Reverse Transcriptase-polymerase Chain Reaction Test Research Articles

Managing severe thrombocytopenia in co-infection of COVID-19 and dengue hemorrhagic fever: a case report

COVID-19 pandemic in dengue endemic countries has becoming a concern due to its similarities in early clinical symptoms and laboratory features. The cases of co-infection between the two diseases are inevitable and associated with higher morbidity and mortality. Here we presented a case of a 28 years old female diagnosed with co-infection of COVID-19 and dengue hemorrhagic fever that complicated with severe thrombocytopenia and spontaneous bleeding. She came with fever that started 3 days prior to admission. Laboratory examination showed leucopenia, thrombocytopenia, elevated liver enzymes, and D-dimer. Patient tested positive for non-structural protein 1 (NS-1) dengue antigen. She had a pre-screening rapid test for COVID-19 as part of hospital protocol, and she tested positive. Followed by positive COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) test confirming the diagnosis. During admission, patient started menstruating, resulting in active spontaneous bleeding while platelet counts dropped to below 10×109/l. Patient was given platelet transfusion, supportive therapy and put under close monitoring. The case of co-infection between COVID-19 and dengue is inevitable in tropical and sub-tropical countries. Both infections shared similar pathophysiology through different mechanism, such as plasma leakage, thrombocytopenia, and coagulopathy. Complications may arise and physician must aware of the therapeutical approach. Diagnostic testing must not be withheld when there was suspicion towards the infection. Prompt treatment and close monitoring can result in good prognosis.

COVID-19 Pandemic and Its Impact on Perinatal Outcomes between Symptomatic and Asymptomatic Women.

Coronavirus disease 2019 (COVID-19) has been increasing among pregnant women worldwide. Its impact on maternal, fetal, and neonatal health is still scarce in the published literature. As a routine COVID-19 prenatal screening has been established for all women requiring hospitalization, it is not clear whether symptomatic women carry worse pregnancy outcomes than those without symptoms. We aimed to analyze perinatal outcomes between symptomatic and asymptomatic women admitted to our center. Materials and Methods. A single-center retrospective cohort study was conducted for fourteen months. All pregnant women with positive reverse transcriptase-polymerase chain reaction (RT-PCR) test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were enrolled, and their perinatal outcomes were analyzed in two groups based on whether they were symptomatic or not. The primary outcomes were composite adverse fetal, neonatal, and maternal outcomes and their comparison between study groups. Results. Out of 209 included COVID-19 positive pregnant women, 62 (30%) presented with one or more infection-related symptoms. Symptomatic women were older, multiparous, carried ≥1 comorbid condition, and attained infection at earlier gestational age (44% vs. 28%; 82% vs. 69%; 28% vs. 16%; and 34 vs. 36 weeks, respectively) (p < 0.05), when compared to asymptomatic women, respectively. Maternal composite adverse outcomes were higher in the symptomatic group and showed either one or more outcomes, positive chest radiological findings, requiring hospitalization with oxygen supplementation, or maternal death (8% vs. 0.7%) (p < 0.05). Composite fetal and neonatal adverse outcomes such as miscarriage, fetal or neonatal death, admission to neonatal intensive care unit, and neonatal COVID-19 infection were not statistically significant (p > 0.05) between symptomatic and asymptomatic women. Conclusion. COVID-19 infection among symptomatic pregnant women may carry a higher risk for adverse maternal outcomes. It may be associated with their advanced age and comorbid conditions. Maternal infection-associated symptoms per se likely do not pose an increased risk for adverse fetal or neonatal outcomes.

Rapid and Highly Sensitive Detection of Target DNA Related to COVID-19 Virus With a Fluorescent Bio-conjugated Probe via a FRET Mechanism

