scholarly journals COVID-19 pandemic: CT chest in COVID-19 infection and prediction of patient’s ICU needs

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed M. Osman ◽  
Ahmed M. Abdrabou ◽  
Reham M. Hashim ◽  
Faisal Khosa ◽  
Aya Yasin
Keyword(s):  
Severity Score ◽  
Gradual Increase ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Icu Patients ◽  
Dominant Feature ◽  
High Incidence ◽  
Polymerase Chain ◽  
Ct Features

Abstract Background With the tremendous rise in COVID-19 infection and the shortage of real-time reverse transcription-polymerase chain reaction (RT-PCR) testing, we aimed to assess the role of CT in the detection of COVID-19 infection and the correlation with the patients’ management. A retrospective study was conducted on 600 patients who presented with symptoms suspicious for COVID-19 infection between March and the end of June 2020. The current study followed the RSNA recommendations in CT reporting and correlated with the RT-PCR. CT was reviewed and the severity score was correlated with the patient’s management. Results Four hundred sixty-six patients were included with a mean age of 46 + 14.8 years and 63.3 % were males. Three hundred forty patients were confirmed positive by RT-PCR. CT sensitivity was 92.6% while the RT-PCR was the reference. The CT specificity showed a gradual increase with the CT probability reaching 97.6% with high probability CT features. Ground-glass opacities (GGO) was the commonest findings 85.9% with a high incidence of bilateral, peripheral, and multilobar involvement (88%, 92.8%, and 92.8% respectively). Consolidation was found in 81.5% of the ICU patients and was the dominant feature in 66.7% of the ICU cases. CT severity score was significantly higher in ICU patients with a score of ≥ 14. Conclusions COVID-19 infection showed typical CT features which can be used as a rapid and sensitive investigation. Two CT phenotypes identified with the predominant consolidation phenotype as well as severity score can be used to determine infection severity and ICU need.

A study of genes involved in adipocyte differentiation

2015 ◽  
Vol 28 (1-2) ◽  
Author(s):  
Shunming Zhu ◽  
Gong Cheng ◽  
Huolan Zhu ◽  
Gongchang Guan
Keyword(s):  
Potential Role ◽  
Adipocyte Differentiation ◽  
Late Phase ◽  
Redox Status ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Lipid Droplet Formation ◽  
Polymerase Chain ◽  
Microarray Technique

AbstractWith the use of the microarray technique, genes expressed in the late phase of adipocyte differentiation were investigated. These genes play an important role in stimulating adipocyte growth and lipid droplet formation. Therefore, they contribute a great deal to the onset of obesity.With the use of SW872 adipocytes and the microarray technique, genes related to adipocyte differentiation were tested and compared with undifferentiated preadipocytes 14 days after induction. Real-time reverse transcription polymerase chain reaction (RT-PCR) was used for confirmation.More than 21,329 transcriptors were expressed and determined, of which 1326 increased and 687 decreased undifferentiated adipocytes. Among them, 21 were highly expressed by more than 10-fold. With RT-PCR, 12 were confirmed, including apelin, CIDEC, PID1, LYRM1, ADD1, PPARγ2, ANGPTL4, ADIPOQ, ACOX1, FIP1L1, MAP3K2 and PEX14. Furthermore, genes involved in lipid metabolism, signal transduction, DNA replication, redox status and transcription factors were determined as well. Novel genes involved in adipogenesis (e.g., apelin) were detected.A variety of genes were discovered and validated with RT-PCR at the late phase of adipocyte differentiation. This may help us better understand the onset of obesity and the potential role of adipocytes in other organs.

Elucidating the Pivotal Role of Immune Players in the Management of COVID-19: Focus on Mesenchymal Stem Cells and Inflammation

2020 ◽  
Vol 15 ◽  
Author(s):  
Seidu A. Richard ◽  
Sylvanus Kampo ◽  
Marian Sackey ◽  
Maite Esquijarosa Hechavarria ◽  
Alexis D. B. Buunaaim ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Disease Burden ◽  
Viral Disease ◽  
Inflammatory Factors ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Paracrine Secretion ◽  
Polymerase Chain

