Phizer-Biontech" vaccine succeeded to eliminate severity in patients without and with comorbidity, and also decreased severity in immunocompromised patients (from 79 to 17%). The "Oxford-AstraZeneca" vaccine and to a lesser extent "Sinopharm" vaccine also decreased the clinical severity in patients with comorbidities and immunocompromised patients (from 15 to 9% & 10% as well as from 79 to 20% & 50% respectively). Significant variance was proved regarding the use of "Sinopharm", "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients without comorbidities (f-ratio averaged 4.0282, 10.8049, and 8.4404 respectively, also p-value averaged 0.04632, 0.001268, and 0.004294). Significant variance was proved regarding the use of "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients with comorbidities and immunocompromised patients (f-ratio averaged 4.7521, and 4.1682 as well as 11.7811, and 15.6 respectively, also p-value averaged 0.03492, and 0.04857, as well as both 0.003177, and 0.0009394 respectively, all < 0.05). No significant variance was proved regarding the use of the "Sinopharm" vaccine. Conclusions In addition to the decline of clinical severity rates & CT severity scores, a significant variance was proved regarding the use of the "Sinopharm", "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients without comorbidities. Significant variance was also proved regarding the use of the "Oxford-AstraZeneca" and "Phizer-Biontech" vaccines in patients with comorbidities and immunocompromised patients. Despite that, no significant variance could be proved regarding the use of the "Sinopharm" vaccine in these patients, it decreases the percentage of clinical severity and CT severity scores.
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Affiliation(s)
- Ahmed Samir
- grid.7155.60000 0001 2260 6941Department of Radio-Diagnosis, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Dina Altarawy
- grid.7155.60000 0001 2260 6941Department of Radio-Diagnosis, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rania Ahmed Sweed
- grid.7155.60000 0001 2260 6941Department of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Amr A. Abdel-Kerim
- grid.7155.60000 0001 2260 6941Department of Radio-Diagnosis, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Chest computed tomography of suspected COVID-19 pneumonia in the Emergency Department: comparative analysis between patients with different vaccination status. Pol J Radiol 2023; 88:e80-e88. [PMID: 36910888 PMCID: PMC9995244 DOI: 10.5114/pjr.2023.125010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/25/2022] [Indexed: 03/06/2023] Open
Abstract
Purpose To identify differences in chest computed tomography (CT) of the symptomatic coronavirus disease 2019 (COVID-19) population according to the patients' severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination status (non-vaccinated, vaccinated with incomplete or complete vaccination cycle). Material and methods CT examinations performed in the Emergency Department (ED) in May-November 2021 for suspected COVID-19 pneumonia with a positive SARS-CoV-2 test were retrospectively included. Personal data were compared for vaccination status. One 13-year experienced radiologist and two 4th-year radiology residents independently evaluated chest CT scans according to CO-RADS and ACR COVID classifications. In possible COVID-19 pneumonia cases, defined as CO-RADS 3 to 5 (ACR indeterminate and typical) by each reader, high involvement CT score (≥ 25%) and CT patterns (presence of ground glass opacities, consolidations, crazy paving areas) were compared for vaccination status. Results 184 patients with known vaccination status were included in the analysis: 111 non-vaccinated (60%) for SARS-CoV-2 infection, 21 (11%) with an incomplete vaccination cycle, and 52 (28%) with a complete vaccination cycle (6 different vaccine types). Multivariate logistic regression showed that the only factor predicting the absence of pneumonia (CO-RADS 1 and ACR negative cases) for the 3 readers was a complete vaccination cycle (OR = 12.8-13.1compared to non-vaccinated patients, p ≤ 0.032). Neither CT score nor CT patterns of possible COVID-19 pneumonia showed any statistically significant correlation with vaccination status for the 3 readers. Conclusions Symptomatic SARS-CoV-2-infected patients with a complete vaccination cycle had much higher odds of showing a negative CT chest examination in ED compared to non-vaccinated patients. Neither CT involvement nor CT patterns of interstitial pneumonia showed differences across different vaccination status.