A novel cyanine 3 (Cy3)-based bio-conjugated sensor has been developed to detect target DNA or extracted RNA from COVID -19 samples using the fluorescence resonance energy transfer (FRET) experiment. A special sequence of the COVID -19 genome was selected as a complementary DNA (target DNA) part. The opposite chain of this target sequence was designed in 2 parts; one part was attached to the Cy3 organic dye (capture DNA or Cy3- DNA), and the other part was attached to the BHQ2 molecule (quencher DNA or BHQ2- DNA). The Cy3 molecule acts as a donor pair, and BHQ2 acts as an acceptor pair in the FRET experiment. The capture DNA and quencher DNA can form a sandwiched complex in the presence of target DNA. The formation of the entitled sandwiched hybrid causes the decrement of emission intensity of the Cy3 donor in bio-conjugated Cy3-DNA via energy transfer from Cy3 (as a donor) to BHQ2 (as an acceptor). Indeed, in the presence of non-complementary DNA, the pairing of DNA strands does not occur, the FRET phenomenon does not exist, and therefore fluorescence intensity of Cy3 does not decrease. Moreover, this biosensor was successfully applied to analyze real samples containing extracted RNA of COVID -19 prepared for the reverse transcriptase-polymerase chain reaction (RT-PCR) test, and the results were promising.

Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients

ObjectivesPatients with COVID-19 may be asymptomatic and are able to transmit COVID-19 during a surgical procedure, resulting in increased pressure on healthcare and reduced control of COVID-19 spread. There remains...

Deriving and validating a risk prediction model for long COVID-19: protocol for an observational cohort study using linked Scottish data

IntroductionCOVID-19 is commonly experienced as an acute illness, yet some people continue to have symptoms that persist for weeks, or months (commonly referred to as ‘long-COVID’). It remains unclear which...

Correlating CT Chest with RT-PCR in Diagnosing COVID-19: Experience at a Tertiary Health Care Hospital in Pakistan

Objective: To establish the accuracy of computed tomography(CT) chest in the diagnosis of COVID-19 pneumonia by taking reverse transcriptase-polymerase chain reaction(RT-PCR) as a reference standard and to analyze discordant CT chest and RT-PCR results.Materials and Methods: A retrospective cross-sectional study of patients presented to a tertiary health care hospital in Punjab, Pakistan for CT examination with suspicion of COVID-19 from April 1, to June 30, 2020. Each CT chest was categorized as positive/negative for COVID-19 pneumonia and the results were compared with the RT-PCR test. Discordant CT chest and PCR results were also investigated.Results: The study population had a mean age of 48 years ± 6.6 years with 54.5% males and 45.4% females. Sensitivity(Sn), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CT in diagnosing COVID-19 pneumonia taking RT- PCR as the gold standard was 92.5%, 46.6%%, 82.2%, 70%, and 80% respectively. Conclusion: CT chest has high sensitivity but modest specificity in the diagnosis of COVID-19 pneumonia. It can be employed as an adjunctive screening and diagnostic test for early diagnosis of disease in places where disease prevalence is high.

The Impact of Childhood and Parental Vaccination on SARS-CoV-2 Infection Rates in Children.

Background:The data on the indirect protection of children via the coronavirus disease 2019 (COVID-19) vaccination of household members are insufficient, and analyses to evaluate the efficacy of COVID-19 vaccines are limited.Methods:We gathered data on 12,442 patients under the age of 18 regarding the vaccination status of their household members, their vaccine preferences and doses, and their previous history of COVID-19 infection immediately before the patients were administered a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between September 1, 2021 and December 5, 2021.Results:A total of 18.4% (2289) were vaccinated, 91.4% with BNT162b2mRNA vaccine, 8.6% with inactivated COVID-19 vaccine; 48.7% received a single dose, and 51.3% had 2 doses. Real-time RT-PCR positivity proportions were much higher in older children (P < 0.001) and were higher in children 12 years of age and older [odds ratio (OR), 1.34; 95% confidence interval (CI): 1.21–1.47] compared with others. SARS-CoV-2 infection was significantly lower in the vaccinated group (fully and incompletely) (P < 0.001). Unvaccinated (OR, 4.88; 95% CI: 3.77–6.13) and incompletely vaccinated children (OR, 1.83; 95% CI: 1.52–2.12) had a higher risk of COVID-19 infection compared with fully vaccinated patients No significant association was found between the COVID-19 real-time RT-PCR positivity rates of patients and the vaccination status or vaccine preferences of household members (P > 0.05 each).Conclusions:SARS-CoV-2 infection rates were significantly lower in vaccinated children, especially with mRNA vaccines. The indirect protection of unvaccinated children via the vaccination of household members against COVID-19 seems inadequate. The individual vaccination of children remains crucial.

