COVID-19 Positive Patients Research Articles

Risk of post-tonsillectomy hemorrhage among COVID-19 positive pediatric patients

ObjectiveCOVID-19 infection has been demonstrated to increase risk for post-operative bleeding. This study investigated the impact of COVID-19 infection on post-tonsillectomy hemorrhage in pediatric patients, a potentially devastating complication. Study designRetrospective cohort study. MethodsThe TriNetX database was queried for pediatric patients who underwent tonsillectomy and evaluated for outcomes of primary and secondary post-tonsillectomy hemorrhage. ResultsAmong subjects 18 years and younger, 1226 were COVID-19 positive and 38,241 were COVID-19 negative in the perioperative period. There was statistically significant increased risk of bleeding with perioperative COVID-19 infection at postoperative days 1, 5, and 10. Additionally, when assessing the role of COVID-19 infection before or after surgery, the risk of bleeding remained statistically significant at all three time points, however these results did not suggest that infection before surgery confers more/less risk compared to infection after. ConclusionThe results of this investigation suggest that the presence of COVID-19 in the perioperative period may pose an increased risk for acute or delayed post tonsillectomy hemorrhage. This study employed a large, diverse population and is the first to address this clinical question.

Clinical Characteristics and Outcomes of COVID-Positive Maintenance Hemodialysis Patients: A Study from India.

This study describes to the clinical features and outcomes of patients on maintenance hemodialysis infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant. This was a retrospective analysis of case records of patients on maintenance hemodialysis admitted for management of coronavirus disease (COVID) infection. Our teaching hospital, being a state-designated referral center, had COVID admissions from March 2020 till December 2020. Epidemiological and clinical data were collected and analyzed. Factors influencing survival and the survival curve analysis were assessed. Of a total of 21,228 admissions during the period, 400 patients were referred for nephrology services. Of the 400 referrals, 226 were maintenance hemodialysis patients. Mean age of the group was 50 years, and fever was the most common presenting symptom. On multivariate analysis, factors influencing mortality were found to be older age, presence of diabetes, leukopenia, thrombocytopenia, hypoxemia, need for support, and a higher qSOFA score. The probability of survival of dialysis patients at the end of 19 days was 60%. During the pandemic by SARS-CoV-2 delta variant, majority of the nephrology referrals were for maintenance hemodialysis patients. Mortality was 38% in the study group, and the factors associated with mortality with a significant hazard ratio were older age and diabetes.

Sex differences in acute stroke metrics and outcome dependent on COVID status.

Biological sex is known to have an impact on quality metrics of acute stroke. We aimed to determine whether COVID positivity accentuates this effect and constitutes worse outcome. The present analysis was based on the Global COVID-19 Stroke Registry, a retrospective, international, cohort study of consecutive ischemic stroke patients receiving intravenous thrombolysis and/or endovascular thrombectomy between 1 March 2020 and 30 June 2021. We investigated differences between the sexes in patient characteristics, acute stroke metrics as well as post-stroke outcome in COVID-positive and COVID-negative stroke patients undergoing acute revascularization procedures. A total of 15,128 patients from 106 centers were recorded in the Global COVID-19 Stroke Registry, 853 (5.6%) of whom were COVID-positive. Overall, COVID-positive individuals were treated significantly slower according to every acute stroke metric compared to COVID-negative patients. We were able to show that key quality indicators in acute stroke treatment were unfavorable for COVID-negative women compared to men (last-seen-well-to-door time + 11 min in women). Furthermore, COVID-negative women had worse 3-month outcomes (3-month modified Rankin Scale score [interquartile range] 3.0 [4.0] vs. 2.0 [3.0]; p < 0.01), even after adjusting for confounders. In COVID-positive individuals no such difference between the sexes, either in acute management metrics or in 3-month outcome, was seen. Known sex-related differences in acute stroke management exist and extend to times of crisis. Nevertheless, if patients were COVID-19-positive at stroke onset, women and men were treated the same, which could be attributed to structured treatment pathways.

