1
|
Nivetha R, Anshul R, Sarojini S, Sivagurunathan C, Maikandaan CJ. Effectiveness of BBV152 vaccine and ChAdOx1-S vaccine in preventing severe disease among vaccinated patients admitted to a designated COVID-19 hospital in India. Clin Exp Vaccine Res 2024; 13:28-34. [PMID: 38362372 PMCID: PMC10864884 DOI: 10.7774/cevr.2024.13.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/16/2023] [Accepted: 01/17/2024] [Indexed: 02/17/2024] Open
Abstract
Purpose Coronavirus disease 2019 (COVID-19) is a highly formidable disease. Globally, multiple vaccines have been developed to prevent and manage this disease. However, the periodic mutations of severe acute respiratory syndrome coronavirus 2 variants cast doubt on the effectiveness of commonly used vaccines in mitigating severe disease in the Indian population. This study aimed to assess the effectiveness of the BBV152 vaccine and ChAdOx1-S vaccine in preventing severe forms of the disease. Materials and Methods This retrospective study, based on hospital records, was conducted on 204 vaccinated COVID-19 patients using a consecutive sampling approach. Data on their vaccination status, comorbidities, and high-resolution computed tomography lung reports' computed tomography severity scores were extracted from their medical records. Fisher's exact test and binomial logistic regression analysis were employed to assess the independent associations of various factors with the dependent variables. Results Of the 204 records, 57.9% represented males, with a mean age of 61.5±9.8 years. Both vaccines demonstrated effective protection against severe illness (90.2%), with BBV152 offering slightly better protection compared to ChAdOx1-S. Male gender, partial vaccination, comorbid conditions, and the type of vaccine were identified as independent predictors of severe lung involvement. Conclusion This study indicates that both vaccines were highly effective (90%) in preventing severe forms of the disease in fully vaccinated individuals. When comparing the two vaccines, BBV152 was slightly more effective than ChAdOx1-S in preventing severe COVID-19.
Collapse
Affiliation(s)
- Rajaraman Nivetha
- Department of Community Medicine, Tagore Medical College and Hospital, Chennai, India
| | - Ramesh Anshul
- Department of Psychiatry, Sri Muthukumaran Medical College Hospital and Research Institute, Chennai, India
| | - Subbarayan Sarojini
- Department of Paediatrics, Sri Muthukumaran Medical College Hospital and Research Institute, Chennai, India
| | | | | |
Collapse
|
2
|
Nivetha R, Rajarajeswari N, Arumugam B, Sivagurunathan C, Iyer RH. Assessment of lung involvement using HRCT among vaccinated and non-vaccinated elderly COVID-19 patients admitted in a designated hospital, Tamil Nadu - A retrospective study. J Family Med Prim Care 2023; 12:1965-1971. [PMID: 38024934 PMCID: PMC10657043 DOI: 10.4103/jfmpc.jfmpc_2491_22] [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: 12/26/2022] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The COVID-19 pandemic is considered one of the most devastating situations globally, the worst affected were the senior citizens. A number of initiatives were carried out to control the COVID-19 pandemic; one such important measure is the development of COVID-19 vaccines to prevent the disease. But the continuous emergence of new SARS-COV2 variants (antigenic drift) and its demographic variation in virulence makes the vaccine's efficacy questionable. This study is intended to evaluate the association between the degree of lung involvement and the effectiveness of vaccination against the disease in cases admitted to a designated hospital in Tamil Nadu. Materials and Methods A hospital records-based-retrospective research was conducted among COVID-19 patients admitted from the 1st of April 2021 to the 31st of May 2021, and information was gathered regarding their vaccination status, comorbid conditions, and CT severity score (CTSS) in the HRCT lung report. A consecutive sampling technique was used to choose the study participants; about 120 participants were included in the study. The Chi-square test and Fisher's extract test were used to evaluate the hypothesis. The relationship between a dependent variable and independent factors was estimated using multiple linear regression. Results Among 120 participants, about 60.2% were males and 39.8% were females. Vaccination status and comorbid conditions had a significant association with severe lung involvement in COVID-19 patients. Conclusion Non-vaccinated patients had severe lung involvement based on the HRCT lung scan findings than the vaccinated patients. To reduce mortality, it is essential to ensure universal coverage of COVID-19 vaccination.