: The world is currently engulfed with a viral disease with no cure. So, far, millions of people are infected with the virus across the length and breadth of world with thousand losing their lives each passing day. The WHO is February 2020 classified the virus as a coronavirus and the name Coronavirus-19 (CoV-19) was offered to the virus. The disease caused by the virus was termed coronavirus disease-19 (COVID-19). The pathogenesis of COVID-19 is associated with elevation of several immune plays as well as inflammatory factors which contributes to cytokine storms. Currently, the detection of CoV-19 RNA is through reverse transcriptase polymerase chain reaction (RT-PCR). Mesenchymal stem cells (MSCs) are capable of suppressing several kinds of cytokines via the paracrine secretion system. Therefore, MSCs therapy could be game charges in the treatment of the current COVID-19 pandemic. Also, intravenous IG may be capable of suppressing the high expression of IL-6 by the CoV-19 resulting in lessen disease burden. Anti-inflammatory medications like, corticosteroids, tocilizumab, glycyrrhetinic acid, as well as etoposide may be very advantageous in decreasing the COVID-19 burden because, their mode of action targets the cytokine storms initiated by the CoV-19. It is important to indicate that, these medication does not target the virus itself. Therefore, potent CoV-19 anti-viral medications are needed to completely cure patients with COVID-19. Also, a vaccine is urgently needed to stop the spread of the virus. This review therefore elucidates the immune players in the management of COVID-19; focusing principally on MSCs and inflammatory mediators.

scholarly journals Endothelin-1–Mediated Alteration of Metallothionein and Trace Metals in the Liver and Kidneys of Chronically Diabetic Rats

2002 ◽  
Vol 3 (3) ◽  
pp. 193-198 ◽  
Author(s):  
Lu Cai ◽  
Shali Chen ◽  
Terry Evans ◽  
M. George Cherian ◽  
Subrata Chakrabarti
Keyword(s):  
Trace Metals ◽  
Diabetic Rats ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Endothelin 1 ◽  
Liver And Kidney ◽  
Polymerase Chain ◽  
Age And Sex

In the present study, the role of endothelin-1 (ET-1) on alterations of hepatic and renal metallothionein (MT) and trace metals (Zn, Cu, and Fe) were investigated in streptozotocin (STZ)- induced diabetic rats. Diabetic rats, age- and sex-matched controls, as well as control and diabetic animals on a dualETA/ETBreceptor blocker, bosentan, were investigated after 6 months of follow-up. MT was measured by cadmium-heme assay. Metals were measured by atomic absorption spectrometer. ET-1 mRNA was analyzed by reverse transcriptase–polymerase chain reaction (RT-PCR) technique. Hepatic and renal ET-1 mRNA was increased in diabetic rats as compared to control rats, along with an increase in both hepatic and renal MT proteins. The increased hepatic MT protein level was associated with decreases in hepatic Cu and Fe, whereas increased renal MT was associated with increases in renal Cu and Fe accumulation. Zn levels were unaltered in both organs in diabetic rats. Bosentan treatment partially prevented the increase in MT levels in both liver and kidney, along with reduced serum creatinine and increased urinary creatinine levels. Further bosentan treatment corrected the increased Cu and Fe levels in the kidney in diabetic rats, but reduced hepatic Cu and Fe levels. No significant effects of bosentan treatment on nondiabetic rats were observed. The data suggest that the possible effects of ET antagonism in diabetes may be mediated via changes in MT and trace metals.

scholarly journals Efficacy of normal saline nasal spray and gargle on SARS-CoV-2 for prevention of COVID-19 pneumonia

2021 ◽  
Author(s):  
Uday Chatterjee ◽  
Ajay Chakraborty ◽  
Sishir Naskar ◽  
Bibhuti Saha ◽  
Bhaswati Bandyapadhyay ◽  
...  
Keyword(s):  
Nasal Spray ◽  
Normal Saline ◽  
Severity Score ◽  
Load Cycle ◽  
Control Group ◽  
Study Group ◽  
Rt Pcr ◽  
Group 14 ◽  
Polymerase Chain

Abstract Background: Role of microaspiration of mucus mixed with SARS-CoV-2 (severe acute respiratory syndrome corona virus 2) causing pneumonia is lacking in searched literature. Recently some authors have emphasized on microaspiration. SARS-CoV-2 primarily replicates in nasal mucosa and sheds in nasal mucus which travels down as microaspiration and causes pneumonia. We aimed to evaluate the efficacy of normal saline nasal spray and gargle (NSNSG) to wash off SARS-CoV-2 from nasal and pharyngeal mucosa to prevent microaspiration and pneumonia. Methods: From RT-PCR (reverse transcriptase polymerase chain reaction) report, we selected 61 patients for study group and 64 patients for control, having higher virion load; cycle threshold (Ct) value 25 or less. Patients in study group were trained with NSNSG. We reviewed HRCT (high resolution computed tomogram) of lung in 56 patients of both groups for severity score in lung and were compared with initial HRCT. Results: Twenty nine out of 61 (47%) of study group significantly (p=0·02) became negative following NSNSG compared to 17 out of 64 patients (26%) of control. Severity score (SS) in 31 out of 34 patients (91%) either decreased or became static in study group. In control group, 14 out of 22 patients (63%) also showed same findings. Nevertheless, study group significantly improved (p=0·028) in SS. Conclusions: NSNSG significantly washes off SARS-CoV-2 from nasal cavity and pharynx and prevents microaspiration of SARS-CoV-2 in lung alveoli. Trial Registration No: CTRI/2020/08/027465

