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Verot E, Chaux R, Gagnaire J, Bonjean P, Gagneux-Brunon A, Berthelot P, Pelissier C, Boulamail B, Chauvin F, Pozzetto B, Botelho-Nevers E. Evaluating the Knowledge of and Behavior Toward COVID-19 and the Possibility of Isolating at a City Level: Survey Study. JMIR Public Health Surveill 2024; 10:e47170. [PMID: 38602767 PMCID: PMC11013031 DOI: 10.2196/47170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 11/05/2023] [Accepted: 12/10/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Mass testing campaigns were proposed in France during the first wave of the COVID-19 pandemic to detect and isolate asymptomatic individuals infected by SARS-CoV-2. During mass testing in Saint-Étienne (February 2021), we performed a survey of the general population. OBJECTIVE We evaluated, on the scale of a city's population, the literacy level about SARS-CoV-2 transmission, barrier gesture respect, and isolation acceptability or possibility in case of SARS-CoV-2 infection. METHODS We used the validated CovQuest-CC questionnaire. Data were analyzed and correlated with volunteer characteristics and their SARS-CoV-2 screening results using multivariate analysis. RESULTS In total, 4707 participants completed the CovQuest-CC questionnaire. Multivariate analysis revealed that female sex was a determinant of a higher score of knowledge about SARS-CoV-2 transmission (adjusted β coefficient=0.14, 95% CI 0.04-0.23; corrected P=.02). Older ages of 50-59 years (adjusted β coefficient=0.25, 95% CI 0.19-0.31; corrected P<.001) and ≥60 years (adjusted β coefficient=0.25, 95% CI 0.15-0.34; corrected P<.001) were determinants of a higher score on barrier gesture respect compared to ages 20-49 years considered as reference. Female sex was also a determinant of a higher score on barrier gesture respect (adjusted β coefficient=0.10, 95% CI 0.02-4.63; corrected P<.001). The knowledge score was correlated with the score on barrier gesture respect measures (adjusted β coefficient=0.03, 95% CI 0.001-0.004; corrected P=.001). Older ages of 50-59 years (adjusted β coefficient=0.21, 95% CI 0.13-0.29; corrected P<.001) and ≥60 years (adjusted β coefficient=0.25, 95% CI 0.1-0.38; corrected P<.001) were determinants of a higher score on isolation acceptability or possibility compared to the age of 20-49 years considered as reference. Finally, the knowledge score regarding SARS-CoV-2 transmission was significantly associated with a lower risk of RT-PCR (reverse transcriptase-polymerase chain reaction) positivity (adjusted odds ratio 0.80, 95% CI 0.69-0.94; corrected P<.03), implying that a 1-point increase in the knowledge score lowers the risk of positivity by 20% on average. CONCLUSIONS This study identified factors associated with health literacy regarding SARS-CoV-2 infection in asymptomatic individuals in a large French city's population. We can confirm that in the context of the COVID-19 pandemic, the determinants of better health literacy are not the same as those in other contexts. It seems critical to obtain a more detailed understanding of the determinants of individual citizens' behavior, as part of a strategy to combat the large-scale spread of the virus. The harsh experience of this pandemic should teach us how to nurture research to structure customized interventions to encourage the adoption of ad hoc behaviors to engage citizens in adapting behaviors more favorable to their health.
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Affiliation(s)
- Elise Verot
- CIC EC 1408 INSERM Saint-Etienne, Saint-Etienne cedex 2, France
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Robin Chaux
- Unité de Recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Julie Gagnaire
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Unité de Gestion des Risques infectieux, Centre Hospitalier Universitaire (CHU) de Saint-Etienne, Saint-Etienne, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Paul Bonjean
- Unité de Recherche Clinique, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Amandine Gagneux-Brunon
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Philippe Berthelot
- Unité de Gestion des Risques infectieux, Centre Hospitalier Universitaire (CHU) de Saint-Etienne, Saint-Etienne, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Laboratoire des Agents Infectieux et d'Hygiène, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Carole Pelissier
- Occupational Health Service University Hospital Center of Saint-Etienne, Saint-Etienne, France
- UMRESTTE, Université Lyon 1, Université Gustave Eiffel-IFSTTAR, UMR t 9405, Lyon, France
| | - Billal Boulamail
- Unité de Gestion des Risques infectieux, Centre Hospitalier Universitaire (CHU) de Saint-Etienne, Saint-Etienne, France
| | - Franck Chauvin
- CIC EC 1408 INSERM Saint-Etienne, Saint-Etienne cedex 2, France
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Chaire Hygée, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
| | - Bruno Pozzetto
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Laboratoire des Agents Infectieux et d'Hygiène, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Elisabeth Botelho-Nevers
- Laboratoire Parcours Santé Systémique- UR4129, Université Jean Monnet, Université de Lyon, St Priest-en-Jarez, France
- Service d'Infectiologie, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Team GIMAP, CIRI-Centre International de Recherche en Infectiologie, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
- Chaire PreVacCI, Institut PRESAGE, Université Jean Monnet, Université de Lyon, Saint-Etienne, France
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Liu L, Ross NM, Handorf EA, Meeker CR, Chen G, Baldwin D, Vijayvergia N. Incidence of asymptomatic COVID-19 positivity in cancer patients and effects on therapy. J Cancer Res Clin Oncol 2023; 149:3243-3247. [PMID: 35904602 PMCID: PMC9334983 DOI: 10.1007/s00432-022-04231-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic is posing unprecedented challenges for patient care, especially for cancer patients. This study looks at asymptomatic (AS) COVID-19 positivity in cancer patients and its effects on their care. METHODS We conducted a retrospective chart review of AS patients testing positive for COVID-19 upon screening at Fox Chase Cancer Center between January 2020 and September 2020. Relationships between positive tests and demographics, clinical characteristics, and treatment delays were investigated using conditional logistic regression or Mantel-Haenszel tests. RESULTS Among 4143 AS patients who underwent COVID-19 testing, 25 (0.6%) were COVID-19 positive (cases) and these were matched to 50 controls. The median age was lower in the cases compared to that of the controls (64 vs 70 years old, p = 0.04). Of the cases, 10 patients (40%) never underwent their planned oncologic intervention [6/10 (60%) did not require the planned intervention once deemed okay to proceed]. Of the controls, only 1 patient (2%) did not undergo the planned intervention. Of these 15 COVID-19 positive patients who underwent the planned intervention, 11 (73.3%) had a delay related to COVID-19, with a mean delay duration of 18 days (range: 0-49, SD: 16.72). CONCLUSION Cancer patients had lower incidence of AS COVID-19 than general population. Delays that occur due to AS COVID screening are not very long and serve as a tool to limit spread of virus. Further studies will be important in addressing delays in cancer care and concerns of patient safety as the pandemic continues.