Family Experiences in Caring for Covid-19 Positive at Home: Phenomenology Study

Aims: Covid-19, a global problem since 2019, has significantly increased in Indonesia since early 2020. Government policies restrict patients from outside activities, making home care a unique experience. This study aims to understand families' experiences in caring for positive Covid-19 patients. Methods: The method used is qualitative with a phenomenological study approach. There were 12 participants in this study with the criteria of accompanying patients who experienced Covid-19 &lt;1 year and these companions cared for patients at home. The sampling technique used was purposive sampling, with in-depth interviews of 30-45 minutes and recorded and recorded. The data analysis technique used is the collaizi method. Results: The results of the study obtained six themes, namely understanding Covid-19 Disease, Information Sources for Covid-19 Treatment, Treatment Considerations, Psychological Burden, Difficulties in Home Care, and Social Support. Conclusions: This study found six themes related to family experience in caring for Covid-19 patients, so that the role of the family and social community is very important in caring for Covid-19 patients in dealing with changing conditions and situations.

Improving compliance with personal protective equipment among anaesthetists through behaviour-changing interventions during the coronavirus disease 2019(COVID-19) pandemic.

Since 2020, the coronavirus disease 2019 (COVID-19) pandemic has seen many changes in our daily infection prevention behaviours so as to reduce healthcare-associated transmission of COVID-19 in patients and healthcare workers. In the early phases of the COVID-19 pandemic of 2020, there was much emphasis on compliant personal protective equipment utilization in the operating theatres (OTs) for COVID-19-positive patients. However, during this period, there was a lack of international validated protocols on the appropriate handling and subsequent storage of personal protective equipment in the context of aerosol-generating procedures in OTs for asymptomatic antigen rapid test (ART)-negative patients. Given the potential for transmission even with a negative ART due to the incubation period, our team developed a checklist of eye protection (e.g. goggles/face shield) and N95 mask handling and storage in non-isolation OTs for these patients. We sought to improve the compliance of best practices from 20% to 80% amongst junior anaesthetists in Singapore General Hospital so as to prevent infection transmission and cross-contamination in the OT through education and behaviour-changing interventions. This quality improvement project took place over 19 weeks from June to October 2020 by our team of anaesthetists and nurse clinicians in the non-isolation OT setting. To analyse the problem, we performed a root cause analysis to understand attitudes and beliefs driving their behaviour. The top 80% of cited root causes for non-compliance then guided prioritization of resources for subsequent behaviour-changing interventions. Using the comprehensive infection control checklist, we conducted several plan-do-study-act cycles while implementing this new checklist amongst junior anaesthetists. A total of 227 assessments of junior anaesthetists were made in the care of asymptomatic ART-negative patients. Compliance with correctly handling goggles post-intubation started out as 33.3% in Week 1, which improved to 78.5% by Week 19. Compliance with goggle storage and face shield disposal started out at 13.6% in Week 1 and increased to 78.6% by Week 19. We attributed this improvement to education and behaviour-changing interventions. This quality improvement project focusing on improving compliance with personal protective equipment utilization during the COVID-19 pandemic in the management of asymptomatic ART-negative patients in non-isolation OTs demonstrated the importance of interventions of education, persuasion, modelling, and training in effecting and sustaining organizational behaviour change in physicians and other healthcare personnel.

Multi-phase failure modes and effects analysis for low dose bilateral whole lung irradiation of COVID-19 positive patients requiring respiratory ventilation.

