82例COVID-19零死亡患者的临床特征分析

目的 探讨新型冠状病毒肺炎(coronavirus disease2019,COVID-19)患者的临床特征。方法 收集82例COVID-19患者的胸部影像学特征、血常规、尿常规及心肌酶谱相关检查指标,观察其可能存在的相关性。除1例重型患者外,将81例COVID-19患者分为轻型及普通型两组,进行相关实验室检查并进行比较分析。结果 81例COVID-19患者中胸部影像学表现为双肺多发磨玻璃影多见,其次为右肺病灶,近1/2的患者均合并淋巴细胞减少,1/3的患者尿蛋白阳性,仅8例患者出现不同程度心肌损害。通过比较分析发现,轻型及普通型组在上述指标中均未见明显差异(P0.05)。结论 轻型及普通型COVID-19患者预后佳,针对疑似COVID-19患者,早诊断、早治疗可减少向重型/危重型COVID-19发展。     

新型冠状病毒肺炎患者临床及CT影像特点分析

目的:探讨新型冠状病毒肺炎（coronavirus disease 19,COVID-19）患者临床及CT影像特点。方法:回顾性分析2020年1—3月广安市收治的30例COVID-19患者的临床资料和胸部CT影像学资料。将23例普通型患者设为普通组,7例重型或危重型患者设为重症组。分析30例COVID-19患者的胸部影...     

人工智能技术在新型冠状病毒肺炎中的应用

新型冠状病毒肺炎（COVID-19）在全球范围内迅速传播,对人类的健康、生活、社会功能和国际关系构成严重威胁。人工智能（AI）已被广泛用于解决从大数据分析到计算机视觉的各种复杂问题。COVID-19疫情防治过程中,研究人员提出大量AI算法与模型以减轻医疗系统的负担,在药物研发、疫情预测、临床诊断等领域发挥了重要作用。本综述从辅助诊断/检测、网络信息监测与分析,生物医学与药物治疗,疾病追踪、识别与检测以及实际临床应用这5个方面讨论了AI在COVID-19中的最新研究进展,旨在为疫情后期管理及未来流行病的及时防治提供参考。     

多排螺旋CT联合多平面重建技术在新型冠状病毒肺炎诊断中的应用

目的探讨多排螺旋CT联合多平面重组技术(MPR)在新型冠状病毒肺炎(COVID-19)早期筛查诊断中的应用价值。方法回顾性分析2020年1~2月我院发热门诊32例疑似COVID-19患者的影像资料,对比原始CT轴位图像和重建后高分辨CT(HRCT)轴位图像结合MPR重组技术对COVID-19影像特征的检出能力,并用SPSS 17.0软件对病灶检出率进行χ2检验分析。结果重建后的HRCT轴位图像可以清楚显示肺小叶内部结构变化,尤其是结合MPR重组技术后在显示跨叶段病灶、支气管充气征、血管束增粗征等病变上优于原始CT轴位图像,差异具有统计学意义(P<0.05)。结论COVID-19疫情爆发期,尽早使用多排螺旋CT扫描,重建HRCT轴位图像并联合运用MPR技术,能够更加直观、立体地显示病灶,为COVID-19的快速鉴别诊断提供更丰富的影像依据,从而早隔离、早治疗,控制疫情发展。     

基于密度分布特征的深度神经网络模型诊断COVID-19的价值

目的:评价基于密度分布特征（CDD）的深度神经网络（DNN）模型对新型冠状病毒肺炎（COVID-19）的诊断价值。方法:收集42例COVID-19病例和43例非COVID-19肺炎病例。将所有患者的211份胸部CT图像分为训练集（n=128）和验证集（n=83）。参考北美放射学会发布的COVID-19相关性肺炎的CT结构化报告,构建基于CT影像特征的DNN模型（DNN-CTIF）。根据胸部CT图像上肺炎CDD建立DNN-CDD模型。采用ROC曲线分析和决策曲线分析对两种模型进行评价。结果:DNN-CTIF模型的AUC在训练集为0.927,在验证集为0.829。DNN-CDD模型的AUC在训练集为0.965,在验证集为0.929。DNN-CDD模型在验证集的AUC高于DNN-CTIF模型（P=0.047）。决策曲线分析表明在0.04~1.00概率阈值范围内,DNN-CDD模型相比DNN-CTIF模型使患者的净获益更高。结论:DNN-CTIF和DNN-CDD模型对COVID-19均具有较好的诊断性能,其中DNN-CDD模型优于DNN-CTIF模型。     

