Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/31
Mohamed Aldaas
A 72-year-old male was brought to the hospital following a motorcycle crash and was admitted for multiple trauma management. His initial course of hospitalization was complicated by mild hypoxemia and altered mental status. Respiratory workup and imaging were consistent with SARS-CoV-2 pneumonia. He completed a five-day course of remdesivir and a ten-day course of dexamethasone. Twenty days later, he developed a low-grade fever. His chest computerized tomography (CT) showed gas and fluid containing parenchymal collection in the anteromedial right middle lobe measuring up to 4.8 cm, most consistent with a pulmonary abscess. Antimicrobial treatment was started. The patient became hypoxic and was intubated and mechanically ventilated. Bronchoalveolar lavage fluid was positive for galactomannan assay, a diagnostic marker for possible aspergillosis. A repeat chest CT showed a cavitary lesion with a positive air crescent sign, a common CT finding of invasive pulmonary aspergillosis. The patient was diagnosed with COVID-19-associated pulmonary aspergillosis and was started on antifungal treatment. He improved clinically and was successfully extubated.
{"title":"COVID-19-associated pulmonary aspergillosis: a case report from the COVID-19 surveillance program.","authors":"Mohamed Aldaas","doi":"10.18297/jri/vol5/iss1/31","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/31","url":null,"abstract":"A 72-year-old male was brought to the hospital following a motorcycle crash and was admitted for multiple trauma management. His initial course of hospitalization was complicated by mild hypoxemia and altered mental status. Respiratory workup and imaging were consistent with SARS-CoV-2 pneumonia. He completed a five-day course of remdesivir and a ten-day course of dexamethasone. Twenty days later, he developed a low-grade fever. His chest computerized tomography (CT) showed gas and fluid containing parenchymal collection in the anteromedial right middle lobe measuring up to 4.8 cm, most consistent with a pulmonary abscess. Antimicrobial treatment was started. The patient became hypoxic and was intubated and mechanically ventilated. Bronchoalveolar lavage fluid was positive for galactomannan assay, a diagnostic marker for possible aspergillosis. A repeat chest CT showed a cavitary lesion with a positive air crescent sign, a common CT finding of invasive pulmonary aspergillosis. The patient was diagnosed with COVID-19-associated pulmonary aspergillosis and was started on antifungal treatment. He improved clinically and was successfully extubated.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84772978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/34
A. A. Salama, Samy H. Darwish, Samir M. Abdel-Mageed, Radwa A Meshref, E. Mohamed
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), famously known as COVID-19, has quickly become a global pandemic. Chest X-ray (CXR) imaging has proven reliable, fast, and cost-effective for identifying COVID-19 infections, which presents with atypical unilateral patchy infiltration in the lungs like typical pneumonia. We employed the deep convolutional neural network (DCNN) ResNet-34 to detect and classify CXR images from patients with COVID-19, other viral pneumonias, and normal controls. Methods: We created a single database, containing 781 source CXR images for COVID-19 (n=240), other viral pneumonias (n=274), and normal controls (n=267) from four different international sub-databases: the Società Italiana di Radiologia Medica e Interventistica (SIRM), the GitHub Database, the Radiology Society of North America (RSNA), and the Kaggle Chest X-Ray Database. Images were resized, normalized without any augmentation, and arranged in m batches of 16 images before supervised training, testing, and cross-validation of the DCNN classifier. Results: The ResNet-34 had a diagnostic accuracy as of the receiver operating characteristic (ROC) curves of the truepositive rate versus the false-positive rate with the area under the curve (AUC) of 1.00, 0.99, and 0.99, for COVID-19, other viral pneumonia, and normal control CXR images, respectively. This accuracy implied identical high sensitivity and specificity values of 100%, 99%, and 99% for the three groups, respectively. ResNet-34 achieved identical sensitivity and specificity of 100%, 99.6%, and 98.9% for classifying CXR images of the three groups, with an overall accuracy of 99.5% for the testing subset for diagnosis/prognosis. Conclusion: Based on this high classification precision, we believe that the output activation map of the final layer of the ResNet-34 is a powerful tool for the accurate diagnosis of COVID-19 infection from CXR images.
