Low Blood Oxygen Levels Research Articles

The Effect of the Severity of Chronic Obstructive Pulmonary Disease on the Pituitary Gonadal Axis

This study aims to investigate the levels of anabolic hormone implicated in specific clinical symptoms of chronic obstructive pulmonary disease (COPD) in relation to disease severity. Sixty-four male patients with COPD for at least two years were included. COPD diagnosed was based on pulmonary function tests, with severity classified using the CAT score and mMRC breathlessness scale. Levels of various hormones including TSH T3 T4, FSH, LH, testesterone, prolactin, progesterone and CRP were measured. Arterial blood gases were also analyzed. Patients were categorized according to GOLD stages. LH, FSH levels decreased during exacerbation, with a significant positive correlation between LH and low arterial oxygen levels. lower testosterone levels were statistically significant in severe COPD patients with FEV1 < 50%. A decrease in LH, testosterone FSH, TSH, progesterone and prolactin was observed with low blood oxygen levels, indicating dysfunction in the hypothalamic-pituitary-gonadal axis. However,stastistical significance varied.In conclusion, hormonal changes occur in male COPD patients, particulary related to disease severity. Testesterone levels correlate significantly with COPD severity. LH decrease during pronounced hypoxemia period was notable. Further research is necessary to evaluate the safety and efficacy of testosterone supplementation in COPD patients.

A new classification for emergency critically ill patients and analysis of their adverse events during intrahospital transport: A cluster analysis.

Critical patients may experience various adverse events during transportation within hospitals. Therefore, quickly evaluating and classifying patients before transporting them from the emergency department and focusing on managing high-risk patients are critical. At present, no unified classification method exists; all the current approaches are subjective. To ensure transportation safety, we conducted a cluster analysis of critically ill patients transferred from the emergency department to the intensive care unit. Single-centre cohort study. This study was conducted at a comprehensive first-class teaching hospital in Beijing. Convenience sampling and continuous enrolment were employed. We collected data from 1 January 2019, to 31 December 2021. All patients were transferred from the emergency department to the intensive care unit, and cluster analysis was conducted using five variables. A total of 584 patients were grouped into three clusters. Cluster 1 (high systolic blood pressure group) included 208 (35.6%) patients. Cluster 2 (high heart rate and low blood oxygen group) included 55 (9.4%) patients. Cluster 3 (normal group) included the remaining 321 (55%) patients. The oxygen saturation levels of all the patients were lower after transport, and the proportion of adverse events (61.8%) was the highest in Cluster 2 (p < .05). This study utilized data on five important vital signs from a cluster analysis to explore possible patient classifications and provide a reference for ensuring transportation safety. Before transferring patients, we should classify them and implement targeted care. Changes in blood oxygen levels in all patients should be considered, with a focus on the occurrence of adverse events during transportation among patients with high heart rates and low blood oxygen levels.

Data mining approaches to pneumothorax detection: Integrating mask-RCNN and medical transfer learning techniques

With the medical condition of pneumothorax, also known as collapsed lung, air builds up in the pleural cavity and causes the lung to collapse. It is a critical disorder that needs to be identified and treated right as it can cause breathing difficulties, low blood oxygen levels, and, in extreme circumstances, death. Chest X-rays are frequently used to diagnose pneumothorax. Using the Mask R-CNN model and medical transfer learning, the proposed work offers•A novel method for pneumothorax segmentation from chest X-rays.•A method that takes advantage of the Mask R-CNN architecture's for object recognition and segmentation.•A modified model to address the issue of segmenting pneumothoraxes and then polish it using a sizable dataset of chest X-rays.The proposed method is tested against other pneumothorax segmentation techniques using a dataset of ‘chest X-rays’ with ‘pneumothorax annotations. The test findings demonstrate that proposed method outperforms other cutting-edge techniques in terms of segmentation accuracy and speed. The proposed method could lead to better patient outcomes by increasing the precision and effectiveness of pneumothorax diagnosis and therapy. Proposed method also benefits other medical imaging activities by using the medical transfer learning approaches which increases the precision of computer-aided diagnosis and treatment planning.

Multimodality Fusion Method Based on Multiview Subspace Clustering for Pulmonary Embolism Diagnosis.