scholarly journals Emergency calls are early indicators of ICU bed requirement during the COVID-19 epidemic

2020 ◽  
Author(s):  
◽  
Bruno Riou
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Icu Patients ◽  
Ambulance Dispatch ◽  
Polymerase Chain ◽  
Gp Visits ◽  
Second Wave

AbstractBackgroundAlthough the number of intensive care unit (ICU) beds is crucial during the COVID-19 epidemic caring for the most critically ill infected patients, there is no recognized early indicator to anticipate ICU bed requirements.MethodsIn the Ile-de-France region, from February 20 to May 5, 2020, emergency medical service (EMS) calls and the response provided (ambulances) together the percentage of positive reverse transcriptase polymerase chain reaction (RT-PCR) tests, general practitioner (GP) and emergency department (ED) visits, and hospital admissions of COVID-19 patients were recorded daily and compared to the number of COVID-19 ICU patients. Correlation curve analysis was performed to determine the best correlation coefficient (R), depending on the number of days the indicator has been shifted. A delay ≥7 days was considered as an early alert, and a delay ≥14 days a very early alert.FindingsEMS calls, percentage of positive RT-PCR tests, ambulances used, ED and GP visits of COVID-19 patients were strongly associated with COVID-19 ICU patients with an anticipation delay of 23, 15, 14, 13, and 12 days respectively. Hospitalization did not anticipate ICU bed requirement.InterpretationThe daily number of COVID19-related telephone calls received by the EMS and corresponding dispatch ambulances, and the proportion of positive RT-PCR tests were the earliest indicators of the number of COVID19 patients requiring ICU care during the epidemic crisis in the Ile-de-France region, rapidly followed by ED and GP visits. This information may help health authorities to anticipate a future epidemic, including a second wave of COVID19 or decide additional social measures.FundingOnly institutional funding was provided.Research in contextEvidence before the studyWe searched PubMed and preprint archives for articles published up to May 17, 2020, that contained information about the anticipation of intensive care unit (ICU) bed requirement during the COVID-19 outbreak using the terms “coronavirus”, “2009-nCOV”, “COVID-19”, SARS-CoV2”, “prediction” “resource” and “intensive care”. We also reviewed relevant references in retrieved articles and the publicly available publication list of the COVID-19 living systematic review.22 This list contains studies on covid-19 published on PubMed and Embase through Ovid, bioRxiv, and medRxiv, and is continuously updated. Although many studies estimated the number of patients who would have severe COVID-19 requiring ICU, very few contained assessment for early signals (from internet or social media), and we retrieved no study whose data came from suspected or infected patients.Added values of this studyDuring the COVID-19 epidemic, emergency medical system (EMS) calls, percentage of positive reverse transcriptase polymerase chain reaction (RT-PCR) tests, ambulance dispatch, emergency department (ED) and general practitioner (GP) visits of COVID-19 patients were strongly associated with COVID-19 ICU patients with an anticipation delay of 23, 15, 14, 13, and 12 days respectively. Hospitalization did not anticipated COVID-19 ICU bed requirement.Implication of all available evidenceEMS calls and ambulance dispatch, percent of positive RT-PCR, and ED and GP visits could be valuable tools as daily alert signals to set up plan to face the burden of ICU bed requirement during the initial wave of the COVID-19 epidemic, and may possibly also help anticipating a second wave. These results are important since mortality has been reported being correlated to health care resources.

scholarly journals Comparison of chest HRCT severity score in PCR positive and PCR negative clinically suspected COVID-19 Patients

2021 ◽  
Vol 21 (4) ◽  
pp. 1558-66
Author(s):  
Hina Hanif Mughal ◽  
Syed Muhammad Jawad Zaidi ◽  
Hamza Waqar Bhatti ◽  
Madiha Maryum ◽  
Maria Khaliq ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Severity Score ◽  
Clinical Symptoms ◽  
False Negative ◽  
Left Lung ◽  
Lung Damage ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Severity Scores ◽  
Polymerase Chain

