16 results on '"Julie Finance"'
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2. Diaphragm dysfunction after severe COVID-19: An ultrasound study
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Alain Boussuges, Paul Habert, Guillaume Chaumet, Rawah Rouibah, Lea Delorme, Amelie Menard, Matthieu Million, Axel Bartoli, Eric Guedj, Marion Gouitaa, Laurent Zieleskiewicz, Julie Finance, Benjamin Coiffard, Stephane Delliaux, and Fabienne Brégeon
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chest ultrasonography ,thickening fraction ,SARS-CoV-2 ,diaphragm motion ,respiratory physiotherapy ,Medicine (General) ,R5-920 - Abstract
BackgroundSARS-CoV-2 infection can impair diaphragm function at the acute phase but the frequency of diaphragm dysfunction after recovery from COVID-19 remains unknown.Materials and methodsThis study was carried out on patients reporting persistent respiratory symptoms 3–4 months after severe COVID-19 pneumonia. The included patients were selected from a medical consultation designed to screen for recovery after acute infection. Respiratory function was assessed by a pulmonary function test, and diaphragm function was studied by ultrasonography.ResultsIn total, 132 patients (85M, 47W) were recruited from the medical consultation. During the acute phase of the infection, the severity of the clinical status led to ICU admission for 58 patients (44%). Diaphragm dysfunction (DD) was detected by ultrasonography in 13 patients, two of whom suffered from hemidiaphragm paralysis. Patients with DD had more frequently muscle pain complaints and had a higher frequency of prior cardiothoracic or upper abdominal surgery than patients with normal diaphragm function. Pulmonary function testing revealed a significant decrease in lung volumes and DLCO and the dyspnea scores (mMRC and Borg10 scores) were significantly increased in patients with DD. Improvement in respiratory function was recorded in seven out of nine patients assessed 6 months after the first ultrasound examination.ConclusionAssessment of diaphragm function by ultrasonography after severe COVID-19 pneumonia revealed signs of dysfunction in 10% of our population. In some cases, ultrasound examination probably discovered an un-recognized pre-existing DD. COVID-19 nonetheless contributed to impairment of diaphragm function. Prolonged respiratory physiotherapy led to improvement in respiratory function in most patients.Clinical trial registration[www.cnil.fr], identifier [#PADS20-207].
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- 2022
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3. Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19
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Maxime Castelli, Arnaud Maurin, Axel Bartoli, Michael Dassa, Baptiste Marchi, Julie Finance, Jean-Christophe Lagier, Matthieu Million, Philippe Parola, Philippe Brouqui, Didier Raoult, Sebastien Cortaredona, Alexis Jacquier, Jean-Yves Gaubert, and Paul Habert
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COVID-19 ,Tomography ,X-ray computed ,Quantitative evaluation ,Pneumonia ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Abstract Background Low-dose chest CT (LDCT) showed high sensitivity and ability to quantify lung involvement of COVID-19 pneumopathy. The aim of this study was to describe the prevalence and risk factors for lung involvement in 247 patients with a visual score and assess the prevalence of incidental findings. Methods For 12 days in March 2020, 250 patients with RT-PCR positive tests and who underwent LDCT were prospectively included. Clinical and imaging findings were recorded. The extent of lung involvement was quantified using a score ranging from 0 to 40. A logistic regression model was used to explore factors associated with a score ≥ 10. Results A total of 247 patients were analyzed; 138 (54%) showed lung involvement. The mean score was 4.5 ± 6.5, and the mean score for patients with lung involvement was 8.1 ± 6.8 [1–31]. The mean age was 43 ± 15 years, with 121 males (48%) and 17 asymptomatic patients (7%). Multivariate analysis showed that age > 54 years (odds ratio 4.4[2.0–9.6] p 54 years (4.1[1.7–10.0] p = 0.002) was a risk factor for a score ≥ 10. Rhinitis (0.3[0.1–0.7] p = 0.005) and anosmia (0.3[0.1–0.9] p = 0.043) were protective against lung involvement. Incidental imaging findings were found in 19% of patients, with a need for follow-up in 0.6%. Conclusion The prevalence of lung involvement was 54% in a predominantly paucisymptomatic population. Age ≥ 55 years and diabetes were risk factors for significant parenchymal lung involvement. Rhinitis and anosmia were protective against LDCT abnormalities.