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Ketai L, Febbo J, Busby HK, Sheehan EB. Community-Acquired Pneumonia: Postpandemic, Not Post-COVID-19. Semin Respir Crit Care Med 2022; 43:924-935. [PMID: 36442476 DOI: 10.1055/s-0042-1755186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic upended our approach to imaging community-acquired pneumonia, and this will alter our diagnostic algorithms for years to come. In light of these changes, it is worthwhile to consider several postpandemic scenarios of community-acquired pneumonia: (1) patient with pneumonia and recent positive COVID-19 testing; (2) patient with air space opacities and history of prior COVID-19 pneumonia (weeks earlier); (3) multifocal pneumonia with negative or unknown COVID-19 status; and (4) lobar or sublobar pneumonia with negative or unknown COVID-19 status. In the setting of positive COVID-19 testing and typical radiologic findings, the diagnosis of COVID-19 pneumonia is generally secure. The diagnosis prompts vigilance for thromboembolic disease acutely and, in severely ill patients, for invasive fungal disease. Persistent or recurrent air space opacities following COVID-19 infection may more often represent organizing pneumonia than secondary infection. When COVID-19 status is unknown or negative, widespread airway-centric disease suggests infection with mycoplasma, Haemophilus influenzae, or several respiratory viruses. Necrotizing pneumonia favors infection with pneumococcus, Staphylococcus, Klebsiella, and anaerobes. Lobar or sublobar pneumonia will continue to suggest the diagnosis of pneumococcus or consideration of other pathogens in the setting of local outbreaks. A positive COVID-19 test accompanied by these imaging patterns may suggest coinfection with one of the above pathogens, or when the prevalence of COVID-19 is very low, a false positive COVID-19 test. Clinicians may still proceed with testing for COVID-19 when radiologic patterns are atypical for COVID-19, dependent on the patient's exposure history and the local epidemiology of the virus.
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Affiliation(s)
- Loren Ketai
- Department of Radiology, University of New Mexico HSC, Albuquerque, New Mexico
| | - Jennifer Febbo
- Department of Radiology, University of New Mexico HSC, Albuquerque, New Mexico
| | - Hellen K Busby
- Department of Internal Medicine, Pulmonary Division, University of New Mexico HSC, Albuquerque, New Mexico
| | - Elyce B Sheehan
- Department of Internal Medicine, Pulmonary Division, University of New Mexico HSC, Albuquerque, New Mexico
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COVID-19 Vaccination reduced pneumonia severity. Eur J Radiol Open 2022; 9:100456. [PMID: 36386765 PMCID: PMC9650570 DOI: 10.1016/j.ejro.2022.100456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the effect of vaccinations and boosters on the severity of COVID-19 pneumonia on CT scans during the period of Delta and Omicron variants. Methods Retrospectively studied were 303 patients diagnosed with COVID-19 between July 2021 and February 2022, who had obtained at least one CT scan within 6 weeks around the COVID-19 diagnosis (-2 to +4 weeks). The severity of pneumonia was evaluated with a 6-point scale Pneumonia Score. The association between demographic and clinical data and vaccination status (booster/additional vaccination, complete vaccination and un-vaccination) and the difference between Pneumonia Scores by vaccination status were investigated. Results Of 303 patients (59.4 ± 16.3 years; 178 females), 62 (20 %) were in the booster/additional vaccination group, 117 (39 %) in the complete vaccination group, and 124 (41 %) in the unvaccinated group. Interobserver agreement of the Pneumonia Score was high (weighted kappa score = 0.875). Patients in the booster/additionally vaccinated group tended to be older (P = 0.0085) and have more underlying comorbidities (P < 0.0001), and the Pneumonia Scores were lower in the booster/additionally vaccinated [median 2 (IQR 0-4)] and completely vaccinated groups [median 3 (IQR 1-4)] than those in the unvaccinated group [median 4 (IQR 2-4)], respectively (P < 0.0001 and P < 0.0001, respectively). A multivariable linear analysis adjusted for confounding factors confirmed the difference. Conclusion Vaccinated patients, with or without booster/additional vaccination, had milder COVID-19 pneumonia on CT scans than unvaccinated patients during the period of Delta and Omicron variants. This study supports the efficacy of the vaccine against COVID-19 from a radiological perspective.