{"title":"Deep Convolutional Neural Networks for Accurate Diagnosis of COVID-19 Patients Using Chest X-Ray Image Databases from Italy, Canada, and the USA","authors":"A. A. Salama, Samy H. Darwish, Samir M. Abdel-Mageed, Radwa A Meshref, E. Mohamed","doi":"10.18297/jri/vol5/iss1/34","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/34","url":null,"abstract":"Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), famously known as COVID-19, has quickly become a global pandemic. Chest X-ray (CXR) imaging has proven reliable, fast, and cost-effective for identifying COVID-19 infections, which presents with atypical unilateral patchy infiltration in the lungs like typical pneumonia. We employed the deep convolutional neural network (DCNN) ResNet-34 to detect and classify CXR images from patients with COVID-19, other viral pneumonias, and normal controls. Methods: We created a single database, containing 781 source CXR images for COVID-19 (n=240), other viral pneumonias (n=274), and normal controls (n=267) from four different international sub-databases: the Società Italiana di Radiologia Medica e Interventistica (SIRM), the GitHub Database, the Radiology Society of North America (RSNA), and the Kaggle Chest X-Ray Database. Images were resized, normalized without any augmentation, and arranged in m batches of 16 images before supervised training, testing, and cross-validation of the DCNN classifier. Results: The ResNet-34 had a diagnostic accuracy as of the receiver operating characteristic (ROC) curves of the truepositive rate versus the false-positive rate with the area under the curve (AUC) of 1.00, 0.99, and 0.99, for COVID-19, other viral pneumonia, and normal control CXR images, respectively. This accuracy implied identical high sensitivity and specificity values of 100%, 99%, and 99% for the three groups, respectively. ResNet-34 achieved identical sensitivity and specificity of 100%, 99.6%, and 98.9% for classifying CXR images of the three groups, with an overall accuracy of 99.5% for the testing subset for diagnosis/prognosis. Conclusion: Based on this high classification precision, we believe that the output activation map of the final layer of the ResNet-34 is a powerful tool for the accurate diagnosis of COVID-19 infection from CXR images.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72974554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/27
J. Bordón
The COVID-19 pandemic is likely an epic reshaping of human behavior across the globe. Beyond our knowledge of previous pandemics and infections, COVID19 demanded extraordinary changes in our lifestyle. The virus spread rapidly across the globe due to its high transmissibility, and the extraordinary death toll was unprecedented. In the early stages of this pandemic, there was a sense of powerlessness leading us to isolation from public gathering. Under the leadership of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and other organizations, the predominant response was to use preventive measures, including social distancing, hand washing and face masks. These measures have been very effective in preventing infection and containing the spread of infection in previous epidemics and pandemics. Ongoing protective measures are critical to mitigate the pandemic; however, controversies persist concerning the use of face masks as a protection measure against COVID.
{"title":"Why Should People Use Face Masks in the Time of COVID? The JRI Position","authors":"J. Bordón","doi":"10.18297/jri/vol5/iss1/27","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/27","url":null,"abstract":"The COVID-19 pandemic is likely an epic reshaping of human behavior across the globe. Beyond our knowledge of previous pandemics and infections, COVID19 demanded extraordinary changes in our lifestyle. The virus spread rapidly across the globe due to its high transmissibility, and the extraordinary death toll was unprecedented. In the early stages of this pandemic, there was a sense of powerlessness leading us to isolation from public gathering. Under the leadership of the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and other organizations, the predominant response was to use preventive measures, including social distancing, hand washing and face masks. These measures have been very effective in preventing infection and containing the spread of infection in previous epidemics and pandemics. Ongoing protective measures are critical to mitigate the pandemic; however, controversies persist concerning the use of face masks as a protection measure against COVID.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76919479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/16
J. Ramirez