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- 2020
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4. Ultrasound Assessment of Diaphragm Thickness and Thickening: Reference Values and Limits of Normality When in a Seated Position
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Alain Boussuges, Sarah Rives, Julie Finance, Guillaume Chaumet, Nicolas Vallée, Jean-Jacques Risso, and Fabienne Brégeon
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chest ultrasonography ,hemidiaphragm ,thickening fraction ,thickening ratio ,respiratory maneuvers ,Medicine (General) ,R5-920 - Abstract
Background: Diagnosing diaphragm dysfunction in the absence of complete paralysis remains difficult. The aim of the present study was to assess the normal values of the thickness and the inspiratory thickening of both hemidiaphragms as measured by ultrasonography in healthy volunteers while in a seated position.Methods: Healthy volunteers with a normal pulmonary function test were recruited. The diaphragmatic thickness was measured on both sides at the zone of apposition of the diaphragm to the rib cage during quiet breathing at end-expiration, end-inspiration, and after maximal inspiration. The thickening ratio, the thickening fraction, and the thickness at end-inspiration divided by the thickness at deep breathing were determined. The mean values and the lower and upper limits of normal were determined for men and women.Results: 200 healthy volunteers (100 men and 100 women) were included in the study. The statistical analysis revealed that women had a thinner hemidiaphragm than men on both sides and at the various breathing times studied. The lower limit of normality of the diaphragm thickness measured at end-expiration was estimated to be 1.3 mm in men and 1.1 mm in women, on both sides. The thickening fraction did not differ significantly between men and women. In men, it ranged from 60 to 260% on the left side and from 57 to 200% on the right side. In women, it ranged from 58 to 264% on the left side and from 60 to 229% on the right side. The lower limits of normality of the thickening fraction were determined to be 40 and 39% in men and 39 and 48% in women for the right and left hemidiaphragms, respectively. The upper limit for normal of the mean of both sides of the ratio thickness at end-inspiration divided by the thickness at deep breathing was determined to be 0.78 in women and 0.79 in men.Conclusion: The normal values of thickness and the indexes of diaphragmatic function should help clinicians with detecting diaphragm atrophy and dysfunction.
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- 2021
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5. Different pattern of the second outbreak of COVID-19 in Marseille, France
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Philippe Gautret, Philippe Colson, Jean Christophe Lagier, Laurence Camoin-Jau, Audrey Giraud-Gatineau, Sophia Boudjema, Julie Finance, Hervé Chaudet, and Didier Raoult
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COVID-19 ,Seasonality ,Severity markers ,Lethality ,Infectious and parasitic diseases ,RC109-216 - Abstract
Objective: To describe the characteristics of COVID-19 patients seen in March-April and June-August 2020 in Marseille, France with the aim to investigate possible changes in the disease between these two time periods. Methods: Demographics, hospitalization rate, transfer to intensive care unit (ICU), lethality, clinical and biological parameters were investigated. Results: Compared to those seen in March-April, COVID-19 patients seen in June-August were significantly younger (39.2 vs. 45.3 years), more likely to be male (52.9% vs. 45.6%), and less likely to be hospitalized (10.7 vs. 18.0%), to be transferred to ICU (0.9% vs. 1.8%) and to die (0.1% vs. 1.1%). Their mean fibrinogen and D-dimer blood levels were lower (1.0 vs. 1.5 g/L and 0.6 vs. 1.1 μg/mL, respectively). By contrast, their viral load was higher (cycle threshold ≤16 = 5.1% vs. 3.7%). Conclusions: Patients in the two periods did not present marked age and sex differences, but markers of severity were undoubtedly less prevalent in the summer period, associating with a 10 times decrease in the lethality rate.