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Affiliation(s)
- Lisa Liu
- Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19128, USA
| | - Nicole M Ross
- Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19128, USA
| | - Elizabeth A Handorf
- Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19128, USA
| | - Caitlin R Meeker
- Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19128, USA
| | - Giana Chen
- Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19128, USA
| | - Donald Baldwin
- Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19128, USA
| | - Namrata Vijayvergia
- Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19128, USA.
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Wong ELY, Qiu H, Wang K, Sun KS, Yam CHK, Cheung AWL, Yeoh EK. Screening Hesitancy of a Universal Voluntary-based Rapid Antigen Test for coronavirus disease 2019 (COVID-19) During Omicron Wave in Hong Kong. J Infect Public Health 2023; 16:1306-1312. [PMID: 37336128 DOI: 10.1016/j.jiph.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND The Hong Kong government distributed rapid antigen test (RAT) kits to households across the city and called for a universal voluntary testing exercise for three consecutive days during the Omicron wave to identify infected persons early for quarantine and disrupt transmission chains in the community. We conducted a survey to evaluate the participation rates and explore the determinants of voluntary RAT adoption and hesitancy. METHODS This cross-sectional survey was conducted through computer-assisted telephone interviews from 19 May to 16 June 2022 using an overlapping dual-frame telephone number sampling design. Information on willingness to adopt voluntary RAT, four themes of personal qualities, attitudes toward the government's health policies, incentives to motivate RAT adoption, and personal sociodemographic factors were collected. Logistic regression analysis was used to examine the factors associated with RAT adoption. RESULTS Of the 1010 participants, 490 successfully responded to the fixed-line and 520 to the mobile phone survey, with response rates of 1.42% and 1.63% and screen hesitancy rates of 36.1% and 39.3%, respectively. Participants of adoption RAT were those aged 30-49 years, with high perceived COVID-19 infection severity, ≥ 3 doses of COVID-19 vaccination, and more agreement with the health policies on material resources and quarantine orders. Individuals who were less risk seeking and more altruistic reported a higher adoption of voluntary RAT. CONCLUSIONS Understanding the willingness to participate in a voluntary universal testing programme might shed light on effective ways to minimise screening hesitancy in future public health strategies and campaigns.
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Affiliation(s)
- Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Hong Qiu
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Kailu Wang
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Kai-Sing Sun
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Carrie Ho-Kwan Yam
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Annie Wai-Ling Cheung
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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Ozsahin DU, Isa NA, Uzun B. The Capacity of Artificial Intelligence in COVID-19 Response: A Review in Context of COVID-19 Screening and Diagnosis. Diagnostics (Basel) 2022; 12:diagnostics12122943. [PMID: 36552949 PMCID: PMC9777320 DOI: 10.3390/diagnostics12122943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/12/2022] [Accepted: 11/18/2022] [Indexed: 11/26/2022] Open
Abstract
Artificial intelligence (AI) has been shown to solve several issues affecting COVID-19 diagnosis. This systematic review research explores the impact of AI in early COVID-19 screening, detection, and diagnosis. A comprehensive survey of AI in the COVID-19 literature, mainly in the context of screening and diagnosis, was observed by applying the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Data sources for the years 2020, 2021, and 2022 were retrieved from google scholar, web of science, Scopus, and PubMed, with target keywords relating to AI in COVID-19 screening and diagnosis. After a comprehensive review of these studies, the results found that AI contributed immensely to improving COVID-19 screening and diagnosis. Some proposed AI models were shown to have comparable (sometimes even better) clinical decision outcomes, compared to experienced radiologists in the screening/diagnosing of COVID-19. Additionally, AI has the capacity to reduce physician work burdens and fatigue and reduce the problems of several false positives, associated with the RT-PCR test (with lower sensitivity of 60-70%) and medical imaging analysis. Even though AI was found to be timesaving and cost-effective, with less clinical errors, it works optimally under the supervision of a physician or other specialists.
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Affiliation(s)
- Dilber Uzun Ozsahin
- Department of Medical Diagnostic Imaging, College of Health Sciences, Sharjah University, Sharjah P.O. Box 27272, United Arab Emirates
- Operational Research Center in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- Correspondence: (D.U.O.); (N.A.I.)
| | - Nuhu Abdulhaqq Isa
- Department of Biomedical Engineering, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- Department of Biomedical Engineering, College of Health Science and Technology, Keffi 961101, Keffi Nasarawa State, Nigeria
- Correspondence: (D.U.O.); (N.A.I.)
| | - Berna Uzun
- Operational Research Center in Healthcare, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
- Department of Statistics, Carlos III Madrid University, 28903 Getafe, Madrid, Spain
- Department of Mathematics, Near East University, TRNC Mersin 10, Nicosia 99138, Turkey
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Elgersma IH, Svarstad E, Kløvstad H, Nygård KM, Kristoffersen AB. No evidence for added value of introducing mandatory COVID-19 testing for international travellers entering Norway with a valid EU digital COVID certificate. Infect Dis (Lond) 2022; 54:934-939. [PMID: 36238994 DOI: 10.1080/23744235.2022.2131899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND As a response to the emergence of the new Omicron SARS-CoV-2 variant, on December 3, 2021, mandatory testing after entry to Norway was extended to include international travellers with a valid COVID-19 certificate. We aim to validate if mandatory testing upon arrival increased the proportion of travellers confirmed with a positive COVID-19 test after entry. METHODS We used individual level data on registered travellers linked with data on COVID-19 testing and confirmed COVID-19 cases. The proportions of confirmed cases among international travellers before and after the requirement were introduced was analysed with an interrupted times series design. RESULTS The proportion of travellers with an EU COVID-19 certificate tested at an official test station increased from 3% to 43% after mandatory testing was introduced. However, the proportion of all travellers confirmed with COVID-19 rose only marginally with 0.14 percentage point directly after the intervention (p-value .06). The results are limited by the absence of data on antigen tests taken by the traveller at home and missing data from travellers without a valid Norwegian ID. CONCLUSIONS Our findings suggest that the benefit of mandatory testing of all international travellers to Norway was marginal in the period directly after the emergence of the omicron variant. This result must be understood in the context of free of charge testing at official test centres, a government recommendation on a low threshold to test when experiencing symptoms in addition to limited surveillance of the compliance of the test after arrival requirement.
