COVID-19-related cardiomyopathy:Can dual-energy computed tomography be a diagnostic tool?

BACKGROUND No study on dual energy computed tomography(DECT)has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019(COVID-19)patients.Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion,and these deficits can be shown via DECT with a perfect interrater agreement.AIM To assess lung perfusion alterations in COVID-19 patients.To our knowledge,no study using DECT has been performed to evaluate possibly fatal cardiac/myocardial problems in COVID-19 patients.The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases.METHODS Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association’s classification of the segmentation of the left ventricular myocardium.Additionally,intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated.Following segment-by-segment analysis,perfusion deficiencies identified on the iodine map pictures on DECT were identified.RESULTS The study enrolled a total of 87 patients.Forty-two of these individuals were classified as COVID-19 positive,and 45 were classified as controls.Perfusion deficits were identified in 66.6%(n=30)of the cases.All control patients had a normal iodine distribution map.Perfusion deficits were found on DECT iodine map images with subepicardial(n=12,40%),intramyocardial(n=8,26.6%),or transmural(n=10,33.3%)anatomical locations within the left ventricular wall.There was no subendocardial involvement in any of the patients.CONCLUSION Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion.These deficits can be shown via DECT with a perfect interrater agreement.Additionally,the presence of perfusion deficit is positively correlated with D-dimer levels.

Population dynamics, pathogen detection and insecticide resistance of mosquito and sand fly in refugee camps, Greece

Background:As of 2015 thousands of refugees are being hosted in temporary refugee camps in Greece.Displaced populations,travelling and living under poor conditions with limited access to healthcare are at a high risk of exposure to vector borne disease(VBD).This study sought to evaluate the risk for VBD transmission within refugee camps in Greece by analyzing the mosquito and sand fly populations present,in light of designing effective and efficient context specific vector and disease control programs.Methods:A vector/pathogen surveillance network targeting mosquitoes and sand flies was deployed in four temporary refugee camps in Greece.Sample collections were conducted bi-weekly during June-September 2017 with the use of Centers for Disease Control(CDC)light traps and oviposition traps.Using conventional and molecular diagnostic tools we investigated the mosquito/sand fly species composition,population dynamics,pathogen infection rates,and insecticide resistance status in the major vector species.Results:Important disease vectors including Anopheles sacharovi,Culex pipiens,Aedes albopictus and the Leishmania vectors Phlebotomus neglectus,P.perfiliewi and P.tobbi were recorded in the study refugee camps.No mosquito pathogens(Plasmodium parasites,flaviviruses)were detected in the analysed samples yet high sand fly Leishmania infection rates are reported.Culex pipiens mosquitoes displayed relatively high knock down resistance(kdr)mutation allelic frequencies(ranging from 41.0 to 63.3%)while kdr mutations were also detected in Ae.albopictus populations,but not in Anopheles and sand fly specimens.No diflubenzuron(DFB)mutations were detected in any of the mosquito species analysed.Conclusions:Important disease vectors and pathogens in vectors(Leishmania spp.)were recorded in the refugee camps indicating a situational risk factor for disease transmission.The Cx.pipiens and Ae.albopictus kdr mutation frequencies recorded pose a potential threat against the effectiveness of pyrethroid insecticides in these settings.In contrast,pyrethroids appear suitable for the control of Anopheles mosquitoes and sand flies and DFB for Cx.pipiens and Ae.albopictus larvicide applications.Targeted actions ensuring adequate living conditions and the establishment of integrated vector-borne disease surveillance programs in refugee settlements are essential for protecting refugee populations against VBDs.