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- 2021
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6. Diaphragmatic motion recorded by M-mode ultrasonography: limits of normality
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Alain Boussuges, Julie Finance, Guillaume Chaumet, and Fabienne Brégeon
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Medicine - Abstract
Chest ultrasonography has proven to be useful in the diagnosis of diaphragm dysfunction. The aim of the present study was to determine the normal values of the motion of both hemidiaphragms recorded by M-mode ultrasonography. Healthy volunteers were studied while in a seated position. Diaphragmatic excursions and diaphragm profiles were measured during quiet breathing, voluntary sniffing and deep breathing. Diaphragmatic excursions were assessed by M-mode ultrasonography, using an approach perpendicular to the posterior part of the diaphragm. Anatomical M-mode was used for the recording of the complete excursion during deep breathing. The study included 270 men and 140 women. The diaphragmatic motions during quiet breathing and voluntary sniffing were successfully recorded in all of the participants. The use of anatomical M-mode was particularly suitable for measurement of the entire diaphragmatic excursion during deep breathing. The statistical analysis showed that the diaphragmatic excursions were larger in men compared to women, supporting the determination of normal values based on sex. The lower and upper limits of normal excursion were determined for men and women for both hemidiaphragms during the three manoeuvres that were investigated. The lower limits of normal diaphragmatic excursions during deep breathing should be used to detect diaphragmatic hypokinesia, i.e. 3.3 and 3.2 cm in women and 4.1 and 4.2 cm in men for the right and the left sides, respectively. The normal values of the diaphragmatic motion and the lower and upper limits of normal excursion can be used by clinicians to detect diaphragmatic dysfunction.
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- 2021
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7. Low-dose chest CT for diagnosing and assessing the extent of lung involvement of SARS-CoV-2 pneumonia using a semi quantitative score.
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Thomas Leger, Alexis Jacquier, Pierre-Antoine Barral, Maxime Castelli, Julie Finance, Jean-Christophe Lagier, Matthieu Million, Philippe Parola, Philippe Brouqui, Didier Raoult, Axel Bartoli, Jean-Yves Gaubert, and Paul Habert
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Medicine ,Science - Abstract
ObjectivesThe purpose is to assess the ability of low-dose CT (LDCT) to determine lung involvement in SARS-CoV-2 pneumonia and to describe a COVID19-LDCT severity score.Materials and methodsPatients with SARS-CoV-2 infection confirmed by RT-PCR were retrospectively analysed. Clinical data, the National Early Warning Score (NEWS) and imaging features were recorded. Lung features included ground-glass opacities (GGO), areas of consolidation and crazy paving patterns. The COVID19-LDCT score was calculated by summing the score of each segment from 0 (no involvement) to 10 (severe impairment). Univariate analysis was performed to explore predictive factor of high COVID19-LDCT score. The nonparametric Mann-Whitney test was used to compare groups and a Spearman correlation used with pResultsEighty patients with positive RT-PCR were analysed. The mean age was 55 years ± 16, with 42 males (53%). The most frequent symptoms were fever (60/80, 75%) and cough (59/80, 74%), the mean NEWS was 1.7±2.3. All LDCT could be analysed and 23/80 (28%) were normal. The major imaging finding was GGOs in 56 cases (67%). The COVID19-LDCT score (mean value = 19±29) was correlated with NEWS (r = 0.48, pConclusionsCOVID19-LDCT score did correlate with NEWS. It was significantly different in the clinical low-risk and high-risk groups. Further work is needed to validate the COVID19-LDCT score against patient prognosis.
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- 2020
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8. Correction to: Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19
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Maxime Castelli, Arnaud Maurin, Axel Bartoli, Michael Dassa, Baptiste Marchi, Julie Finance, Jean-Christophe Lagier, Matthieu Million, Philippe Parola, Philippe Brouqui, Didier Raoult, Sebastien Cortaredona, Alexis Jacquier, Jean-Yves Gaubert, and Paul Habert
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Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
An amendment to this paper has been published and can be accessed via the original article.
