StatementThis prospective longitudinal study systematically described the temporal changes of CT findings in COVID-19 pneumonia and summarized the CT findings at the time of hospital discharge. Key ResultsThe extent of CT abnormalities progressed rapidly after symptom onset, peaked during illness days 6-11, and followed by persistence of high levels.The predominant pattern of abnormalities after symptom onset was ground-glass opacity; the percentage of mixed pattern peaked during illness days 12-17, and became the second most prevalent pattern thereafter.Sixty-six of the 70 patients (94%) discharged had residual disease on final CT scans, with ground-glass opacity the most common pattern. Abbreviations: COVID-19: corona virus disease 2019 SARS-CoV-2: severe acute respiratory syndrome coronavirus 2 rRT-PCR: real-time reverse transcriptase-polymerase chain reaction I n P r e s s Abstract Background: CT may play a central role in the diagnosis and management of COVID-19 pneumonia.Purpose: To perform a longitudinal study to analyze the serial CT findings over time in patients with COVID-19 pneumonia. Materials and Methods:During January 16 to February 17, 2020, 90 patients (male:female, 33:57; mean age, 45 years) with COVID-19 pneumonia were prospectively enrolled and followed up until they were discharged or died, or until the end of the study. A total of 366 CT scans were acquired and reviewed by 2 groups of radiologists for the patterns and distribution of lung abnormalities, total CT scores and number of zones involved. Those features were analyzed for temporal change.Results: CT scores and number of zones involved progressed rapidly, peaked during illness days 6-11 (median: 5 and 5), and followed by persistence of high levels. The predominant pattern of abnormalities after symptom onset was ground-glass opacity (35/78 [45%] to 49/79 [62%] in different periods). The percentage of mixed pattern peaked (30/78 [38%]) on illness days 12-17, and became the second most predominant pattern thereafter. Pure ground-glass opacity was the most prevalent sub-type of groundglass opacity after symptom onset (20/50 [40%] to 20/28 [71%]). The percentage of ground-glass opacity with irregular linear opacity peaked on illness days 6-11 (14/50 [28%)]) and became the second most prevalent subtype thereafter. The distribution of lesions was predominantly bilateral and subpleural. 66/70 (94%) patients discharged had residual disease on final CT scans (median CT scores and zones involved: 4 and 4), with ground-glass opacity (42/70 [60%]) and pure ground-glass opacity (31/42 [74%]) the most common pattern and subtype. Conclusion:The extent of lung abnormalities on CT peaked during illness days 6-11. The temporal changes of the diverse CT manifestations followed a specific pattern, which might indicate the progression and recovery of the illness.
Previous research on gaming disorder (GD) has highlighted key methodological and conceptual hindrances stemming from the heterogeneity of nomenclature and the use of nonstandardized psychometric tools to assess this phenomenon. The recent recognition of GD as an official mental health disorder and behavioral addiction by the World Health Organization (WHO) in the 11th Revision of the International Classification of Diseases (ICD-11) opens up new possibilities to investigate further the psychosocial and mental health implications due to excessive and disordered gaming. However, before further research on GD can be conducted in a reliable way and within a robust cross-cultural context, a valid and reliable standardized psychometric tool to assess the construct as defined by the WHO should be developed. The aim of this study was to develop The Gaming Disorder Test (GDT), a brief four-item measure to assess GD and to further explore its psychometric properties. A sample of 236 Chinese (47% male, mean age 19.22 years, SD = 1.57) and 324 British (49.4% male, mean age 26.74 years, SD = 7.88) gamers was recruited online. Construct validity of the GDT was examined via factorial validity, nomological validity, alongside convergent and discriminant validity. Concurrent validity was also examined using the Internet Gaming Disorder Scale-Short-Form (IGDS9-SF). Finally, reliability indicators involving the Cronbach's alpha and composite reliability coefficients were estimated. Overall, the results indicated that GDT is best conceptualized within a single-factor structure. Additionally, the four items of the GDT are valid, reliable, and proved to be highly suitable for measuring GD within a cross-cultural context.
Currently, there are no approved specific antiviral agents for 2019 novel coronavirus disease . In this study, ten severe patients confirmed by real-time viral RNA test were enrolled prospectively. One dose of 200 mL convalescent plasma (CP) derived from recently recovered donors with the neutralizing antibody titers above 1:640 was transfused to the patients as an addition to maximal supportive care and antiviral agents. The primary endpoint was the safety of CP transfusion. The second endpoints were the improvement of clinical symptoms and laboratory parameters within 3 days after CP transfusion. The median time from onset of illness to CP transfusion was 16.5 days. After CP transfusion, the level of neutralizing antibody increased rapidly up to 1:640 in five cases, while that of the other four cases maintained at a high level (1:640). The clinical symptoms were significantly improved along with increase of oxyhemoglobin saturation within 3 days. Several parameters tended to improve as compared to pre-transfusion, including increased lymphocyte counts (0.65×10 9 /L vs. 0.76×10 9 /L) and decreased C-reactive protein (55.98 mg/L vs. 18.13 mg/L). Radiological examinations showed varying degrees of absorption of lung lesionswithin 7 days. The viral load was undetectable after transfusion in seven patients who had previous viremia. No severe adverse effects were observed. This study showed CP therapy was welltolerated and could potentially improve the clinical outcomes through neutralizing viremia in severe COVID-19 cases. The optimal dose and time point, as well as the clinical benefit of CP therapy, needs further investigation in larger well-controlled trials. Significance StatementCOVID-19is currently a big threat to global health. However, no specific antiviral agents are available for its treatment. In this work, we explored the feasibility of convalescent plasma (CP) transfusion to rescue severe patients. The results from 10 severe adult cases showed that one dose (200 mL) of CP was welltolerated and could significantly increase or maintain the neutralizing antibodies at a high level, leading to disappearance of viremia in 7 days. Meanwhile, clinical symptoms and paraclinical criteria rapidly improved within 3 days. Radiological examination All rights reserved. No reuse allowed without permission.
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