To identify high-priority risks in a clinical trial investigating the use of radiation to alleviate COVID-19 pneumonia using a multi-phase failure modes and effects analysis (FMEA). A comprehensive FMEA survey of 133 possible causes of failure was developed for the clinical trial workflow (Phase I). The occurrence, severity, and detection risk of each possible cause of failure was scored by three medical physicists. High-risk potential failure modes were identified using the risk priority number (RPN) and severity scores, which were re-scored by 13 participants in radiation oncology (Phase II). Phase II survey scores were evaluated to identify steps requiring possible intervention and examine risk perception patterns. The Phase II participants provided consensus scores as a group. Thirty high-priority failure modes were selected for the Phase II survey. Strong internal consistency was shown in both surveys using Cronbach's alpha (αc≥0.85). The 10 failures with the largest median RPN values concerned SARS-CoV-2 transmission (N=6), wrong treatment (N=3), and patient injury (N=1). The median RPN was larger for COVID-related failures than other failure types, primarily due to the perceived difficulty of failure detection. Group re-scoring retained 8/10 of the highest-priority risk steps that were identified in the Phase II process, and discussion revealed interpretation differences of process steps and risk evaluation. Participants who were directly involved with the trial working group had stronger agreement on severity scores than those who were not. The high ranking of failures concerning SARS-CoV-2 transmission suggest that these steps may require additional quality management intervention when treating critically ill COVID-19+ patients. The results also suggest that a multi-phase FMEA survey led by a facilitator may be a useful tool for assessing risks in radiation oncology procedures, supporting future efforts to adapt FMEA to clinical procedures.

Study of HRCT Score, Comorbidities, Specific Blood Findings, and Management of COVID-positive Patients at Dr DY Patil Medical College and Hospital, Pune

Study of HRCT Score, Comorbidities, Specific Blood Findings, and Management of COVID-positive Patients at Dr DY Patil Medical College and Hospital, Pune

Family caregiver experience of caring COVID-19 patients admitted in COVID-19 hospital of a tertiary care hospital in Nepal.

Informal caregivers played a significant role in caring for COVID-19 patients during hospitalization in Nepal. This study aimed to understand the experiences of family caregivers attending to their relatives in a COVID-19 hospital in Nepal. A descriptive phenomenological approach was adopted to understand the caregiver's experience in supporting their relatives admitted to the COVID-19 hospital of the BP Koirala Institute of Health Sciences (BPKIHS). Thirteen caregivers of COVID-19 positive patients were purposively selected from April to June, 2022. Face-to-face interviews were conducted at a caregiver residential facility using the interview schedule developed by the department for the purpose of data collection after obtaining ethical clearance from the Institutional review committee of BPKIHS. Data were audio recorded and manually analyzed. Among the 13 caregivers, six were male and seven were female. The findings were categorized into five domains: challenges encountered, changes in physical and mental health, changes in roles and responsibilities, positive experiences, and strategies to ease caregiving tasks. Major challenges included financial burdens, communication problems, stigmatization, Insecurity, substandard accommodation, and visitor restrictions. Caregivers reported negative emotions, unmet physical health needs, and shifts in family and occupational roles. Despite these challenges, caregivers attempted to cope positively and acknowledged the efforts of healthcare personnel and other family members. Suggestions for improving caregiving included providing essential medical and basic services within the hospital, enhancing accommodation facilities, establishing proper communication channels, and allowing visitations. Caregivers of COVID-19 patients face significant challenges during the caregiving process. Enhancing hospital services, promoting effective communication, fostering positive attitudes, and ensuring a safe environment can facilitate caregiving tasks.

The Effectiveness of Advanced Cardiac Testing on Identifying Risk for Sudden Cardiac Arrest/Death in Athletes Following COVID-19 Infection During Preparticipation Examination: A Critically Appraised Topic

Clinical Scenario: Due to the potential side effects in athletes, there is a need to evaluate for cardiac-related side effects due to COVID-19 infection during preparticipation examinations. Clinical Question: Does advanced cardiac testing during preparticipation examinations in athletes who have contracted the COVID-19 virus identify cardiac abnormalities? Summary of Key Findings: The literature was searched based on athletes’ post–COVID-19 infection who were tested for risk of sudden cardiac arrest/death. The initial search yielded 32 studies, but 7 were excluded based on abstract content. Of the remaining 25 studies, 17 were excluded based on patient age or non-athletic populations. Four relevant studies met the inclusion criteria and were included. The need for cardiac screening and advanced cardiac testing was supported to identify risk of sudden cardiac arrest/death during preparticipation examinations in COVID-19–positive patients. Clinical Bottom Line: The use of advanced cardiac testing along with a comprehensive symptom and history questionnaire is essential to reduce cardiac complications due to COVID-19. Symptom-based questionnaires following COVID-19 infection can detect possible COVID-19–related cardiac abnormalities better than the standard cardiac symptom-based questionnaires alone. These combined screening measures for patients with a COVID-19 infection can safely help return athletes to sports. Strength of Recommendation: This recommendation has a strength of B based on Oxford Centre for Evidence-Based Medicine due to consistently lower quality limited evidence that supports the use of advanced cardiac testing in identifying heart-related complications and risk of sudden cardiac arrest/death in COVID-19–positive patients.

