Medicine and Health Sciences Commons^™

Multisystem Imaging Manifestations Of Covid-19, Part 2: From Cardiac Complications To Pediatric Manifestations., M. V. Revzin, S. Raza, N. C. Srivastava, R. Warshawsky, C. D'Agostino, A. Malhotra, A. S. Bader, R. D. Patel, K. Chen, C. C. Kyriakakos, J. S. Pellerito

Journal Articles

Infection with severe acute respiratory syndrome coronavirus 2 results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. COVID-19 has been reported in most countries, and as of August 15, 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19-associated deaths. Although COVID-19 predominantly affects the respiratory system, it has become apparent that many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease and its related complications, and proper utilization …

Racial And Ethnic Disparity And Spatiotemporal Trends In Severe Acute Respiratory Syndrome Coronavirus 2 Prevalence On Obstetrical Units In New York., M. J. Blitz, B. Rochelson, L. Prasannan, W. Shan, F. A. Chervenak, M. Nimaroff, E. Bornstein

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No abstract provided.

Lessons Learnt From Covid-19: How Can We Prepare For Another Pandemic?, M. I. Ehrlich, M. W. Saif

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No abstract provided.

Lung Ultrasonography As An Alternative To Chest Computed Tomography In Covid-19 Pneumonia?, A. Vieillard-Baron, A. Goffi, P. Mayo

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No abstract provided.

Machine Learning To Assist Clinical Decision-Making During The Covid-19 Pandemic., S. Debnath, D. P. Barnaby, K. Coppa, A. Makhnevich, E. J. Kim, S. Chatterjee, V. Tóth, T. J. Levy, M. D. Paradis, S. L. Cohen, J. S. Hirsch, T. P. Zanos, Northwell Covid-19 Research Consortium

Journal Articles

Background:The number of cases from the coronavirus disease 2019 (COVID-19) global pandemic has overwhelmed existing medical facilities and forced clinicians, patients, and families to make pivotal decisions with limited time and information. Main body:While machine learning (ML) methods have been previously used to augment clinical decisions, there is now a demand for "Emergency ML." Throughout the patient care pathway, there are opportunities for ML-supported decisions based on collected vitals, laboratory results, medication orders, and comorbidities. With rapidly growing datasets, there also remain important considerations when developing and validating ML models. Conclusion:This perspective highlights the utility of evidence-based prediction tools in …

Major Thrombotic Event Despite Anticoagulation In A Patient With Covid-19., B. Ataallah, A. Sharma, S. Tamanna, J. Ng, G. Haggerty

Journal Articles

The outbreak of coronavirus disease 2019 (known as COVID-19), which started in Wuhan, China in December 2019, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has been associated with both venous and arterial thromboembolism likely secondary to significant cytokine activation and inflammation. Reports on the incidence of thrombotic complications, however, are not well documented. Our case will examine a young man diagnosed with COVID-19 who developed an acute, severe bilateral saddle pulmonary embolism while on prophylactic dose anticoagulation after being admitted to the hospital and treated for two weeks with significant improvement.

Monoclonal Antibodies Capable Of Binding Sars-Cov-2 Spike Protein Receptor Binding Motif Specifically Prevent Gm-Csf Induction., X. Qiang, S. Zhu, J. Li, P. Wang, K. J. Tracey, H. Wang

Journal Articles

A severe acute respiratory syndrome (SARS)-like coronavirus (SARS-CoV-2) has recently caused a pandemic COVID-19 disease that infected more than 25.6 million and killed 852,000 people worldwide. Like the SARS-CoV, SARS-CoV-2 also employs a receptor-binding motif (RBM) of its envelope spike protein for binding the host angiotensin-converting enzyme 2 (ACE2) to gain viral entry. Currently, extensive efforts are being made to produce vaccines against a surface fragment of a SARS-CoV-2, such as the spike protein, in order to boost protective antibody responses. It was previously unknown how spike protein-targeting antibodies would affect innate inflammatory responses to SARS-CoV-2 infections. Here we generated …