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Mah AJ, Nguyen T, Ghazi Zadeh L, Shadgan A, Khaksari K, Nourizadeh M, Zaidi A, Park S, Gandjbakhche AH, Shadgan B. Optical Monitoring of Breathing Patterns and Tissue Oxygenation: A Potential Application in COVID-19 Screening and Monitoring. Sensors (Basel) 2022; 22:7274. [PMID: 36236373 PMCID: PMC9573619 DOI: 10.3390/s22197274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
The worldwide outbreak of the novel Coronavirus (COVID-19) has highlighted the need for a screening and monitoring system for infectious respiratory diseases in the acute and chronic phase. The purpose of this study was to examine the feasibility of using a wearable near-infrared spectroscopy (NIRS) sensor to collect respiratory signals and distinguish between normal and simulated pathological breathing. Twenty-one healthy adults participated in an experiment that examined five separate breathing conditions. Respiratory signals were collected with a continuous-wave NIRS sensor (PortaLite, Artinis Medical Systems) affixed over the sternal manubrium. Following a three-minute baseline, participants began five minutes of imposed difficult breathing using a respiratory trainer. After a five minute recovery period, participants began five minutes of imposed rapid and shallow breathing. The study concluded with five additional minutes of regular breathing. NIRS signals were analyzed using a machine learning model to distinguish between normal and simulated pathological breathing. Three features: breathing interval, breathing depth, and O2Hb signal amplitude were extracted from the NIRS data and, when used together, resulted in a weighted average accuracy of 0.87. This study demonstrated that a wearable NIRS sensor can monitor respiratory patterns continuously and non-invasively and we identified three respiratory features that can distinguish between normal and simulated pathological breathing.
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Affiliation(s)
- Aaron James Mah
- Implantable Biosensing Laboratory, ICORD, Vancouver, BC V5Z 1M9, Canada
- Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
| | - Thien Nguyen
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Rockville, MD 20847, USA
| | - Leili Ghazi Zadeh
- Implantable Biosensing Laboratory, ICORD, Vancouver, BC V5Z 1M9, Canada
| | - Atrina Shadgan
- Implantable Biosensing Laboratory, ICORD, Vancouver, BC V5Z 1M9, Canada
| | - Kosar Khaksari
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Rockville, MD 20847, USA
| | - Mehdi Nourizadeh
- Implantable Biosensing Laboratory, ICORD, Vancouver, BC V5Z 1M9, Canada
| | - Ali Zaidi
- Implantable Biosensing Laboratory, ICORD, Vancouver, BC V5Z 1M9, Canada
| | - Soongho Park
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Rockville, MD 20847, USA
| | - Amir H. Gandjbakhche
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Health, Rockville, MD 20847, USA
| | - Babak Shadgan
- Implantable Biosensing Laboratory, ICORD, Vancouver, BC V5Z 1M9, Canada
- Department of Pathology & Laboratory Medicine, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
- Department of Orthopedics, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
- Department of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z7, Canada
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Hishikawa T, Ohashi T, Tadakoshi M, Kamikawa Y, Kageyama S, Kojima A, Hioki K, Yamauchi H. Effect of waiting time for COVID-19 screening on postoperative outcomes of type A aortic dissection: An institutional study. Asian Cardiovasc Thorac Ann 2022; 30:912-915. [PMID: 35971227 PMCID: PMC9382570 DOI: 10.1177/02184923221120413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Since November 2020, all patients undergoing emergency surgery at our hospital have been subjected to preoperative reverse transcription polymerase chain reaction (RT-PCR) screening to prevent nosocomial COVID-19 infection, with admission to the operating room requiring a negative result. Herein, we compared the pre- and postoperative outcomes of acute type A aortic dissection surgery before and after implementing the RT-PCR screening for all patients. METHODS We compared the postoperative results of 105 patients who underwent acute type A aortic dissection emergency surgery from January 2019 to October 2020 (Group I) and 109 patients who underwent the surgery following RT-PCR screening from November 2020 to March 2022 (Group II). RESULTS The average waiting time from arrival at the hospital to admission to the operating room was 36 and 81 min in Groups I and II, respectively. Ruptured cardiac tamponade was observed preoperatively in 26.6% and 21.1% of Groups I and II patients, respectively. The preoperative waiting time due to RT-PCR screening did not contribute to the cardiac tamponade. Surgical complications such as bleeding (reopened chest), respiratory failure, cerebral neuropathy, or mediastinitis did not increase significantly. The number of deaths 30 days after surgery (Group I = 13 and Group II = 3) showed no significant difference between the groups. There were no cases of nosocomial COVID-19 infections. CONCLUSIONS Preoperative COVID-19 screening is an important method to prevent nosocomial infections. The associated waiting time did not affect the number of preoperative ruptures or affect postoperative complications or mortality.
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Affiliation(s)
- Takanori Hishikawa
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
| | - Takeki Ohashi
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
| | - Masao Tadakoshi
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
| | - Yuji Kamikawa
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
| | - Soichiro Kageyama
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
| | - Akinori Kojima
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
| | - Kaoru Hioki
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
| | - Hirotaka Yamauchi
- Cardiovascular Surgery, 38111Nagoya Tokushukai General Hospital, Kasugai, Aichi, Japan
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Lee RC, Soto DW, Deva S, Macedo M, Shanker K, Rodriguez A, Alhajri D, Unger JB. Evaluation of a COVID-19 Rapid Antigen Testing Program in a Supervised Community Distance Learning Setting for K-8 Students. J Sch Health 2022; 92:445-451. [PMID: 35156210 PMCID: PMC9115139 DOI: 10.1111/josh.13146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/26/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND School-based COVID-19 testing is a potential strategy to limit COVID-19 transmission among youth in congregate settings such as schools, sports programs, and summer camps. The purpose of this study is to evaluate the feasibility and effectiveness of frequent rapid antigen testing at a supervised distance-learning setting for elementary and middle school children while their schools were closed. METHODS This evaluation examines participation rates and testing data in addition to qualitative analysis of focus groups from a Los Angeles City-sponsored rapid antigen testing pilot program. In total, 434 children and staff were enrolled in the 13-week pilot program in the spring of 2021. RESULTS In this pilot program, 2482 rapid antigen tests were administered, resulting in 3 positive test results, 1 of which was a false positive (confirmed by polymerase chain reaction testing) and 0 outbreaks or community spread. CONCLUSIONS Throughout this pilot program, implementing rapid antigen tests allowed for the quick identification and isolation of potentially COVID-19-positive children, improved perceived safety for parents and staff who interact with children, and demonstrated the ability for staff and non-health care professionals in a school-based setting to implement a widespread COVID-19 screening program with minimal training.
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Affiliation(s)
- Ryan C. Lee
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 302, 2001 N. Soto StreetLos AngelesCA90033.
| | - Daniel W. Soto
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 302, 2001 N. Soto StreetLos AngelesCA90033.
| | - Sohini Deva
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 302, 2001 N. Soto StreetLos AngelesCA90033.
| | - Marisol Macedo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 302, 2001 N. Soto StreetLos AngelesCA90033.
| | - Kush Shanker
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 302, 2001 N. Soto StreetLos AngelesCA90033.
| | - Anna Rodriguez
- USC Schaeffer Center for Health Policy & Economics, University of Southern California, 635 Downey Way, Verna & Peter Dauterive Hall (VPD)Los AngelesCA90089.
| | - Danyah Alhajri
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 302, 2001 N. Soto StreetLos AngelesCA90033.
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 302, 2001 N. Soto StreetLos AngelesCA90033.