骨质疏松症与新型冠状病毒感染的研究进展

新型冠状病毒感染(COVID-19)对神经、肺、肾、血管和心脏均会产生负面影响, 但对肌肉骨骼的作用仍缺乏关注。新近的研究表明COVID-19与骨质疏松症(OP)存在紧密关联。COVID-19本身及其治疗、患者自身因素等都与OP的发生有关, 同时骨密度(BMD)降低与COVID-19患者的临床病程及预后也密切相关。此外, 抗OP治疗与COVID-19之间的关系尚未得到深入研究。因此, 本文就COVID-19与OP的相互关系进行总结分析, 以期为COVID-19患者以及未来疫情下治疗OP、加强骨健康管理提供新思路和指导。     

新型冠状病毒肺炎期间方舱CT感染防控经验（英文）

新型冠状病毒肺炎(COVID-19)爆发后,胸部CT迅速成为COVID-19诊断、治疗、随访等必不可少的检查手段,但影像科内交叉感染的风险也随之升高。为降低此风险,方舱CT被专门用于疑似和确诊患者的CT检查。本研究结合实际工作经验,从方舱CT的安装环境及功能划分及操作步骤、患者检查次序、技师的排班管理及感控措施、CT设备与机房内物表消毒等方面,介绍疫情期间方舱CT的检查流程及防控策略。     

新型冠状病毒肺炎期间方舱CT感染防控经验

新型冠状病毒肺炎（COVID-19）爆发后，胸部CT迅速成为COVID-19诊断、治疗、随访等必不可少的检查手段，但影像科内交叉感染的风险也随之升高。为降低此风险，方舱CT被专门用于疑似和确诊患者的CT检查。本研究结合实际工作经验，从方舱CT的安装环境及功能划分及操作步骤、患者检查次序、技师的排班管理及感控措施、CT设备与机房内物表消毒等方面，介绍疫情期间方舱CT的检查流程及防控策略。     

COVID-19相关性凝血病的临床表现及病理机制

COVID-19相关性凝血病是COVID-19重症患者的主要临床表现和病理特征,也是患者的主要死亡原因之一。当前研究表明,COVID-19相关性凝血病的发生率较高,即使进行了预防性治疗,仍不可避免该病的发生。肺血管内凝血病可能是COVID-19中肺损伤机理的重要因素之一。COVID-19相关的凝血病的病理机制较为复杂,...     

新型冠状病毒肺炎疫情期间定点医院缓冲隔离病区的建立与运行

目的新型冠状病毒肺炎(COVID-19)疫情期间,通过建立与运行定点医院缓冲隔离病区,确保新入院非COVID-19的其他传染性疾病患者得到精准救治,防止发生交叉感染。方法结合宜昌市第三人民医院传染病患者收治实际情况,设置缓冲隔离病区,制定门急诊患者诊疗管理流程,通过门诊预检分诊及各专科门诊筛查,初步识别非COVID-19患者与COVID-19患者,并对新入院非COVID-19的普通传染病患者单间收治,集中管理,通过为期6 d的健康监测及规范筛查,再分流到各专科传染病区。结果在COVID-19流行期间,缓冲隔离病区的建立及运行可确保非COVID-19的其他传染性疾病患者也能得到最大限度的及时高效救治,防止医务人员与患者之间、患者与患者之间发生交叉感染。同时通过缓冲隔离病区集中收治,可减少人力资源及防护物资的投入,更利于规范管理。结论设置缓冲隔离病区集中管理,确保了新入院的非COVID-19的其他传染性疾病患者得以精准救治且无交叉感染发生。     

Utility of cardiac bioenzymes in predicting cardiovascular outcomes in SARS-CoV-2

The relationship between coronavirus disease-19 (COVID-19) and cardiovascular diseases has been an important issue. Therefore, cardiac biomarkers and cardiac imaging have an important place in the diagnostic phase. It is important to know the relationship of biomarkers in COVID-19 so that we can understand the diagnosis of the disease, the predicted course and results after diagnosis.     