Accuracy of Rapid Antigen vs Reverse Transcriptase–Polymerase Chain Reaction Testing for SARS-CoV-2 Infection in College Athletes During Prevalence of the Omicron Variant

Accuracy of Rapid Antigen vs Reverse Transcriptase–Polymerase Chain Reaction Testing for SARS-CoV-2 Infection in College Athletes During Prevalence of the Omicron Variant

COVID-19 Cycle Threshold/Cycle Number Testing at a Community Living Center.

COVID-19 imposes a special risk to the nursing home population, including community living centers (CLCs) for veterans. Cycle threshold/cycle number (CT/CN) values obtained by serial reverse transcriptase polymerase chain reaction (RT-PCR) testing could yield valuable information about viral load and potential infectiousness. Serial testing for COVID-19 with CT/CN correlates in a nursing home population during an outbreak has not yet been reported in the literature. A retrospective review of serial RT-PCR testing for COVID-19 during an outbreak at a CLC was performed from March 28 to April 4, 2020, with follow-up of identified patients until November 10, 2020. Testing was performed on the Abbot m2000 or Cepheid platform. Of 80 patients tested, 25 (31%) were positive for COVID-19. CT/CN values corresponded to the infection course as expected. Repeat testing for COVID-19 accompanied by CT/CN values could provide clinical and epidemiologic information about the likely stage of the patients' disease course, which may aid public health measures and clinical management.

Oral Co-Supplementation of Curcumin, Quercetin, and Vitamin D3 as an Adjuvant Therapy for Mild to Moderate Symptoms of COVID-19-Results From a Pilot Open-Label, Randomized Controlled Trial.

Background: Curcumin, quercetin, and vitamin D3 (cholecalciferol) are common natural ingredients of human nutrition and reportedly exhibit promising anti-inflammatory, immunomodulatory, broad-spectrum antiviral, and antioxidant activities.Objective: The present study aimed to investigate the possible therapeutic benefits of a single oral formulation containing supplements curcumin, quercetin, and cholecalciferol (combinedly referred to here as CQC) as an adjuvant therapy for early-stage of symptomatic coronavirus disease 2019 (COVID-19) in a pilot open-label, randomized controlled trial conducted at Mayo Hospital, King Edward Medical University, Lahore, Pakistan.Methods: Reverse transcriptase polymerase chain reaction (RT-PCR) confirmed, mild to moderate symptomatic COVID-19 outpatients were randomized to receive either the standard of care (SOC) (n = 25) (control arm) or a daily oral co-supplementation of 168 mg curcumin, 260 mg quercetin, and 9 µg (360 IU) of cholecalciferol, as two oral soft capsules b.i.d. as an add-on to the SOC (n = 25) (CQC arm) for 14 days. The SOC includes paracetamol with or without antibiotic (azithromycin). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR test, acute symptoms, and biochemistry including C-reactive protein (CRP), D-dimer, lactate dehydrogenase, ferritin, and complete blood count were evaluated at baseline and follow-up day seven.Results: Patients who received the CQC adjuvant therapy showed expedited negativization of the SARS-CoV-2 RT-PCR test, i.e., 15 (60.0%) vs. five (20.0%) of the control arm, p = 0.009. COVID-19- associated acute symptoms were rapidly resolved in the CQC arm, i.e., 15 (60.0%) vs. 10 (40.0%) of the control arm, p = 0.154. Patients in the CQC arm experienced a greater fall in serum CRP levels, i.e., from (median (IQR) 34.0 (21.0, 45.0) to 11.0 (5.0, 16.0) mg/dl as compared to the control arm, i.e., from 36.0 (28.0, 47.0) to 22.0 (15.0, 25.0) mg/dl, p = 0.006. The adjuvant therapy of co-supplementation of CQC was safe and well-tolerated by all 25 patients and no treatment-emergent effects, complications, side effects, or serious adverse events were reported.Conclusion: The co-supplementation of CQC may possibly have a therapeutic role in the early stage of COVID-19 infection including speedy negativization of the SARS-CoV-2 RT-PCR test, resolution of acute symptoms, and modulation of the hyperinflammatory response. In combination with routine care, the adjuvant co-supplementation of CQC may possibly help in the speedy recovery from early-stage mild to moderate symptoms of COVID-19. Further research is warranted.Clinical Trial Registration: Clinicaltrials.gov, identifier NCT05130671