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Álvarez-Rodríguez L, Moura JD, Novo J, Ortega M. Does imbalance in chest X-ray datasets produce biased deep learning approaches for COVID-19 screening? BMC Med Res Methodol 2022; 22:125. [PMID: 35484483 PMCID: PMC9046709 DOI: 10.1186/s12874-022-01578-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background The health crisis resulting from the global COVID-19 pandemic highlighted more than ever the need for rapid, reliable and safe methods of diagnosis and monitoring of respiratory diseases. To study pulmonary involvement in detail, one of the most common resources is the use of different lung imaging modalities (like chest radiography) to explore the possible affected areas. Methods The study of patient characteristics like sex and age in pathologies of this type is crucial for gaining knowledge of the disease and for avoiding biases due to the clear scarcity of data when developing representative systems. In this work, we performed an analysis of these factors in chest X-ray images to identify biases. Specifically, 11 imbalance scenarios were defined with female and male COVID-19 patients present in different proportions for the sex analysis, and 6 scenarios where only one specific age range was used for training for the age factor. In each study, 3 different approaches for automatic COVID-19 screening were used: Normal vs COVID-19, Pneumonia vs COVID-19 and Non-COVID-19 vs COVID-19. The study was validated using two public chest X-ray datasets, allowing a reliable analysis to support the clinical decision-making process. Results The results for the sex-related analysis indicate this factor slightly affects the system in the Normal VS COVID-19 and Pneumonia VS COVID-19 approaches, although the identified differences are not relevant enough to worsen considerably the system. Regarding the age-related analysis, this factor was observed to be influencing the system in a more consistent way than the sex factor, as it was present in all considered scenarios. However, this worsening does not represent a major factor, as it is not of great magnitude. Conclusions Multiple studies have been conducted in other fields in order to determine if certain patient characteristics such as sex or age influenced these deep learning systems. However, to the best of our knowledge, this study has not been done for COVID-19 despite the urgency and lack of COVID-19 chest x-ray images. The presented results evidenced that the proposed methodology and tested approaches allow a robust and reliable analysis to support the clinical decision-making process in this pandemic scenario. Supplementary Information The online version contains supplementary material available at (10.1186/s12874-022-01578-w).
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Affiliation(s)
- Lorena Álvarez-Rodríguez
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, A Coruña, 15071, Spain.,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, 15006, Spain
| | - Joaquim de Moura
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, A Coruña, 15071, Spain. .,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, 15006, Spain.
| | - Jorge Novo
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, A Coruña, 15071, Spain.,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, 15006, Spain
| | - Marcos Ortega
- Centro de Investigación CITIC, Universidade da Coruña, Campus de Elviña, A Coruña, 15071, Spain.,Grupo VARPA, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, A Coruña, 15006, Spain
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10
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Sørbye LW, Grue EV, Hogeveen S. Before the COVID-Vaccine-Vulnerable Elderly in Homecare. Nurs Rep 2022; 12:270-80. [PMID: 35466247 DOI: 10.3390/nursrep12020027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/08/2022] [Accepted: 03/18/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND At the beginning of 2020, the COVID-19 virus was spreading all over the world. Frail elderly were at risk for illness and death. Isolation seemed to be the best solution. The aim of this paper was to describe how the lockdown affected elderly homecare patients. METHODS We used an international self-reported screening instrument built on well-documented risk factors adapted to COVID-19. We considered ethical, legal, and practical concerns. The research included telephone interviews with 30 homecare patients. RESULTS Seventy percent lived alone. Seventy-three percent of the sample suffered from major comorbidity. Cardiovascular disorder was the most frequent diagnosis. Nineteen (63.3%) needed help for personal care. Several of the participants were lonely and depressed. The homecare teams struggled to give proper care. The health authorities encouraged the population to reduce their outside physical activities to a minimum. The restrictions due to COVID-19 affected daily life and several respondents expressed uncertainties about the future. CONCLUSIONS It is important to describe the patients' experiences in a homecare setting at the initiation of lockdowns due to COVID-19. The isolation protected them from the virus, but they struggled with loneliness and the lack of physical contact with their loved ones. In the future, we need to understand and address the unmet needs of elderly homecare patients in lockdown.
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Jones J, Saul R, Sathe L, Xie J, Marquette D, Arboleda VA. Lean Principles to Improve Quality in High-Throughput COVID-19 Testing Using SwabSeq: A Barcoded Sequencing-Based Testing Platform. Lab Med 2022; 53:e8-e13. [PMID: 34436601 PMCID: PMC8499806 DOI: 10.1093/labmed/lmab069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To describe and quantify the effect of quality control (QC) metrics to increase testing efficiency in a high-complexity, Clinical Laboratory Improvement Amendments-certified laboratory that uses amplicon-based, next generation sequencing for the clinical detection of SARS-CoV-2. To enable rapid scalability to several thousands of specimens per day without fully automated platforms, we developed internal QC methods to ensure high-accuracy testing. METHODS We implemented procedures to increase efficiency by applying the Lean Six Sigma model into our sequencing-based COVID-19 detection. RESULTS The application of the Lean Six Sigma model increased laboratory efficiency by reducing errors, allowing for a higher testing volume to be met with minimal staffing. Furthermore, these improvements resulted in an improved turnaround time. CONCLUSION Lean Six Sigma model execution has increased laboratory efficiency by decreasing critical testing errors and has prepared the laboratory for future scaling up to 50,000 tests per day.
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Affiliation(s)
- Janae Jones
- Department of Computational Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
- UCLA SwabSeq COVID19 Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
| | - Rosita Saul
- Department of Computational Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
- UCLA SwabSeq COVID19 Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
| | - Laila Sathe
- UCLA SwabSeq COVID19 Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
- Department of Pathology and Lab Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
| | - Joanna Xie
- UCLA SwabSeq COVID19 Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
| | - Dawn Marquette
- Department of Computational Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
- UCLA SwabSeq COVID19 Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
| | - Valerie A Arboleda
- Department of Computational Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
- UCLA SwabSeq COVID19 Laboratory, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
- Department of Pathology and Lab Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, US
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12
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Wong MS, Yuan AH, Haderlein TP, Jones KT, Washington DL. Variations by race/ethnicity and time in Covid-19 testing among Veterans Health Administration users with COVID-19 symptoms or exposure. Prev Med Rep 2021; 24:101503. [PMID: 34312589 PMCID: PMC8295495 DOI: 10.1016/j.pmedr.2021.101503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/10/2021] [Accepted: 07/18/2021] [Indexed: 12/19/2022] Open
Abstract
Racial/ethnic disparities in coronavirus disease 2019 (COVID-19) hospitalization and mortality have emerged in the United States, but less is known about whether similar differences exist in testing, and how this changed as COVID-19 knowledge and policies evolved. We examined racial/ethnic variations in COVID-19 testing over time among veterans who sought care for COVID-19 symptoms or exposure. In the national population of all Veterans who sought Veterans Health Administration (VHA) care for COVID-19 symptoms or exposure (n = 913,806), we conducted multivariate logistic regressions to explore race/ethnicity-by-time period differences in testing from 3/1/2020-11/25/2020, and calculated predicted probabilities by race/ethnicity and time period. Early in the pandemic (3/1/2020-4/6/2020) when testing was limited and there was less awareness of racial/ethnic disparities, non-Hispanic Black, Hispanic, and other non-White racial/ethnic minority Veterans who sought care from VHA for COVID-19 symptoms or exposure were more likely than non-Hispanic White Veterans to receive a COVID-19 test (p < 0.05). In subsequent time periods (4/7/2020-11/25/2020), testing was similar among all racial/ethnic groups. Among Veterans with COVID-19 symptoms or exposure, non-Hispanic Black and Hispanic patients were just as likely, and in some cases, more likely, to receive a COVID-19 test versus non-Hispanic White patients. The United States faced testing shortages at the start of the third wave of the pandemic; additional shortages are likely to emerge as the pandemic continues to peak and ebb. It is important to ensure that racial/ethnic minorities and others at greater risk for infection continue to have access to COVID-19 testing with each of these peaks.
