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Article ; Online: A statistical framework to estimate diagnostic test performance for COVID-19.

Symons, R / Beath, K / Dangis, A / Lefever, S / Smismans, A / De Bruecker, Y / Frans, J

2020 Volume 76, Issue 1, Page(s) 75.e1–75.e3

MeSH term(s)	COVID-19/diagnosis ; COVID-19/diagnostic imaging ; COVID-19 Nucleic Acid Testing/methods ; COVID-19 Nucleic Acid Testing/standards ; COVID-19 Nucleic Acid Testing/statistics & numerical data ; Humans ; Lung/diagnostic imaging ; Reproducibility of Results ; Tomography, X-Ray Computed/methods ; Tomography, X-Ray Computed/standards ; Tomography, X-Ray Computed/statistics & numerical data
Keywords	covid19
Language	English
Publishing date	2020-10-21
Publishing country	England
Document type	Journal Article
ZDB-ID	391227-9
ISSN	1365-229X ; 0009-9260
ISSN (online)	1365-229X
ISSN	0009-9260
DOI	10.1016/j.crad.2020.10.004
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Article ; Online: Feasibility of using point-of-care lung ultrasound for early triage of COVID-19 patients in the emergency room.

Narinx, Nick / Smismans, Annick / Symons, Rolf / Frans, Johan / Demeyere, Annick / Gillis, Marc

Emergency radiology

2020 Volume 27, Issue 6, Page(s) 663–670

Abstract: Purpose: Diagnostic value of point-of-care lung ultrasound (POCUS) in detection of coronavirus disease (COVID-19) in an emergency setting is currently unclear. In this study, we aimed to compare diagnostic performance, in terms of sensitivity, ... ...

Abstract	Purpose: Diagnostic value of point-of-care lung ultrasound (POCUS) in detection of coronavirus disease (COVID-19) in an emergency setting is currently unclear. In this study, we aimed to compare diagnostic performance, in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, of POCUS lung, chest CT, and RT-PCR for clinically suspected COVID-19 infections in patients submitting to the emergency room (ER). Material and methods: This retrospective study enrolled 93 patients with a suspected COVID-19 infection, admitted to the ER between March 28th and April 20th, 2020. Test subjects showed one or more symptoms of an acute respiratory infection, for which consequent COVID-19 testing was achieved using POCUS lung, chest CT, and RT-PCR. CT images were analyzed by 2 radiologists blinded to RT-PCR results. POCUS lung was performed by three emergency medical doctors, and reports were analyzed by the researcher, blinded to clinical information, US imaging, CT, and RT-PCR test results. Results: Compared with RT-PCR, POCUS lung demonstrated outstanding sensitivity and NPV (93.3% and 94.1% respectively) while showing poor values for specificity, PPV, and accuracy (21.3%, 19.2%, and 33.3% respectively). In contrast, similar inquiries using chest CT as index test, excellent sensitivity, specificity, NPV, and accuracy (80.0%, 86.7%, 95.6%, and 85.6%, respectively) were reported, beside a moderate value for PPV (54.5%). Conclusion: POCUS may provide early ER triage with a useful, rapid, low-threshold, and safe screening tool in evaluating possible COVID-19 infections. Due to limited specificity, suggestive POCUS lung findings should be confirmed with RT-PCR or chest CT.
MeSH term(s)	Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/diagnostic imaging ; Emergency Service, Hospital ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Point-of-Care Systems ; Predictive Value of Tests ; Retrospective Studies ; SARS-CoV-2 ; Sensitivity and Specificity ; Triage
Keywords	covid19
Language	English
Publishing date	2020-09-10
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	1425144-9
ISSN	1438-1435 ; 1070-3004
ISSN (online)	1438-1435
ISSN	1070-3004
DOI	10.1007/s10140-020-01849-3
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Article: A statistical framework to estimate diagnostic test performance for COVID-19

Symons, R / Beath, K / Dangis, A / Lefever, S / Smismans, A / De Bruecker, Y / Frans, J

Clin. radiol

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #885244
Database	COVID19

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Article ; Online: A statistical framework to estimate diagnostic test performance for COVID-19

Symons, R. / Beath, K. / Dangis, A. / Lefever, S. / Smismans, A. / De Bruecker, Y. / Frans, J.