Background: Lockdown measures to control COVID-19 have exacerbated the poverty epidemic. We hypothesized that the synergistic interaction of COVID-19 and poverty epidemics favors the development of more severe forms of COVID-19 in the population living in poverty. To test this hypothesis, we assessed whether an ecological association exists between the geographic distribution of hospitalized patients with SARS-CoV-2 pneumonia and markers of poverty in the city of Louisville, KY. Methods: Using the geomasked home addresses of hospitalized patients with SARS-CoV-2 pneumonia in the city of Louisville, a kernel density heatmap was created. Kuldorff’s spatial scan statistic was used to calculate areas of increased risk for SARS-CoV-2 pneumonia hospitalization. Heat maps were created for census tract–level demographics according to income, age, race, and ethnicity to assess whether an ecological association exists with the spatial distribution of SARSCoV-2 pneumonia hospitalization. Results: Four areas of increased risk of hospitalization due to SARS-CoV-2 pneumonia were identified in the western and central sections of the city, with relative risks (RRs) ranging from 2.3 (95% confidence interval (CI): 1.7–3.0) to 3.2 (95% CI: 2.1–5.0) (p<0.001 for each area). Most high-risk areas were associated with areas of the city with low-income populations and black and Hispanic communities but were not associated with areas of older adults. Conclusion: Residents from low-income areas are almost three times more likely to develop SARS-CoV-2 pneumonia requiring hospitalization. Current efforts to decrease the number of COVID-19 hospitalizations through vaccination of populations at risk should be concentrated in city areas with a low-income level population. ULJRI | https://ir.library.louisville.edu/jri/vol5/iss1/16 1 ULJRI The Syndemic of COVID-19 and Poverty
{"title":"The Population Affected by the Syndemic of COVID-19 and Poverty is More Likely to be Hospitalized with SARS-CoV-2 Pneumonia","authors":"J. Ramirez","doi":"10.18297/jri/vol5/iss1/16","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/16","url":null,"abstract":"Background: Lockdown measures to control COVID-19 have exacerbated the poverty epidemic. We hypothesized that the synergistic interaction of COVID-19 and poverty epidemics favors the development of more severe forms of COVID-19 in the population living in poverty. To test this hypothesis, we assessed whether an ecological association exists between the geographic distribution of hospitalized patients with SARS-CoV-2 pneumonia and markers of poverty in the city of Louisville, KY. Methods: Using the geomasked home addresses of hospitalized patients with SARS-CoV-2 pneumonia in the city of Louisville, a kernel density heatmap was created. Kuldorff’s spatial scan statistic was used to calculate areas of increased risk for SARS-CoV-2 pneumonia hospitalization. Heat maps were created for census tract–level demographics according to income, age, race, and ethnicity to assess whether an ecological association exists with the spatial distribution of SARSCoV-2 pneumonia hospitalization. Results: Four areas of increased risk of hospitalization due to SARS-CoV-2 pneumonia were identified in the western and central sections of the city, with relative risks (RRs) ranging from 2.3 (95% confidence interval (CI): 1.7–3.0) to 3.2 (95% CI: 2.1–5.0) (p<0.001 for each area). Most high-risk areas were associated with areas of the city with low-income populations and black and Hispanic communities but were not associated with areas of older adults. Conclusion: Residents from low-income areas are almost three times more likely to develop SARS-CoV-2 pneumonia requiring hospitalization. Current efforts to decrease the number of COVID-19 hospitalizations through vaccination of populations at risk should be concentrated in city areas with a low-income level population. ULJRI | https://ir.library.louisville.edu/jri/vol5/iss1/16 1 ULJRI The Syndemic of COVID-19 and Poverty","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90645204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/21
{"title":"RSV-induced Guillain–Barré Syndrome","authors":"","doi":"10.18297/jri/vol5/iss1/21","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/21","url":null,"abstract":"","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85427510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/30
Dawn Balcom
The Coronavirus Disease 2019 (COVID-19) pandemic has had a dramatic impact on international travel. According to the US Travel Association, travel expenditure in 2020 declined by 42%, approximately $500 billion, when compared with 2019.[1] Dwindling international travel paralleled a concomitant decline in the need for services provided by international travel clinics. Nonetheless, relationships between travel clinics and their clientele blossomed during this period. Having expertise in specialized preventive care and public health, travel clinics are equipped with the knowledge of infectious diseases to establish new avenues for patient and community support during the pandemic and beyond. In this perspective, approaches taken at the Division of Infectious Diseases International Travel Clinic at the University of Louisville (UL Travel Clinic) will be used as a model, demonstrating avenues in which travel clinic services might pivot to meet community needs during the ongoing COVID-19 pandemic and beyond.
