Background A retrospective multicentric study gathered 1439 CT chest studies with suspected coronavirus disease 2019 (COVID-19) affection. Three radiologists, blinded to other results, interpreted all studies using both lexicons with documentation of applicability and preferred score in assessing every case. The purpose of the study is to assess COVID-19 standardized assessment schemes’ (CO-RADS and COVID-RADS lexicons) applicability and diagnostic efficacy. Results This study included 991 RT-PCR-confirmed CT studies. An almost perfect agreement was found in COVID-RADS among the three observers (Fleiss Kappa = 0.82), opposed by a substantial agreement in CO-RADS (Κ = 0.78). The preference records favor COVID-RADS/CO-RADS in 78.5%/12.5%, 75.5%/24.5%, and 73.4%/24.5% regarding the three radiologists’ records, respectively. The distinguishability between positive and negative RT-PCR cases was 0.92 for COVID-RADS, while it was 0.85 for CO-RADS. On the other hand, both lexicons’ performance regarding clinical diagnosis and clinical suspicion index was 0.93 for COVID-RADS and 0.94 for CO-RADS. A very high to excellent agreement between the three observers for COVID-RADS/CO-RADS preference was concluded (Fleiss Kappa = 0.80 to 0.94). These results were statistically significant (p < 0.001). Conclusion Both lexicon scores (CO-RADS and COVID-RADS) were found to be applicable in the COVID-19 structured report with the preference of COVID-RADS in more than 50% of cases. The diagnostic accuracy of COVID-RADS against RT-PCR was higher than that of CO-RADS.

Background Poorly controlled bronchial asthma limits patients’ quality of life (QOL), the condition which may potentiate the development of psychiatric disorders. The aim of this study was the assessment of anxiety and depression in bronchial asthma patients, and their interrelation with both level of asthma control and quality of life in our society. Results This study included 102 bronchial asthma patients, and 50 healthy control individuals. Patients had poorer QOL, and higher anxiety and depression scores compared to healthy control, moreover these scores were higher in uncontrolled asthma patients compared to controlled group. Poor QOL, frequent hospital admissions, and poor asthma control were the predictors for psychiatric disorders. Conclusion Depression and anxiety are frequently encountered in patients with bronchial asthma in our society; poor symptom control, poor QOL, and frequent hospital admissions are the main predictors for these psychiatric disorders.

Background Regarding risk stratification of intermediate-risk pulmonary embolism, data are still not sufficient. Transthoracic echocardiography parameters may be useful in risk evaluation in those patients. Some novel echocardiographic indices mainly tricuspid regurgitation peak gradient (TRPG), pulmonary artery acceleration time, and tricuspid annulus plane systolic excursion (TAPSE) were evaluated showing that they may be used for risk stratification of normotensive cases with acute pulmonary embolism (APE). Results The studied cases were subdivided into two classes: Class I with intermediate-low-risk pulmonary embolism included 32 patients (53.3%) and class II with intermediate high-risk pulmonary embolism involved 28 cases (46.7%). Dyspnea, tachypnea, troponin level, RVD, RVD/LVD, TR velocity, and TRPG/TAPSE were statistically higher in cases of class II than that of class I (p < 0.001). On the other hand, TAPSE and PA acceleration time were markedly lower in the case of class II than that of class I (p < 0.001). Ten cases (35.7%) of group II required thrombolytic agents with a significant difference (p<0.001). Conclusions RVD/LVD ratio, TAPSE, TRPG/TAPSE ratio, and PA acceleration time are echocardiographic parameters that might be helpful for risk stratification of cases with moderate-risk pulmonary embolism. The addition of elevated levels of cardiac troponins to imaging and clinical findings can improve PE-related risk identification. Trial registration NCT04020250. Registered on 16 July 2019.

Background Patient-ventilator asynchrony is a common problem in mechanically ventilated patients. It is associated with adverse effects including increased work of breathing, patient discomfort, increased need for sedation, prolonged mechanical ventilation, weaning difficulties, and weaning failure. The purpose of the present was to describe patient-ventilator asynchrony and its impact on weaning outcomes in mechanically ventilated chronic obstructive pulmonary disease (COPD) patients. Results One hundred mechanically ventilated COPD patients were enrolled in this prospective study. Weaning failure (need of NIV or reintubation within 48 h) was noticed in 27 (27%) patients while 73 (73%) patients had successful weaning. Patients with failed weaning had significantly higher asynchrony index (A.I) and ineffective trigger index (ITI) in comparison with those with successful weaning (7.69 ± 3.71, 3.46 ± 2.59 versus 6.27 ± 3.14, 2.47 ± 2.08, respectively; P value< 0.04). Data were expressed as mean ± standard deviation. Conclusion High asynchrony index and high ineffective trigger index may be early predictors of weaning failure in mechanically ventilated COPD patients.

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