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COVID-19 Vaccine Updates
With inputs from Dr Monica Vasudev
1031: Can Trained Dogs Identify COVID-19 Infections?
Following some training, dogs may be able to sniff out and spot the individuals infected with the coronavirus, revealed a study published in BMC Infectious Diseases.
This was a small pilot project tested by the German Armed Forces, the University of Veterinary Medicine in Hannover and the Hanover Medical School.
Eight dogs who were part of the German Armed Forces, were trained for a week to identify the virus in samples of saliva. This was followed by giving them over 1,000 infected and non-infected samples. The dogs could detect 94% of cases. They were able to correctly identify 157 positive samples and 792 negative samples; however, they missed 30 positive samples and gave false positive finding for 33 samples.
Dogs cab detect a specific smell of the metabolic changes that occur in those patients. Trained dogs could be sent to airports, sporting events, etc., to detect infections.
Dogs have previously been trained to detect cancer, malaria, and other bacterial and viral infections. [Medscape]
Cardiovascular effects of COVID-19
As per a study published in JAMA Cardiology, cardiac inflammatory involvement is frequently seen among patients who have recently recovered from COVID-19 infection, irrespective of pre-existing conditions. In a cohort of 100 German patients who had recently recovered from the infection, cardiovascular magnetic resonance (CMR) revealed cardiac involvement in 78% and ongoing myocardial inflammation in 60%.
Cardiac involvement was seen regardless of infection severity, overall course of COVID-19 presentation, time from the original diagnosis, or the presence of cardiac symptoms.
This was a prospective observational study including patients who had recovered from COVID-19 from April through June 2020. The participants were at least 2 weeks out from being diagnosed with COVID-19, and their respiratory symptoms had resolved; they had negative results on a swab test at the end of the isolation period.
Fifty three patients were male, with a median age of 49 years. The median time interval between COVID-19 diagnosis and CMR was 71 days. Of the patients, 67 recovered at home, and 33 needed hospitalization. Pre-existing conditions among the patients included hypertension, diabetes, and known coronary artery disease, but no previously known heart failure or cardiomyopathy. Pre-existing conditions were similar between patients who recovered at home and those who were hospitalized.
At the time of CMR, 71 patients had detectable high-sensitivity troponin T (hsTnT) (≥3 pg/mL) while it was significantly elevated (≥13.9 pg/mL) in 5 patients. Patients recently recovered from COVID-19 had lower left ventricular ejection fraction, higher left ventricle volumes, higher left ventricle mass, and elevated native T1 and T2 compared to the control groups.
Myocardial inflammation was the most common abnormality observed on CMR , defined as abnormal native T1 and T2 measures. It was evident in 73 and 60 patients, respectively. This was followed by regional scar and pericardial enhancement, which was evident in 32 and 22 patients, respectively. Findings on classic parameters, such as volumes and ejection fractions, were mildly abnormal.
A small but significant difference could be observed in native T1 mapping between patients who recovered at home compared to those who were hospitalized (median, 1122 ms vs 1143 ms; P = .02), but not for native T2, hsTnT, or N-terminal pro-b-type natriuretic peptide levels. None of these measures correlated with time from COVID-19 diagnosis.
Levels of hsTnT significantly correlated with native T1 mapping (P < .001) and native T2 mapping (P = .03). A cross-correlation was also seen between native T1 and T2 (P < .001). There was a significant correlation of hsTnT with native T1 (P < .001) and left ventricle mass (P < .001). The associations of hsTnT with mapping measures were significant even after controlling for the presence of comorbidities (overall or separately) or treatment received for COVID-19 infection.
Unlike the previous studies, the findings in this study indicate that significant cardiac involvement occurs independently of the severity of original presentation and persists beyond the period of acute presentation. Additionally, there is no significant trend toward reduction of imaging or serological findings during the recovery period. [DG alert]
Dr KK Aggarwal
President CMAAO, HCFI and Past National President IMA