Multisystem Imaging Manifestations Of Covid-19, Part 1: Viral Pathogenesis And Pulmonary And Vascular System Complications, M. V. Revzin, S. Raza, R. Warshawsky, C. D’Agostino, N. C. Srivastava, A. S. Bader, R. D. Patel, K. Chen, C. Kyriakakos, J. S. Pellerito, +1 Additional Author

Journal Articles

© RSNA, 2020. Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in coronavirus disease 2019 (COVID-19), which was declared an official pandemic by the World Health Organization on March 11, 2020. The infection has been reported in most countries around the world. As of August 2020, there have been over 21 million cases of COVID-19 reported worldwide, with over 800 000 COVID-19–associated deaths. It has become appar-ent that although COVID-19 predominantly affects the respiratory system, many other organ systems can also be involved. Imaging plays an essential role in the diagnosis of all manifestations of the disease, as …

Myocardial Injury Associated With Coronavirus Disease 2019 In Pregnancy., S. L. Pachtman Shetty, N. Meirowitz, M. J. Blitz, T. Gadomski, C. R. Weinberg

Journal Articles

OBJECTIVE:Coronavirus disease 2019 (COVID-19) is associated with cardiac injury1-3 and bradycardia4 in the non-pregnant population. The incidence of these complications in pregnancy is unknown. The objective of this study was to determine the rate of abnormal serum cardiac biomarkers or bradycardia among pregnant and immediately postpartum women admitted for treatment of severe or critical COVID-19 in a large integrated health system in New York. STUDY DESIGN:This is a retrospective review of all pregnant and immediately postpartum women hospitalized for COVID-19 at 7 hospitals within Northwell Health, the largest academic health system in New York state, from March 1 to April …

Nebulized In-Line Endotracheal Dornase Alfa And Albuterol Administered To Mechanically Ventilated Covid-19 Patients: A Case Series, A. G. Weber, A. S. Chau, M. Egeblad, B. J. Barnes, T. Janowitz

Journal Articles

© 2020 The Author(s). Background: Mechanically ventilated patients with COVID-19 have a mortality of 24-53%, in part due to distal mucopurulent secretions interfering with ventilation. DNA from neutrophil extracellular traps (NETs) contribute to the viscosity of mucopurulent secretions and NETs are found in the serum of COVID-19 patients. Dornase alfa is recombinant human DNase 1 and is used to digest DNA in mucoid sputum. Here, we report a single-center case series where dornase alfa was co-administered with albuterol through an in-line nebulizer system. Methods: Demographic and clinical data were collected from the electronic medical records of five mechanically ventilated patients …

Outcomes Of Patients With End-Stage Kidney Disease Hospitalized With Covid-19., J. H. Ng, J. S. Hirsch, R. Wanchoo, M. Sachdeva, V. Sakhiya, S. Hong, K. D. Jhaveri, S. Fishbane, Northwell Covid-19 Research Consortium, Northwell Nephrology Covid-19 Research Consortium

Journal Articles

Given the high risk of infection-related mortality, patients with end-stage kidney disease (ESKD) may be at increased risk with COVID-19. To assess this, we compared outcomes of patients with and without ESKD, hospitalized with COVID-19. This was a retrospective study of patients admitted with COVID-19 from 13 New York. hospitals from March 1, 2020, to April 27, 2020, and followed through May 27, 2020. We measured primary outcome (in-hospital death), and secondary outcomes (mechanical ventilation and length of stay), Of 10,482 patients with COVID-19, 419 had ESKD. Patients with ESKD were older, had a greater percentage self-identified as Black, and …

Presentation Of Severe Acute Respiratory Syndrome-Coronavirus 2 Infection As Cholestatic Jaundice In Two Healthy Adolescents, A. Perez, D. Kogan-Liberman, S. Sheflin-Findling, A. Raizner, K. L. Ahuja, N. Ovchinsky

Journal Articles

© 2020 Elsevier Inc. Liver abnormalities in severe acute respiratory syndrome-coronavirus 2 infection, including hepatitis and cholestasis, have been observed in adults and are associated with worse outcomes. We describe 2 adolescents with cholestasis and hepatitis with mild presentation of severe acute respiratory syndrome-coronavirus 2 lacking typical symptoms. Our intention is to raise index of suspicion for testing and protective equipment use.