Pulmonary embolism (PE) is an important clinical disorder that will result in lung tissue damage or low blood oxygen levels, which need early diagnosis and timely treatment. While computed tomographic pulmonary angiography (CTPA) is the gold standard to diagnose PE, previous studies have verified the effectiveness of combing CTPA and EMR data in computer-aided PE detection or diagnosis. In this paper, we proposed a multimodality fusion method based on multi-view subspace clustering guided feature selection (MSCUFS). The extracted high-dimensional image and EMR features are firstly selected and fused by the MSCUFS, and then are feed into different machine learning models with different fusion strategy to construct the PE classifier. The experiment results showed that the joint fusion strategy with MSCUFS achieved best AUROC of 0.947, surpassing other early fusion and late fusion models. The comparison between single modality and multimodality also illustrated the effectiveness of the proposed method.

Plain language summary of the MonumenTAL-1 study of talquetamab in people with relapsed or refractory multiple myeloma.

This plain language summary describes the results of a phase 1 research study (or clinical trial) called MonumenTAL-1 published in the New England Journal of Medicine in December 2022. A phase 1 study is an early clinical trial where researchers evaluate how safe a medicine is at different doses in a small number of people. In the MonumenTAL-1 study, researchers looked at a new medicine under development called talquetamab, for people living with multiple myeloma (a type of blood cancer) who did not respond (refractory), stopped responding (relapsed), or who had difficulty dealing with their previous treatments. The phase 1 MonumenTAL-1 study was performed in 2 parts. Safety was the main focus of Part 1 in which side effects, and how serious they were, were assessed. The results of Part 1 were used to identify doses of talquetamab that were well tolerated, without a need to stop treatment or reduce the doses, for further study in Part 2. Part 2 of the study examined how well talquetamab worked to decrease signs of the cancer and what side effects, and their severity, people experienced at the doses identified in Part 1. In Part 1 of the study, researchers identified 2 doses of talquetamab for further study: 405 micrograms for every kilogram of body weight (μg/kg) given weekly and 800μg/kg every other week. All participants experienced at least one side effect of treatment at these 2 doses. Less than half of participants (43% at 405μg/kg weekly dose and 34% at the 800μg/kg every other week dose) experienced serious side effects which are those side effects that led to hospitalization, death, or permanent or life-threatening damage). The most common side effects at both doses were a condition known as cytokine release syndrome (CRS); changes in blood cell levels (where different types of cells in the blood were measured); changes in skin such as itching, dry skin, eczema, ulcers or shedding; changes in nails such as discoloration or ridging (lines or dents); and changes in sense of taste such as food tasting sour or metallic. CRS is caused by the overactivation of the immune system (the body's natural defense system) and can result in fever, feeling sick (nausea), being tired (fatigue), low blood pressure, low blood oxygen levels and body aches. Most cases of CRS, as well as most other side effects, were mild or moderate. Most common serious events were CRS, fever and bone pain. Most people had fewer signs of the cancer after taking talquetamab, and the response was similar between the 2 doses. The median duration of response at the 2 identified doses was 8-10months. Most of the side effects people experienced when taking talquetamab were mild or moderate. Most people who took talquetamab responded to the treatment even though they hadn't responded or stopped responding to previous multiple myeloma treatments or stopped taking those treatments because they were unable to tolerate them. These results demonstrate the potential of talquetamab as a treatment option in people who have used up other available therapy options. The 2 doses of talquetamab identified here are being examined in a larger group of participants to further test for safety and to test how well people respond.

Reducing racial bias in SpO2 estimation: The effects of skin pigmentation.

Accurate pulse-oximeter readings are critical for clinical decisions, especially when arterial blood-gas tests - the gold standard for determining oxygen saturation levels - are not available, such as when determining COVID-19 severity. Several studies demonstrate that pulse oxygen saturation estimated from photoplethysmography (PPG) introduces a racial bias due to the more profound scattering of light in subjects with darker skin due to the increased presence of melanin. This leads to an overestimation of blood oxygen saturation in those with darker skin that is increased for low blood oxygen levels and can result in a patient not receiving potentially life-saving supplemental oxygen. This racial bias has been comprehensively studied in conventional finger pulse oximetry but in other less commonly used measurement sites, such as in-ear pulse oximetry, it remains unexplored. Different measurement sites can have thinner epidermis compared with the finger and lower exposure to sunlight (such as is the case with the ear canal), and we hypothesise that this could reduce the bias introduced by skin tone on pulse oximetry. To this end, we compute SpO2 in different body locations, during rest and breath-holds, and compare with the index finger. The study involves a participant pool covering 6-pigmentation categories from Fitzpatrick's Skin Pigmentation scale. These preliminary results indicate that locations characterized by cartilaginous highly vascularized tissues may be less prone to the influence of melanin and pigmentation in the estimation of SpO2, paving the way for the development of non-discriminatory pulse oximetry devices.