Background: The limitations and false-negative results of Real-time Polymerase chain reaction (RT PCR) in diagnosing COVID-19 infection demand the need for imaging modalities such as chest HRCT to improve the diagnostic accuracy andassess the severity of the infection. Objectives: The study aimed to compare the chest HRCT severity scores in RT-PCR positive and negative cases of COVID-19. Methods: This cross-sectional study included 50 clinically suspected COVID-19 patients. Chest HRCT and PCR testing of all 50 patients were done and the chest HRCT severity scores for each lung and bronchopulmonary segments were compared in patients with positive and negative PCR results. Chi-square and Mann Whitney U test were used to assess differences among study variables. Results: Chest HRCT severity score was more in PCR negative patients than in those with PCR positive results . However, the difference was not significant (p=0.11). There was a significant association in severity scores of the anterior basal segment of the left lung (p=0.022) and posterior segment upper lobe of right lung (p=0.035) with PCR results. This association was insignificantfor other bronchopulmonary segments (p>0.05). Conclusion: CR negativity does not rule out infection in clinically suspected COVID-19 patients. The use of chest HRCT helps to determine the extent of lung damage in clinically suspected patients irrespective of PCR results. Guidelines that consider clinical symptoms, chest HRCT severity score and PCR results for a confirmed diagnosis of COVID-19 in suspected patientsare needed. Keywords: Chest High resolution computed tomography (HRCT); COVID-19; Polymerase Chain Reaction (PCR).

scholarly journals Application of RT-PCR for diagnosis of respiratory syncytial virus and human metapneumovirus infections in Bulgaria, 2006-7 and 2007-8

2009 ◽  
Vol 14 (23) ◽  
Author(s):  
S Pavlova ◽  
T Hadzhiolova ◽  
P Abadjieva ◽  
R Kotseva
Keyword(s):  
Respiratory Syncytial Virus ◽  
Respiratory Diseases ◽  
National Laboratory ◽  
Human Metapneumovirus ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Acute Respiratory Diseases ◽  
Polymerase Chain ◽  
Syncytial Virus

We describe here the results of respiratory syncytial virus (RSV) detection by reverse transcription polymerase chain reaction (RT-PCR) during two consecutive seasons, from December 2006 to February 2007 and from October 2007 to March 2008, performed in the National Laboratory of Influenza and Acute Respiratory Diseases, Bulgaria. A total number of 278 nasopharyngeal samples obtained from hospitalised children up to the age of five years were investigated for these two seasons. During the first season, the aetiological role of RSV was confirmed in 56 of 148 samples (37.8%) compared to 11 of 130 samples (8.5%) during the second season. Since the beginning of January 2008, RT-PCR for the detection of the recently identified human metapneumovirus (HMPV) has also been introduced in Bulgaria. This virus has been demonstrated as the aetiological agent in 13 out of 81 samples (16%) from children of the same age group. The use of RT-PCR allows the detection of a broader spectrum of viruses causing respiratory diseases, as well as better discrimination of the aetiological agents in clinically similar cases.

scholarly journals Role of HRCT Scan of Chest in the Evaluation of COVID-19 Pneumonia

2021 ◽  
Vol 34 (1) ◽  
pp. 109-114
Author(s):  
Md Hafizur Rahman ◽  
Nashid Amir ◽  
Md Anisur Rahman ◽  
AHM Tohurul Islam ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
High Specificity ◽  
Viral Disease ◽  
Rt Pcr ◽  
Chain Reaction ◽  
Severity Scoring ◽  
Proper Diagnosis ◽  
Disease Spreading ◽  
Polymerase Chain

Coronavirus disease (COVID-19) pneumonia emerged in Wuhan, China, in December 2019. It is a highly contagious viral disease spreading worldwide, with a rapid increase in the number of cases & deaths. COVID-19 pneumonia is characterized by fever, fatigue, dry cough, and dyspnea with other systemic features such as diarrhea, altered sensorium, stroke & multi-organ failure. HRCT chest is one of the most sensitive modalities for early detection of COVID-19 pneumonia & monitor the outcome of these patients. It is an important complement to the reverse transcriptase polymerase chain reaction (RT-PCR) tests. HRCT shows high specificity & sensitivity in detection of COVID-19 pneumonia being 90.7% & 70.8% respectively. In this pandemic situation, proper diagnosis & management of COVID-19 positive cases largely depends on HRCT findings & severity scoring. TAJ 2021; 34: No-1: 109-114

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