{"title":"University of Louisville International Travel Clinic: Pivoting During the COVID-19 Pandemic","authors":"Dawn Balcom","doi":"10.18297/jri/vol5/iss1/30","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/30","url":null,"abstract":"The Coronavirus Disease 2019 (COVID-19) pandemic has had a dramatic impact on international travel. According to the US Travel Association, travel expenditure in 2020 declined by 42%, approximately $500 billion, when compared with 2019.[1] Dwindling international travel paralleled a concomitant decline in the need for services provided by international travel clinics. Nonetheless, relationships between travel clinics and their clientele blossomed during this period. Having expertise in specialized preventive care and public health, travel clinics are equipped with the knowledge of infectious diseases to establish new avenues for patient and community support during the pandemic and beyond. In this perspective, approaches taken at the Division of Infectious Diseases International Travel Clinic at the University of Louisville (UL Travel Clinic) will be used as a model, demonstrating avenues in which travel clinic services might pivot to meet community needs during the ongoing COVID-19 pandemic and beyond.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89679345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/15
A. Afolabi, O S Ilesanmi, T. Afolabi
The index case of Coronavirus disease 2019 (COVID19) was reported by the World Health Organization in Wuhan city, China, during the fall of 2019.[1] Since this period, 150,708,255 COVID-19 cases have been recorded globally as of April 29, 2021, with Africa accounting for 4,573,989 cases out of the global total.[2] The evolving community transmission of COVID-19 has increasingly placed certain groups at disproportionate risk.[3] Global inequity is evident in the unequal distribution of material and economic resources across different population groups as a result of exploitation and unequal living standards, as well as differences in environmental conditions and geographical location.[4] The COVID-19 pandemic has further widened the existing global disparity, with a disproportionate increase in the vulnerability of marginalized population groups.[5] These include the urban slum dwellers, incarcerated individuals, and internally displaced persons, among others. Therefore, this opinion piece will examine the COVID-19 pandemic in an inequitable world and suggest strategies to minimize these inequalities.
{"title":"Bridging the Inequality Gap Among Marginalized Populations in Africa Amid the COVID-19 Pandemic: A Call for Responsible Cooperation","authors":"A. Afolabi, O S Ilesanmi, T. Afolabi","doi":"10.18297/jri/vol5/iss1/15","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/15","url":null,"abstract":"The index case of Coronavirus disease 2019 (COVID19) was reported by the World Health Organization in Wuhan city, China, during the fall of 2019.[1] Since this period, 150,708,255 COVID-19 cases have been recorded globally as of April 29, 2021, with Africa accounting for 4,573,989 cases out of the global total.[2] The evolving community transmission of COVID-19 has increasingly placed certain groups at disproportionate risk.[3] Global inequity is evident in the unequal distribution of material and economic resources across different population groups as a result of exploitation and unequal living standards, as well as differences in environmental conditions and geographical location.[4] The COVID-19 pandemic has further widened the existing global disparity, with a disproportionate increase in the vulnerability of marginalized population groups.[5] These include the urban slum dwellers, incarcerated individuals, and internally displaced persons, among others. Therefore, this opinion piece will examine the COVID-19 pandemic in an inequitable world and suggest strategies to minimize these inequalities.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81343486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/JRI/VOL5/ISS1/1
R. Fernandez-Botran
Background: The potential association of the ABO blood group with the risk of COVID-19 and its severity has attracted a lot of interest since the start of the pandemic. While a number of studies have reported an increased risk associated with blood type A and a reduced risk with type O, other studies have did not found a significant effect. This study aimed to define the prevalence of different ABO blood groups in hospitalized COVID-19 patients in the Louisville, KY area and to investigate whether an association exists between the blood group and disease severity. Methods: This was a retrospective observational study of 380 patients with SARS-CoV-2 infection hospitalized to eight of the adult hospitals in the city of Louisville. Patients were divided into four different groups according to their ABO blood type. Demographic characteristics and clinical variables, including laboratory data as well as clinical outcomes were compared. Results: Type O was the most common blood group among the hospitalized patients (51%) followed by type A (31%), B (14%) and AB (4%). The observed blood group distribution among the patients was not significantly different from the distribution expected when compared to a population of similar racial/ethnic composition. No significant associations were found between the blood group and comorbidities, inflammatory biomarkers as well as with recorded outcomes, including the mortality rate and the length of the hospital stay. Conclusions: The data from hospitalized patients in Louisville is is not consistent with the ABO blood group having a significant effect as a risk or severity factor for COVID-19, but it is representative in COVID-19 or its severity of its prevalence among different racial/ethnic populations.
