Screening Test For COVID-19 Research Articles

Economic benefits of COVID-19 screening tests

Economic benefits of COVID-19 screening tests

White blood cells scattergram as a valuable tool for COVID-19 screening: A multicentric study.

New tools have been developed to distinguish the COVID-19 diagnosis from other viral infections presenting similar symptomatology and mitigate the lack of sensitivity of molecular testing. We previously identified a specific "sandglass" aspect on the white blood cells (WBC) scattergram of COVID-19 patients, as a highly reliable COVID-19 screening test (sensitivity: 85.9%, specificity: 83.5% and positive predictive value: 94.3%). We then decided to validate our previous data in a multicentric study. This retrospective study involved 817 patients with flu-like illness, among 20 centers, using the same CBC instrument (XN analyzer, SYSMEX, Japan). After training, one specialist per center independently evaluated, under the same conditions, the presence of the "sandglass" aspect of the WDF scattergram, likely representing plasmacytoid lymphocytes. Overall, this approach showed sensitivity: 59.0%, specificity: 72.9% and positive predictive value: 77.7%. Sensitivity improved with subgroup analysis, including in patients with lymphopenia (65.2%), patients presenting symptoms for more than 5 days (72.3%) and in patients with ARDS (70.1%). COVID-19 patients with larger plasmacytoid lymphocyte cluster (>15 cells) more often have severe outcomes (70% vs. 15% in the control group). Our findings confirm that the WBC scattergram analysis could be added to a diagnostic algorithm for screening and quickly categorizing symptomatic patients as either COVID-19 probable or improbable, especially during COVID-19 resurgence and overlapping with future influenza epidemics. The observed large size of the plasmacytoid lymphocytes cluster appears to be a hallmark of COVID-19 patients and was indicative of a severe outcome. Furthers studies are ongoing to evaluate the value of the new hematological parameters in combination with WDF analysis.

Nasal Cerebrospinal Leaks in the Milieu of COVID-19 Pandemic

Abstract Background The unintentional ingestion of oropharyngeal or gastric contents into the respiratory tract is known as aspiration. Rhinorrhea can cause aspiration pneumonia (cerebrospinal fluid leakage). Objective There are only a few reports in the literature about pneumonia as a complication of rhinorrhea. There are no reports on how to handle such cases if they present to the clinic at the peak of COVID-19 disease and distinguish between these two conditions. Methods We reviewed the literature and retrospectively analyzed the clinical information and treatment protocols used to treat the two clinical cases. Results By screening the COVID-19 PCR and antibodies more than twice, surgery was postponed for 10–14 days in both cases to rule out COVID-19-induced pneumonia. Chest CT scans still revealed ground glass opacities. In both cases, the skull base defect was repaired. In both cases, radiological signs of rhinorrhea-induced pneumonia had completely resolved at the 24- and 30-day follow-ups. Conclusion CSF aspiration causes radiological changes in the lungs in rhinnorhea. This is a short-term local decrease in lung tissue airness (partial filling of alveoli with fluids), which is visible radiographically (ground-glass opacities). To rule out COVID-19 infection, surgery should be postponed for 10–14 days, and PCR and antibodies (IgG,IgM) should be performed at least twice. If the COVID-19 screening test is negative, repair surgery can be scheduled.

Economic Evaluation of Wastewater Surveillance Combined with Clinical COVID-19 Screening Tests, Japan.

The COVID-19 pandemic has imposed substantial burdens on the global society. To find an optimal combination of wastewater surveillance and clinical testing for tracking COVID-19, we evaluated the economic efficiency of hypothetical screening options at a single facility in Japan. To conduct cost-benefit analyses, we developed standard decision models in which we assumed model parameters from literature and primary data, such as screening policies used at the Tokyo Olympic and Paralympic Village in 2021. We compared hypothetical 2-step screening options that used clinical PCR to diagnose COVID-19 after a positive result from primary screening using antigen tests (option 1) or wastewater surveillance (option 2). Our simulation results indicated that option 2 likely would be economically more justifiable than option 1, particularly at lower incidence levels. Our findings could help justify and promote the use of wastewater surveillance as a primary screening at a facility level for COVID-19 and other infectious diseases.