Clinical Radiology ; ISSN 0009-9260

2020

Keywords	Radiology Nuclear Medicine and imaging ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.crad.2020.10.004
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: First case of

Dewaele, Klaas / Frans, Johan / Smismans, Annick / Ho, Erwin / Tollens, Tim / Lagrou, Katrien

Acta clinica Belgica

2018 Volume 75, Issue 3, Page(s) 221–228

Abstract: Objective and importance: ...

Abstract	Objective and importance:
MeSH term(s)	Anastomotic Leak ; Anidulafungin/therapeutic use ; Antifungal Agents/therapeutic use ; Belgium ; Candida/genetics ; Candida/isolation & purification ; Candidiasis, Invasive/diagnosis ; Candidiasis, Invasive/drug therapy ; Candidiasis, Invasive/microbiology ; Catheter-Related Infections/diagnosis ; Catheter-Related Infections/drug therapy ; Catheter-Related Infections/microbiology ; Central Venous Catheters ; Drug Resistance, Fungal ; Female ; Gastric Bypass ; Humans ; Ileum/injuries ; Intestinal Fistula/complications ; Intestinal Perforation/complications ; Kuwait ; Microbial Sensitivity Tests ; Middle Aged ; Patient Transfer ; Postoperative Complications/diagnosis ; Postoperative Complications/drug therapy ; Postoperative Complications/microbiology ; Surgical Wound Infection/complications ; Urinary Tract Infections/complications
Chemical Substances	Antifungal Agents ; Anidulafungin (9HLM53094I)
Language	English
Publishing date	2018-12-04
Publishing country	England
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	390201-8
ISSN	2295-3337 ; 0001-5512 ; 1784-3286
ISSN (online)	2295-3337
ISSN	0001-5512 ; 1784-3286
DOI	10.1080/17843286.2018.1555114
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Article: Feasibility of using point-of-care lung ultrasound for early triage of COVID-19 patients in the emergency room

Narinx, Nick / Smismans, Annick / Symons, Rolf / Frans, Johan / Demeyere, Annick / Gillis, Marc

Emerg Radiol

Abstract: PURPOSE: Diagnostic value of point-of-care lung ultrasound (POCUS) in detection of coronavirus disease (COVID-19) in an emergency setting is currently unclear. In this study, we aimed to compare diagnostic performance, in terms of sensitivity, ... ...

Abstract	PURPOSE: Diagnostic value of point-of-care lung ultrasound (POCUS) in detection of coronavirus disease (COVID-19) in an emergency setting is currently unclear. In this study, we aimed to compare diagnostic performance, in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, of POCUS lung, chest CT, and RT-PCR for clinically suspected COVID-19 infections in patients submitting to the emergency room (ER). MATERIAL AND METHODS: This retrospective study enrolled 93 patients with a suspected COVID-19 infection, admitted to the ER between March 28th and April 20th, 2020. Test subjects showed one or more symptoms of an acute respiratory infection, for which consequent COVID-19 testing was achieved using POCUS lung, chest CT, and RT-PCR. CT images were analyzed by 2 radiologists blinded to RT-PCR results. POCUS lung was performed by three emergency medical doctors, and reports were analyzed by the researcher, blinded to clinical information, US imaging, CT, and RT-PCR test results. RESULTS: Compared with RT-PCR, POCUS lung demonstrated outstanding sensitivity and NPV (93.3% and 94.1% respectively) while showing poor values for specificity, PPV, and accuracy (21.3%, 19.2%, and 33.3% respectively). In contrast, similar inquiries using chest CT as index test, excellent sensitivity, specificity, NPV, and accuracy (80.0%, 86.7%, 95.6%, and 85.6%, respectively) were reported, beside a moderate value for PPV (54.5%). CONCLUSION: POCUS may provide early ER triage with a useful, rapid, low-threshold, and safe screening tool in evaluating possible COVID-19 infections. Due to limited specificity, suggestive POCUS lung findings should be confirmed with RT-PCR or chest CT.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #754460
Database	COVID19

