Medical Specialties Commons^™

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

Journal Articles

No abstract provided.

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

Journal Articles

No abstract provided.

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 …

Covid-19 And Orthopaedics: Recovery After The Pandemic Surge., B. Petrone, C. R. Iturriaga, T. Mauri, N. Sgaglione

Journal Articles

The novel Coronavirus (COVID-19) pandemic has placed an immense strain on health care systems and orthopedic surgeons across the world. To limit the spread, federal and state governments mandated the cancellation of all nonurgent surgical cases to address surging hospital admissions and manage workforce and resource reallocation. During the pandemic surge, thousands of surgical cancellations have been required. We outline our experience through the onset and advance of the surge, detail our incident response and discuss the transition toward recovery. Level of Evidence: Level V.

Covid-19 And Cancer Patients., R Patel, J Park, A Shah, Mw Saif

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No abstract provided.

The Irresponsible Use Of Social Media Among Medical Students, M. Curato, A. Husain, K. Shah, M. Kanter, D. Egan, H. Thompson, M. Silverberg, M. Jones, T. Dulani, P. Mukherji, +8 Additional Authors

Journal Articles

No abstract provided.

Abdominal Pelvic Ct Findings Compared Between Covid-19 Positive And Covid-19 Negative Patients In The Emergency Department Setting, S. A. Funt, S. L. Cohen, J. J. Wang, P. C. Sanelli, M. A. Barish

Journal Articles

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Purpose: Manifestations of COVID-19 are primarily respiratory based, however, gastrointestinal symptoms are now recognized as an important component of the disease. The purpose of this study is to evaluate differences in abdominal pelvic CT findings in the emergency department by COVID-19 test result. Methods: This retrospective study identified patients tested by PCR for COVID-19 infection who underwent abdominal pelvic CT scan in the ED across an academic health system from March 15 to April 15, 2020. Radiology reports were reviewed for the presence of ground glass opacity in the lungs …

Acute Arterial Thromboembolism In Patients With Covid-19 In The New York City Area, Y. Etkin, A. M. Conway, J. Silpe, K. Qato, A. Carroccio, P. Manvar-Singh, G. Giangola, J. S. Deitch, L. Davila-Santini, J. A. Schor, K. Singh, F. F. Mussa, G. S. Landis

Journal Articles

© 2020 Elsevier Inc. Background: Coronavirus disease 2019 (COVID-19) predisposes to arterial and venous thromboembolic complications. We describe the clinical presentation, management, and outcomes of acute arterial ischemia and concomitant infection at the epicenter of cases in the United States. Methods: Patients with confirmed COVID-19 infection between March 1, 2020 and May 15, 2020 with an acute arterial thromboembolic event were reviewed. Data collected included demographics, anatomical location of the thromboembolism, treatments, and outcomes. Results: Over the 11-week period, the Northwell Health System cared for 12,630 hospitalized patients with COVID-19. A total of 49 patients with arterial thromboembolism and confirmed …

Acute Limb Ischemia In Covid-19 Disease: A Mysterious Coagulopathy., S. Anwar, S. Acharya, S. Shabih, A. Khabut

Journal Articles

Severe coronavirus disease 2019 (COVID-19) as a respiratory tract infection has been noted to be a causative agent for acute respiratory distress syndrome, shock, and multiple organ failure. It is also being suggested that COVID-19 results in serious systemic coagulopathies similar to disseminated intravascular coagulation. We describe a case of severe arterial thrombosis induced by COVID-19 infection along with its pathological implications.

Acute Liver Failure In A Covid-19 Patient Without Any Preexisting Liver Disease., D. Gurala, H. Al Moussawi, J. Philipose, J. R. Abergel

Journal Articles

In December 2019, an outbreak of novel coronavirus started in Wuhan, China, which gradually spread to the entire world. The World Health Organization (WHO) on February 11, 2020, officially announced the name for the disease as coronavirus disease 2019, abbreviated as COVID-19. It is caused by severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2). The WHO declared SARS-CoV-2 as a pandemic on March 11, 2020. SARS-CoV-2 mainly causes fever as well as respiratory symptoms such as cough and shortness of breath. Gastrointestinal/hepatic sequelae such as diarrhea, nausea, vomiting, and elevated liver enzymes have been reported as well. Studies and data so …