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- 2021
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9. Diaphragmatic motion recorded by M-mode ultrasonography: limits of normality
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Julie Finance, Guillaume Chaumet, Fabienne Brégeon, Alain Boussuges, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), AltraBio [Lyon], Microbes évolution phylogénie et infections (MEPHI), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung Imaging ,media_common.quotation_subject ,lcsh:Medicine ,Diaphragmatic breathing ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Hypokinesia ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,medicine ,Statistical analysis ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,Normality ,media_common ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,business.industry ,lcsh:R ,Excursion ,Original Articles ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,Diaphragm (structural system) ,030228 respiratory system ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Cardiology ,medicine.symptom ,Diaphragmatic excursion ,Ultrasonography ,business - Abstract
Chest ultrasonography has proven to be useful in the diagnosis of diaphragm dysfunction. The aim of the present study was to determine the normal values of the motion of both hemidiaphragms recorded by M-mode ultrasonography. Healthy volunteers were studied while in a seated position. Diaphragmatic excursions and diaphragm profiles were measured during quiet breathing, voluntary sniffing and deep breathing. Diaphragmatic excursions were assessed by M-mode ultrasonography, using an approach perpendicular to the posterior part of the diaphragm. Anatomical M-mode was used for the recording of the complete excursion during deep breathing. The study included 270 men and 140 women. The diaphragmatic motions during quiet breathing and voluntary sniffing were successfully recorded in all of the participants. The use of anatomical M-mode was particularly suitable for measurement of the entire diaphragmatic excursion during deep breathing. The statistical analysis showed that the diaphragmatic excursions were larger in men compared to women, supporting the determination of normal values based on sex. The lower and upper limits of normal excursion were determined for men and women for both hemidiaphragms during the three manoeuvres that were investigated. The lower limits of normal diaphragmatic excursions during deep breathing should be used to detect diaphragmatic hypokinesia, i.e. 3.3 and 3.2 cm in women and 4.1 and 4.2 cm in men for the right and the left sides, respectively. The normal values of the diaphragmatic motion and the lower and upper limits of normal excursion can be used by clinicians to detect diaphragmatic dysfunction., These normal values of diaphragmatic motion, and the lower and upper limits of normal excursion, can be used by physicians to detect diaphragm hypokinesia and hyperkinesia, and thus diagnose diaphragmatic dysfunction https://bit.ly/35R9OFk
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- 2021
10. Different pattern of the second outbreak of COVID-19 in Marseille, France
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Hervé Chaudet, Audrey Giraud-Gatineau, Didier Raoult, Philippe Colson, Sophia Boudjema, Jean-Christophe Lagier, Philippe Gautret, Julie Finance, Laurence Camoin-Jau, Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Microbes évolution phylogénie et infections (MEPHI), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)
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Male ,Time Factors ,Disease Outbreaks ,law.invention ,Hospitalization rate ,0302 clinical medicine ,law ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,0303 health sciences ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,General Medicine ,Middle Aged ,Intensive care unit ,3. Good health ,Hospitalization ,Intensive Care Units ,Infectious Diseases ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Female ,France ,Seasons ,Viral load ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Demographics ,Short Communication ,Age and sex ,lcsh:Infectious and parasitic diseases ,Fibrin Fibrinogen Degradation Products ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Internal medicine ,medicine ,Humans ,lcsh:RC109-216 ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,Aged ,030304 developmental biology ,Cycle threshold ,Lethality ,SARS-CoV-2 ,business.industry ,COVID-19 ,Outbreak ,Seasonality ,Severity markers ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,business - Abstract
Highlights • The number of COVID-19 cases in Marseille, France, peaked in March-April. • Resurgence was observed in June-August. • Patients in the two periods did not present marked age and sex differences. • Markers of severity were less prevalent in the summer period • A 10 times decrease in the lethality rate was observed in June-August., Objective To describe the characteristics of COVID-19 patients seen in March-April and June-August, 2020 in Marseille, France with the aim to investigate possible changes in the disease between these two time periods. Methods Demographics, hospitalization rate, transfer to intensive care unit (ICU), lethality, clinical and biological parameters were investigated. Results Compared to those seen in March-April, COVID-19 patients seen in June-August were significantly younger (39.2 vs. 45.3 years), more likely to be male (52.9% vs. 45.6%), less likely to be hospitalized (10.7 vs. 18.0%), to be transferred to ICU (0.9% vs. 1.8%) and to die (0.1% vs. 1.1%). Their mean fibrinogen and D-dimer blood levels were lower (1.0 vs. 1.5 g/L and 0.6 vs. 1.1 µg/mL, respectively). By contrast, their viral load was higher (cycle threshold ≤16 = 5.1% vs. 3.7%). Conclusions Patients in the two periods did not present marked age and sex differences, but markers of severity were undoubtedly less prevalent in the summer period, associating with a 10 times decrease in the lethality rate.