Investigating the accuracy of blood oxygen saturation measurements in common consumer smartwatches.

Blood oxygen saturation (SpO2) is an important measurement for monitoring patients with acute and chronic conditions that are associated with low blood oxygen levels. While smartwatches may provide a new method for continuous and unobtrusive SpO2 monitoring, it is necessary to understand their accuracy and limitations to ensure that they are used in a fit-for-purpose manner. To determine whether the accuracy of and ability to take SpO2 measurements from consumer smartwatches is different by device type and/or by skin tone, our study recruited patients aged 18-85 years old, with and without chronic pulmonary disease, who were able to provide informed consent. The mean absolute error (MAE), mean directional error (MDE) and root mean squared error (RMSE) were used to evaluate the accuracy of the smartwatches as compared to a clinical grade pulse oximeter. The percent of data unobtainable due to inability of the smartwatch to record SpO2 (missingness) was used to evaluate the measurability of SpO2 from the smartwatches. Skin tones were quantified based on the Fitzpatrick (FP) scale and Individual Typology Angle (ITA), a continuous measure of skin tone. A total of 49 individuals (18 female) were enrolled and completed the study. Using a clinical-grade pulse oximeter as the reference standard, there were statistically significant differences in accuracy between devices, with Apple Watch Series 7 having measurements closest to the reference standard (MAE = 2.2%, MDE = -0.4%, RMSE = 2.9%) and the Garmin Venu 2s having measurements farthest from the reference standard (MAE = 5.8%, MDE = 5.5%, RMSE = 6.7%). There were also significant differences in measurability across devices, with the highest data presence from the Apple Watch Series 7 (88.9% of attempted measurements were successful) and the highest data missingness from the Withings ScanWatch (only 69.5% of attempted measurements were successful). The MAE, RMSE and missingness did not vary significantly across FP skin tone groups, however, there may be a relationship between FP skin tone and MDE (intercept = 0.04, beta coefficient = 0.47, p = 0.04). No statistically significant difference was found between skin tone as measured by ITA and MAE, MDE, RMSE or missingness.

Routine postoperative admission to the neurocritical intensive care unit after microvascular decompression: necessary or can it be abandoned?

Postoperative neurocritical intensive care unit (NICU) admission of patients who underwent craniotomy for close observation is common practice. In this study, we performed a comparative analysis to determine if there is a real need for NICU admission after microvascular decompression (MVD) for cranial nerve disorders or whether it may be abandoned. The present study evaluates a consecutive series of 236 MVD surgeries performed for treatment of trigeminal neuralgia (213), hemifacial spasm (17), vagoglossopharyngeal neuralgia (2), paroxysmal vertigo (2), and pulsatile tinnitus (2). All patients were operated by the senior surgeon according to a standard protocol over a period of 12years. Patients were admitted routinely to NICU during the first phase of the study (phase I), while in the second phase (phase II), only patients with specific indications would go to NICU. While 105 patients (44%) were admitted to NICU postoperatively (phase I), 131 patients (56%) returned to the ward after a short stay in a postanaesthesia care unit (PACU) (phase II). Specific indications for NICU admission in phase I were pneumothorax secondary to central venous catheter insertion (4 patients), AV block during surgery, low blood oxygen levels after extubation, and postoperative dysphagia and dysphonia (1 patient, respectively). There were no significant differences in the distribution of ASA scores or the presence of cardiac and pulmonary comorbidities like congestive heart failure, arterial hypertension, or chronic obstructive pulmonary disease between groups. There were no secondary referrals from PACU to NICU. Our study shows that routine admission of patients after eventless MVD to NICU does not provide additional value. NICU admission can be restricted to patients with specific indications. When MVD surgery is performed in experienced hands according to a standard anaesthesia protocol, clinical observation on a neurosurgical ward is sufficient to monitor the postoperative course. Such a policy results in substantial savings of costs and human resources.