Collapse
Affiliation(s)
- Rajaraman Nivetha
- Department of Community Medicine, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India
| | | | - Balaji Arumugam
- Department of Community Medicine, Arunai Medical College and Hospital, Tiruvannamalai, Tamil Nadu, India
| | - Chinnaian Sivagurunathan
- Department of Community Medicine, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Ramesh Harihara Iyer
- Department of Community Medicine, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India
| |
Collapse
|
3
|
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: 0] [Impact Index Per Article: 0] [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.
Collapse
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.)
| |
Collapse
|
4
|
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: 1.0] [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.
Collapse
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.)
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Zaczyński A, Hampel M, Piątkiewicz P, Nasiłowski J, Butkiewicz S, Religioni U, Barańska A, Herda J, Neumann-Podczaska A, Vaillancourt R, Merks P. The Course of COVID-19 among Unvaccinated Patients—Data from the National Hospital in Warsaw, Poland. Vaccines (Basel) 2023; 11:vaccines11030675. [PMID: 36992258 DOI: 10.3390/vaccines11030675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
Introduction. Studies to date indicate the relatively high effectiveness of vaccinations in preventing severe COVID-19 symptoms. However, in Poland, 40% of the population remains unvaccinated. Objective. The objective of this study was to describe the natural history of COVID-19 in unvaccinated hospital patients in Warsaw, Poland. Material and methods. This study evaluated data from 50 adult patients from the National Hospital in Warsaw, Poland, in the period 26 November 2021 to 11 March 2022. None of these patients had been vaccinated against COVID-19. Results. Analysis showed that the average hospitalisation time for these unvaccinated COVID-19 patients was 13 days. Clinical deterioration was observed in 70% of these patients, 40% required the intensive care unit, and 34% subsequently died prior to the end of the study. Conclusions. There was a significant deterioration and high mortality rate in the unvaccinated patients. For this reason, it seems prudent to take measures to increase the vaccination coverage level of the population against COVID-19.
Collapse
Affiliation(s)
- Artur Zaczyński
- Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, 02-507 Warsaw, Poland
| | - Michał Hampel
- Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, 02-507 Warsaw, Poland
| | - Paweł Piątkiewicz
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński, 01-815 Warsaw, Poland
| | - Jacek Nasiłowski
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński, 01-815 Warsaw, Poland
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Sławomir Butkiewicz
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński, 01-815 Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-826 Warsaw, Poland
| | - Agnieszka Barańska
- Department of Medical Informatics and Statistics with e-Health Lab, Medical University of Lublin, 20-124 Lublin, Poland
| | - Jolanta Herda
- Department of Medical Informatics and Statistics with e-Health Lab, Medical University of Lublin, 20-124 Lublin, Poland
| | | | - Regis Vaillancourt
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński, 01-815 Warsaw, Poland
| | - Piotr Merks
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum Cardinal Stefan Wyszyński, 01-815 Warsaw, Poland
| |
Collapse
|
7
|
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; 307:e222730. [PMID: 36880948 PMCID: PMC10031570 DOI: 10.1148/radiol.222730] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant has a higher infection rate than previous variants but results in less severe disease. However, the impacts of omicron and vaccination on chest CT findings are difficult to evaluate. Purpose To investigate the impact of vaccination status and predominant variant on chest CT findings, diagnostic and severity scores in 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 RT-PCR 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 Chi-square 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 [Q1-Q3: 54-80], 1695 females). Diagnostic and severity scores were associated with the predominant variant (delta- versus omicron-predominant, Chi-square=112.4 and 33.7, both P<.001) and vaccination (Chi-square=243.6 and 210, both P<.001) and their interaction (Chi-square=4.3, P=.04 and Chi-square=28.7, P<.001, respectively). In multivariable analyses, omicron variant was associated with lower odds of typical CT findings than delta variant (OR=0.46, P<.001). Two and three vaccine doses were associated with lower odds of demonstrating typical CT findings (OR=0.32 and OR=0.20, both P<.001), and of having high severity score (OR=0.47 and OR=0.33, both P<.001), compared with unvaccinated patients. Conclusion Both the omicron variant and vaccination were associated with less typical chest CT manifestations for COVID-19 and lesser extent of disease. See also the editorial by Yoon and Goo in this issue.