{"title":"Lack of Association of the ABO Blood Group with COVID-19 risk and Severity in Hospitalized Patients in Louisville, KY","authors":"R. Fernandez-Botran","doi":"10.18297/JRI/VOL5/ISS1/1","DOIUrl":"https://doi.org/10.18297/JRI/VOL5/ISS1/1","url":null,"abstract":"Background: The potential association of the ABO blood group with the risk of COVID-19 and its severity has attracted a lot of interest since the start of the pandemic. While a number of studies have reported an increased risk associated with blood type A and a reduced risk with type O, other studies have did not found a significant effect. This study aimed to define the prevalence of different ABO blood groups in hospitalized COVID-19 patients in the Louisville, KY area and to investigate whether an association exists between the blood group and disease severity. Methods: This was a retrospective observational study of 380 patients with SARS-CoV-2 infection hospitalized to eight of the adult hospitals in the city of Louisville. Patients were divided into four different groups according to their ABO blood type. Demographic characteristics and clinical variables, including laboratory data as well as clinical outcomes were compared. Results: Type O was the most common blood group among the hospitalized patients (51%) followed by type A (31%), B (14%) and AB (4%). The observed blood group distribution among the patients was not significantly different from the distribution expected when compared to a population of similar racial/ethnic composition. No significant associations were found between the blood group and comorbidities, inflammatory biomarkers as well as with recorded outcomes, including the mortality rate and the length of the hospital stay. Conclusions: The data from hospitalized patients in Louisville is is not consistent with the ABO blood group having a significant effect as a risk or severity factor for COVID-19, but it is representative in COVID-19 or its severity of its prevalence among different racial/ethnic populations.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83400390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/25
J. Ramirez
Introduction: Current literature indicates that African American individuals are at increased risk of becoming infected with the SARS-CoV-2 virus and suffer higher SARS-CoV-2-related mortality rates. However, there is a lack of consensus as to how the clinical outcomes of African American patients differ from those of other groups. The objective of this study was to define the clinical outcomes of African American and White hospitalized patients with SARS-CoV-2 community-acquired pneumonia (CAP) in Louisville, Kentucky. Methods: This was a retrospective cohort study of hospitalized patients with SARS-CoV-2 CAP at eight hospitals in Louisville, Kentucky. Severity of CAP at time of hospitalization was evaluated using the pneumonia severity index (PSI), CURB-65 score, SARS-CoV-2 viral load, and the World Health Organization severity score. The following thirteen clinical outcomes were compared: discharge alive to home, time to home discharge, admission to the ICU, length of ICU stay, need for invasive mechanical ventilation (IMV), duration of IMV, development of acute respiratory distress syndrome (ARDS), development of septic shock, need for vasopressors, development of cardiovascular events, time to cardiovascular events, in-hospital mortality, and time to death. Results: A total of 541 patients were eligible for this study, 343 White (63%) and 198 African American (37%). None of the thirteen clinical outcomes were significantly different between the two groups. Conclusion: This study indicates that African American and White patients do not have different clinical outcomes after the point of hospitalization due to SARS-CoV-2 CAP. ULJRI | https://ir.library.louisville.edu/jri/vol5/iss1/25 1 ULJRI No Difference in SARS-CoV-2 Pneumonia Outcomes for African American and White Patients