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Ufuk F, Savaş R. COVID-19 pneumonia: lessons learned, challenges, and preparing for the future. Diagn Interv Radiol 2022; 28:576-585. [PMID: 36550758 PMCID: PMC9885718 DOI: 10.5152/dir.2022.221881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/16/2022] [Indexed: 12/24/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a viral disease that causes life-threatening health problems during acute illness, causing a pandemic and millions of deaths. Although computed tomography (CT) was used as a diagnostic tool for COVID-19 in the early period of the pan demic due to the inaccessibility or long duration of the polymerase chain reaction tests, cur rent studies have revealed that CT scan should not be used to diagnose COVID-19. However, radiologic findings are vital in assessing pneumonia severity and investigating complications in patients with COVID-19. Long-term symptoms, also known as long COVID, in people recovering from COVID-19 affect patients' quality of life and cause global health problems. Herein, we aimed to summarize the lessons learned in COVID-19 pneumonia, the challenges in diagnosing the disease and complications, and the prospects for future studies.
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Affiliation(s)
- Furkan Ufuk
- From the Department of Radiology (F.U. ✉ ), School of Medicine, University of Pamukkale, Denizli, Turkey Department of Radiology (R.S.), School of Medicine, University of Ege, Izmir, Turkey.
| | - Recep Savaş
- From the Department of Radiology (F.U. ✉ ), School of Medicine, University of Pamukkale, Denizli, Turkey Department of Radiology (R.S.), School of Medicine, University of Ege, Izmir, Turkey.
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Vicini S, Bellini D, Iannarelli A, Rengo M, Pelle G, Ruggiero S, Fusco M, Ambrogi C, Carbone I. Pneumonia Frequency and Severity in Patients With Symptomatic COVID-19: Impact of mRNA and Adenovirus Vector Vaccines. AJR Am J Roentgenol 2022; 219:752-761. [PMID: 35642761 DOI: 10.2214/ajr.22.27843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND. Additional evidence of the role of COVID-19 vaccination in reducing pneumonia frequency and severity in the setting of breakthrough infection could help combat ongoing vaccine hesitancy. OBJECTIVE. The purpose of this article was to compare the frequency and severity of pneumonia on chest CT in patients with confirmed COVID-19 between patients who are unvaccinated and those who are fully vaccinated by messenger RNA (mRNA) or adenovirus vector vaccines. METHODS. This retrospective single-center study included 467 patients (250 men, 217 women; mean age, 65 ± 17 [SD] years) who underwent chest CT between December 15, 2021, and February 18, 2022, during hospitalization for symptomatic COVID-19, confirmed by reverse transcriptase-polymerase chain reaction assay. A total of 216 patients were unvaccinated, and 167 and 84 patients were fully vaccinated (defined as receipt of the second dose at least 14 days before COVID-19 diagnosis) by the BNT162b2 mRNA vaccine or the ChAdOx1-S adenovirus vector vaccine, respectively. Semiquantitative CT severity scores (CT-SS; 0-25 scale) were determined; CT-SS of 0 indicated absence of pneumonia. Presence of bilateral involvement was assessed in patients with pneumonia. Associations were explored between vaccination status and CT findings. RESULTS. The frequency of the absence of pneumonia was 15% (32/216) in unvaccinated patients, 29% (24/84) in patients fully vaccinated with ChAdOx1-S vaccine, and 51% (85/167) in patients fully vaccinated with BNT162b2 vaccine (unvaccinated and ChAdOx1-S vs BNT162b2: p < .001; unvaccinated vs ChAdOx1-S: p = .08). Mean CT-SS was significantly higher in unvaccinated patients (9.7 ± 6.1) than in patients fully vaccinated with BNT162b2 (5.2 ± 6.1) or ChAdOx1-S (6.2 ± 5.9) vaccine (both p < .001). Full vaccination was significantly associated with CT-SS independent of patient age and sex (estimate = -4.46; p < .001). Frequency of bilateral lung involvement was significantly higher in unvaccinated patients (158/184, 86%) and in patients fully vaccinated with ChAdOx1-S vaccine (54/60, 90%) than in patients fully vaccinated with BNT162b2 vaccine (47/82, 57%) (both p < .001). CONCLUSION. Pneumonia frequency and severity were lower in patients with full vaccination by mRNA and adenovirus vector vaccines who experienced breakthrough infections in comparison with unvaccinated patients. CLINICAL IMPACT. The visual observation by radiologic imaging of the protective effect of vaccination on lung injury in patients with breakthrough infections provides additional evidence supporting the clinical benefit of vaccination.
