Leaders in Pharmaceutical Business Intelligence (LPBI) Group

Diagnosis of Coronavirus Infection by Medical Imaging and ALL other Cardiovascular Impacts of Viral Infection

Aviva Lev-Ari, PhD, RN 

• Lead Curator – e–mail Contact: avivalev-ari@alum.berkeley.edu

UPDATED on 9/2/2020

UPDATED on 7/12/2020

Combining PCR and CT testing for COVID Chen Shen∗ , Ron Mark MD DABR† , Nolan J. Kagetsu MD DABR‡ , Anton S. Becker MD PhD, Yaneer Bar-Yam∗

∗New England Complex Systems Institute,

†Mark Medical Care PLLC, ‡Mt. Sinai Hospital May 26, 2020

https://pharmaceuticalintelligence.files.wordpress.com/2020/03/7b0a4-ct_and_pcr_f1.pdf

UPDATED on 5/18/2020

TOP STORIES

Use CTA to evaluate obese COVID-19 patients for PE risk CT angiography (CTA) is an effective way to evaluate the risk of pulmonary embolism (PE) in patients with COVID-19, especially those who are obese or who have high levels of inflammation when they present at the hospital, according to a study published May 14 in Radiology.  Ultrasound scoring aids COVID-19 decisions A risk-stratification system that includes scores from lung ultrasound scans may help emergency clinicians quickly make care decisions for patients with COVID-19, according to an article published on May 9 in Emergency Medicine Australasia.  CT angio images show stroke in COVID-19 patient Some of the first CT angiography images documenting the rapid progression of acute ischemic stroke in a patient with COVID-19 were published on May 14 in the American Journal of Neuroradiology.  ISMRM annual meeting goes virtual The International Society for Magnetic Resonance in Medicine (ISMRM), along with the Society for MR Radiographers and Technologists, have announced that their annual meeting will be turned into a virtual conference this year due to safety concerns surrounding the COVID-19 pandemic.

CT COMMUNITY
Sponsored by Canon Medical Systems

Use CTA to evaluate obese COVID-19 patients for PE risk CT angiography (CTA) is an effective way to evaluate the risk of pulmonary embolism (PE) in patients with COVID-19, especially those who are obese or who have high levels of inflammation when they present at the hospital, according to a study published May 14 in Radiology.  CT angio images show stroke in COVID-19 patient Some of the first CT angiography images documenting the rapid progression of acute ischemic stroke in a patient with COVID-19 were published on May 14 in the American Journal of Neuroradiology.

SOURCE

From: AuntMinnie’s Letter from the Editor <letters@auntminnie.com>

Reply-To: <do-not-reply@auntminnie.com>

Date: Monday, May 18, 2020 at 7:50 AM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: Use CTA to evaluate obese COVID-19 patients for PE risk

UPDATED on 5/6/2020

SOURCE

From: Science News from the American Heart Association <email@heartemail.org>

Reply-To: American Heart Association <reply-71896937-7991033_HTML-1648404797-10171707-0@heartemail.org>

Date: Wednesday, May 6, 2020 at 12:32 PM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: Family caregiving and SDOH in HF care; CVD during pregnancy; COVID-19 health disparities

UPDATED ON 4/2/2020

SOURCE

From: Diagnostic and Interventional Cardiology <mail@sgc-editorial.com>

Reply-To: Diagnostic and Interventional Cardiology <DoNotReply@sgc-editorial.com>

Date: Tuesday, April 21, 2020 at 3:46 PM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: VIDEO: 9 Cardiologists share COVID-19 takeaways from across the U.S.

UPDATED ON 4/16/2020

“Every ER physician I know recognizes the power of these scans,” said Joseph Fraiman, an emergency medicine physician at hospitals in the New Orleans area who does two or three chest CTs on suspected Covid-19 patients every shift. “Aggressive disease identification would involve both [swab tests] and CT to ensure the highest sensitivity, missing the fewest cases possible.”

But despite China’s experience, the use of chest CT to diagnose Covid-19 in the U.S. remains very limited (no one has data on how many have been done). That’s due in large part of the CDC and the American College of Radiology recommendations.

One of their objections is that CT scanners will become contaminated with the coronavirus. China, whose fever clinics routinely scanned 200 patients per day per machine, managed to clean the machines between patients well enough to avoid infecting health care workers or subsequent patients, however. Researchers there reported last month that CT scanning is far safer for health care workers than the swabs that reach the throat via the nose, and often trigger explosive coughing that can spew virus particles into the air. Thanks to staff training and between-patient scanner cleaning, after 3,340 CT scans for suspected Covid-19, another group of physicians in China reported, “none of the staff of the radiology department was infected with Covid-19.”

“It’s not like China has a monopoly on the technology to clean CT scanners,” said the Louisiana emergency medicine physician who asked not to be identified, so as not to anger colleagues. “Are you really going to say that your cleaning protocol is why you’re willing to kill 1 million people?” if the test/isolate/trace strategy fails because of faulty swab tests.

Fraiman said he is able to do chest CTs for his suspected Covid-19 cases by getting the technicians and cleaning crews on board: “I tell them, you are the guys who are going to save us!”

Another objection is that CT scans cannot easily distinguish between Covid-19, SARS, MERS, and other viral pneumonias, including from influenza. “They’re not specific enough,” said Sanjat Kanjilal, an infectious disease physician at Brigham and Women’s Hospital in Boston.

Although SARS, which is caused by a coronavirus related to the one causing Covid-19, was eliminated, and MERS (also from a coronavirus) is extremely rare outside the Middle East, viral pneumonia looks a lot like Covid-19 in a chest CT. “That makes me skeptical that it can have a big role to play,” Kanjilal said.

The rate of false positives from misidentifying other viral pneumonias as Covid-19 might be as high as 30%, said radiologist Paras Lakhani of Thomas Jefferson University Hospital in Philadelphia. But it would be much lower outside of flu season, which is ending. Reading scans during a time of year when flu and therefore pneumonia is rare, he said, “would give us more confidence in interpreting a scan.”

To be sure, chest CTs are no panacea. They, too, can miss Covid-19 cases; just two-fifths of the Diamond Princess passengers who had positive swab tests had lung opacities, researchers reported last month.

“There is evidence that a large fraction of Covid-19 patients have normal CTs,” said radiologist Mark Hammer of Brigham and Women’s Hospital in Boston. “Using CT to screen patients would let a lot of people go who may be infectious.”

Absent more accurate Covid-19 tests of any kind, whether swabs or CT or a combination, states’ tentative “re-opening” plans will be inefficient at best and failures at worst. The many Covid-19 cases that swab tests miss, said BU’s Galea, “is why the proposed Massachusetts contact tracing plan I have seen will quarantine people for 14 days even if they test negative” — a fortnight that someone could have been safely back at work and in the community if only a negative result on the molecular tests were more credible.

SOURCE

https://www.statnews.com/2020/04/16/ct-scans-alternative-to-inaccurate-coronavirus-tests/?utm_source=STAT+Newsletters&utm_campaign=fffd3e2a6e-Daily_Recap&utm_medium=email&utm_term=0_8cab1d7961-fffd3e2a6e-150237109

UPDATED ON 3/27/2020