Health Counseling and COVID-19 Screening Test at Universitas Nasional in 2021

Rapid tests for initial screening of COVID-19 are urgently needed given the very fast spread of the disease. However, WHO emphasized that this examination does not establish a clinical diagnosis of COVID-19 and is not recommended for triaging patients with suspected COVID-19, the rapid test is only an initial screening; Real-Time Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) must still confirm the results. Meanwhile, triage of patients uses a rapid risk assessment from the Ministry of Health which refers to the WHO Rapid Risk Assessment of Acute Public Health guidelines. In order to assist the government's program in preventing the spread of Covid-19, it is necessary to carry out health education about the behavior of preventing Covid-19 and early detection of Covid-19 by testing rapid antibodies at the National University. The results of the dedication activity showed that the participants were enthusiastic about listening to the material provided and participating in the inspection activities. Participants admitted that this inspection activity provided great benefits for breaking the chain of the spread of the coronavirus in the National University environment.

Ocular Manifestations and Tear or Conjunctival Swab PCR Positivity For SARS-CoV-2 In Patients With COVID-19: A Systematic Review and Meta-Analysis

Background: Respiratory viruses have a tendency for ocular-tropism and SARS-CoV-2 is one of them. In this context, we have undertaken this systematic literature-review and metaanalysis for systemic evaluation of ocular symptoms of COVID-19. Material and Method: We have screened 14 literature databases applying key-words “Ocular”, “Ophthalmic”, “Conjunctiva”, “Cornea”, “Retina”, “Sclera”, “Uvea”, “2019-nCov”, “2019 novel corona virus”, “COVID-19”, “corona virus disease-2019”. Studies published till 26th April 2020 were included. Studies conducted in COVID-19 population and reporting ocular ma infestations were included. Case reports, series, observational studies were included in the systematic review part, while only observational studies were included in the metaanalysis part. Pooled proportions were evaluated and reported along with 95% confidence interval. Heterogeneity was evaluated using I2 statistics and random or fixed-effect model was selected to evaluate the pooled proportions based upon presence of extent of heterogeneity. Result: A total of 14 studies (total 2259 patients) were included in our systematic-review and metaanalysis which reported occurrence of ocular symptoms in COVID-19. In our study, prevalence of conjunctivitis/red eye in COVID-19 was 2.8% (95% CI 1.3% to 4.2%, I2=72.41%). Conjunctivitis/red eye was the first symptom of COVID-19 in 1.08% of patients (95% CI 0.37% to 2.44%, I2=0%). Tear sample PCR positivity rate in COVID-19 was 2.6% (1.3% to 4.5%, I2=47%). However, among COVID-19 patients with conjunctivitis/red eye, the PCR positivity rate in tear sample was 20.6% (6/29 cases). Again, among patients who were positive for the virus in tear sample by PCR, the proportion of conjunctivitis/red eye was 33.3% (4/12 cases). We also evaluated the association between occurrence of ocular manifestations and disease severity (mild and moderate vs. severe and critical). The odds was 0.28 (95% CI 0.12-0.67, I2=0%). This highlights that the mild to moderate severity disease had significantly lower occurrence of the ocular symptoms compared to the severe and critical group. However, we couldn’t find any association between tear sample PCR positivity and disease severity [odds ratio 0.46 (95% CI 0.06-3.45, I2=0%)]. Conclusion: In patients with COVID-19, 2.8% of patients show ocular manifestation. However, among patients with ocular manifestation, only 20.6% cases showed tear/conjunctival swab RT-PCR positivity. So, ocular symptoms may warrant a COVID-19 screening test during thie epidemic of COVID-19.