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Article ; Online: Feasibility of using point-of-care lung ultrasound for early triage of COVID-19 patients in the emergency room

Narinx, Nick / Smismans, Annick / Symons, Rolf / Frans, Johan / Demeyere, Annick / Gillis, Marc

Emergency Radiology ; ISSN 1070-3004 1438-1435

2020

Keywords	Radiology Nuclear Medicine and imaging ; Emergency Medicine ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
DOI	10.1007/s10140-020-01849-3
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Frailty and mortality in hospitalized older adults with COVID-19: retrospective observational study

De Smet, R. / Mellaerts, B. / Vandewinckele, H. / Lybeert, P. / Frans, E. / Ombelet, S. / Lemahieu, W. / Symons, R. / Ho, E. / Frans, J. / Smismans, A. / Laurent, M. R.

Abstract: Background: Older adults with coronavirus disease 2019 (COVID-19) face an increased risk of adverse health outcomes including mortality. Ethical guidelines consider allocation of limited resources based on likelihood of survival, frailty, co-morbidities ... ...

Abstract	Background: Older adults with coronavirus disease 2019 (COVID-19) face an increased risk of adverse health outcomes including mortality. Ethical guidelines consider allocation of limited resources based on likelihood of survival, frailty, co-morbidities and age. However, the association of frailty with clinical outcomes in older COVID-19 patients remains unclear. Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for COVID-19. Design: Retrospective single-center observational study. Setting and participants: N = 81 patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of Imelda general hospital, Belgium. Measurements: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical and radiological variables, co-morbidities, symptoms and treatment were extracted from electronic medical records. Results: Participants (N = 48 women, 59%) had a median age of 85 years (range 65 - 97 years), median CFS score of 7 (range 2 - 9), and 42 (52%) were long-term care residents. Within six weeks, eighteen patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = 0.03) and CFS score (r = 0.282, P = 0.011), baseline lactate dehydrogenase (LDH) (r = 0.301, P = 0.009), lymphocyte count (r = -0.262, P = 0.02) and RT-PCR Ct value (r = -0.285, P = 0.015). Mortality was not associated with long-term care residence, dementia, delirium or polypharmacy. In multivariable logistic regression analyses, CFS, LDH and RT-PCR Ct values (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH and viral load significantly predicted survival. Conclusions and implications: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available.
Keywords	covid19
Publisher	MedRxiv; WHO
Document type	Article ; Online
DOI	10.1101/2020.05.26.20113480
Database	COVID19

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Article ; Online: Frailty and Mortality in Hospitalized Older Adults With COVID-19: Retrospective Observational Study.

De Smet, Robert / Mellaerts, Bea / Vandewinckele, Hannelore / Lybeert, Peter / Frans, Eric / Ombelet, Sara / Lemahieu, Wim / Symons, Rolf / Ho, Erwin / Frans, Johan / Smismans, Annick / Laurent, Michaël R

Journal of the American Medical Directors Association

2020 Volume 21, Issue 7, Page(s) 928–932.e1

Abstract: Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19).: Design: Retrospective single-center observational study.: Setting and participants: Eighty-one ...