A National Study of Olfactory Dysfunction among COVID-19 Patients in Saudi Arabia

Abstract Introduction: COVID-19 has different symptomatology reported in the literature, including olfactory and/or gustatory dysfunction. The evidence now points to smelling loss as one of the most common symptoms, and in some patient is the only symptom. The prevalence of smelling loss has various bases in the literature. Over time, many centers realized the potential of olfactory and/or gustatory dysfunction to be early symptoms of COVID-19. Recently, the Centers of Disease Control and Prevention added smell or taste loss to symptoms that may appear after exposure to COVID-19. In this study, we are the first national project to report anosmia in COVID-19 patients in Saudi Arabia. Methods: This is the first national cross-sectional study from the Saudi Ministry of Health’s database. Ethics and written approval from the Institutional Review Board was obtained from the King Abdullah Medical City Research Center, Makkah, Saudi Arabia. Results: There were 5492 patients with a positive COVID-19 enrolled in this study. The most common comorbidity among positive COVID-19 patients is bronchial asthma (8.6%), followed by diabetes mellitus (7.5%). Approximately 30% had olfactory and taste dysfunction during the COVID-19 infection period. We found the presence of comorbidities, such as cognitive disorder (54.9%), immunodeficiency (46.8), and diabetes mellitus (23%), as significantly related to olfactory and taste dysfunction (P &lt; 0.05). Conclusion: The olfactory and gustatory dysfunction may be the only presenting symptoms of COVID-19 in diabetic and immunocompromised patients, such that awareness of COVID-19 is crucial for early diagnosis, treatment, and prevention.

Readiness, acceptability, and feasibility of differentiated TB care for COVID-positive pulmonary tuberculosis patients diagnosed in a district in South India: Mixed methods study.

Differentiated tuberculosis care (DTC) approach is the need of the hour to mitigate those risks and provide better treatment outcomes to reduce both mortality and morbidity. Before implementing such an approach, there should be adequate literature on healthcare facility assessment along with qualitative exploration on readiness and acceptability among various stakeholders that are currently needed to fill the gaps in National Tuberculosis Elimination Program. Our study objectives were to assess the availability of equipment, treatment, and investigations for managing patients under the DTC approach, to explore the readiness, acceptability, and feasibility of the DTC approach among healthcare providers involved in TB care provision, and to determine the knowledge regarding DTC approach among healthcare providers delivering TB care for COVID-positive pulmonary TB patients. All Peripheral Health Institutes (PHIs) in two randomly chosen blocks within the Tiruchirappalli district's health units were selected for the healthcare facilities assessment. By the universal sampling method, all the stakeholders were included. The study population was assessed for their knowledge regarding DTC. Checklist-based assessment of the feasibility of healthcare services followed by a questionnaire-based knowledge assessment was done. An in-depth interview-based exploration of readiness and acceptability of the DTC approach was conducted. This study was conducted among various stakeholders involved in TB care in selected PHIs of Tiruchirappalli from July 2022 to October 2022. The majority of healthcare workers (HCWs) are unaware of bidirectional screening (89.0%) and lack training in providing TB care to COVID-co-infected patients (87.8%), although the majority were aware of risk stratification for TB patients (90.2%) and are linking TB with other co-morbidities (82.9%). About 62.2% of HCWs claimed they are not using information communication technology-based services to receive lab findings from public scans and laboratory centers, and more than one-third were unaware of these facilities. Based on the qualitative assessment, most of them were willing to undergo periodic training to improvise their approach and treatment. Also, most of the HCWs felt manpower can be increased for the specific care of the patients. The research suggests that with sufficient training and upskilling of the HCWs, DTC is almost feasible and that HCWs will accept it if specific strategies are used. More studies like these in assessing the feasibility and acceptability of this DTC approach and exploring the challenges and solutions will help the policymakers in finding the lacunae before implementing this DTC model in various states across India.