Evaluating the performance characteristics of five lateral flow assays for the detection of the SARS-CoV-2 nucleocapsid antigen

In response to the COVID-19 pandemic, lateral flow assays (LFAs) for the detection of SARS-CoV-2 antigen have been proposed as a complementary option to the more costly and time consuming reverse-transcriptase polymerase chain reaction (RT-PCR). We assessed five commercially available SARS-CoV-2 antigen detecting LFAs (ASSUT EUROPE (Rome, Italy), Besthree (Taizhou, China), Encode (Zhuhai, China), Fortress (Antrim UK), and Hughes Medical (Buckinghamshire, UK), using samples collected from hospitalised individuals with COVID-19 and compared these results against established RT-PCR assays with the aim of estimating test performance characteristics. We performed a diagnostic accuracy study of the five LFAs on 110 inpatients with confirmed COVID-19 and 75 COVID-19 negative control participants. Assay evaluation was performed using a modified version of each manufacturer’s protocol allowing for parallel testing of a single sample on multiple assays. Additional variables were studied including infection acquisition, oxygenation requirements at time of swabbing, and patient outcomes. The 110 patients were 48% (53) female, with mean age 67 years (range 26–100 years), and 77% (85) cases were community onset SARS-CoV-2. Across the five assays, sensitivity ranged from 64 (95% CI 53–73) to 76% (95% CI 65–85); Fortress performed best with sensitivity of 76% (95% CI 65–85). Specificity was high across all assays with 4/5 LFAs achieving 100%. LFA sensitivity was not dependant on RT-PCR cycle thresholds. SARS-CoV-2 antigen detecting LFAs may complement RT-PCR testing to facilitate early diagnosis and provide community testing strategies for identification of patients with COVID-19, however we find suboptimal test performance characteristics across a range of commercially available manufacturers, below WHO and MHRA pre-set sensitivity performance thresholds. With such variation in sensitivity between LFAs and PCR testing and between assay brands, we advise caution in the deployment of LFAs outside of environments with clinical oversight.

Performance of the Sofia SARS-CoV-2 Rapid Antigen Test in Symptomatic and Asymptomatic Pediatric Patients.

The sensitivity and specificity of SARS-CoV-2 antigen tests have not been widely assessed in children. We evaluated children presenting to outpatient care with Quidel Sofia SARS-CoV-2 antigen test (Sofia-Ag-RDT) compared against Cepheid Xpert Xpress SARS-CoV-2/Flu/RSV reverse transcriptase-polymerase chain reaction test from November 2020 to April 2021. Sofia-Ag-RDT had the highest sensitivity in symptomatic (82%; 95% confidence interval, 68%-91%) children.

COVID-19 Vaccination Status Among Healthcare Workers and Its Effect on Disease Manifestations: A Study From Northeast India.

Background and objectiveSince being declared a global pandemic, coronavirus disease 2019 (COVID-19) has led to millions of cases and deaths worldwide. Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to wreak havoc on individuals, healthcare systems, and economies, the intensive vaccination strategies adopted by several countries have significantly slowed the progress and the severity of the disease. In this study, we aimed to determine the COVID-19 vaccination status among healthcare workers (HCWs) and examine the effects of vaccination on disease manifestations.Materials and methodsThis cross-sectional study was conducted at a teaching hospital in Northeast India from April 2021 to September 2021, during the second phase of the COVID-19 pandemic. HCWs employed in the hospital who were laboratory-confirmed cases of COVID-19 based on semiquantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) or cartridge-based nucleic acid amplification test (CBNAAT) on oropharyngeal samples were included in the study. Data analysis was performed using Microsoft Excel (Microsoft Office Professional Plus 2019, Microsoft Corp., Redmond, WA)ResultsA total of 178 HCWs reported positive for COVID-19 infection during the study period. Of these, 42 (23.59%) were males and 136 were females (76.40%). Among them, 86 (48.32%) HCWs were fully vaccinated, 58 (32.58%) were partially vaccinated, and 34 (19.10%) were not vaccinated. Most of the HCWs experienced mild disease (145, 81.46%), and only four (2.24%) reported moderate to severe disease. Compared with unvaccinated HCWs, individuals who have had either one or two doses of vaccines were less likely to have moderate to severe disease or seek treatment at the hospital. On symptoms analysis, shortness of breath was found to be more common in unvaccinated individuals than in vaccinated patients, and anosmia and loss of taste were more common in vaccinated than in unvaccinated individuals. No deaths were reported among the participants included in this study.ConclusionsFollowing the first and second waves of the COVID-19 pandemic, a substantial proportion of HCWs were infected with SARS-CoV-2, likely as a result of the acquisition of the virus in the community during the early phase of local spread. Fully vaccinated individuals with COVID-19 were more likely to be completely asymptomatic or only mildly symptomatic compared to unvaccinated HCWs.