Assessment of inflammatory markers and their association with disease mortality in severe COVID-19 patients of tertiary care hospital in South India

BackgroundCOVID-19 infection involves a complex interplay of the immunological and inflammatory responses. Low blood-oxygen levels have been a hallmark in COVID-19 patients. The lung tissue damage infiltered by the viral-mediated inflammation decreases oxygen saturation to cause silent hypoxia and cell death. This study aimed to evaluate the association of inflammatory biomarkers with oxygen saturation (SpO2) and mortality in severe COVID-19 patients.MethodsA total of 190 severe COVID-19 patients were included in this study after confirmed by the RT-PCR assay. The laboratory tests were performed for biochemical assessment. Serum levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), and ferritin were determined and compared between survivors and nonsurvivors using independent sample t-test. The correlation of these inflammatory markers was studied using Spearman’s correlation, and their association with mortality was studied using logistic regression.ResultsAll the COVID-19 patients were severe with SpO2< 90% and respiratory rate > 30/min. While the serum levels of CRP, LDH, ferritin, aspartate transaminase (AST), urea, and random blood sugar (RBS) were elevated, hemoglobin (Hb) and SpO2 levels were reduced in COVID-19 patients. LDH and ferritin levels were significantly higher in nonsurvivors compared to survivors with p values of 0.001 and 0.022 respectively. Spearman’s correlation showed a significant correlation of the inflammatory markers with SpO2, serum electrolytes (potassium, chloride), liver enzymes (AST and alanine transaminase (ALT)), and markers of kidney damage (urea, creatinine).ConclusionInflammatory markers could effectively discriminate the risk of mortality in severe COVID-19 patients. As CRP, LDH, and ferritin levels determine the tissue oxygen availability, they seem to be valuable biomarkers in the prognosis of COVID-19.

Monitoring Kadar Oksigen Pasien COVID-19 Untuk Isolasi Mandiri Berbasis IoT

Corona virus or commonly known as COVID-19, where the virus can be transmitted by animals or by humans, with symptoms such as a high fever that can reach 37.7℃ or more, or low blood oxygen levels and handling cases of the covid- 19 virus has been pursued properly. With direct treatment by doctors, treatment in hospitals to self-isolation treatment and with the application of self-isolation for covid-19 patients, it is hoped that they can always see the condition of body temperature and oxygen levels in the blood. This study, the method of checking the number of heart beats of isoman patients and the amount of oxygen in the patient's body was developed by connecting the device to the IOT Telegram, which for the microcontroller used is Wemos D1minilite and with this development it is hoped that it can help the front group to overcome COVID-19 to always be able to help patients who are running isoman. The results of the testing of the tools made obtained a data success of 99.71% by comparing the results of the two tools, namely a tool made by researchers with an oximeter, and in these results obtained a data error value of 0.29% of the total data of 20 isoman patients. The data used were taken from COVID-19 patients who were self-isolating, and there were some patients whose test results were below the specified parameters.

Migrant Health and COVID-19 Pandemic: A Cross-sectional Study of Characteristics, Clinical Features, and Health Outcome from Iran

BackgroundAs the pandemic unfolds, major concerns remain with those in disadvantaged positions who may be disproportionately affected. This paper aimed to present the characteristics of COVID-19 immigrant patients and investigate whether they were disproportionately affected by COVID-19 pandemic.MethodsA cross-sectional study was performed using data on 589,146 patients diagnosed with COVID-19 in Iran. Descriptive analyses were used to summarize the study population’s characteristics. Chi-squared test and logistic regression model were applied.ResultsAfter accounting for possible confounding covariates, being an immigrant was significantly associated with increased risk of death due to COVID-19 (OR 1.64, CI 1.568–1.727). When compared to Iranian-born patients, the prevalence of low blood oxygen levels on admission was higher among immigrant patients (53.9% versus 47.7%, P value < 0.001). Moreover, greater proportions of immigrants who were diagnosed with COVID-19 were admitted to an ICU (17% versus 15.8%, P value < 0.001). Patients aged 65 and above were the largest age category in both populations. However, there was a significant difference between the age profiles of patients, with children under the age of eighteen presenting 16% of immigrant patients vs 6.6% of Iranian-born patients (P value < 0.001). In both groups, more men were affected by COVID-19 than women, yet the sex bias was more prominent for migrant patients (P value < 0.001).ConclusionThe evidence from this study revealed that immigrant patients infected with COVID-19 were more likely to suffer from severe health outcome of the disease compared to Iranian-born patients.