COVID-19 vaccines: Knowing the unknown

Vaccine development against SARS-CoV-2 has drawn attention around the globe due to the exploding pandemic. Although COVID-19 is caused by a new coronavirus, SARS-CoV-2, previous research on other coronavirus vaccines, such as FIPV, SARS, and MERS, has provided valuable information for the rapid development of COVID-19 vaccine. However, important knowledge gaps remain — some are specific to SARS-CoV-2, others are fundamental to immunology and vaccinology. Here, we discuss areas that need to be addressed for COVID-19 vaccine development, and what can be learned from examples of vaccine development in the past. Since the beginning of the outbreak, the research progress on COVID-19 has been remarkable. We are therefore optimistic about the rapid development of COVID-19 vaccine.     

Dermatomyositis Following BNT162b2 mRNA COVID-19 Vaccination

Dermatomyositis (DM) is one of the uncommon multi-organ idiopathic inflammatory myopathies that has been reported following the hepatitis B, Influenza, tetanus toxoid, H1N1, and BCG vaccines. However, an association with the coronavirus disease 2019 (COVID-19) vaccine is yet to be reported. In this case, we present the case of a 43-year-old Asian Indian female who was diagnosed with DM 10 days after receiving the second dosage of BNT162b2 mRNA COVID-19 vaccination, in the absence of any additional triggering factors. The diagnosis was established based on physical examination, serological antibodies, magnetic resonance imaging of the muscles, skin biopsy, and electromyography. She received standard treatment for DM, including oral high doses of prednisolone, hydroxychloroquine, mycophenolate, and physiotherapy. The treatment successfully reversed skin changes and muscle weakness. This is the first reported case of classic DM complicated by interstitial lung disease following COVID-19 vaccination. More clinical and functional studies are needed to elucidate this association. Clinicians should be aware of this unexpected adverse event following COVID-19 vaccination and arrange for appropriate management.     

Multisystem Inflammatory Syndrome in an Adult after COVID-19 Vaccination: a Case Report and Literature Review

As the number of people vaccinated increases, people who complain of adverse reactions continue to occur. We experienced a case characterized by low blood pressure, persistent fever, edema due to increased systemic vascular permeability, and systemic inflammation confirmed by image and laboratory examinations after ChAdOx1 coronavirus disease 2019 (COVID-19) vaccination. The diagnostic criteria for multisystem inflammatory syndrome (MIS) in adults are known as fever of 3 days or more in adults, 2 or more mucocutaneous/gastrointestinal/neurologic symptoms, elevation of inflammatory markers, and clinical/imaging diagnosis of heart failure. A 67-year-old man who was medicated for hypertension and diabetes was admitted complaining of fever, maculopapular rash, diarrhea, headache, chills, and dizziness 6 days after the first vaccination of ChAdOx1 nCoV-19 in Korea. The COVID-19 test was negative but with low blood pressure, leukocytosis, skin rash, pulmonary edema, and increased inflammation markers. His lab findings and clinical course were consistent with those of MIS after COVID-19 vaccination. He was medicated with methylprednisolone 1 mg/kg and diuretics and recovered rapidly. He was discharged after 2 weeks and confirmed cure at outpatient clinic. We report an MIS case after COVID-19 vaccination in Korea.     

Asthma in patients with suspected and diagnosed coronavirus disease 2019

BackgroundPatients with asthma are comparatively susceptible to respiratory viral infections and more likely to develop severe symptoms than people without asthma. During the coronavirus disease 2019 (COVID-19) pandemic, it is necessary to adequately evaluate the characteristics and outcomes of the population with asthma in the population tested for and diagnosed as having COVID-19.ObjectiveTo perform a study to assess the impact of asthma on COVID-19 diagnosis, presenting symptoms, disease severity, and cytokine profiles.MethodsThis was an analysis of a prospectively collected cohort of patients suspected of having COVID-19 who presented for COVID-19 testing at a tertiary medical center in Missouri between March 2020 and September 2020. We classified and analyzed patients according to their pre-existing asthma diagnosis and subsequent COVID-19 testing results.ResultsPatients suspected of having COVID-19 (N = 435) were enrolled in this study. The proportions of patients testing positive for COVID-19 were 69.2% and 81.9% in the groups with asthma and without asthma, respectively. The frequencies of relevant symptoms were similar between the groups with asthma with positive and negative COVID-19 test results. In the population diagnosed as having COVID-19 (n = 343), asthma was not associated with several indicators of COVID-19 severity, including hospitalization, admission to an intensive care unit, mechanical ventilation, death due to COVID-19, and in-hospital mortality after multivariate adjustment. Patients with COVID-19 with asthma exhibited significantly lower levels of plasma interleukin-8 than patients without asthma (adjusted P = .02).ConclusionThe population with asthma is facing a challenge in preliminary COVID-19 evaluation owing to an overlap in the symptoms of COVID-19 and asthma. However, asthma does not increase the risk of COVID-19 severity if infected.     