Successful Intrapericardial Fibrinolysis on Acute Recurrent Purulent Pericarditis with Impending Cardiac Tamponade during Pandemic Situation: A Rare Case Report

Introduction: Acute recurrent purulent pericarditis is an uncommon pericardium infection that can be life-threatening due to pus production, leading to cardiac tamponade. Case presentation: We report a 36-year-old man referring to our hospital with impending cardiac tamponade who needed urgent pericardiocentesis. The patient's complaints were worsening dyspnea and palpitations in the last two days. The patient had been hospitalized for the same complaint and had pericardiocentesis due to cardiac tamponade approximately three weeks earlier. Physical exam, ECG, and CXR suggest impending cardiac tamponade. Echocardiography indicated massive right and left pericardial effusion and right atrial collapse. The Covid-19 screening test was positive; however, RT-PCR revealed a negative result. The patient was diagnosed with recurrent acute purulent pericarditis with impending cardiac tamponade requiring urgent pericardiocentesis. After the procedure, 1.5 million units of intrapericardial fibrinolytic were administered to patients. His improved hemodynamic and clinical symptoms indicate a successful procedure. Conclusion: This case highlights the challenges of managing an acute recurrent purulent pericarditis patient due to Staphylococcus A. infection in the current pandemic era, including distinguishing it from other contagious diseases due to nonspecific dyspnea, limited therapeutic options, and the effectiveness of intrapericardial fibrinolytic in improving the overall patient conditions, and reducing the mortality rate.

Letter to the Editor: Commentary on Does the COVID-19 Screening Test Affect the Postoperative Prognosis of Patients Who Undergo Emergency Surgery for Cerebral Hemorrhage? (Korean J Neurotrauma 2022;18:198-207).

Letter to the Editor: Commentary on Does the COVID-19 Screening Test Affect the Postoperative Prognosis of Patients Who Undergo Emergency Surgery for Cerebral Hemorrhage? (Korean J Neurotrauma 2022;18:198-207).

Cutaneous Mucormycosis Co-infection in a Patient with COVID-19

Mucormycosis is a life-threatening fungal infection usually seen in patients who are immunocompromised; however, to date, it has been rarely described in patients with COVID-19, although more recently, reports from India have described an increased incidence of these infections. This report describes a patient with COVID-19 who developed a fatal dermatologic mucormycosis infection. The patient, whose history included therapy for diffuse large B-cell lymphoma, had an incidental positive screening test for COVID-19 in February 2021 after exposure to a family member who had tested positive. They then presented to the emergency room a few weeks later exhibiting progressive dyspnoea and fever. A CT scan of the chest revealed ground glass opacities. They were intubated approximately 2 weeks later and their course was complicated by renal failure, for which continuous renal replacement therapy was started, and by refractory hypoxaemic and hypercapnic respiratory failure in which they were placed on venovenous extracorporeal membrane oxygenation. During their course in the intensive care unit (ICU), they developed a right thigh haematoma, thought to be related to the previous insertion of a femoral arterial pressure monitoring catheter. Several days before the patient’s death, the wound noted to be covered by a brown-black eschar was cultured on April 30 and returned positive for Rhizopus oryzae and Staphylococcus epidermidis on May 5. The patient was immediately started on liposomal amphotericin and posaconazole and taken urgently taken to the operating room for a radical debridement. Unfortunately, their post-operative course was characterised by fulminant haemodynamic collapse and multiple system organ failure, from which the patient died.

Strategies to Improve Patient Flow in the Emergency Department during the COVID-19 Pandemic: A Narrative Review of Our Experience.

The COVID-19 pandemic has resulted in a tremendous strain on the global healthcare system. Emergency departments worldwide have been challenged to the extreme end. This has led clinicians and policy creators to rearrange patient flow pathways for an efficient emergency department (ED). It was reported according to our experience of utilizing a novel strategy to enhance patient flow while reducing the risk of infection transmission among patients and healthcare staff. This included the development of three layers of triage. First, an outer checkpoint prior to the hospital entrance was established to identify eligible patients for emergency department visits. The second layer of triage is located at the ED entrance to direct patients either to the respiratory or nonrespiratory care area to identify potentially infected patients and the third is the routine full triage activity. Then, after completing a clinical assessment in the ED, physicians determine the need for an inpatient isolation unit, a nonisolation inpatient unit, or discharge. Moreover, examples of additional measures were substantial changes to shift schedules; rerouting ambulance crews with COVID patients to inpatient beds directly bypassing the ED; controlled use of personal protective equipment (PPE); and implementing appropriate COVID-19 screening tests. During the peak of the pandemic, our strategies achieved favorable results and minimized unnecessary ED visits without any patient complications. This current study provides a set of newly developed steps and procedures that can be further control patient flow pathways and maintain a low risk of infection transmission to a manageable level for an efficient ED.