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- 2021
11. Olfactory and gustative disorders for the diagnosis of COVID-19
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Matthieu Million, Thomas Radulesco, Justin Michel, Didier Raoult, Philippe Parola, Sophia Boudjema, Moïse Michel, Julie Finance, Fatoumata Coulibaly, Line Meddeb, Hervé Tissot-Dupont, Florence Fenollar, Philippe Brouqui, Jean-Christophe Lagier, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Hôpital Nord, Explorations Fonctionnelles Respiratories, Service d'Oto-rhino-laryngologie et Chirurgie cervico-faciale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)
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Coronavirus disease 2019 (COVID-19) ,[SDV]Life Sciences [q-bio] ,Anosmia ,Pneumonia, Viral ,Betacoronavirus ,03 medical and health sciences ,COVID-19 Testing ,0302 clinical medicine ,Correspondence ,Prevalence ,Humans ,Medicine ,030212 general & internal medicine ,030223 otorhinolaryngology ,Pandemics ,Clinical Laboratory Techniques ,SARS-CoV-2 ,business.industry ,Public Health, Environmental and Occupational Health ,COVID-19 ,Smell ,Infectious Diseases ,Taste ,Coronavirus Infections ,Ageusia ,business ,Neuroscience - Published
- 2020
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12. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study
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Jacques Sevestre, Hervé Tissot-Dupont, Carole Eldin, Jean-Marc Rolain, Julie Finance, Line Meddeb, Véronique Veit, Andreas Stein, Morgane Mailhe, Vera Esteves Vieira, Philippe Brouqui, Philippe Parola, Matthieu Million, Marie Hocquart, Philippe Gautret, Jean Claude Deharo, Alexis Jacquier, Pierre-Edouard Fournier, Barbara Doudier, Jean-Christophe Lagier, Didier Raoult, Bernard La Scola, Michel Drancourt, Van Thuan Hoang, Stéphane Honoré, Piseth Seng, Philippe Colson, Sophie Amrane, Camille Aubry, Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Microbes évolution phylogénie et infections (MEPHI), Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU), Hôpital Nord, Explorations Fonctionnelles Respiratories, Service Pharmacie [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Unité de Médecine Aigue Polyvalente (UMAP), Centre de résonance magnétique biologique et médicale (CRMBM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Département de Cardiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), and Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)
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medicine.medical_specialty ,030231 tropical medicine ,Azithromycin ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Internal medicine ,Intensive care ,medicine ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,030212 general & internal medicine ,Young adult ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,business.industry ,Public Health, Environmental and Occupational Health ,Hydroxychloroquine ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,3. Good health ,Infectious Diseases ,Carriage ,Cohort ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,Observational study ,business ,Viral load ,medicine.drug - Abstract
Background We need an effective treatment to cure COVID-19 patients and to decrease virus carriage duration. Methods We conducted an uncontrolled, non-comparative, observational study in a cohort of 80 relatively mildly infected inpatients treated with a combination of hydroxychloroquine and azithromycin over a period of at least three days, with three main measurements: clinical outcome, contagiousness as assessed by PCR and culture, and length of stay in infectious disease unit (IDU). Results All patients improved clinically except one 86 year-old patient who died, and one 74 year-old patient still in intensive care. A rapid fall of nasopharyngeal viral load was noted, with 83% negative at Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% of patients at Day5. Consequently patients were able to be rapidly discharged from IDU with a mean length of stay of five days. Conclusion We believe there is urgency to evaluate the effectiveness of this potentially-life saving therapeutic strategy at a larger scale, both to treat and cure patients at an early stage before irreversible severe respiratory complications take hold and to decrease duration of carriage and avoid the spread of the disease. Furthermore, the cost of treatment is negligible.