The role of hypoxia and inflammation in the regulation of iron metabolism and erythropoiesis in COVID-19: The IRONCOVID study.

Coronavirus Disease (COVID‐19) can be considered as a human pathological model of inflammation combined with hypoxia. In this setting, both erythropoiesis and iron metabolism appear to be profoundly affected by inflammatory and hypoxic stimuli, which act in the opposite direction on hepcidin regulation. The impact of low blood oxygen levels on erythropoiesis and iron metabolism in the context of human hypoxic disease (e.g., pneumonia) has not been fully elucidated. This multicentric observational study was aimed at investigating the prevalence of anemia, the alterations of iron homeostasis, and the relationship between inflammation, hypoxia, and erythropoietic parameters in a cohort of 481 COVID‐19 patients admitted both to medical wards and intensive care units (ICU). Data were collected on admission and after 7 days of hospitalization. On admission, nearly half of the patients were anemic, displaying mild‐to‐moderate anemia. We found that hepcidin levels were increased during the whole period of observation. The patients with a higher burden of disease (i.e., those who needed intensive care treatment or had a more severe degree of hypoxia) showed lower hepcidin levels, despite having a more marked inflammatory pattern. Erythropoietin (EPO) levels were also lower in the ICU group on admission. After 7 days, EPO levels rose in the ICU group while they remained stable in the non‐ICU group, reflecting that the initial hypoxic stimulus was stronger in the first group. These findings strengthen the hypothesis that, at least in the early phases, hypoxia‐driven stimuli prevail over inflammation in the regulation of hepcidin and, finally, of erythropoiesis.

Stochastic Modeling of Inter-Hypoxemia Intervals in Preterm Infants.

Hypoxemia, characterized by low blood oxygen levels is pervasive in preterm infants and is associated with development of multiple adverse cardiovascular morbidities. In clinical practice, it is often quantified using frequency, pattern and time spent in it. A predictive tool of hypoxemia occurrence will aid clinicians in risk stratifying infant oxygenation patterns and improving personalized care. As a first step towards this goal in characterizing the underlying temporal processes, we studied inter-hypoxemia interval distributions in preterm infants on oxygen supplementation. We derived regression relationships of characterizing parameters of the distributions with gestational age and birth weight of infants. The modeling and goodness of fit tests of pooled and individual inter-hypoxemia intervals indicated that the inverse Gaussian and Birnbaum Saunders distributions fit well over short time scales and the lognormal at longer time scales. Information from distribution modeling may provide insights into hypoxemia recurrence times and be helpful in developing models to predict severe hypoxemic events that may be translated to personalized care in clinical settings. Clinical relevance - Understanding the stochastic nature of temporal processes underlying hypoxemia in preterm infants is a critical step towards developing predictive models for their occurrence. This may potentially aid in the neonatal care and treatment of these vulnerable infants.

Apparent Association of Insulin With Interleukin-6 (IL-6) in Severe COVID-19 Patients Having Chronic Disease Comorbidities.

BackgroundThe severe acute respiratory syndrome caused by the novel coronavirus (COVID-19), due to its fast spread, is a disease with global health, social and economic burden. This is complicated by its high morbidity and mortality among those with medical comorbidities and older adults. During the outbreak in Libya, intensive care facilities were overwhelmed by the number of patients requiring special care. Admission to such facilities was reserved for severe cases showing low blood oxygen levels. Due to the inflammatory process in COVID-19, we believed it was essential to evaluate the outcome of inflammation reflected in the changes in interleukin-6 (IL-6) and insulin.ObjectiveTo study the changes in IL-6 and insulin during the course of the disease, if an association between them exists, and whether this association changes following seven days of treatment.MethodWe analyzed the data of 60 patients diagnosed with COVID-19 and admitted to the hospitals' Intensive Care Units (ICU) in the eastern part of Libya. The study was initiated on January 18th and concluded on March 22, 2021. Samples for the analysis were collected on the first day of admission and after seven days of hospitalization for patients who survived till the selected day. The collected samples were used to analyze IL-6 as an indicator of change in inflammation and insulin as a potential anti-inflammatory modulator. In addition, the association of insulin with IL-6 was statistically tested.ResultsDiabetes and hypertension, the most commonly observed chronic diseases in Libya, were found to represent the highest comorbidities among the ICU patients included in this study. Nonetheless, other diseases affected a smaller proportion of them, ranging from two patients for malignancy to 10 patients for cardiovascular disease. In addition, both age and gender showed differences in the number of ICU hospitalized patients and the death tally among them.The study showed that the IL-6 level was on the rise during the course of COVID-19, whereas that of insulin was on the decrease. The two variables showed an association for admission day samples as well as for samples after seven days of ICU hospitalization.ConclusionAlthough, IL-6 appears to play a predictive role in the development and outcome of severe COVID-19, along with other biochemical and clinical findings it could serve as an indicator of the disease outcome. On the other hand, the role of insulin as a complementary factor for alleviating inflammation remains to be fully understood and requires further research. There is a pressing necessity for establishing the mechanism through which insulin is associated with inflammation modulatory pathways, in particular through the pathways involving IL-6.