Abstract	Objectives: To determine the association between frailty and short-term mortality in older adults hospitalized for coronavirus disease 2019 (COVID-19). Design: Retrospective single-center observational study. Setting and participants: Eighty-one patients with COVID-19 confirmed by reverse-transcriptase polymerase chain reaction (RT-PCR), at the Geriatrics department of a general hospital in Belgium. Measurements: Frailty was graded according to the Rockwood Clinical Frailty Scale (CFS). Demographic, biochemical, and radiologic variables, comorbidities, symptoms, and treatment were extracted from electronic medical records. Results: Participants (N = 48 women, 59%) had a median age of 85 years (range 65-97 years) and a median CFS score of 7 (range 2-9); 42 (52%) were long-term care residents. Within 6 weeks, 18 patients died. Mortality was significantly but weakly associated with age (Spearman r = 0.241, P = .03) and CFS score (r = 0.282, P = .011), baseline lactate dehydrogenase (LDH; r = 0.301, P = .009), lymphocyte count (r = -0.262, P = .02), and RT-PCR cycle threshold (Ct, r = -0.285, P = .015). Mortality was not associated with long-term care residence, dementia, delirium, or polypharmacy. In multivariable logistic regression analyses, CFS, LDH, and RT-PCR Ct (but not age) remained independently associated with mortality. Both age and frailty had poor specificity to predict survival. A multivariable model combining age, CFS, LDH, and viral load significantly predicted survival. Conclusions and implications: Although their prognosis is worse, even the oldest and most severely frail patients may benefit from hospitalization for COVID-19, if sufficient resources are available.
MeSH term(s)	Aged ; Aged, 80 and over ; Belgium/epidemiology ; COVID-19 ; Cohort Studies ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Disease Outbreaks/statistics & numerical data ; Female ; Frail Elderly ; Frailty/mortality ; Geriatric Assessment ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Hospitals, General ; Humans ; Incidence ; Male ; Pandemics/prevention & control ; Pandemics/statistics & numerical data ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Retrospective Studies
Keywords	covid19
Language	English
Publishing date	2020-06-09
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2020.06.008
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Article: Comparison of five different immunoassays for the detection of Borrelia burgdorferi IgM and IgG antibodies.

Smismans, A / Goossens, V J / Nulens, E / Bruggeman, C A

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2006 Volume 12, Issue 7, Page(s) 648–655

Abstract: The performances of five commercially available enzyme immunoassays were compared for the detection of Borrelia burgdorferi IgM and IgG antibodies. Sensitivity was assessed with European serum samples collected from 45 patients with clinically defined ... ...

Abstract	The performances of five commercially available enzyme immunoassays were compared for the detection of Borrelia burgdorferi IgM and IgG antibodies. Sensitivity was assessed with European serum samples collected from 45 patients with clinically defined Lyme disease in conjunction with a positive immunoblot (n = 44) or other serological test (n = 1). Sensitivities for the detection of IgM and IgG with each test were: Dako IgM 64%; Dako IgG 53%; Serion IgM 89%; and Serion IgG 88%. The Immunetics assay makes no distinction between IgM and IgG antibodies and had a sensitivity of 91%. Specificity was calculated by testing a control group comprising 40 patients with acute Epstein-Barr virus infection, cytomegalovirus infection, syphilis or rheumatoid factor positivity. The specificities achieved for each test were: Dako IgM 78%; Dako IgG 100%; Serion IgM 52%; Serion IgG 92%; and Immunetics 92%. The discriminatory power between control and patient samples appeared highest for the Immunetics assay. Between-run variation was comparable for the five tests and did not exceed 13%. When the Immunetics assay was used as an initial screening test, with low-titre positive results confirmed by an immunoblot, a sensitivity of 91% and a specificity of 100% were achieved. To attain maximal sensitivity, the Serion IgM and IgG tests were also performed on samples with negative Immunetics results. All positive Serion IgM and IgG results were also confirmed by immunoblot. In conclusion, the Immunetics assay, based on a synthetic C6 peptide, can be used reliably as an initial screening test for the serodiagnosis of Lyme disease.
MeSH term(s)	Blotting, Western/methods ; Borrelia burgdorferi Group/immunology ; Europe ; Humans ; Immunoenzyme Techniques/methods ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Lyme Disease/diagnosis ; Lyme Disease/immunology ; Reagent Kits, Diagnostic ; Sensitivity and Specificity ; Serologic Tests/methods
Chemical Substances	Immunoglobulin G ; Immunoglobulin M ; Reagent Kits, Diagnostic
Language	English
Publishing date	2006-07
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1198-743X ; 1470-9465
ISSN (online)	1469-0691
ISSN	1198-743X ; 1470-9465
DOI	10.1111/j.1469-0691.2006.01448.x
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