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- 2020
13. Prevalence and risk factors for lung involvement on low-dose chest CT (LDCT) in a paucisymptomatic population of 247 patients affected by COVID-19
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Philippe Parola, Didier Raoult, Julie Finance, Michael Dassa, Sébastien Cortaredona, Baptiste Marchi, Matthieu Million, Philippe Brouqui, Maxime Castelli, Paul Habert, Axel Bartoli, Jean-Christophe Lagier, Arnaud Maurin, Jean Gaubert, Alexis Jacquier, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre d'Exploration Métabolique par Résonance Magnétique [Marseille] (CEMEREM), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Department of Radiology, Département de Radiologie [Hôpital de la Timone - APHM], Laboratoire d'Imagerie Interventionnelle Expérimentale (LIIE), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Européen de Recherche en Imagerie médicale (CERIMED), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-École Centrale de Marseille (ECM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Centre National de la Recherche Scientifique (CNRS), Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM] (CEMEREM), Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)
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lcsh:Medical physics. Medical radiology. Nuclear medicine ,medicine.medical_specialty ,Quantitative evaluation ,lcsh:R895-920 ,[SDV]Life Sciences [q-bio] ,Population ,Anosmia ,X-ray computed ,030204 cardiovascular system & hematology ,Logistic regression ,Asymptomatic ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Radiology, Nuclear Medicine and imaging ,Risk factor ,education ,Tomography ,Neuroradiology ,education.field_of_study ,business.industry ,Correction ,COVID-19 ,Odds ratio ,Pneumonia ,medicine.disease ,3. Good health ,030220 oncology & carcinogenesis ,Original Article ,medicine.symptom ,business - Abstract
Background Low-dose chest CT (LDCT) showed high sensitivity and ability to quantify lung involvement of COVID-19 pneumopathy. The aim of this study was to describe the prevalence and risk factors for lung involvement in 247 patients with a visual score and assess the prevalence of incidental findings. Methods For 12 days in March 2020, 250 patients with RT-PCR positive tests and who underwent LDCT were prospectively included. Clinical and imaging findings were recorded. The extent of lung involvement was quantified using a score ranging from 0 to 40. A logistic regression model was used to explore factors associated with a score ≥ 10. Results A total of 247 patients were analyzed; 138 (54%) showed lung involvement. The mean score was 4.5 ± 6.5, and the mean score for patients with lung involvement was 8.1 ± 6.8 [1–31]. The mean age was 43 ± 15 years, with 121 males (48%) and 17 asymptomatic patients (7%). Multivariate analysis showed that age > 54 years (odds ratio 4.4[2.0–9.6] p p = 0.049) were risk factors for a score ≥ 10. Multivariate analysis including symptoms showed that only age > 54 years (4.1[1.7–10.0] p = 0.002) was a risk factor for a score ≥ 10. Rhinitis (0.3[0.1–0.7] p = 0.005) and anosmia (0.3[0.1–0.9] p = 0.043) were protective against lung involvement. Incidental imaging findings were found in 19% of patients, with a need for follow-up in 0.6%. Conclusion The prevalence of lung involvement was 54% in a predominantly paucisymptomatic population. Age ≥ 55 years and diabetes were risk factors for significant parenchymal lung involvement. Rhinitis and anosmia were protective against LDCT abnormalities.