Underuse of primary healthcare in France during the COVID-19 epidemic in 2020 according to individual characteristics: a national observational study

BackgroundThe organization of healthcare systems changed significantly during the COVID-19 pandemic. The impact on the use of primary care during various key periods in 2020 has been little studied.MethodsUsing individual data from the national health database, we compared the numbers of people with at least one consultation, deaths, the total number of consultations for the population of mainland France (64.3 million) and the mean number of consultations per person (differentiating between teleconsultations and consultations in person) between 2019 and 2020. We performed analyses by week, by lockdown period (March 17 to May 10, and October 30 to December 14 [less strict]), and for the entire year. Analyses were stratified for age, sex, deprivation index, epidemic level, and disease.ResultsDuring the first lockdown, 26% of the population consulted a general practitioner (GP) at least once (-34% relative to 2019), 7.4% consulted a nurse (-28%), 1.6% a physiotherapist (-80%), and 5% a dentist (-95%). For specialists, consultations were down 82% for ophthalmologists and 37% for psychiatrists. The deficit was smaller for specialties making significant use of teleconsultations. During the second lockdown, the number of consultations was close to that in 2019, except for GPs (-7%), pediatricians (-8%), and nurses (+ 39%). Nurses had already seen a smaller increase in weekly consultations during the summer, following their authorization to perform COVID-19 screening tests. The decrease in the annual number of consultations was largest for dentists (-17%), physiotherapists (-14%), and many specialists (approximately 10%). The mean number of consultations per person was slightly lower for the various specialties, particularly for nurses (15.1 vs. 18.6). The decrease in the number of consultations was largest for children and adolescents (GPs: -10%, dentists: -13%). A smaller decrease was observed for patients with chronic diseases and with increasing age. There were 9% excess deaths, mostly in individuals over 60 years of age.ConclusionsThere was a marked decrease in primary care consultations in France, especially during the first lockdown, despite strong teleconsultation activity, with differences according to age and healthcare profession. The impact of this decrease in care on morbidity and mortality merits further investigation.

MO22-3 Gravity of COVID-19 infection in oncology patients undergoing active treatment, a Romanian Cancer Center experience

COVID-19 pandemic had a great impact on the way we deal with oncology patients. One of the compulsory methods to restrain the spread of the virus implemented by Romanian Ministry of Health in April 2020 was the compulsory PCR COVID-19 screening test for all asymptomatic patients undergoing chemotherapy, molecular treatment or immunotherapy, 24-48 hours before the beginning of treatment.

Explainable Vision Transformers and Radiomics for COVID-19 Detection in Chest X-rays.

The rapid spread of COVID-19 across the globe since its emergence has pushed many countries’ healthcare systems to the verge of collapse. To restrict the spread of the disease and lessen the ongoing cost on the healthcare system, it is critical to appropriately identify COVID-19-positive individuals and isolate them as soon as possible. The primary COVID-19 screening test, RT-PCR, although accurate and reliable, has a long turn-around time. More recently, various researchers have demonstrated the use of deep learning approaches on chest X-ray (CXR) for COVID-19 detection. However, existing Deep Convolutional Neural Network (CNN) methods fail to capture the global context due to their inherent image-specific inductive bias. In this article, we investigated the use of vision transformers (ViT) for detecting COVID-19 in Chest X-ray (CXR) images. Several ViT models were fine-tuned for the multiclass classification problem (COVID-19, Pneumonia and Normal cases). A dataset consisting of 7598 COVID-19 CXR images, 8552 CXR for healthy patients and 5674 for Pneumonia CXR were used. The obtained results achieved high performance with an Area Under Curve (AUC) of 0.99 for multi-class classification (COVID-19 vs. Other Pneumonia vs. normal). The sensitivity of the COVID-19 class achieved 0.99. We demonstrated that the obtained results outperformed comparable state-of-the-art models for detecting COVID-19 on CXR images using CNN architectures. The attention map for the proposed model showed that our model is able to efficiently identify the signs of COVID-19.