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Affiliation(s)
- Michelle S. Wong
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, United States
| | - Anita H. Yuan
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, United States
| | - Taona P. Haderlein
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, United States
| | - Kenneth T. Jones
- VHA Office of Health Equity, 810 Vermont Ave, NW, Washington, DC 20420, United States
| | - Donna L. Washington
- VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, United States
- Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California Los Angeles Geffen School of Medicine, 1100 Glendon Ave, Suite 850, Los Angeles, CA 90024, United States
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Wu J, Shen J, Xu M, Shao M. A novel combined dynamic ensemble selection model for imbalanced data to detect COVID-19 from complete blood count. Comput Methods Programs Biomed 2021; 211:106444. [PMID: 34614451 PMCID: PMC8479386 DOI: 10.1016/j.cmpb.2021.106444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/22/2021] [Indexed: 06/01/2023]
Abstract
BACKGROUND As blood testing is radiation-free, low-cost and simple to operate, some researchers use machine learning to detect COVID-19 from blood test data. However, few studies take into consideration the imbalanced data distribution, which can impair the performance of a classifier. METHOD A novel combined dynamic ensemble selection (DES) method is proposed for imbalanced data to detect COVID-19 from complete blood count. This method combines data preprocessing and improved DES. Firstly, we use the hybrid synthetic minority over-sampling technique and edited nearest neighbor (SMOTE-ENN) to balance data and remove noise. Secondly, in order to improve the performance of DES, a novel hybrid multiple clustering and bagging classifier generation (HMCBCG) method is proposed to reinforce the diversity and local regional competence of candidate classifiers. RESULTS The experimental results based on three popular DES methods show that the performance of HMCBCG is better than only use bagging. HMCBCG+KNE obtains the best performance for COVID-19 screening with 99.81% accuracy, 99.86% F1, 99.78% G-mean and 99.81% AUC. CONCLUSION Compared to other advanced methods, our combined DES model can improve accuracy, G-mean, F1 and AUC of COVID-19 screening.
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Affiliation(s)
- Jiachao Wu
- College of Management and Economics, Tianjin University, Tianjin, 300072, China
| | - Jiang Shen
- College of Management and Economics, Tianjin University, Tianjin, 300072, China
| | - Man Xu
- Business School, Nankai University, Tianjin, 300071, China
| | - Minglai Shao
- School of New Media and Communication, Tianjin University, Tianjin, 300072, China.
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14
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Cwalinski J, Cwalinska A, Paszkowski J, Banasiewicz T, Hermann J. The Role of Diagnostic Management in COVID-19 Screening of Asymptomatic Patients Admitted for Elective Surgery. In Vivo 2021; 35:3321-3323. [PMID: 34697164 DOI: 10.21873/invivo.12628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Due to the high risk of COVID-19 transmission by asymptomatic patients, the aim of this study was to evaluate chest computed tomography (CT) and blood differential test as an additional COVID-19 screening tool for patients undergoing elective or urgent surgery. PATIENTS AND METHODS The preoperative assessment of 118 patients hospitalized from June to July 2020 included real-time reverse transcriptase polymerase chain reaction RNA test before elective surgery or rapid antigen test in emergency patients. The diagnostics were supplemented by chest CT and a complete blood count with a blood smear in all patients. RESULTS None of the hospitalized patients had molecular, serological or radiographic symptoms of COVID-19 infection. The chest CT revealed non-COVID-19 pathologies in a total of 48 patients. Leukocytosis and lymphopenia were typical of emergency patients. CONCLUSION Routine chest CT scans have no benefit in screening for potential COVID-19 changes in asymptomatic patients. Blood differential tests are readily available, which makes them more helpful in COVID-19 screening.
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Affiliation(s)
- Jaroslaw Cwalinski
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland;
| | - Agnieszka Cwalinska
- Department of Infectious Diseases and Child Neurology, University of Medical Sciences in Poznan, Poznan, Poland
| | - Jacek Paszkowski
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Tomasz Banasiewicz
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Hermann
- Department of General, Endocrinological Surgery and Gastroenterological Oncology, Poznan University of Medical Sciences, Poznan, Poland
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15
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Kundu R, Singh PK, Ferrara M, Ahmadian A, Sarkar R. ET-NET: an ensemble of transfer learning models for prediction of COVID-19 infection through chest CT-scan images. Multimed Tools Appl 2021; 81:31-50. [PMID: 34483709 PMCID: PMC8405348 DOI: 10.1007/s11042-021-11319-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 07/07/2021] [Accepted: 07/21/2021] [Indexed: 05/02/2023]
Abstract
The COVID-19 virus has caused a worldwide pandemic, affecting numerous individuals and accounting for more than a million deaths. The countries of the world had to declare complete lockdown when the coronavirus led to community spread. Although the real-time Polymerase Chain Reaction (RT-PCR) test is the gold-standard test for COVID-19 screening, it is not satisfactorily accurate and sensitive. On the other hand, Computer Tomography (CT) scan images are much more sensitive and can be suitable for COVID-19 detection. To this end, in this paper, we develop a fully automated method for fast COVID-19 screening by using chest CT-scan images employing Deep Learning techniques. For this supervised image classification problem, a bootstrap aggregating or Bagging ensemble of three transfer learning models, namely, Inception v3, ResNet34 and DenseNet201, has been used to boost the performance of the individual models. The proposed framework, called ET-NET, has been evaluated on a publicly available dataset, achieving 97.81 ± 0.53 % accuracy, 97.77 ± 0.58 % precision, 97.81 ± 0.52 % sensitivity and 97.77 ± 0.57 % specificity on 5-fold cross-validation outperforming the state-of-the-art method on the same dataset by 1.56%. The relevant codes for the proposed approach are accessible in: https://github.com/Rohit-Kundu/ET-NET_Covid-Detection.