Phosphorylation regulation of cardiac proteins in Babesia microti infected mice in an effort to restore heart function

BackgroundBabesia is a common protozoan parasite that infects red blood cells. In mice infected with Babesia microti, the red blood cells were lysed, resulting in decreased oxygen-carrying capacity. To compensate for low blood oxygen levels, stress on the heart was greatly increased. Babesiosis induces a variety of pathologies; meanwhile, heart tissues initiate self-repair responses to babesiosis-induced tissue damage to restore heart function.MethodsTo discover the molecular mechanisms of the damage and self-repair in the heart after B. microti infection in mice, we investigated the changes in protein expression and phosphorylation modification levels in heart tissues at 0, 5, 8, 11, and 19 days post-infection using data-independent acquisition (DIA) quantitative proteomics.ResultsThe numbers of global proteins we identified were 1934, 1966, 1984, 1989, and 1955 and of phosphopeptides were 5118, 5133, 5130, 5133, and 5140 at 0, 5, 8, 11, and 19 days, respectively, in heart cells after infection with B. microti. The results showed that after B. microti infection the differentially expressed proteins in mice mainly include fibrinogen α (Fgα), fibrinogen β (Fgβ), Serpina1b, Serpina1c, cathepsin Z, cytochrome c oxidases (COXs), RPS11, and RPS20. The proteins with phosphorylation changes mainly include 20-kDa light chain of myosin II (MLC20), myosin light chain kinase (MLCK), mitogen-activated protein kinase 14 (MAPK14), and Akt1. These proteins were mainly involved in coagulation processes, cell apoptosis, oxidative phosphorylation, and ribosomes.ConclusionsThe coagulation cascade-related proteins, apoptosis-related proteins, oxidative phosphorylation-related proteins, and other types of proteins are all involved in the damage and self-repair process in the heart after B. microti infection. These results offer a wealth of new targets for further exploration into the causes of heart disease induced by Babesia infection and are of great significance for novel drug development and new opportunities for targeted therapies.Graphical

A Multi-Channel Ratio-of-Ratios Method for Noncontact Hand Video Based SpO$_2$ Monitoring Using Smartphone Cameras

Blood oxygen saturation (SpO<inline-formula><tex-math notation="LaTeX">$_2$</tex-math></inline-formula>) is an important indicator forpulmonary and respiratory functionalities. Clinical findings on COVID-19 show that many patients had dangerously low blood oxygen levels not long before conditions worsened. It is therefore recommended, especially for the vulnerable population, to regularly monitor the blood oxygen level for precaution. Recent works have investigated how ubiquitous smartphone cameras can be used to infer SpO<inline-formula><tex-math notation="LaTeX">$_2$</tex-math></inline-formula>. Most of these works are contact-based, requiring users to cover a phone&#x2019;s camera and its nearby light source with a finger to capture reemitted light from the illuminated tissue. Contact-based methods may lead to skin irritation and sanitary concerns, especially during a pandemic. In this paper, we propose a noncontact method for SpO<inline-formula><tex-math notation="LaTeX">$_2$</tex-math></inline-formula> monitoring using hand videos acquired by smartphones. Considering the optical broadband nature of the red (R), green (G), and blue (B) color channels of the smartphone cameras, we exploit all three channels of RGB sensing to distill the SpO<inline-formula><tex-math notation="LaTeX">$_2$</tex-math></inline-formula> information beyond the traditional ratio-of-ratios (RoR) method that uses only two wavelengths. To further facilitate an accurate SpO<inline-formula><tex-math notation="LaTeX">$_2$</tex-math></inline-formula> prediction, we design adaptive narrow bandpass filters based on accurately estimated heart rate to obtain the most cardiac-related AC component for each color channel. Experimental results show that our proposed blood oxygen estimation method can reach a mean absolute error of 1.26&#x0025; when a pulse oximeter is used as a reference, outperforming the traditional RoR method by 25&#x0025;.