COVID-19 Pandemic Management in Oil and Gas Company, a Corporate Office Experience Based

Background: The COVID-19 pandemic is first and foremost a human tragedy that has played out across the globe. People are experiencing unprecedented levels of disruption in their homes and communities, as well as in their jobs. Office worker of an international oil and gas company located in Jakarta was also had the impact of COVID-19 pandemic. The company must establish system to protect their worker to perform their work safely and avoid COVID-19 exposure.Objective: To describe COVID-19 statistic period 2020 – November 2021 and how company address the system to prevent outbreak and the re-occurrence.Methods: A case study based on company record and performance on tackling COVID-19 problem during 2020 – 2021.Result: Two cases started in March 2020 and total were up to 111 of 800’s workers until Nov 2021. 56% were asymptomatic, 39% were 50 yo or above. 74% did not have co morbid. 46% were domestic cluster. Cases trend were like local and national cases statistic trend.Conclusion: COVID-19 had also impact to corporate office workers which potentially lead to business disruption. The company set dedicated health system to prevent and control COVID-19 system. Principally, it must be set higher than local government standard other than 3M as follows: WFH policy, lowered body temperature identification to min 370C for COVID-19 testing, applied mobile application for health monitoring and tracing, biweekly COVID-19 screening test prior to work at office and included COVID-19 prevention behavior into individual key performance indicator.

Importance of pre-operative COVID-19 screening test in elective surgeries.

Background and Objectives:Since the COVID-19 pandemic initiation, more than 28 million elective surgeries were postponed with a cancellation rate of 72.3%. However, studies suggested that the patient treatment should be conducted within 12 weeks of diagnosis because delay in treatment might have had adverse impacts on patients' health status, prognosis, and pathologic stage. Hence, the current study aimed to assess the importance of a pre-operative COVID-19 screening test for the patients were candidates for elective surgery.Materials and Methods:This cross-sectional study was conducted on 141 patients who were candidates for any type of elective surgeries or cesarean section at a tertiary university-based hospital, between June 2020, and September 2020.Results:The mean age of participants was 41.38 ± 11.66 years. Of them, 91.5% were women and 8.5% were men. The COVID-19 polymerase chain reaction (PCR) screening tests were positive in 12 (8.5%) patients. From whose PCR tests were positive, only five people (less than half) had symptoms of COVID-19 such as fever (three patients), a distinctive smell (two patients), and cough (one patient). Suspected exposure to COVID-19 was reported in four of them.Conclusion:In this study, we found that more than half of PCR positive COVID-19 patients were asymptomatic. Therefore, to have a safe hospital environment, and improve patient health outcomes, the COVID-19 screening test should be applied before any interventions.

"Costs Associated with A COVID-19 Screening Test, Country Comparison Editorial"

"Costs Associated with A COVID-19 Screening Test, Country Comparison Editorial"

Resuming elective orthopaedic services during the COVID-19 pandemic : our experience.

AimsThe aim of this study was to surveil whether the standard operating procedure created for the NHS Golden Jubilee sufficiently managed COVID-19 risk to allow safe resumption of elective orthopaedic surgery.MethodsThis was a prospective study of all elective orthopaedic patients within an elective unit running a green pathway at a COVID-19 light site. Rates of preoperative and 30-day postoperative COVID-19 symptoms or infection were examined for a period of 40 weeks. The unit resumed elective orthopaedic services on 29 June 2020 at a reduced capacity for a limited number of day-case procedures with strict patient selection criteria, increasing to full service on 29 August 2020 with no patient selection criteria.ResultsA total of 2,373 cases were planned in the 40-week study period. Surgery was cancelled in 59 cases, six (10.2%) of which were due to having a positive preoperative COVID-19 screening test result. Of the remaining 2,314, 996 (43%) were male and 1,318 (57%) were female. The median age was 67 years (interquartile range 59.2 to 74.6). The median American Society of Anesthesiologists grade was 2. Hip and knee arthroplasties accounted for the majority of the operations (76%). Six patients tested positive for COVID-19 preoperatively (0.25%) and 39 patients were tested for COVID-19 within 30 days after discharge, with only five patients testing positive (0.22%).ConclusionThrough strict application of a COVID-19 green pathway, elective orthopaedic surgery could be safely delivered to a large number of patients with no selection criteria.Cite this article: Bone Jt Open 2021;2(11):951–957.