Collapse
Affiliation(s)
- Amandine Crombé
- IMADIS, 48 Rue Quivogne, Lyon, Bordeaux, Marseille, France
- Department of radiology, Pellegrin university hospital and Bordeaux
university, Bordeaux, France
| | - Lounès Bensid
- IMADIS, 48 Rue Quivogne, Lyon, Bordeaux, Marseille, France
| | - Mylène Seux
- IMADIS, 48 Rue Quivogne, Lyon, Bordeaux, Marseille, France
| | - David Fadli
- IMADIS, 48 Rue Quivogne, Lyon, Bordeaux, Marseille, France
- Department of radiology, Pellegrin university hospital and Bordeaux
university, Bordeaux, France
| | - François Arnaud
- IMADIS, 48 Rue Quivogne, Lyon, Bordeaux, Marseille, France
- Ramsay Générale de Santé, Hôpital
privé Clairval, Marseille, France
| | - Axel Benhamed
- Service SAMU-Urgences, Centre Hospitalier Universitaire
Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Nathan Banaste
- IMADIS, 48 Rue Quivogne, Lyon, Bordeaux, Marseille, France
- Ramsay Générale de Santé, Clinique Convert,
Bourg-en-Bresse
| | - Guillaume Gorincour
- IMADIS, 48 Rue Quivogne, Lyon, Bordeaux, Marseille, France
- ELSAN, Clinique Bouchard, Marseille, France
| |
Collapse
|
8
|
Plasencia Martínez JM. Schematic approach to the diagnosis of multifocal lung opacities in the emergency department. RADIOLOGIA 2023; 65 Suppl 1:S63-S72. [PMID: 37024232 DOI: 10.1016/j.rxeng.2022.09.013] [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: 06/17/2022] [Accepted: 09/21/2022] [Indexed: 04/08/2023]
Abstract
Radiologists in the emergency department must be prepared to deal with any type of disease in any organ at any time. Many entities involving the chest can result in patients' presenting at the emergency department. This chapter deals with entities that manifest with multifocal lung opacities and that can be mistaken for pneumonia. To facilitate their identification, this chapter approaches these entities by considering their most characteristic distribution on chest X-rays, the main diagnostic modality used for thoracic problems in the emergency department. Our schematic approach includes the key findings in patients' personal histories, clinical examination, laboratory tests, and imaging studies that can be available during the initial workup.
Collapse
|
9
|
Abordaje esquemático del diagnóstico de las opacidades pulmonares multifocales en la urgencia. RADIOLOGIA 2023. [DOI: 10.1016/j.rx.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
|
10
|
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.