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- 2020
14. Assessment of diaphragmatic function by ultrasonography: Current approach and perspectives
- Author
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Sarah Rives, Fabienne Brégeon, Julie Finance, Alain Boussuges, Institut de Recherche Biomédicale des Armées (IRBA), Hôpital Nord, Explorations Fonctionnelles Respiratories, Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), and Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)
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medicine.medical_specialty ,M-mode ,[SDV]Life Sciences [q-bio] ,Ultrasound shear wave elastography ,Diaphragmatic breathing ,Hemidiaphragm ,Review ,Diaphragmatic paralysis ,Phrenic Nerve Injury ,03 medical and health sciences ,Motion ,0302 clinical medicine ,Internal medicine ,Ultrasound ,medicine ,Paralysis ,Expiration ,Two-dimensional mode ,Rib cage ,business.industry ,General Medicine ,musculoskeletal system ,Diaphragm (structural system) ,Dysfunction ,030220 oncology & carcinogenesis ,Cardiology ,030211 gastroenterology & hepatology ,medicine.symptom ,Speckle tracking imaging ,business ,Thickness - Abstract
This article reports the various methods used to assess diaphragmatic function by ultrasonography. The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography, during respiratory maneuvers such as quiet breathing, voluntary sniffing and deep inspiration. On the zone of apposition to the rib cage for both hemidiaphragms, it is possible to measure the thickness on expiration and during deep breathing to assess the percentage of thickening during inspiration. These two approaches make it possible to assess the quality of the diaphragmatic function and the diagnosis of diaphragmatic paralysis or dysfunction. These methods are particularly useful in circumstances where there is a high risk of phrenic nerve injury or in diseases affecting the contractility or the motion of the diaphragm such as neuro-muscular diseases. Recent methods such as speckle tracking imaging and ultrasound shear wave elastography should provide more detailed information for better assessment of diaphragmatic function.
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- 2020
15. Low-dose chest CT for diagnosing and assessing the extent of lung involvement of SARS-CoV-2 pneumonia using a semi quantitative score
- Author
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Matthieu Million, Jean-Yves Gaubert, Jean-Christophe Lagier, Philippe Parola, Didier Raoult, Pierre-Antoine Barral, Philippe Brouqui, Thomas Leger, Julie Finance, Alexis Jacquier, Maxime Castelli, Paul Habert, Axel Bartoli, Department of Radiology, Assistance Publique des Hôpitaux de Marseille, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Laboratoire d'Imagerie Interventionnelle Expérimentale (LIIE), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Européen de Recherche en Imagerie médicale (CERIMED), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-École Centrale de Marseille (ECM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Centre National de la Recherche Scientifique (CNRS), COMBE, Isabelle, and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA)
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Male ,Viral Diseases ,Pulmonology ,[SDV]Life Sciences [q-bio] ,Artificial Gene Amplification and Extension ,Blood Pressure ,Polymerase Chain Reaction ,Vascular Medicine ,Severity of Illness Index ,Diagnostic Radiology ,030218 nuclear medicine & medical imaging ,Medical Conditions ,0302 clinical medicine ,Risk Factors ,Medicine and Health Sciences ,Medicine ,Young adult ,Tomography ,Lung ,Aged, 80 and over ,Univariate analysis ,Multidisciplinary ,Radiology and Imaging ,Middle Aged ,Early warning score ,Pulmonary Imaging ,3. Good health ,[SDV] Life Sciences [q-bio] ,Chemistry ,Infectious Diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Physical Sciences ,Female ,Coronavirus Infections ,Research Article ,Chemical Elements ,Adult ,medicine.medical_specialty ,Adolescent ,Fever ,Imaging Techniques ,Science ,Pneumonia, Viral ,Neuroimaging ,Research and Analysis Methods ,Statistics, Nonparametric ,Respiratory Disorders ,Betacoronavirus ,Young Adult ,03 medical and health sciences ,Respiratory Rate ,Diagnostic Medicine ,Diabetes mellitus ,Internal medicine ,Severity of illness ,Humans ,Molecular Biology Techniques ,Molecular Biology ,Pandemics ,Aged ,Retrospective Studies ,SARS-CoV-2 ,business.industry ,Biology and Life Sciences ,COVID-19 ,Covid 19 ,Retrospective cohort study ,Pneumonia ,Reverse Transcriptase-Polymerase Chain Reaction ,medicine.disease ,Computed Axial Tomography ,Oxygen ,Dyspnea ,Blood pressure ,Cough ,Tomography, X-Ray Computed ,business ,Neuroscience - Abstract