基于改进阈值的VGG网络的新冠肺炎CT图像自动诊断算法

肺部CT能够较准确地鉴定新冠肺炎病例,但医生工作量较大,本研究提出一种基于改进阈值的VGG网络的新冠肺炎CT图像自动诊断算法,通过该模型可快速准确地完成新冠肺炎病例的自动识别,为进一步控制其传播提供帮助。通过比较卷积神经网络VGG中的VGG-11、VGG-13、VGG-16,获得准确率较高的新冠肺炎CT图像自动诊断模型VGG-13,并在此基础上通过改进阈值的方式使准确率由86%提高到了89%,进一步提高诊断的准确性。     

Comparison of chest HRCT severity score in PCR positive and PCR negative clinically suspected COVID-19 Patients

BackgroundThe limitations and false-negative results of Real-time Polymerase chain reaction (RT PCR) in diagnosing COVID-19 infection demand the need for imaging modalities such as chest HRCT to improve the diagnostic accuracy and assess the severity of the infection.ObjectivesThe study aimed to compare the chest HRCT severity scores in RT-PCR positive and negative cases of COVID-19.MethodsThis cross-sectional study included 50 clinically suspected COVID-19 patients. Chest HRCT and PCR testing of all 50 patients were done and the chest HRCT severity scores for each lung and bronchopulmonary segments were compared in patients with positive and negative PCR results. Chi-square and Mann Whitney U test were used to assess differences among study variablesResultsChest HRCT severity score was more in PCR negative patients than in those with PCR positive results. However, the difference was not significant (p=0.11). There was a significant association in severity scores of the anterior basal segment of the left lung (p=0.022) and posterior segment upper lobe of right lung (p=0.035) with PCR results. This association was insignificant for other bronchopulmonary segments (p>0.05).ConclusionCR negativity does not rule out infection in clinically suspected COVID-19 patients. The use of chest HRCT helps to determine the extent of lung damage in clinically suspected patients irrespective of PCR results. Guidelines that consider clinical symptoms, chest HRCT severity score and PCR results for a confirmed diagnosis of COVID-19 in suspected patients are needed.     

窗宽和层厚在COVID-19磨玻璃征象中的诊断价值

目的:探讨并筛选适合观察新型冠状病毒肺炎（COVID-19）中磨玻璃影及各征象的最佳窗宽及层厚设置方案。方法: 回顾性分析11例COVID-19患者的影像资料,分别选取30个磨玻璃影、铺路石征、血管影增粗及空气支气管征的COVID-19 病灶进行分析对照,两名具有15年以上诊断经验的胸部影像医生对固定窗位下不同窗宽及层厚下的磨玻璃影及其他各征 象的显示程度进行主观评分,得出图像质量评分。结果:对磨玻璃影显示为3分的占比最大的窗宽值为1 000 HU（76.7%）, 对铺路石征显示为3分的占比最大的窗宽值为1 400 HU（80.0%）,对血管影增粗显示为3分的占比最大的窗宽值为1 400 HU （83.3%）,对空气支气管征显示为3分的占比最大的窗宽值为1 000 HU（83.3%）,以上结果与其他窗宽组的显示结果比较均 具有显著统计学意义（P<0.001）。对磨玻璃影、铺路石征、血管影增粗及空气支气管征显示为3分的占比最多的层厚均为1 mm（100%）;与其他层厚组比较,差异均具有显著统计学意义（P<0.001）。结论:在COVID-19的影像诊断过程中,1 000 HU 是观察磨玻璃影及空气支气管征的最佳窗宽值,1 400 HU是观察铺路石征及血管影增粗的最佳窗宽值;1 mm是观察磨玻璃 影及各征象的最佳层厚值。     

基于深度特征融合的肺炎影像识别研究

在新型冠状病毒肺炎(COVID-19)疫情背景下,肺炎影像快速准确诊断显得尤为重要.针对肺炎影像纹理及细粒度特征受噪声影响大、常规手段识别率低等问题,本研究构建了一种新的基于跨层连接机制的多主干网络特征融合卷积模型.依托并行特征挖掘思路,利用多尺度感受野挖掘融合来捕获医学图像的局部细节,实现对COVID-19医学影像的...