Prevalence, Risk Factors, And Outcomes Of Hospitalized Patients With Covid-19 Presenting As Acute Pancreatitis., S. Inamdar, P. C. Benias, Y. Liu, D. V. Sejpal, S. K. Satapathy, A. J. Trindade, Northwell Covid-19 Research Consortium

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No abstract provided.

Pulmonary Embolism And Increased Levels Of D-Dimer In Patients With Coronavirus Disease, D. O. Griffin, A. Jensen, M. Khan, J. Chin, K. Chin, J. Saad, R. Parnell, C. Awwad, D. Patel

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No abstract provided.

Pulmonary Embolism In Patients Hospitalized With Covid-19 (From A New York Health System), H. Xu, A. Martin, A. Singh, M. Narasimhan, J. Lau, M. Weinberg, R. Jauhar, G. Rao

Journal Articles

© 2020 Elsevier Inc. Pulmonary embolisms (PEs) in coronavirus disease 2019 (COVID-19) have increasingly been reported in observational studies. However, limited information describing their clinical characteristics and outcomes exists. Our study aims to describe clinical features and risk stratification strategies of hospitalized COVID-19 patients with PE. We retrospectively analyzed 101 hospitalized patients with COVID-19 infection and acute PE. Clinical outcomes measured were intensive care unit admission, mechanical ventilation, bleeding and transfusion events, acute kidney injury (AKI) and mortality. Pulmonary severity index (PESI) scores were used for risk stratification. The most common comorbidities were hypertension (50%), obesity (27%) and hyperlipidemia (32%) …

Rapid Emergence Of Sars-Cov-2 In The Greater New York Metropolitan Area: Geolocation, Demographics, Positivity Rates, And Hospitalization For 46,793 Persons Tested By Northwell Health., S. B. Reichberg, P. P. Mitra, A. Haghamad, G. Ramrattan, J. M. Crawford, G. J. Berry, K. W. Davidson, A. Drach, S. Duong, S. Juretschko, N. I. Maria, Y. Yang, Y. C. Ziemba, Northwell Covid-19 Research Consortium

Journal Articles

BACKGROUND:In March 2020, the greater New York metropolitan area became an epicenter for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The initial evolution of case incidence has not been well characterized. METHODS:Northwell Health Laboratories tested 46,793 persons for SARS-CoV-2 from March 4 through April 10. The primary outcome measure was a positive reverse-transcription-polymerase-chain-reaction (RT-PCR) test for SARS-CoV-2. The secondary outcomes included patient age, sex, and race if stated; dates the specimen was obtained and the test result; clinical practice site sources; geo-location of patient residence; and hospitalization. RESULTS:From March 8 through April 10, a total of 26,735 of 46,793 …

Correction To: Safety Of Psychotropic Medications In People With Covid-19: Evidence Review And Practical Recommendations (Vol 18, 215, 2020), G. Ostuzzi, D. Papola, C. Gastaldon, G. Schoretsanitis, F. Bertolini, F. Amaddeo, A. Cuomo, R. Emsley, C. U. Correll, C. Barbui, +12 Additional Authors

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No abstract provided.

Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies In Pregnant Women Admitted To Labor And Delivery Units., L. Haizler-Cohen, A. Davidov, M. J. Blitz, G. Fruhman

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No abstract provided.

Severe Coronavirus Disease 2019 Infection In An Adolescent Patient After Hematopoietic Stem Cell Transplantation, G. Fisler, A. Haimed, C. F. Levy, J. Stiles, C. A. Capone, J. D. Fish, J. A. Brochstein, M. D. Taylor

Journal Articles

© 2020 American College of Chest Physicians Infection with the severe acute respiratory syndrome coronavirus 2 causes severe acute lung injury in approximately 5% of infected adults, but few reports have been made of severe pediatric disease. We present an adolescent patient who contracted severe acute respiratory syndrome coronavirus 2 one week after a paternal haplo-identical hematopoietic stem cell transplant, with development of severe hyperferritinemic acute lung injury and macrophage activation-like syndrome. We present her case and a comparison of her laboratory data with those of a cohort of pediatric patients with coronavirus disease 2019 without severe disease.