Endovascular aortic repair for ruptured abdominal aortic aneurysm during the COVID-19 era

ObjectiveThe COVID-19 pandemic caused significant stress on health care systems, leading to altered care processes (ie, altered treatment algorithms, supply shortages, and personnel shortages). However, the effect of COVID and subsequent altered care processes on many surgical outcomes has not been characterized. In particular, patient outcomes after endovascular aortic repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) have not been well reported. Using COVID prevalence as a surrogate for altered processes of care, our aim is to determine changes in COVID-negative patient outcomes after EVAR for rAAA. MethodsUsing the Center for Disease Control COVID-19 data, COVID mortality per 3-month quarter was calculated in Florida. The quarters with the three highest mortality rates and three lowest mortality rates were used to establish COVID-heavy and COVID-light timeframes, respectively. Three quarters of 2019 were used for the pre-COVID timeframe for comparison. The Florida Agency for Health Care Administration database was queried using International Classification of Diseases-10 codes to identify patients diagnosed with rAAA who underwent EVAR during each timeframe. COVID-positive patients were excluded. Primary outcomes were in-hospital mortality, morbidity, and length of stay. Stepwise linear and logistic regression with 10-fold cross-validation determined which factors most impacted primary outcomes. Secondary outcomes included individual complication rates. ResultsA total of 316 patients were included. There were no significant differences in surgical volume, demographics, or comorbidities except that more patients had peripheral vascular disease in the COVID-light timeframe compared with the pre-COVID timeframe (P = .01). Mortality, length of stay, and complications were not significantly different per timeframe on univariable analysis. Regression confirmed that timeframe was not significantly associated with any primary outcome. ConclusionsDespite increased stress on the health care system during the COVID-19 pandemic, outcomes after EVAR for rAAA were unchanged in Florida. These results imply that despite periods of COVID-heavy stress on the health care system, patient care was maintained at the pre-COVID standard of care.

Clinical profile of COVID-19 patients and factors impacting mortality in a rural tertiary care center of Solapur

Background: A retrospective and cohort study was conducted in our center to study the parameters among surviving and non-surviving patients that have a significant impact on in hospital mortality. Along with this, demographic and clinical profile was also studied. Aims and Objectives: The aim of this study was to evaluate clinical profile of COVID-19 patients and factors impacting mortality. Materials and Methods: The present study is a single-center, retrospective, and cohort study done on COVID-19 positive (by real-time polymerase chain reaction) patients admitted between May 2019 and June 2021 in the intensive care unit (ICU). Of the total 1694 patients, 422 required ICU treatment and the remaining 1272 patients were treated in wards and rooms and discharged home. The analysis was based on demographic, clinical, associated comorbidities, laboratory and radiological data, and treatment modalities used. Outcome data were analyzed by regression analysis and the Kaplan–Meir survival plot was used to calculate mortality trend. Results: Of the 422 patients, 158 (37.4%) died and 264 (62.6%) survived. Males predominated with 297/422 (70.4%). ICU admissions comprised 115/158 (72.8%) of the total deaths. Fever (88%), dyspnea (78.48), and cough (67.1%) were the most common symptoms in non-survival group. Hypertension (43.7%) and diabetes (37.3%) were the most common comorbidities. High oxygen (&gt;10 L/min) (P&lt;0.0001), invasive ventilation (P&lt;0.0001), noradrenaline infusion P&lt;0.0001), renal replacement therapy (P&lt;0.0001) and tocilizumab requirement (P&lt;0.0001), procalcitonin (P&lt;0.009) and interleukin-6 (P&lt;0.004) acute respiratory distress syndrome (ARDS) with septic shock, and multiorgan failure (P&lt;0.0001), all indicated higher risk of death. Conclusion: Mortality was 37.4% in our study. Elderly age (&gt;60 years), high serum ferritin (&gt;931.9), and severe disease with a high resolution computed tomography score (&gt;15), ARDS with septic complications requiring invasive ventilation and vasopressor support, are associated with increased mortality in these patients.