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Affiliation(s)
- Rohit Kundu
- Department of Electrical Engineering, Jadavpur University, Kolkata, 700032 India
| | - Pawan Kumar Singh
- Department of Information Technology, Jadavpur University, Kolkata, 700106 India
| | - Massimiliano Ferrara
- Department of Law, Economics and Human Sciences & Decisions Lab, Mediterranea University of Reggio Calabria, Reggio Calabria, 89125 Italy
- ICRIOS - The Invernizzi Centre for Research in Innovation, Organization, Strategy and Entrepreneurship, Bocconi University - Department of Management and Technology, Via Sarfatti 25, Milano, 20136 MI Italy
| | - Ali Ahmadian
- Institute of IR 4.0, The National University of Malaysia, Bangi, 43600 UKM Selangor Malaysia
- Department of Mathematics, Near East University, Nicosia, TRNC, Mersin 10 Turkey
- Institute for Mathematical Research, Universiti Putra Malaysia, Seri Kembangan, Selangor 43400 UPM Malaysia
| | - Ram Sarkar
- Department of Computer Science & Engineering, Jadavpur University, Kolkata, 700032 India
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Zulkifley MA, Abdani SR, Zulkifley NH, Shahrimin MI. Residual-Shuffle Network with Spatial Pyramid Pooling Module for COVID-19 Screening. Diagnostics (Basel) 2021; 11:1497. [PMID: 34441431 DOI: 10.3390/diagnostics11081497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/14/2021] [Accepted: 08/16/2021] [Indexed: 12/24/2022] Open
Abstract
Since the start of the COVID-19 pandemic at the end of 2019, more than 170 million patients have been infected with the virus that has resulted in more than 3.8 million deaths all over the world. This disease is easily spreadable from one person to another even with minimal contact, even more for the latest mutations that are more deadly than its predecessor. Hence, COVID-19 needs to be diagnosed as early as possible to minimize the risk of spreading among the community. However, the laboratory results on the approved diagnosis method by the World Health Organization, the reverse transcription-polymerase chain reaction test, takes around a day to be processed, where a longer period is observed in the developing countries. Therefore, a fast screening method that is based on existing facilities should be developed to complement this diagnosis test, so that a suspected patient can be isolated in a quarantine center. In line with this motivation, deep learning techniques were explored to provide an automated COVID-19 screening system based on X-ray imaging. This imaging modality is chosen because of its low-cost procedures that are widely available even in many small clinics. A new convolutional neural network (CNN) model is proposed instead of utilizing pre-trained networks of the existing models. The proposed network, Residual-Shuffle-Net, comprises four stacks of the residual-shuffle unit followed by a spatial pyramid pooling (SPP) unit. The architecture of the residual-shuffle unit follows an hourglass design with reduced convolution filter size in the middle layer, where a shuffle operation is performed right after the split branches have been concatenated back. Shuffle operation forces the network to learn multiple sets of features relationship across various channels instead of a set of global features. The SPP unit, which is placed at the end of the network, allows the model to learn multi-scale features that are crucial to distinguish between the COVID-19 and other types of pneumonia cases. The proposed network is benchmarked with 12 other state-of-the-art CNN models that have been designed and tuned specially for COVID-19 detection. The experimental results show that the Residual-Shuffle-Net produced the best performance in terms of accuracy and specificity metrics with 0.97390 and 0.98695, respectively. The model is also considered as a lightweight model with slightly more than 2 million parameters, which makes it suitable for mobile-based applications. For future work, an attention mechanism can be integrated to target certain regions of interest in the X-ray images that are deemed to be more informative for COVID-19 diagnosis.
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Rodríguez-Aguilar M, Díaz de León-Martínez L, Zamora-Mendoza BN, Comas-García A, Guerra Palomares SE, García-Sepúlveda CA, Alcántara-Quintana LE, Díaz-Barriga F, Flores-Ramírez R. Comparative analysis of chemical breath-prints through olfactory technology for the discrimination between SARS-CoV-2 infected patients and controls. Clin Chim Acta 2021; 519:126-132. [PMID: 33901429 PMCID: PMC8064814 DOI: 10.1016/j.cca.2021.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND We identified a global chemical pattern of volatile organic compounds in exhaled breath capable of discriminating between COVID-19 patients and controls (without infection) using an electronic nose. METHODS The study focused on 42 SARS-CoV-2 RT-qPCR positive subjects as well as 42 negative subjects. Principal component analysis indicated a separation of the study groups and provides a cumulative percentage of explanation of the variation of 98.3%. RESULTS The canonical analysis of principal coordinates model shows a separation by the first canonical axis CAP1 (r2 = 0.939 and 95.23% of correct classification rate), the cut-off point of 0.0089; 100% sensitivity (CI 95%:91.5-100%) and 97.6% specificity (CI 95%:87.4-99.9%). The predictive model usefulness was tested on 30 open population subjects without prior knowledge of SARS-CoV-2 RT-qPCR status. Of these 3 subjects exhibited COVID-19 suggestive breath profiles, all asymptomatic at the time, two of which were later shown to be SARS-CoV-2 RT-qPCR positive. An additional subject had a borderline breath profile and SARS-CoV-2 RT-qPCR positive. The remaining 27 subjects exhibited healthy breath profiles as well as SARS-CoV-2 RT-qPCR test results. CONCLUSIONS In all, the use of olfactory technologies in communities with high transmission rates as well as in resource-limited settings where targeted sampling is not viable represents a practical COVID-19 screening approach capable of promptly identifying COVID-19 suspect patients and providing useful epidemiological information to guide community health strategies in the context of COVID-19.