New Optimized Deep Learning Application for COVID-19 Detection in Chest X-ray Images

Due to false negative results of the real-time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) test, the complemental practices such as computed tomography (CT) and X-ray in combination with RT-PCR are discussed to achieve a more accurate diagnosis of COVID-19 in clinical practice. Since radiology includes visual understanding as well as decision making under limited conditions such as uncertainty, urgency, patient burden, and hospital facilities, mistakes are inevitable. Therefore, there is an immediate requirement to carry out further investigation and develop new accurate detection and identification methods to provide automatically quantitative evaluation of COVID-19. In this paper, we propose a new computer-aided diagnosis application for COVID-19 detection using deep learning techniques. A new technique, which receives symmetric X-ray data as the input, is presented in this study by combining Convolutional Neural Networks (CNN) with Ant Lion Optimization Algorithm (ALO) and Multiclass Naïve Bayes Classifier (NB). Moreover, several other classifiers such as Softmax, Support Vector Machines (SVM), K-Nearest Neighbors (KNN) and Decision Tree (DT) are combined with CNN. The promising results of these classifiers are evaluated and presented for accuracy, precision, and F1-score metrics. NB classifier with Ant Lion Optimization Algorithm and CNN produced the best results with 98.31% accuracy, 100% precision and 98.25% F1-score and with the lowest execution time.

Association Between the Use of Psychotropic Medications and the Risk of COVID-19 Infection Among Long-term Inpatients With Serious Mental Illness in a New York State–wide Psychiatric Hospital System

Individuals with serious mental illness are at increased risk of severe COVID-19 infection. Several psychotropic medications have been identified as potential therapeutic agents to prevent or treat COVID-19 but have not been systematically examined in this population. To evaluate the associations between the use of psychotropic medications and the risk of COVID-19 infection among adults with serious mental illness receiving long-term inpatient psychiatric treatment. This retrospective cohort study assessed adults with serious mental illness hospitalized in a statewide psychiatric hospital system in New York between March 8 and July 1, 2020. The final date of follow-up was December 1, 2020. The study included 1958 consecutive adult inpatients with serious mental illness (affective or nonaffective psychoses) who received testing for SARS-CoV-2 by reverse transcriptase-polymerase chain reaction or antinucleocapsid antibodies and were continuously hospitalized from March 8 until medical discharge or July 1, 2020. Psychotropic medications prescribed prior to COVID-19 testing. COVID-19 infection was the primary outcome, defined by a positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction or antibody test result. The secondary outcome was COVID-19-related death among patients with laboratory-confirmed infection. Of the 2087 adult inpatients with serious mental illness continuously hospitalized during the study period, 1958 (93.8%) underwent testing and were included in the study; 1442 (73.6%) were men, and the mean (SD) age was 51.4 (14.3) years. A total of 969 patients (49.5%) had laboratory-confirmed COVID-19 infection that occurred while they were hospitalized; of those, 38 (3.9%) died. The use of second-generation antipsychotic medications, as a class, was associated with decreased odds of infection (odds ratio [OR], 0.62; 95% CI, 0.45-0.86), whereas the use of mood stabilizers was associated with increased odds of infection (OR, 1.23; 95% CI, 1.03-1.47). In a multivariable model of individual medications, the use of paliperidone was associated with decreased odds of infection (OR, 0.59; 95% CI, 0.41-0.84), and the use of valproic acid was associated with increased odds of infection (OR, 1.39; 95% CI, 1.10-1.76). Clozapine use was associated with reduced odds of mortality in unadjusted analyses (unadjusted OR, 0.25; 95% CI, 0.10-0.62; fully adjusted OR, 0.43; 95% CI, 0.17-1.12). In this cohort study of adults hospitalized with serious mental illness, the use of second-generation antipsychotic medications was associated with decreased risk of COVID-19 infection, whereas the use of valproic acid was associated with increased risk. Further research is needed to assess the mechanisms that underlie these findings.