Collapse
|
11
|
Muacevic A, Adler JR, Bagali S, Karigoudar R, Wavare DS, P J, Kandi V, Suvvari TK, Mittal RJ, Jadhav M. Breakthrough Infections: Clinical Profile and Outcomes of COVID-19 Vaccinated and Unvaccinated People From a Tertiary Care Hospital. Cureus 2022; 14:e32089. [PMID: 36601158 PMCID: PMC9803927 DOI: 10.7759/cureus.32089] [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: 11/30/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Despite the availability of a vaccine and extensive vaccination, breakthrough infections are commonly noted, which is jeopardizing the vaccine-based protection against COVID-19. The present study aims to evaluate COVID-19 breakthrough infections and to compare the clinical profile and outcomes of the vaccinated and unvaccinated populations. Methods A retrospective observational study was conducted for two months (March-April 2021), and all cases reported during the study period were included in the study. Socio-demographic details, COVID-19 profiles, clinical outcomes, vaccination statuses, and types of vaccine were collected from the patients. Further, COVID-19-positive samples were screened for lineages using next-generation sequencing (NGS). Results Of the total 103 patients included in the study, 79 (76.7%) were symptomatic and 24 (23.3%) were asymptomatic. Only 32% were vaccinated and 68% were unvaccinated. 29.2% were hospitalized due to COVID-19 and all of them were unvaccinated. The mortality among hospitalized patients was extremely high (60%). The time to positivity after complete vaccination was noted to be 37.09±23.74 days. The unvaccinated study participants showed lower Cycle threshold (Ct) values (E Gene/N Gene: 17.38±4.53) as compared to the vaccinated people (E Gene/N Gene: 22±4.25). The Delta (B. 1.1. 629) (76.7%) was the predominant variant among the study population followed by AY.4 (20.4%) and Kappa (2.9%) variants. Conclusion Although the vaccination does not restrict/avoid infection, it appears to protect the vaccinated people from severe forms of COVID-19. Also, the higher Ct values among vaccinated people indicate that the viral load among such people may be lower and, therefore, minimizes viral transmission.
Collapse
|
12
|
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: 7] [Impact Index Per Article: 3.5] [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.
Collapse
|
13
|
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.
Collapse
Affiliation(s)
- Furkan Ufuk
- Department of Radiology, School of Medicine, University of Pamukkale, Denizli, Turkey
| | - Recep Savaş
- Department of Radiology, School of Medicine, University of Ege, Izmir, Turkey
| |
Collapse
|
14
|
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: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [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.
Collapse
|
15
|
HERZ THORAX – COVID-19: Grundimmunisierung schützt vor schweren Lungenveränderungen in der CT. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/a-1932-1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
16
|
Files DC, Tacke F, O’Sullivan A, Dorr P, Ferguson WG, Powderly WG. Rationale of using the dual chemokine receptor CCR2/CCR5 inhibitor cenicriviroc for the treatment of COVID-19. PLoS Pathog 2022; 18:e1010547. [PMID: 35749425 PMCID: PMC9231801 DOI: 10.1371/journal.ppat.1010547] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has created a global pandemic infecting over 230 million people and costing millions of lives. Therapies to attenuate severe disease are desperately needed. Cenicriviroc (CVC), a C-C chemokine receptor type 5 (CCR5) and C-C chemokine receptor type 2 (CCR2) antagonist, an agent previously studied in advanced clinical trials for patients with HIV or nonalcoholic steatohepatitis (NASH), may have the potential to reduce respiratory and cardiovascular organ failures related to COVID-19. Inhibiting the CCR2 and CCR5 pathways could attenuate or prevent inflammation or fibrosis in both early and late stages of the disease and improve outcomes of COVID-19. Clinical trials using CVC either in addition to standard of care (SoC; e.g., dexamethasone) or in combination with other investigational agents in patients with COVID-19 are currently ongoing. These trials intend to leverage the anti-inflammatory actions of CVC for ameliorating the clinical course of COVID-19 and prevent complications. This article reviews the literature surrounding the CCR2 and CCR5 pathways, their proposed role in COVID-19, and the potential role of CVC to improve outcomes.
Collapse
Affiliation(s)
- Daniel Clark Files
- Department of Internal Medicine, Pulmonary, Critical Care, Allergy and Immunology Section, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Frank Tacke
- Medical Department of Hepatology and Gastroenterology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany
| | | | - Patrick Dorr
- AbbVie Inc., North Chicago, Illinois, United States of America
| | | | - William G. Powderly
- John T. Milliken Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine in St Louis, St Louis, Missouri, United States of America
| |
Collapse
|