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Affiliation(s)
| | - Lorena Díaz de León-Martínez
- Faculty of Medicine-Center for Applied Research on Environment and Health (CIAAS), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, Mexico
| | - Blanca Nohemí Zamora-Mendoza
- Faculty of Medicine-Center for Applied Research on Environment and Health (CIAAS), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, Mexico
| | - Andreu Comas-García
- Center for Research in Biomedicine and Health Sciences, Faculty of Medicine, Autonomous University of San Luis Potosi, San Luis Potosi, SLP, Mexico
| | | | | | - Luz Eugenia Alcántara-Quintana
- CONACYT Research Fellow, Coordination for Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, Mexico
| | - Fernando Díaz-Barriga
- Faculty of Medicine-Center for Applied Research on Environment and Health (CIAAS), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, Mexico
| | - Rogelio Flores-Ramírez
- CONACYT Research Fellow, Coordination for Innovation and Application of Science and Technology (CIACYT), Autonomous University of San Luis Potosí, Avenida Sierra Leona No. 550, CP 78210, Colonia Lomas Segunda Sección, San Luis Potosí, SLP, Mexico,Corresponding author at: Av. Venustiano Carranza 2405, CP 78210 San Luis Potosí, SLP, Mexico
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Chong SMY, Hung RKY, Gwozdz A, Irwin S, Eastbury J, Cross T, Ahmed K, Taylor C, Goldenberg SD, Sanderson J, Olsburgh J. 30-Day postoperative COVID-19 outcomes in 398 patients from regional hospitals utilising a designated COVID-19 minimal surgical site pathway. Ann R Coll Surg Engl 2021; 103:395-403. [PMID: 33956529 PMCID: PMC10335038 DOI: 10.1308/rcsann.2020.7072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Postoperative pulmonary complications and mortality rates during the COVID-19 pandemic have been higher than expected, leading to mass cancellation of elective operating in the UK. To minimise this, the Guy's and St Thomas' Hospital NHS Foundation Trust elective surgery hub and the executive team at London Bridge Hospital (LBH) created an elective operating framework at LBH, a COVID-19 minimal site, in which patients self-isolated for two weeks and proceeded with surgery only following a negative preoperative SARS-CoV-2 polymerase chain reaction swab. The aim was to determine the rates of rates of postoperative COVID-19 infection. METHODS The collaboration involved three large hospital trusts, covering the geographic area of south-east London. All patients were referred to LBH for elective surgery. Patients were followed up by telephone interview at four weeks postoperatively. RESULTS Three hundred and ninety-eight patients from 13 surgical specialties were included in the analysis. The median age was 60 (IQR 29-71) years. Sixty-three per cent (252/398) were female. In total, 78.4% of patients had an American Society of Anesthesiologists grade of 1-2 and the average BMI was 27.2 (IQR 23.7-31.8) kg/m2. Some 83.6% (336/402) were 'major' operations. The rate of COVID-19-related death in our cohort was 0.25% (1/398). Overall, there was a 1.26% (5/398) 30-day postoperative all-cause mortality rate. Seven patients (1.76%) reported COVID-19 symptoms, but none attended the emergency department or were readmitted to hospital as a result. CONCLUSION The risk of contracting COVID-19 in our elective operating framework was very low. We demonstrate that high-volume major surgery is safe, even at the peak of the pandemic, if patients are screened appropriately preoperatively.
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Affiliation(s)
| | | | | | - S Irwin
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | | | | | | | - C Taylor
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - SD Goldenberg
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - J Sanderson
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - J Olsburgh
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
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Alizad-Rahvar AR, Vafadar S, Totonchi M, Sadeghi M. False Negative Mitigation in Group Testing for COVID-19 Screening. Front Med (Lausanne) 2021; 8:661277. [PMID: 34095171 PMCID: PMC8170512 DOI: 10.3389/fmed.2021.661277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
After lifting the COVID-19 lockdown restrictions and opening businesses, screening is essential to prevent the spread of the virus. Group testing could be a promising candidate for screening to save time and resources. However, due to the high false-negative rate (FNR) of the RT-PCR diagnostic test, we should be cautious about using group testing because a group's false-negative result identifies all the individuals in a group as uninfected. Repeating the test is the best solution to reduce the FNR, and repeats should be integrated with the group-testing method to increase the sensitivity of the test. The simplest way is to replicate the test twice for each group (the 2Rgt method). In this paper, we present a new method for group testing (the groupMix method), which integrates two repeats in the test. Then we introduce the 2-stage sequential version of both the groupMix and the 2Rgt methods. We compare these methods analytically regarding the sensitivity and the average number of tests. The tradeoff between the sensitivity and the average number of tests should be considered when choosing the best method for the screening strategy. We applied the groupMix method to screening 263 people and identified 2 infected individuals by performing 98 tests. This method achieved a 63% saving in the number of tests compared to individual testing. Our experimental results show that in COVID-19 screening, the viral load can be low, and the group size should not be more than 6; otherwise, the FNR increases significantly. A web interface of the groupMix method is publicly available for laboratories to implement this method.
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Affiliation(s)
- Amir Reza Alizad-Rahvar
- School of Biological Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Safar Vafadar
- Laboratory of Biological Complex Systems and Bioinformatics (CBB), Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Mehdi Totonchi
- Department of Genetics, Royan Institute for Reproductive Biomedicine, The Academic Center for Education, Culture, and Research (ACECR), Tehran, Iran
| | - Mehdi Sadeghi
- Department of Medical Genetics, National Institute for Genetic Engineering and Biotechnology, Tehran, Iran
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20
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Feki I, Ammar S, Kessentini Y, Muhammad K. Federated learning for COVID-19 screening from Chest X-ray images. Appl Soft Comput 2021; 106:107330. [PMID: 33776607 PMCID: PMC7979273 DOI: 10.1016/j.asoc.2021.107330] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/17/2021] [Accepted: 03/16/2021] [Indexed: 12/14/2022]
Abstract
Today, the whole world is facing a great medical disaster that affects the health and lives of the people: the COVID-19 disease, colloquially known as the Corona virus. Deep learning is an effective means to assist radiologists to analyze the vast amount of chest X-ray images, which can potentially have a substantial role in streamlining and accelerating the diagnosis of COVID-19. Such techniques involve large datasets for training and all such data must be centralized in order to be processed. Due to medical data privacy regulations, it is often not possible to collect and share patient data in a centralized data server. In this work, we present a collaborative federated learning framework allowing multiple medical institutions screening COVID-19 from Chest X-ray images using deep learning without sharing patient data. We investigate several key properties and specificities of federated learning setting including the not independent and identically distributed (non-IID) and unbalanced data distributions that naturally arise. We experimentally demonstrate that the proposed federated learning framework provides competitive results to that of models trained by sharing data, considering two different model architectures. These findings would encourage medical institutions to adopt collaborative process and reap benefits of the rich private data in order to rapidly build a powerful model for COVID-19 screening.