{"title":"No difference in clinical outcomes for African American and White patients hospitalized with SARS-CoV-2 pneumonia in Louisville, Kentucky","authors":"J. Ramirez","doi":"10.18297/jri/vol5/iss1/25","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/25","url":null,"abstract":"Introduction: Current literature indicates that African American individuals are at increased risk of becoming infected with the SARS-CoV-2 virus and suffer higher SARS-CoV-2-related mortality rates. However, there is a lack of consensus as to how the clinical outcomes of African American patients differ from those of other groups. The objective of this study was to define the clinical outcomes of African American and White hospitalized patients with SARS-CoV-2 community-acquired pneumonia (CAP) in Louisville, Kentucky. Methods: This was a retrospective cohort study of hospitalized patients with SARS-CoV-2 CAP at eight hospitals in Louisville, Kentucky. Severity of CAP at time of hospitalization was evaluated using the pneumonia severity index (PSI), CURB-65 score, SARS-CoV-2 viral load, and the World Health Organization severity score. The following thirteen clinical outcomes were compared: discharge alive to home, time to home discharge, admission to the ICU, length of ICU stay, need for invasive mechanical ventilation (IMV), duration of IMV, development of acute respiratory distress syndrome (ARDS), development of septic shock, need for vasopressors, development of cardiovascular events, time to cardiovascular events, in-hospital mortality, and time to death. Results: A total of 541 patients were eligible for this study, 343 White (63%) and 198 African American (37%). None of the thirteen clinical outcomes were significantly different between the two groups. Conclusion: This study indicates that African American and White patients do not have different clinical outcomes after the point of hospitalization due to SARS-CoV-2 CAP. ULJRI | https://ir.library.louisville.edu/jri/vol5/iss1/25 1 ULJRI No Difference in SARS-CoV-2 Pneumonia Outcomes for African American and White Patients","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88206510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.18297/jri/vol5/iss1/28
L. R. Lopes, S. Kasinski
Patients with COVID-19, caused by SARS-CoV-2 infection, have presented with fever, cough, dyspnea, pneumonia, acute lung injury, and other respiratory symptoms.[1] An inflammatory overreaction, called a cytokine storm, has also been associated with severe COVID-19.[2] Cytokine storm involves elevated levels of circulating cytokines and hyperactivation of immune system cells.[3] Patients with mild COVID-19 can also produce elevated levels of pro-inflammatory cytokines.[4] Furthermore, those patients present dysregulated expression of genes related to immune functions.[4] Consequently, the immune disorder can hinder a return to homeostasis, leading to multiorgan dysfunction or even multiorgan failure.[3] The pathophysiological consequences of cytokine storm also include circulatory coagulopathy and acute respiratory distress syndrome.[3] In this context, the hyper-inflammatory state and physiological disruption caused by SARSCoV-2 infection hinder the patient’s recovery from physiological stress and injury caused by surgery procedures, for example.
{"title":"Pulmonary Inflammation and Injury Triggered by Spine Surgery in Recovered COVID-19 Patients Demand Consideration","authors":"L. R. Lopes, S. Kasinski","doi":"10.18297/jri/vol5/iss1/28","DOIUrl":"https://doi.org/10.18297/jri/vol5/iss1/28","url":null,"abstract":"Patients with COVID-19, caused by SARS-CoV-2 infection, have presented with fever, cough, dyspnea, pneumonia, acute lung injury, and other respiratory symptoms.[1] An inflammatory overreaction, called a cytokine storm, has also been associated with severe COVID-19.[2] Cytokine storm involves elevated levels of circulating cytokines and hyperactivation of immune system cells.[3] Patients with mild COVID-19 can also produce elevated levels of pro-inflammatory cytokines.[4] Furthermore, those patients present dysregulated expression of genes related to immune functions.[4] Consequently, the immune disorder can hinder a return to homeostasis, leading to multiorgan dysfunction or even multiorgan failure.[3] The pathophysiological consequences of cytokine storm also include circulatory coagulopathy and acute respiratory distress syndrome.[3] In this context, the hyper-inflammatory state and physiological disruption caused by SARSCoV-2 infection hinder the patient’s recovery from physiological stress and injury caused by surgery procedures, for example.","PeriodicalId":91979,"journal":{"name":"The University of Louisville journal of respiratory infections","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90841084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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