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Affiliation(s)
- Simone Vicini
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, I.C.O.T. Hospital, Via Franco Faggiana 1668, 04100, Latina, Italy
| | - Davide Bellini
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, I.C.O.T. Hospital, Via Franco Faggiana 1668, 04100, Latina, Italy
| | - Angelo Iannarelli
- Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, Latina, Italy
| | - Marco Rengo
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, I.C.O.T. Hospital, Via Franco Faggiana 1668, 04100, Latina, Italy
| | - Giuseppe Pelle
- Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, Latina, Italy
| | - Sergio Ruggiero
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, I.C.O.T. Hospital, Via Franco Faggiana 1668, 04100, Latina, Italy
| | - Michele Fusco
- Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, Latina, Italy
| | - Cesare Ambrogi
- Department of Diagnostic Imaging and Interventional Radiology, Santa Maria Goretti Hospital, Latina, Italy
| | - Iacopo Carbone
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, I.C.O.T. Hospital, Via Franco Faggiana 1668, 04100, Latina, Italy
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Sharifi H, Hsu J. COVID-19 Pneumonia: Clinical Manifestations. Clin Chest Med 2022; 44:227-237. [PMID: 37085216 PMCID: PMC9682061 DOI: 10.1016/j.ccm.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Coronavirus disease-2019 (COVID-19) pneumonia has diverse clinical manifestations, which have shifted throughout the pandemic. Formal classifications include presymptomatic infection and mild, moderate, severe, and critical illness. Social risk factors are numerous, with Black, Hispanic, and Native American populations in the United States having suffered disproportionately. Biological risk factors such as age, sex, underlying comorbid burden, and certain laboratory metrics can assist the clinician in triage and management. Guidelines for classifying radiographic findings have been proposed and may assist in prognosis. In this article, we review the risk factors, clinical course, complications, and imaging findings of COVID-19 pneumonia.
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Affiliation(s)
- Husham Sharifi
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA.
| | - Joe Hsu
- Division of Pulmonary, Allergy, and Critical Care Medicine, Stanford University, 300 Pasteur Drive, Stanford, CA 94305, USA
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Parchwani D, Dholariya S, Katoch CDS, Singh R. Growth differentiation factor 15 as an emerging novel biomarker in SARS-CoV-2 infection. World J Methodol 2022; 12:438-447. [PMID: 36186744 PMCID: PMC9516548 DOI: 10.5662/wjm.v12.i5.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 06/29/2022] [Accepted: 08/30/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Growth differentiation factor (GDF)-15 is a member of a transforming growth factor-β cytokine superfamily that regulates metabolism and is released in response to inflammation, hypoxia and tissue injury. It has evolved as one of the most potent cytokines for predicting the severity of infections and inflammatory conditions, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. AIM To investigate the utility of GDF-15 in predicting the severity of SARS-CoV-2 infection. METHODS PubMed, Reference Citation Analysis, CNKI, and Goggle Scholar were explored by using related MeSH keywords and data such as the first author's name, study duration, type and place of study, sample size and subgroups of participants if any, serum/plasma GDF- 15 level in pg/mL, area under the curve and cut-off value in receiver operating characteristic analysis, method of measurement of GDF-15, and the main conclusion were extracted. RESULTS In all studies, the baseline GDF-15 level was elevated in SARS-CoV-2-infected patients, and it was significantly associated with severity, hypoxemia, viral load, and worse clinical consequences. In addition, GDF-15 levels were correlated with C-reactive protein, D-dimer, ferritin and procalcitonin, and it had superior discriminatory ability to detect severity and in-hospital mortality of SARS-CoV-2 infection. Hence, GDF-15 might be used to predict the severity and prognosis of hospitalized patients with SARS-CoV-2. CONCLUSION Serial estimation of GDF-15 levels in hospitalized patients with SARS-CoV-2 infection appeared to have useful prognostic value and GDF-15 can be considered a clinically prominent sepsis biomarker for SARS-CoV-2 infection.