International audience; Objectives The purpose is to assess the ability of low-dose CT (LDCT) to determine lung involvement in SARS-CoV-2 pneumonia and to describe a COVID19-LDCT severity score. Materials and methods Patients with SARS-CoV-2 infection confirmed by RT-PCR were retrospectively analysed. Clinical data, the National Early Warning Score (NEWS) and imaging features were recorded. Lung features included ground-glass opacities (GGO), areas of consolidation and crazy paving patterns. The COVID19-LDCT score was calculated by summing the score of each segment from 0 (no involvement) to 10 (severe impairment). Univariate analysis was performed to explore predictive factor of high COVID19-LDCT score. The nonparametric Mann-Whitney test was used to compare groups and a Spearman correlation used with p
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- 2020
16. Low Dose Chest CT and Lung Ultrasound for the Diagnosis and Management of COVID-19
- Author
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Julie Finance, Philippe Parola, Carole Eldin, Alain Boussuges, Laurent Zieleskewicz, Paul Habert, Alexis Jacquier, Fabienne Brégeon, Service des explorations fonctionnelles respiratoires [Hôpital Nord - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de Radiologie Cardio-Thoracique, Hôpital La Timone, Département de Cardiologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire d'Imagerie Interventionnelle Expérimentale (LIIE), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique (CRMBM-CEMEREM), Vecteurs - Infections tropicales et méditerranéennes (VITROME), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées (IRBA), Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge] (IRBA), and Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM)
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Chest ct ,Computed tomography ,Context (language use) ,Review ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,medicine ,pneumonia ,[SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology ,lung ultrasound ,[SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases ,medicine.diagnostic_test ,SARS-CoV-2 ,business.industry ,Low dose ,COVID-19 ,030208 emergency & critical care medicine ,General Medicine ,medicine.disease ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,3. Good health ,Lung ultrasound ,Pneumonia ,Infectious disease (medical specialty) ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,low-dose CT ,Medicine ,Radiology ,business - Abstract
International audience; Background: The COVID-19 pandemic has provided an opportunity to use low- and non-radiating chest imaging techniques on a large scale in the context of an infectious disease, which has never been done before. Previously, low-dose techniques were rarely used for infectious diseases, despite the recognised danger of ionising radiation. Method: To evaluate the role of low-dose computed tomography (LDCT) and lung ultrasound (LUS) in managing COVID-19 pneumonia, we performed a review of the literature including our cases. Results: Chest LDCT is now performed routinely when diagnosing and assessing the severity of COVID-19, allowing patients to be rapidly triaged. The extent of lung involvement assessed by LDCT is accurate in terms of predicting poor clinical outcomes in COVID-19-infected patients. Infectious disease specialists are less familiar with LUS, but this technique is also of great interest for a rapid diagnosis of patients with COVID-19 and is effective at assessing patient prognosis. Conclusions: COVID-19 is currently accelerating the transition to low-dose and “no-dose” imaging techniques to explore infectious pneumonia and their long-term consequences.
- Published
- 2021
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