Diagnostic performance of oral swab specimen for SARS-CoV-2 detection with rapid point-of-care lateral flow antigen test.

We evaluated the performance of oral swab specimen both health-care worker (HCW) collected and self-collected for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) detection with rapid antigen test (RAT) as compared to reverse transcriptase polymerase chain reaction (RT-PCR). Of the 529 participants enrolled, 121 (22.8%) were RT-PCR positive. Among the RT-PCR positives, 62 (51.2%) were RAT positive using oral swab. When compared with RT-PCR, RAT with oral swab had sensitivity and specificity of 63.3 and 96.8% respectively among symptomatic individuals. No statistically significant difference was observed in RAT positivity with HCW collection and self-collection, p = 0.606. Ct values were significantly lower in RT-PCR and RAT positive samples (ORF gene: 18.85 ± 4.36; E gene: 18.72 ± 4.84) as compared to RT-PCR positive and RAT negative samples (ORF gene: 26.98 ± 7.09; E gene: 26.97 ± 7.07), p < 0.0001. Our study demonstrated moderate sensitivity of RAT with oral swab in symptomatic individuals. Oral swab was the preferred sampling by almost all participants in terms of convenience and comfort as compared to nasopharyngeal swab. Oral swabs have utility for SARS-CoV-2 antigen detection among symptomatic individuals residing in remote rural areas and can serve as an initial screening tool during COVID-19 spikes when cases rise exponentially and laboratory capacities for RT-PCR testing become overwhelmed.

Role of computed tomography in COVID-19 emergent conditions

Background: The COVID-19 pandemic has strained global healthcare systems, highlighting challenges in diagnosing and managing the disease while ensuring patient safety. Aim: This review evaluates the role of computed tomography (CT) in identifying COVID-19-related emergent conditions, emphasizing its diagnostic significance beyond conventional reverse transcriptase-polymerase chain reaction (RT-PCR) testing. Methods: We conducted a comprehensive literature review on CT imaging's effectiveness in detecting pulmonary involvement in COVID-19 patients, comparing its findings with those of RT-PCR and other imaging modalities. Results: CT scans reveal characteristic features of COVID-19 pneumonia, including bilateral ground-glass opacities and consolidations, which can occur even when RT-PCR tests yield negative results. The integration of CT imaging has enhanced early diagnosis and informed clinical decision-making, particularly in emergency settings. Conclusion: CT imaging plays a critical role in managing COVID-19, aiding in the early detection of pulmonary complications and facilitating appropriate patient triage. However, its effectiveness is influenced by pandemic prevalence trends and clinical context, necessitating a multi-faceted diagnostic approach. A standardized strategy incorporating CT imaging alongside RT-PCR testing is essential for improving patient outcomes during pandemic surges.

The effect of coronavirus disease 2019 pneumonia on myocardial ischemia detected by single-photon emission computed tomography myocardial perfusion imaging.

ObjectiveWe aimed to examine the effects of COVID-19 pneumonia on cardiac ischemia detected by myocardial perfusion imaging with single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI) in patients presenting with chest pain and shortness of breath after recovery from COVID-19.Materials and methodPatients with a history of COVID-19 confirmed by reverse transcriptase-PCR test who underwent SPECT-MPI for the evaluation of ischemia with the complaints of chest pain and shortness of breath were screened for this study. Patients who underwent thorax CT during the acute period of the COVID-19 were included. Patients with and without pneumonia were determined based on computed tomographic criteria. The patients with a summed stress score of at least 4 on SPECT-MPI were considered to have abnormal MPI in terms of ischemia.ResultsA total of 266 patients were included in the study. Sixty-five (24%) patients had ischemia findings on SPECT-MPI. Thorax CT showed pneumonia in 152 (57%) patients, and the patients were divided into two groups as pneumonia and nonpneumonia. Abnormal SPECT-MPI scores, which represented myocardial ischemia, were higher in the pneumonia group. Multivariate logistic regression analyses showed that the presence of hyperlipidemia and pneumonia on CT increased the risk of ischemia on SPECT-MPI (OR, 2.08; 95% CI, 1.08–3.99; P-value = 0.029; and OR, 2.90; 95% Cl, 1.52–5.54; P-value = 0.001, respectively).ConclusionCOVID-19 pneumonia was identified as an independent predictor of ischemia on SPECT-MPI. Symptoms including chest pain and shortness of breath in patients who have had COVID-19 pneumonia may be attributed to coronary ischemia.