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Affiliation(s)
- Ines Feki
- Digital Research Center of Sfax, B.P. 275, Sakiet Ezzit, 3021 Sfax, Tunisia
| | - Sourour Ammar
- Digital Research Center of Sfax, B.P. 275, Sakiet Ezzit, 3021 Sfax, Tunisia.,SM@RTS : Laboratory of Signals, systeMs, aRtificial Intelligence and neTworkS, Sfax, Tunisia
| | - Yousri Kessentini
- Digital Research Center of Sfax, B.P. 275, Sakiet Ezzit, 3021 Sfax, Tunisia.,SM@RTS : Laboratory of Signals, systeMs, aRtificial Intelligence and neTworkS, Sfax, Tunisia
| | - Khan Muhammad
- Department of Software, Sejong University, Seoul 143-747, Republic of Korea
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21
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Hanton K, McHugh D, Boris G. A Case Series: Successfully Preventing COVID-19 Outbreak in a Residential Community Setting at a Drug and Alcohol Addiction Treatment Center. Healthcare (Basel) 2021; 9:88. [PMID: 33477319 PMCID: PMC7829973 DOI: 10.3390/healthcare9010088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/10/2021] [Accepted: 01/15/2021] [Indexed: 01/12/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has reduced the capacity of many addiction treatment centers, limiting access to safe, continual treatment for people with substance use disorders (SUD) in the setting of a pandemic. Here, we describe the COVID-19 screening process of a residential addiction treatment center in rural Connecticut that has had no outbreaks, closures, or reductions in capacity since the pandemic began. Out of 420 patients screened for COVID-19 from 1 February to 1 July, five patients tested positive for COVID-19: four prior to entering its residential community setting, and one after entering the residential community, resulting in no COVID-19 spread to other patients. Patient 1 presented from home and tested positive during screening prior to entry into the community. The primary care provider for patient 2 notified staff of a recent pos-itive COVID-19 test prior to the patient's arrival on-site. Patient 3 had a COVID-19 infection in the weeks prior to arrival and tested positive during initial screening. Patient 4 tested positive af-ter coming from another addiction treatment facility that was shut down due to a COVID-19 outbreak. Patient 5 tested negative for COVID-19 during initial screening, entered the residential community, and later tested positive. It is imperative that in-person support for SUD continues during the pandemic. This case report highlights the importance of implementing a variety of tools in an effective screening process, including polymerase chain reaction screening and daily symptomology and temperature screening, which may help prevent further closures or reductions in capacity of addiction treatment centers during the COVID-19 pandemic or future outbreaks.
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Affiliation(s)
- Kenneth Hanton
- Frank H. Netter MD School of Medicine, Quinnipiac University, North Haven, CT 06473, USA; (D.M.); (G.B.)
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22
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Qiu C, Cui C, Hautefort C, Haehner A, Zhao J, Yao Q, Zeng H, Nisenbaum EJ, Liu L, Zhao Y, Zhang D, Levine CG, Cejas I, Dai Q, Zeng M, Herman P, Jourdaine C, de With K, Draf J, Chen B, Jayaweera DT, Denneny JC, Casiano R, Yu H, Eshraghi AA, Hummel T, Liu X, Shu Y, Lu H. Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study. Otolaryngol Head Neck Surg 2020; 163:714-721. [PMID: 32539586 PMCID: PMC7298561 DOI: 10.1177/0194599820934376] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/15/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the prevalence and characteristics of olfactory or gustatory dysfunction in coronavirus disease 2019 (COVID-19) patients. STUDY DESIGN Multicenter case series. SETTING Five tertiary care hospitals (3 in China, 1 in France, 1 in Germany). SUBJECTS AND METHODS In total, 394 polymerase chain reaction (PCR)-confirmed COVID-19-positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and visual analog scale (VAS) were used to quantify olfactory and gustatory dysfunction, respectively. All subjects at 1 hospital (Shanghai) without subjective olfactory complaints underwent objective testing. RESULTS Of 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n = 239), German (n = 39), and French (n = 116) cohorts was 32%, 69%, and 49%, respectively. The median age of included subjects was 39 years, 92 of 161 (57%) were male, and 10 of 161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10 of 90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. Forty-three percent (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. CONCLUSIONS Olfactory and/or gustatory disorders may represent early or isolated symptoms of severe acute respiratory syndrome coronavirus 2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.
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Affiliation(s)
- Chenghao Qiu
- Center of Stomatology, Shanghai Public Health Clinical Center, Shanghai, China
| | - Chong Cui
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Charlotte Hautefort
- Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France
| | - Antje Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Jun Zhao
- Center of Pediatrics, Shanghai Public Health Clinical Center, Shanghai, China
| | - Qi Yao
- Department of Otorhinolaryngology, Chinese and Western Medicine Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Zeng
- Department of Cardiovascularology, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Eric J. Nisenbaum
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Li Liu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
| | - Yu Zhao
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Di Zhang
- Department of Otolaryngology, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Corinna G. Levine
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ivette Cejas
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Qi Dai
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Mei Zeng
- Department of Infectious Diseases, Children’s Hospital of Fudan University, Shanghai, China
| | - Philippe Herman
- Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France
| | - Clement Jourdaine
- Department of Head and Neck Surgery, Hopital Lariboisiere, University of Paris, Paris, France
| | - Katja de With
- Division of Infectious Diseases, University Hospital Carl Gustav Carus at the TU Dresden, Dresden, Germany
| | - Julia Draf
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Bing Chen
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Dushyantha T. Jayaweera
- Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - James C. Denneny
- American Academy of Otolaryngology–Head and Neck Surgery, Alexandria, Virginia, USA
| | - Roy Casiano
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Hongmeng Yu
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Adrien A. Eshraghi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Thomas Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Xuezhong Liu
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Yilai Shu
- ENT Institute and Otorhinolaryngology Department of the Affiliated Eye and ENT Hospital, State Key Laboratory of Medical Neurobiology, Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
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23
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Meng Y, Leng K, Shan L, Guo M, Zhou J, Tian Q, Hai Y. A clinical pathway for pre-operative screening of COVID-19 and its influence on clinical outcome in patients with traumatic fractures. Int Orthop 2020; 44:1549-1555. [PMID: 32468202 PMCID: PMC7254976 DOI: 10.1007/s00264-020-04645-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic. The toughest issue traumatic orthopaedic surgeons are faced with is how to maintain a balance between adequate COVID-19 screening and timely surgery. In this study, we described our experience with pre-operative COVID-19 screening in patients with traumatic fractures. Furthermore, we analysed the clinical results of fracture patients undergoing confined or emergency surgery during the COVID-19 outbreak. METHODS This was a case series study. Patients with traumatic fractures who were admitted to our hospital for surgery were enrolled in this study during the COVID-19 outbreak from March to April 2020. All patients were enrolled and managed using the standardized clinical pathway we designed for preoperative COVID-19 screening. Clinical, laboratory and outcome data were analysed. RESULTS The average surgery waiting time from injury to surgery was 8.7 ± 3.4 days. The average waiting time from admission to surgery was 5.3 ± 2.8 days. These average waiting times were increased by 4.1 days and 2.0 days, respectively, compared with 2019 data. Cardiovascular complications, venous thromboembolism and pneumonia occurred in one, two and one patient, respectively. Three and two patients developed pre-operative and postoperative fevers, respectively. CONCLUSIONS We introduced a novel clinical pathway for pre-operatively screening of COVID-19 in traumatic orthopaedic patients. The delay in surgery caused by COVID-19 screening was minimized to a point at which reasonable and acceptable clinical outcomes were achieved. Doctors should pay more attention to perioperative complications, such as cardiovascular complications, venous thromboembolism, pneumonia and fever.
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Affiliation(s)
- Yutong Meng
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Kunpeng Leng
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lei Shan
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Meng Guo
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Junlin Zhou
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
| | - Qingxian Tian
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
| | - Yong Hai
- Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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