Abstracts from The International Society for Aerosols in Medicine 23rd ISAM Congress Boise, Idaho May 22–26, 2021

Abstracts from The International Society for Aerosols in Medicine 23rd ISAM Congress Boise, Idaho May 22–26, 2021

Persons with type 1 diabetes have low blood oxygen levels in the supine and standing body positions

IntroductionBlood oxygen saturation is low compared with healthy controls (CONs) in the supine body position in individuals with type 1 diabetes (T1D) and has been associated with complications. Since most...

Erythroid precursors and progenitors suppress adaptive immunity and get invaded by SARS-CoV-2.

SummarySARS-CoV-2 infection is associated with lower blood oxygen levels, even in patients without hypoxia requiring hospitalization. This discordance illustrates the need for a more unifying explanation as to whether SARS-CoV-2 directly or indirectly affects erythropoiesis. Here, we show significantly enriched CD71+ erythroid precursors/progenitors in the blood circulation of COVID-19 patients. We found that these cells have distinctive immunosuppressive properties. In agreement, we observed a strong negative correlation between the frequency of these cells with T and B cell proportions in COVID-19 patients. The expansion of these CD71+ erythroid precursors/progenitors was negatively correlated with the hemoglobin levels. A subpopulation of abundant erythroid cells, CD45+ CD71+ cells, co-express ACE2, TMPRSS2, CD147, and CD26, and these can be infected with SARS-CoV-2. In turn, pre-treatment of erythroid cells with dexamethasone significantly diminished ACE2/TMPRSS2 expression and subsequently reduced their infectivity with SARS-CoV-2. This provides a novel insight into the impact of SARS-CoV-2 on erythropoiesis and hypoxia seen in COVID-19 patients.

Clinical Efficacy of an Osmotic, Antiviral and Anti-Inflammatory Polymeric Nasal Film to Treat Covid-19 Early-Phase Respiratory Symptoms

Background: Covid-19 infection is a multifactorial disease where the virus mainly enters through the nasal cavity, grows, triggers inflammation, and destroys nasal mucosa cells, allowing systemic virus entry and infection of other organs. When symptoms appear, the disease physiopathology is already established. The immune system tries to control the infection but if the infection persists, it gets tired, fatigued, stressed, and finally, there is burnout. Therefore, an effective treatment should be multi-targeted and should not focus only on one parameter. Minimizing virus concentration, reducing nasal mucosa inflammation, and keeping the nasal surface clean should lessen systemic infection and the probability of developing severe respiratory distress. We evaluated clinical efficacy and safety of an osmotic nasal surface cleaning, virus and cytokine trapping polymeric film, in early-stage Covid-19 positive symptomatic patients. Methods: A randomized, multicentric, observational study was performed to evaluate the efficacy and safety of the osmotic film in 213 patients, randomized in 2 equal arms, and confined for 14-days just after the RT-PCR+ test. Due to ethical reasons, all patients received symptomatic treatments (ST). In addition, the patients in Arm-1 received the test product (ST+TP, 2-3 sprays, 4-5 times/ day) for 14-days. Leicester Cough Questionnaire, Visual Analogue Scale, and Covid-19-associated symptoms such as fever, pain, taste, smell, and headache were evaluated daily. Home-confined patients were immediately hospitalized in case of aggravation of any life-threatening clinical sign. Results: Among 213 patients, 98 in the ST and 102 in the ST+TP group completed the study. Thirteen patients did not complete the study as 8 in the ST group and 5 in the ST+TP group were hospitalized during the study due to low blood oxygen levels or sudden health deterioration and were excluded from the study. In the remaining control standard treatment group (n=98), clinical signs sharply aggravated on day 1-2 followed by stabilisation between days 3-6 and progressive reduction thereafter. In the test product group (n=102), symptoms were stabilized just after the first application and improved progressively. Only 42/102 patients in the test product group presented nasal discharge or irritation due to the osmotic properties of the product. Conclusion: The continuous multi-target approach of detaching and neutralizing virus particles and pro-inflammatory cytokines from the nasal surface to minimize systemic virus exposure is a very logical and efficient approach to avoid Covid-19-induced systemic pathology.