Frontiers in medicine
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Frontiers in medicine · Jan 2020
COVID-19 Infection Among Healthcare Workers: Serological Findings Supporting Routine Testing.
A growing body of evidence demonstrates that asymptomatic and pre-symptomatic transmission of SARS-CoV-2 is a major contributor to the COVID-19 pandemic. Frontline healthcare workers in COVID-19 hotspots have faced numerous challenges, including shortages of personal protective equipment (PPE) and difficulties acquiring clinical testing. The magnitude of the exposure of healthcare workers and the potential for asymptomatic transmission makes it critical to understand the incidence of infection in this population. ⋯ These results indicate that there is considerable asymptomatic infection with SARS-CoV-2 within the healthcare workforce, despite current mitigation policies. Furthermore, presuming that asymptomatic staff are not carrying SARS-CoV-2 is inconsistent with our results, and this could result in amplified transmission within healthcare settings. Consequently, aggressive testing regiments, such as testing frontline healthcare workers on a regular, multi-modal basis, may be required to prevent further spread within the workforce and to patients.
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Frontiers in medicine · Jan 2020
Artificial Intelligence in Skin Cancer Diagnostics: The Patients' Perspective.
Background: Artificial intelligence (AI) has shown promise in numerous experimental studies, particularly in skin cancer diagnostics. Translation of these findings into the clinic is the logical next step. This translation can only be successful if patients' concerns and questions are addressed suitably. ⋯ They would prefer an application scenario where physician and AI classify the lesions independently. With respect to AI-based applications in medicine, patients were concerned about insufficient data protection, impersonality and susceptibility to errors, but expected faster, more precise and unbiased diagnostics, less diagnostic errors and support for physicians. Conclusions: The vast majority of participants exhibited a positive attitude toward the use of artificial intelligence in melanoma diagnostics, especially as an assistance system.
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Frontiers in medicine · Jan 2020
D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study.
Background: Identifying clinical-features or a scoring-system to predict a benefit from hospital admission for patients with COVID-19 can be of great value for the decision-makers in the health sector. We aimed to identify differences in patients' demographic, clinical, laboratory, and radiological findings of COVID-19 positive cases to develop and validate a diagnostic-model predicting who will develop severe-form and who will need critical-care in the future. Methods: In this observational retrospective study, COVID-19 positive cases (total 417) diagnosed in Al Kuwait Hospital, Dubai, UAE were recruited, and their prognosis in terms of admission to the hospital and the need for intensive care was reviewed until their tests turned negative. ⋯ ROC and Precision-Recall curves showed that among all variables, D dimers (>1.5 mg/dl), Urea (>6.5 mmol/L), and Troponin (>13.5 ng/ml) could positively predict the admission to ICU in patients with COVID-19. On the other hand, decreased Lymphocyte count and albumin can predict admission to ICU in patients with COVID-19 with acceptable sensitivity (59.32, 95% CI [49.89-68.27]) and specificity (79.31, 95% CI [72.53-85.07]). Conclusion: Using these three predictors with their cut of values can identify patients who are at risk of developing critical COVID-19 and might need aggressive intervention earlier in the course of the disease.
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Frontiers in medicine · Jan 2020
Liver Injury in Critically Ill and Non-critically Ill COVID-19 Patients: A Multicenter, Retrospective, Observational Study.
Background: Liver injury commonly occurs in patients with COVID-19. There is limited data describing the course of liver injury occurrence in patients with different disease severity, and the causes and risk factors are unknown. We aim to investigate the incidence, characteristics, risk factors, and clinical outcomes of liver injury in patients with COVID-19. ⋯ Liver injury was related to prolonged hospital stay and viral shedding duration in patients with COVID-19. Clinical Trial Registration: World Health Organization International Clinical Trials Registry Platform, ChiCTR2000030593. Registered March 8, 2020.
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Frontiers in medicine · Jan 2020
Development and Validation of a Sepsis Mortality Risk Score for Sepsis-3 Patients in Intensive Care Unit.
Background: Many severity scores are widely used for clinical outcome prediction for critically ill patients in the intensive care unit (ICU). However, for patients identified by sepsis-3 criteria, none of these have been developed. This study aimed to develop and validate a risk stratification score for mortality prediction in sepsis-3 patients. ⋯ As shown by the decision curve analysis, the score always had a positive net benefit. Conclusion: We observed moderate discrimination and calibration for the score termed Sepsis Mortality Risk Score (SMRS), allowing stratification of patients according to mortality risk. However, we still require further modification and external validation.