COVID-19 Testing Trends: Pre-Radiation and Throughout Cancer Care

Purpose/Objective(s)Timely care is critical for individuals diagnosed with cancer—despite the ongoing COVID-19 pandemic—as delays adversely affect cancer outcomes. Patients presenting for radiotherapy (RT) at a single institution who underwent COVID-19 screening procedures prior to RT were analyzed regarding treatment delays and disparities.Materials/MethodsOur institution is an urban multidisciplinary cancer center. In April 2020, our Radiation Oncology department implemented universal COVID-19 screening protocols prior to RT initiation (with possible patient opt-out) to ensure patient/staff safety. Patients did not start RT until testing negative. We collected patient demographics and COVID-19 testing information on patients planned for RT from April to October 2020. We studied trends of other lifetime COVID-19 testing that these patients received to evaluate for overall delays. Summary statistics were analyzed within a data collection web application.Results177 consecutive patients with cancer were scheduled to begin RT. 15 (8.5%) declined pre-RT COVID-19 testing and proceeded to RT. Of patients who consented to pre-RT testing, 99 (61.1%) were female; mean age was 60.6 (range 24-94). Most patients were Black (n = 98, 60.5%). 61 (37.7%) and 41 (25.3%) were insured through Medicare and Medicaid, respectively. Common primary cancer sites were breast (n = 52, 32.1%), prostate (n = 27, 16.7%), and lung (n = 23, 14.2%). 58 (35.8%) patients presented with metastatic disease; the most common metastatic sites were bone (n = 26, 44.8%) and brain (n = 12, 20.7%). Most patients received external RT (n = 152, 93.8%), primarily adjuvant (n = 66, 40.7%) and palliative (n = 59, 36.4%) RT. One (0.6%) asymptomatic patient tested "presumptive positive" for COVID-19 pre-RT. The patient was COVID-19 negative on immediate repeat testing and proceeded to RT. Overall, the 162 patients who consented to pre-RT testing received 549 total lifetime COVID-19 tests. Most of these patients received palliative RT (n = 219, 39.9%), followed by adjuvant (n = 199, 36.2%) and definitive RT (n = 101, 18.4%). Mean number of total COVID-19 tests per patient was 3.4 (range 1-14). Only 32 patients (19.8%) were administered a solitary pre-RT COVID-19 screening test. 24 (14.8%) patients had at least one positive COVID-19 test over the study period. In total, 32 (5.8%) positive COVID-19 test results were documented; 11 patients (6.8%) experienced a mean RT delay of 4.0 (range 3-8) weeks until testing negative. Other care delays included surgical/diagnostic procedure delays (n = 4), delayed presentation due to COVID-19 fears (n = 2), and travel restrictions (n = 1).ConclusionThe majority of patients with cancer planned for RT tested negative for COVID-19 and proceeded to RT without delay. However, delays prior to radiation oncology consultation due to diagnostic workup, imaging, or biopsies, as well as testing positive for COVID-19, could intensify underlying disparities affecting our urban patient population.

Impact of the COVID-19 pandemic on catheterization laboratory procedural volumes at a tertiary cardiac centre in a low- & middle-income country in South Asia

