Comment on “COVID-19 infection control protocol inside computed tomography suites”

Orsi, Marcello; Oliva, Giancarlo; Toluian, Tahereh; Pittino, Carlo Valenti; Gibelli, Daniele; Cellina, Michaela

doi:10.1007/s11604-020-00975-9

Cited by 5 publications

(5 citation statements)

References 2 publications

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“…In fact, not only it increases the risk of transmission to healthcare workers and other patients, but also the necessary decontamination procedures required after scanning COVID-19 patients could obviously disrupt radiological service availability in a setting where a dedicated COVID-19 CT scanner is not available. Thus, the Fleischner Society Consensus and the American College of Radiology caution towards this approach and the latter suggests the use of CXR to minimize the risk of cross-infection [ 5 , 20 – 22 ]. Keeping all this in consideration, and the fact that CXR is widely available and already routinely obtained in the ED, improving our understanding of the role of COVID-19 CXR radiographic features is mandatory.…”

Section: Discussionmentioning

confidence: 99%

Initial chest radiographs and artificial intelligence (AI) predict clinical outcomes in COVID-19 patients: analysis of 697 Italian patients

et al. 2020

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Objective To evaluate whether the initial chest X-ray (CXR) severity assessed by an AI system may have prognostic utility in patients with COVID-19. Methods This retrospective single-center study included adult patients presenting to the emergency department (ED) between February 25 and April 9, 2020, with SARS-CoV-2 infection confirmed on real-time reverse transcriptase polymerase chain reaction (RT-PCR). Initial CXRs obtained on ED presentation were evaluated by a deep learning artificial intelligence (AI) system and compared with the Radiographic Assessment of Lung Edema (RALE) score, calculated by two experienced radiologists. Death and critical COVID-19 (admission to intensive care unit (ICU) or deaths occurring before ICU admission) were identified as clinical outcomes. Independent predictors of adverse outcomes were evaluated by multivariate analyses. Results Six hundred ninety-seven 697 patients were included in the study: 465 males (66.7%), median age of 62 years (IQR 52–75). Multivariate analyses adjusting for demographics and comorbidities showed that an AI system-based score ≥ 30 on the initial CXR was an independent predictor both for mortality (HR 2.60 (95% CI 1.69 − 3.99; p < 0.001)) and critical COVID-19 (HR 3.40 (95% CI 2.35–4.94; p < 0.001)). Other independent predictors were RALE score, older age, male sex, coronary artery disease, COPD, and neurodegenerative disease. Conclusion AI- and radiologist-assessed disease severity scores on CXRs obtained on ED presentation were independent and comparable predictors of adverse outcomes in patients with COVID-19. Trial registration ClinicalTrials.gov NCT04318366 (https://clinicaltrials.gov/ct2/show/NCT04318366). Key Points • AI system–based score ≥ 30 and a RALE score ≥ 12 at CXRs performed at ED presentation are independent and comparable predictors of death and/or ICU admission in COVID-19 patients. • Other independent predictors are older age, male sex, coronary artery disease, COPD, and neurodegenerative disease. • The comparable performance of the AI system in relation to a radiologist-assessed score in predicting adverse outcomes may represent a game-changer in resource-constrained settings.

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Section: Discussionmentioning

confidence: 99%

Initial chest radiographs and artificial intelligence (AI) predict clinical outcomes in COVID-19 patients: analysis of 697 Italian patients

et al. 2020

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“…22 CT scans have been used as first-line investigation but this has significant challenges in terms of infection control and burden of work on radiology departments. 19 23 CT scan findings typically show a combination of ground glass opacities and peripheral consolidations and are highly sensitive (approaching 97% in some cases, 24 ) although not completely specific. 25 Hence, it has been suggested that CT not be used as a first-line diagnostic test, but is reserved for a patient with high clinical suspicion of COVID-19 and a negative swab result.…”

Section: Role Of Imaging and Lung Ultrasound In Covid-19 Pathwaymentioning

confidence: 99%

Lung ultrasound in the COVID-19 pandemic

Jackson

Butler

Aujayeb

2020

Postgraduate Medical Journal

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Lung ultrasound has been described for over a decade and international protocols exist for its application. It is a controversial area among pulmonologists and has had more uptake with emergency as well as intensive care physicians. We discuss the basics and evidence behind the use of lung ultrasound in respiratory failure, and what role we see it playing in the current 2019 novel coronavirus pandemic.

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“…Radiologists review the CT images far away from the relocatable CT or review CT images online to minimize the number of medical staff entering the relocatable CT. Traditional CT requires a radiographer to position the machine in the scanning room, which inevitably leads to close contact with patients (12,13). The mobile cabin hospital implements paperless communication to reduce unnecessary contact between medical staff and patients.…”

Section: Health Protection Of Medical Staffmentioning

confidence: 99%

Health Protection of CT Radiographers During the Outbreak of COVID-19: Application of Automatic Positioning Technology for Relocatable CT in the Fang Cang Hospital

Jiang

Luo

et al. 2021

Front. Med.

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Background: To investigate the value of automatic positioning technology in improving the protection of radiographers in the relocatable CT room of a Fang Cang hospital during the outbreak of coronavirus disease 2019 (COVID-19).Methods: The National Emergency Medical Team of our hospital assumed command of Wuchang Fang Cang Hospital and treated confirmed COVID-19 patients with mild symptoms. Relocatable CT was used to examine patients in this hospital. Automatic positioning technology was applied to avoid close contact between medical staff and patients and to protect medical staff more effectively.Results: Seven hundred lung CT scans acquired from 269 patients were completed from February 17 to 26, 2020 with automatic positioning technology for relocatable CT in a Fang Cang hospital. All scans were conducted successfully using automatic positioning technology. All patients entered the scanning room from a separate door. All the position lines were accurate, and all images met the requirement for diagnosis of COVID-19, with satisfied quality. None of our medical staff had any close contact with patients.Conclusion: Automatic positioning technology applied to relocatable CT can minimize the close contact between technologists and patients and effectively improve the protection of medical staff without sacrificing image quality.

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Comment on “COVID-19 infection control protocol inside computed tomography suites”

Abstract: Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Cited by 5 publications

References 2 publications

Initial chest radiographs and artificial intelligence (AI) predict clinical outcomes in COVID-19 patients: analysis of 697 Italian patients

Initial chest radiographs and artificial intelligence (AI) predict clinical outcomes in COVID-19 patients: analysis of 697 Italian patients

Lung ultrasound in the COVID-19 pandemic

Health Protection of CT Radiographers During the Outbreak of COVID-19: Application of Automatic Positioning Technology for Relocatable CT in the Fang Cang Hospital

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