MO696: Characteristics and Survival Results of Peritoneal Dialysis Patients Suffering from Covid-19 in Turkey: A Multicenter National Study

Abstract BACKGROUND AND AIMS Although existing data suggest an increased mortality rate, data about the course of coronavirus disease 2019 (COVID-19) in peritoneal dialysis (PD) patients, its short- and long-term effects on the patient and technique survival are limited. Moreover, specific factors associated with increased risk of death have not been clearly defined yet. Therefore, we aimed to study the characteristics of PD patients with COVID-19, determine the short-term mortality and other medical complications, and delineate the factors associated with COVID-19 outcome. METHOD This national multicenter study included all PD patients who had confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on positive reverse transcriptase–polymerase chain reaction testing of a nasopharyngeal swab recorded in this database from the attending 27 PD centers. The demographic data, comorbidities, medications used, PD-related data were recorded as well as clinical, laboratory and radiological findings of COVID-19 and outcomes at the end of the first month were recorded. RESULTS We enrolled 142 COVID-19 patients (median age: 52 years). A total of 58.2% of patients had mild disease at diagnosis, lung involvement was detected in 60.8% of patients. A total of 83 (58.4%) patients were hospitalized, 31 (21.8%) patients were admitted to intensive care unit and 24 needed mechanical ventilation. A total of 15 (10.5%) patients were switched to hemodialysis and hemodiafiltration was performed for 4 (2.8%) patients. Persisting pulmonary symptoms (n = 27), lower respiratory system infection (n = 12), rehospitalization for any reason (n = 24), malnutrition (n = 6), hypervolemia (n = 13), peritonitis (n = 7), ultrafiltration failure (n = 7) and in PD modality change (n = 8) were reported in survivors. During the 1 month from the diagnosis of COVID-19, 26 patients (18.31%) died. The non-survivor group was older and comorbidities were more prevalent. Fever, dyspnea, cough, serious-vital disease at presentation, bilateral pulmonary involvement and pleural effusion were more frequent among non-survivors. Age (OR:1.102; 95% CI: 1.032–1.117; P:0.004), moderate–severe clinical disease at presentation (OR:26.825; 95% CI: 4.578–157.172; P &amp;lt; 0.001) and CRP levels (OR:1.008; 95% CI; 1.000–1.016; P:0.040) were associated with increased first-month mortality in multivariate analysis. CONCLUSION Early mortality rate and medical complications are quite high in PD patients with COVID-19. Age, clinical severity of COVID-19 and baseline CRP level are the independent parameters associated with mortality.

Prognostic Performance of Shock Index, Diastolic Shock Index, Age Shock Index, and Modified Shock Index in COVID-19 Pneumonia.

We aimed to compare the prognostic accuracy of shock indexes in terms of mortality in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia. Hospitalized patients whose COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) test results were positive, had thoracic computed tomography (CT) scan performed, and had typical thoracic CT findings for COVID-19 were included in the study. Eight hundred one patients were included in the study. Chronic obstructive pulmonary disease, congestive heart failure, chronic neurological diseases, chronic renal failure, and a history of malignancy were found to be chronic diseases that were significantly associated with mortality in patients with COVID-19 pneumonia. White blood cell, neutrophil, lymphocyte, C reactive protein, creatinine, sodium, aspartate aminotransferase, alanine aminotransferase, total bilirubin, high sensitive troponin, d-dimer, hemoglobin, and platelet had a statistically significant relationship with in-hospital mortality in patients with COVID-19 pneumonia. The area under the curve (AUC) values of shock index (SI), age shock index (aSI), diastolic shock index (dSI), and modified shock index (mSI) calculated to predict mortality were 0.772, 0.745, 0.737, 0.755, and Youden Index J (YJI) values were 0.523, 0.396, 0.436, 0.452, respectively. The results of this study show that SI, dSI, mSI, and aSI are effective in predicting in-hospital mortality.