The Crisis Close At Hand: How Covid-19 Challenges Long-Term Care Planning For Adults With Intellectual Disability, C. Wright, C. Steinway, S. Jan

Journal Articles

© 2020 Charmaine Wright et al. Published by Mary Ann Liebert, Inc. Whether cared for in the community or in a facility, adults with intellectual disability are among the most vulnerable individuals in the United States. Families caring for these individuals face financial, social, and emotional stress as they navigate long-term care choices for their loved ones. COVID-19 has stressed an already overwhelmed and disparate system.

The Ethics Of Treating Acute Achilles Tendon Ruptures During The Covid-19 Pandemic: A Case Report, P. B. White, M. J. Partan, R. M. Cohn, C. J. Humbyrd, G. Katsigiorgis, A. Bitterman

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No abstract provided.

The Resilience Of Radiation Oncology In The Covid Era And Beyond, S. Teckie, D. Koffler, L. Potters

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No abstract provided.

Three Months Of Informational Trends In Covid-19 Across New York City, W. Lieberman-Cribbin, N. Alpert, A. Gonzalez, R. M. Schwartz, E. Taioli

Journal Articles

© The Author(s) 2020. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: [email protected]. In the midst of widespread community transmission of coronavirus disease 2019 (COVID-19) in New York, residents have sought information about COVID-19. We analyzed trends in New York State (NYS) and New York City (NYC) data to quantify the extent of COVID-19-related queries. Data on the number of 311 calls in NYC, Google Trend data on the search term 'Coronavirus' and information about trends in COVID-19 cases in NYS and the USA were compiled from multiple sources. …

Use Of A Smartwatch For Assessment Of The Qt Interval In Outpatients With Coronavirus Disease 2019., J. S. Chinitz, R. Goyal, D. C. Morales, M. Harding, S. Selim, L. M. Epstein

Journal Articles

The coronavirus disease 2019 (COVID-19) pandemic has necessitated rapid implementation of innovative strategies to manage patients remotely to help reduce the risk of community and nosocomial transmission. This case demonstrates the use of an Apple Watch (Apple, Cupertino, CA, USA) to monitor for arrhythmias and QT prolongation in a patient with COVID-19 during home isolation.

Implementation Of Telehealth In Radiation Oncology: Rapid Integration During Covid-19 And Its Future Role In Our Practice., A. Goenka, Daniel Ma, S. Teckie, C. Alfano, B. Bloom, J. Hwang, L. Potters

Journal Articles

Introduction: The widespread coronavirus disease 2019 (COVID-19) has resulted in significant changes in care delivery among radiation oncology practices and demanded the rapid incorporation of telehealth. However, the impact of a large-scale transition to telehealth in radiation oncology on patient access to care and the viability of care delivery are largely unknown. In this manuscript, we review our implementation and report data on patient access to care and billing implications. As telehealth is likely to continue after COVID-19, we propose a radiation oncology-specific algorithm for telehealth.

Material and Methods: In March 2020, our department began to use telehealth for all …

Impact Of Covid-19 Pandemic On Stemi Care: An Expanded Analysis From The United States., S. Garcia, L. Stanberry, C. Schmidt, S. Sharkey, M. Megaly, M. S. Albaghdadi, P. M. Meraj, R. Garberich, H. Khalili, T. D. Henry, +20 Additional Authors

Journal Articles

OBJECTIVE: To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care.

BACKGROUND: We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data.