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Affiliation(s)
- Deepak Parchwani
- Department of Biochemistry, All India Institute of Medical Sciences, Rajkot 360001, Gujarat, India
| | - Sagar Dholariya
- Department of Biochemistry, All India Institute of Medical Sciences, Rajkot 360001, Gujarat, India
| | - CDS Katoch
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Rajkot 360001, Gujarat, India
| | - Ragini Singh
- Department of Biochemistry, All India Institute of Medical Sciences, Rajkot 360001, Gujarat, India
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Filograna L, Manenti G, Grassi S, Zedda M, Cazzato F, Ryan CP, Arena V, Pascali VL, Colosimo C, Floris R, Oliva A. Virtual autopsy in SARS-CoV-2 breakthrough infection: a case report. FORENSIC IMAGING 2022. [PMCID: PMC9433066 DOI: 10.1016/j.fri.2022.200520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
It is well documented that COVID-19 vaccines are effective tools for limiting the pandemic. Unfortunately, as is true for all vaccines, SARS-CoV-2 infection in vaccinated individuals is still possible. We present an autopsy case of SARS-CoV-2 infection after vaccination (“breakthrough infection”) in an elderly man with several comorbidities where post-mortem CT scan was performed. The death was histologically attributed to cardio-respiratory arrest due to ischemic heart failure related to superinfected COVID-19 pneumonia and pre-existing comorbidities. For the first time in the literature, PMCT imaging related to a fatal, autopsy case of breakthrough SARS-CoV-2 infection is reported. PMCT of the lungs, in accordance with histopathological results, showed few signs of COVID-19 pneumonia, large area of consolidation in the right lower lobe, interpreted as bronco-pneumonic focus, and hypostasis. These findings were well-correlated with the previously reported literature about both PMCT and clinical CT imaging of the lungs in non-vaccinated individuals with early COVID-19 pneumonia and about pulmonary clinical CT imaging in COVID-19 pneumonia in breakthrough SARS-COV-2 infections. Further studies are needed to cover the whole spectrum of PMCT lung imaging in fatal breakthrough SARS-CoV-2 infection, however, this case represent a first step for exploring this difficult challenge during SARS-CoV-2 pandemic using virtual autopsy.
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Magawa S, Nii M, Maki S, Enomoto N, Takakura S, Kusaka N, Maegawa Y, Osato K, Tanaka H, Kondo E, Ikeda T. Comparative study of the usefulness of risk score assessment in the early stages of
COVID
‐19 affected pregnancies: Omicron variant versus previous variants. J Obstet Gynaecol Res 2022; 48:2721-2729. [PMID: 36319204 PMCID: PMC9538931 DOI: 10.1111/jog.15387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 01/08/2023]
Abstract
Aim To evaluate the utility of the risk score in assessing the current status and prognosis of COVID‐19 in pregnancy. Methods Seventy‐seven cases affected before the Omicron variant epidemic and 50 pregnant cases affected by the Omicron variant were included. The risk score consists of maternal background, current condition, and examination findings. We determined the risk score in the early stages of disease onset. Results There were no significant differences in the maternal or gestational ages between the groups. The risk score was significantly lower in the After‐Group patients (those affected during the Omicron epoch), while 14.3% of the Before‐Group patients (those affected during the pre‐Delta and Delta epochs), experienced a worsening of disease after the visit to the center, whereas none of the After‐Group patients did. The Before Group's frequency of risk score items was higher among the two groups for “fever for ≥48 h,” “mild pneumonia image,” and “blood tests,” whereas “disease onset 14 days after the second vaccination” was increased in After Group. The blood test parameters for platelet count, C‐reactive protein, and D‐dimer levels were not significantly different between the groups. Conclusions The risk score system appeared superior in detecting deteriorating cases. There were no cases of post‐illness deterioration in the After‐Group, suggesting that cases of the Omicron variant in pregnancy may have had a less severe course compared to that of previous variants. However, there was no significant difference between the groups in terms of a specific blood test evaluation, suggesting the need for a combined evaluation of cases affected during pregnancy.