COVID-19 associated anosmia in pediatric patients: subject publications review.

Aim: To review the publications subject to the problem of COVID-19 associated anosmia incidence in pediatric patients as well as its pathogenesis, diagnostics, treatment and recovery. The peculiarity of pediatric COVID-19 anosmia is due to children accounting for very low percentage of COVID-19 patients (comparing to one in adults), mostly with milder course of the disease. Awareness of anosmia and its proper diagnostics is crucial in children and adolescents, considering it can be the only manifestation in COVID-19 positive pediatric patients. Materials and Methods: In order to achieve this goal a meta-analysis of information from databases followed by statistical processing and generalisation of the obtained data was carried out. Conclusions: Publications on COVID-19 anosmia in children and adolescents are less numerous than those concerning adult patients, so it is important to use every single trustworthy one. Anosmia/ageusia may be the only symptom, early identifier and the strongest predictor of COVID-19 infection in pediatric patients. Prospects for further scientific researches. Further researches regarding differential diagnostics of COVID-19 and other infections, including seasonal influenza, manifesting with both olfactory and taste dysfunction as well as anosmia diagnostics in children and adolescents with autistic spectrum and different types of mental disorders are possible.

Comparing demographics, treatments, and outcomes of patients with COVID-19 lesions versus hospital-acquired pressure ulcers/injuries during the first year of COVID-19.

As COVID-19 has emerged as a pandemic virus, multiple reports have surfaced to describe skin lesions that occur either associated with the virus or due to treatment. To compare patient demographics, treatments, and outcomes in COVID-19 symptomatic patients who developed skin lesions (COVID-19 or hospital-acquired pressure ulcer/injury [HAPU/I]) during the first year of the pandemic. A retrospective chart review was conducted on COVID-positive symptomatic patients admitted from March 1, 2020, through March 1, 2021. The authors analyzed the difference in patient demographics, patient skin tones, treatments, hospital length of stay (LOS), intensive care unit (ICU) LOS, death, and discharge disposition for those with COVID-19 lesions compared to those who developed HAPU/Is. Of those who developed lesions, 2.3% developed COVID-19 lesions and 7.2% developed HAPU/Is. Patients with COVID-19 lesions were more likely to be male (64%), younger (median age 60), and had a higher BMI (30) than patients with no wounds and patients with HAPU/I. This study advances the knowledge of the patient demographics and treatments that may contribute to identifying the new phenomenon of COVID lesions and how they differ from HAPU/Is.

Abnormal Serum Biochemical Results and Mitochondrial Damage of Lymphocytes in Patients with Schizophrenia and SARS-CoV-2 Infection: A Retrospective Study.

In this study, we investigated the differences in clinical biochemical values and mitochondrial mass between schizophrenia patients with and without COVID-19, so as to provide assistance to the treatment and management of COVID-19 positive patients with schizophrenia. We undertook an exploratory, retrospective review of patient data from Dec. 6, 2022, to Jan. 31, 2023. A total of 1696 inpatients with psychosis (921 schizophrenia patients and 775 diagnosed with other mental diseases) during this period were identified. Finally, 60 schizophrenia patients were enrolled in our study, and 20 of them were infected with syndrome coronavirus 2 (SARS-CoV-2). The serum biochemical levels and single-cell mitochondrial mass (SCMM) of the T lymphocytes of all schizophrenia patients were analyzed. The serum levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), creatinine (Cr) and lactate dehydrogenase (LDH) were significantly higher in schizophrenia patients with COVID-19 (SCZ-C) group. In addition, the SCZ-C group showed lower CD3+, CD3+CD4+ and CD3+CD8+ cell counts and higher SCMM of T lymphocytes compared to SCZ group. Furthermore, positive correlations were found between the T-cell subpopulation counts and positive symptom scores on the Positive and Negative Syndrome Scale (PANSS). Our study findings showed that schizophrenia patients with COVID-19 have a phenotype of mitochondrial damage in T lymphocytes and higher serum levels of AST, ALP, Cr and LDH, which might provide evidence for treating individuals with schizophrenia during subsequent spread of infectious disease.