METHODS: Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), …

Comparison Of Clinical And Epidemiologic Characteristics Of Young Febrile Infants With And Without Sars-Cov-2 Infection., J. Leibowitz, W. Krief, S. Barone, K. A. Williamson, P. Goenka, S. Rai, S. Moriarty, P. Baodhankar, L. G. Rubin

Journal Articles

OBJECTIVE: To determine features that distinguish febrile young infants with SARS-CoV-2 infection.

STUDY DESIGN: Retrospective single-center study included febrile infantsChildren's Medical Center of Northwell Health, New Hyde Park, New York during March 1-April 30 of 2018, 2019, and 2020. Sociodemographic and clinical features were compared between those seen during the 2020 COVID-19 pandemic and previous years, as well as between SARS-CoV-2 infected infants and SARS-CoV-2 uninfected infants (SARS-CoV-2 negative or evaluated during 2018 and 2019).

RESULTS: In all, 124 febrile infantsidentified; 38 during the 2-month study period in 2018, 33 in 2019, and 53 in 2020. During 2020, fewer febrile …

Clinical Mortality In A Large Covid-19 Cohort: Observational Study., M. Jarrett, S. Schultz, J. Lyall, J. Wang, L. Stier, M. De Geronimo, K. Nelson

Journal Articles

BACKGROUND: Northwell Health, an integrated health system in New York, has treated more than 15,000 inpatients with COVID-19 at the US epicenter of the SARS-CoV-2 pandemic.

OBJECTIVE: We describe the demographic characteristics of patients who died of COVID-19, observation of frequent rapid response team/cardiac arrest (RRT/CA) calls for non-intensive care unit (ICU) patients, and factors that contributed to RRT/CA calls.

METHODS: A team of registered nurses reviewed the medical records of inpatients who tested positive for SARS-CoV-2 via polymerase chain reaction before or on admission and who died between March 13 (first Northwell Health inpatient expiration) and April 30, 2020, …

Are Children With Sars-Cov-2 Infection At High Risk For Thrombosis? Viscoelastic Testing And Coagulation Profiles In A Case Series Of Pediatric Patients, M. Al-Ghafry, B. Aygun, A. Appiah-Kubi, A. Vlachos, G. Ostovar, C. Capone, T. Sweberg, N. Palumbo, P. Goenka, L. L. Wolfe, J. M. Lipton, S. S. Acharya

Journal Articles

© 2020 Wiley Periodicals LLC The coagulopathy of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well documented in adults, with increases in D-dimer and prothrombin time found to be strong predictors of mortality, and anticoagulation shown to decrease this mortality. Viscoelastic parameters such as elevations in maximum clot firmness (MCF) on rotational thromboelastometry (ROTEM) have correlated with a hypercoagulable state in adults with SARS-CoV-2. We report our experience in children infected with SARS-CoV-2, with noted elevations in D-dimer and MCF on ROTEM (indicating hypercoagulability). Exploration of viscoelastic testing to provide additional laboratory-based evidence for pediatric-specific risk assessment …

Comparative Survival Analysis Of Immunomodulatory Therapy For Coronavirus Disease 2019 Cytokine Storm., S. Narain, D. G. Stefanov, A. S. Chau, A. G. Weber, G. Marder, B. Kaplan, P. Malhotra, O. Bloom, A. Liu, M. M. Lesser, N. Hajizadeh, Northwell Covid-19 Research Consortium

Journal Articles

BACKGROUND:Cytokine storm is a marker of coronavirus disease 2019 (COVID-19) illness severity and increased mortality. Immunomodulatory treatments have been repurposed to improve mortality outcomes. RESEARCH QUESTION:Do immunomodulatory therapies improve survival in patients with COVID-19 cytokine storm (CCS)? STUDY DESIGN AND METHODS:We conducted a retrospective analysis of electronic health records across the Northwell Health system. COVID-19 patients hospitalized between March 1, 2020, and April 24, 2020, were included. CCS was defined by inflammatory markers: ferritin, > 700 ng/mL; C-reactive protein (CRP), > 30 mg/dL; or lactate dehydrogenase (LDH), > 300 U/L. Patients were subdivided into six groups: no immunomodulatory treatment (standard of care) and …