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Affiliation(s)
- Shoichi Magawa
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
| | - Masafumi Nii
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
| | - Shintaro Maki
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
| | - Naosuke Enomoto
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
| | - Sho Takakura
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
| | - Naoko Kusaka
- Department of Obstetrics and Gynecology Mie Central Medical Center Mie Japan
| | - Yuka Maegawa
- Department of Obstetrics and Gynecology Mie Central Medical Center Mie Japan
| | - Kazuhiro Osato
- Department of Obstetrics and Gynecology Mie Prefectural General Medical Center Mie Japan
| | - Hiroaki Tanaka
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology Mie University Faculty Medicine Mie Japan
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Borghesi A, Maroldi R. Vaccination and Reduced Severity of COVID-19 Pneumonia Visualized with Chest Radiography. Radiology 2022; 304:E47. [PMID: 35994398 PMCID: PMC9190207 DOI: 10.1148/radiol.220309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Andrea Borghesi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili, 1, I - 25123 Brescia, Italy
| | - Roberto Maroldi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili, 1, I - 25123 Brescia, Italy
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Schiebler M, Bluemke D. Seeing Is Believing: COVID-19 Vaccination Leads to Less Pneumonia at Chest CT. Radiology 2022; 303:693-695. [PMID: 35103545 PMCID: PMC9131167 DOI: 10.1148/radiol.220129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Mark Schiebler
- From the Department of Radiology, University of Wisconsin Madison School of Medicine and Public Health, E3/378 Clinical Science Center, 600 Highland Ave, Madison, WI 53794
| | - David Bluemke
- From the Department of Radiology, University of Wisconsin Madison School of Medicine and Public Health, E3/378 Clinical Science Center, 600 Highland Ave, Madison, WI 53794
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Tian W, Ren X, Han M, Zhang Y, Gao X, Chen Z, Zhang W. Epidemiological and clinical characteristics of vaccinated COVID-19 patients: A meta-analysis and systematic review. Int J Immunopathol Pharmacol 2022; 36:3946320221141802. [PMID: 36412572 PMCID: PMC9692180 DOI: 10.1177/03946320221141802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: With the global epidemic of coronavirus disease 2019 (COVID-19),
vaccination rates are increasing globally. This study evaluated the relevant
clinical manifestations of vaccinated COVID-19 patients. Methods: We searched
carefully in 11 databases such as PubMed, Embase, Scopus, Cochrane Library, Web
of Science, Ovid, China National Knowledge Infrastructure Database, Wan Fang
Data, Sinomed, VIP Database, and Reading Showing Database up to 26 March 2022.
To search for articles that have described the characteristics of vaccinated
patients including epidemiological and clinical symptoms. Statistical analysis
of the extracted data using STATA 14.0. Results: A total of 58 articles and
263,708 laboratory-confirmed COVID-19 patients were included. Most of the
patients in the vaccinated group had more asymptomatic infection and fewer
severe illnesses. There were significant differences in ethnicity, and strain
infected with COVID-19, and comorbidities (hyperlipidemia, diabetes, obesity,
kidney disease, immunocompromised, cardiovascular disease, and tumor) and
symptoms (fever, cough, gastrointestinal symptoms, neurological symptoms, and
dysgeusia/anosmia) between vaccinated group and unvaccinated group. Oxygen
support, use of steroid, days in hospital, hospital treatment, ICU treatment,
death, and poor prognosis were also significantly different. Conclusion:
Compared with the vaccinated group, patients in the unvaccinated group had a
more severe clinical manifestations. Vaccines are also protective for infected
people.
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Affiliation(s)
- Wen Tian
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xingxiang Ren
- Department of Endocrinology, Peking University International Hospital, Beijing, China
| | - Mei Han
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanyuan Zhang
- Beijing Key Laboratory of Emerging Infectious Disease, Beijing Ditan Hospital, Captital Medical University, Beijing, China
| | - Xu Gao
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| |
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