Prevalence of COVID-19 neurological manifestations in patients referred to the Golestan Hospital in Ahvaz between March 2020 to the March 2023.

Due to the abundance of ACE2 receptors in nervous system cells, the SARS-CoV-2 virus can cause damage to this system. This study aims to examine the prevalence of neurological symptoms in COVID-19 patients. In this cross-sectional observational study, 75 COVID-19 positive patients admitted to Golestan Hospital's neurology department in Ahvaz, Iran, from March 2020 to March 2023, were investigated. Neurological clinical symptoms were categorized into three groups: central nervous system, peripheral, and muscular symptoms. The relevant information was collected from patient files, including medical history, imaging data, and laboratory test results. Statistical analysis was performed using SPSS software, employing the rank-biserial correlation coefficient (r), Mann-Whitney U tests, Phi correlation, Cramer's V, and Kendall's Tau to evaluate the prevalence and significance of neurological symptoms. The most common clinical symptoms observed were hemiparesis, dysarthria, Central Facial Palsy (CFP), ataxia, and nausea, respectively. Among these symptoms, headaches (p = 0.001), seizures (p = 0.024), and nausea (p = 0.046) were found to be more prevalent in younger patients. Additionally, a significant relationship was identified between the level of serum Creatine phosphokinase (CPK) and seizures (p = 0.024), with lower levels observed in individuals with vomiting (p = 0.024), and higher levels observed in individuals with CFP (p = 0.040). This study highlights that patients with COVID-19 may experience serious neurological symptoms. The clinical spectrum and range of neurological symptoms associated with COVID-19 were found to be diverse and extensive, emphasizing the importance of considering this infection as a potential cause of neurological disorders.

Clinical Profile and Outcomes of COVID-19 Positive Patients with Chronic Obstructive Pulmonary Disease (COPD) in a Tertiary Government COVID-19 Referral Center

Clinical Profile and Outcomes of COVID-19 Positive Patients with Chronic Obstructive Pulmonary Disease (COPD) in a Tertiary Government COVID-19 Referral Center

Comparison of Oral Manifestations in Hospitalized COVID-19 Positive Patients and COVID-19 Negative Dental Outpatients. A Case Series Study and Literature Review

Comparison of Oral Manifestations in Hospitalized COVID-19 Positive Patients and COVID-19 Negative Dental Outpatients. A Case Series Study and Literature Review

A Phantom-Free Approach for Estimating the Backscatter Coefficient of Aggregated Red Blood Cells applied to COVID-19 Patients.

The ultrasound backscatter coefficient is a frequency-dependent quantity intrinsic to biological tissues that can be recovered from backscattered radiofrequency signals, granted acquisitions on a reference phantom are available under the same system's settings. A phantom-free backscatter coefficient estimation method is proposed based on Gaussian-shaped approximation of the point spread function (electronics and piezoelectric characteristics of the scanner's probe) and the effective medium theory combined with the structure factor model, albeit the proposed approach is amenable to other models. Meanwhile, the total attenuation due to intervening tissues is refined from its theoretical value, which is based on reported average behaviors of tissues, while allowing correction for diffraction due to the probe's geometry. The reference phantom method adapted to a similar approach except for the Gaussian approximation is also presented. The proposed phantom-free and reference phantom methods were compared on ten COVID-19 positive patients and twelve control subjects with measures on femoral veins and arteries. In this context, red blood cells are viewed as scatterers that form aggregates increasing the backscatter under the COVID-19 inflammatory condition. The considered model comprises five parameters, including the mean aggregate size estimated according to polydispersity of aggregates' radii, and anisotropy of their shape. The mean aggregate size over the two proposed methods presented an intraclass correlation coefficient of 0.964 for consistency. The aggregate size presented a significant difference between the two groups with either two methods, despite the confounding effect of the maximum Doppler velocity within the blood vessel and its diameter.