BackgroundGlobally, reports have suggested that cardiac catheterization procedures, particularly elective coronary procedures declined as a result of the COVID-19 pandemic. However, there is scarce data on this aspect, in terms of a South Asian low- & middle-income country (LMIC) setting.PurposeWe aimed to evaluate temporal trends and impact of the pandemic on elective and emergency cardiac catheterization procedural volumes at a high-volume tertiary cardiac centre in a LMIC.MethodsData on both emergency and elective catheterization procedures, including coronary angiography, percutaneous coronary intervention (PCI), peripheral angiography, pacing & electrophysiology (EP) were collected from January to December 2020, and compared with corresponding data for the same months in 2019. Data were obtained from hospital's catheterization laboratory database. The difference was expressed as a percentage (%Δ). Data for each quarter were compared using paired t-test. A p value <0.05 was considered significant.ResultsOverall, a significant (32.4%) reduction of cath lab procedures was seen in 2020, as compared with 2019 (p=0.006). There were significantly reduced numbers of coronary angiographies (%Δ −31.4%; p=0.009), PCI (%Δ −32.2%; p=0.008), peripheral procedures (%Δ −69.9%; p=0.001) and pacing & EP procedures (Δ−-48.7%; p=0.001) in 2020, as compared with 2019 (Table 1 & Figure 1). For coronary procedures this was most marked in 2nd and 3rd quarters of 2020 (p<0.05). The greatest deficits for coronary angiographies were observed in April 2020, compared to 2019 (Δ −85.1%); the greatest reductions in PCI (Δ-87.7%) and pacing & EP (Δ −94.7%) were seen in May 2020, coinciding with the nation-wide lockdown measures. Coronary procedures showed a gradually increasing trend since July 2020. Given their elective nature, no peripheral procedures were performed from April to July 2020. In terms of PCI, there was a significant reduction in elective procedures in the 2nd quarter of 2020 (p=0.001), with a steep “catch-up” incline in September (Δ +2.9%) and October 2020 (Δ −8.3%), coinciding with availability of in-hospital COVID19 screening tests (Table 1). Among ad hoc PCI for acute coronary syndrome (ACS), although a 32.3% reduction was seen overall (p=0.108), a significant decrease was only observed in the 2nd quarter. Ad hoc PCI for non-ACS was significantly reduced throughout 2nd to 4th quarters of 2020. In line with national guidelines preferring fibrinolysis as first-line for STEMI, as well as absence of negative pressure ventilation cath labs and unavailability of rapid-screening COVID test kits, no primary PCI procedures were performed since May 2020.ConclusionThe impact of COVID-19 resulted in a significant reduction in all cardiac catheterization procedures in 2020, as compared with 2019. This reduction was most marked for coronary procedures in the 2nd and 3rd quarters of 2020, with a significant reduction in elective procedures.Funding AcknowledgementType of funding sources: None. Table 1

Highly sensitive scent-detection of COVID-19 patients in vivo by trained dogs.

Timely and accurate diagnostics are essential to fight the COVID-19 pandemic, but no test satisfies both conditions. Dogs can scent-identify the unique odors of volatile organic compounds generated during infection by interrogating specimens or, ideally, the body of a patient. After training 6 dogs to detect SARS-CoV-2 by scent in human respiratory secretions (in vitro diagnosis), we retrained 5 of them to search and find the infection by scenting the patient directly (in vivo screening). Then, efficacy trials were designed to compare the diagnostic performance of the dogs against that of the rRT-PCR in 848 human subjects: 269 hospitalized patients (COVID-19 prevalence 30.1%), 259 hospital staff (prevalence 2.7%), and 320 government employees (prevalence 1.25%). The limit of detection in vitro was lower than 10-12 copies ssRNA/mL. During in vivo efficacy experiments, our 5 dogs detected 92 COVID-19 positive patients among the 848 study subjects. The alert (lying down) was immediate, with 95.2% accuracy and high sensitivity (95.9%; 95% C.I. 93.6-97.4), specificity (95.1%; 94.4-95.8), positive predictive value (69.7%; 65.9-73.2), and negative predictive value (99.5%; 99.2-99.7) in relation to rRT-PCR. Seventy-five days after finishing in vivo efficacy experiments, a real-life study (in vivo effectiveness) was executed among the riders of the Metro System of Medellin, deploying the human-canine teams without previous training or announcement. Three dogs were used to examine the scent of 550 volunteers who agreed to participate, both in test with canines and in rRT-PCR testing. Negative predictive value remained at 99.0% (95% C.I. 98.3-99.4), but positive predictive value dropped to 28.2% (95% C.I. 21.1-36.7). Canine scent-detection in vivo is a highly accurate screening test for COVID-19, and it detects more than 99% of infected individuals independent of key variables, such as disease prevalence, time post-exposure, or presence of symptoms. Additional training is required to teach the dogs to ignore odoriferous contamination under real-life conditions.