Adherence And Acceptability Of Telehealth Appointments For High Risk Obstetrical Patients During The Covid-19 Pandemic., S. Jeganathan, L. Prasannan, M. J. Blitz, N. Vohra, B. Rochelson, N. Meirowitz

Journal Articles

Background:Telehealth has been successfully implemented for the delivery of obstetrical care. However, little is known regarding the attitudes and acceptability of patients and providers in high risk obstetrics and if implementation improves access to care in non-rural settings. Objective:The study aims to: 1) Describe patient and provider attitudes toward telehealth for delivery of high risk obstetrical care in a large health care system with both urban and suburban settings. 2) Determine if implementation of a telehealth model improves patient adherence to scheduled appointments in this patient population.Study DesignTwo self-administered surveys were designed. The first survey was sent to all high-risk …

An Unusual Case Of Moraxella Osleonsis Bacteremia In An Immunocompetent Patient With Sars-Cov-2 Infection., B. C. Veerabathini, K. Manthani, S. Gandhi

Journal Articles

Moraxella osleonsis (M.osleonsis ) is an organism that rarely presents with bacteremia in immunocompetent patients. We report a case of an immunocompetent 59-year-old male with a recent SARS-CoV-2 infection that developed M. osleonsis bacteremia. We believe that SARS-CoV-2 infection may have played a role in developing M. osleonsis bacteremia in this patient and may be one of the first reported cases of such bacteremia in a COVID-19 patient.

Aortic Arch Thrombus And Pulmonary Embolism In A Covid-19 Patient, P. Gandotra, A. Supariwala, S. Selim, G. Garra, L. Gruberg

Journal Articles

© 2020 Elsevier Inc. Background: Coronavirus disease 2019 (COVID-19) is associated with endothelial inflammation and a hypercoagulable state resulting in both venous and arterial thromboembolic complications. We present a case of COVID-19-associated aortic thrombus in an otherwise healthy patient. Case Report: A 53-year-old woman with no past medical history presented with a 10-day history of dyspnea, fever, and cough. Her pulse oximetry on room air was 84%. She tested positive for severe acute respiratory syndrome coronavirus 2 infection, and chest radiography revealed moderate patchy bilateral airspace opacities. Serology markers for cytokine storm were significantly elevated, with a serum D-dimer level …

Bilateral Pneumothorax As Possible Atypical Presentation Of Coronavirus Disease 2019 (Covid-19), A. S. Ahluwalia, T. Qarni, N. Narula, W. Sadiq, M. N. Chalhoub

Journal Articles

© 2020 The Authors Coronavirus disease 2019 (COVID-19) is most frequently associated with a mild presentation of fever, cough, and shortness of breath. Typical radiographic findings of COVID-19 are bilateral ground-glass opacities on computed tomography (CT) scans. However, there have been instances of pneumothorax, giant bulla, and pneumomediastinum, mainly in elderly COVID-19 patients and predominately occurring at least one week after symptom onset. Here, we report a case where a healthy, young Hispanic man presented with three days of fever, cough, and dyspnea. On admission to the emergency department, he was found to have bilateral pneumothoraces, pneumomediastinum, and pneumopericardium requiring …

Bradyarrhythmias In Patients With Covid-19: Marker Of Poor Prognosis?, J. S. Chinitz, R. Goyal, M. Harding, G. Veseli, L. Gruberg, R. Jadonath, P. Maccaro, P. Gandotra, L. Ong, L. M. Epstein

Journal Articles

No abstract provided.

Cardiac Dysfunction And Shock In Pediatric Patients With Covid-19., K. Joshi, D. Kaplan, A. Bakar, J. F. Jennings, D. A. Hayes, S. Mahajan, N. Misra, E. Mitchell, T. M. Sweberg, M. D. Taylor, C. A. Capone

Journal Articles

Coronavirus disease-2019 (COVID-19) has been reported to cause significant morbidity in adults, with reportedly a lesser impact on children. Cardiac dysfunction has only been described in adults thus far. We describe 3 cases of previously healthy children presenting with shock and COVID-19-related cardiac inflammation. (Level of Difficulty: Intermediate.).

Central Nervous System Complications Associated With Sars-Cov-2 Infection: Integrative Concepts Of Pathophysiology And Case Reports, S. Najjar, A. Najjar, D. J. Chong, B. K. Pramanik, C. Kirsch, R. Kuzniecky, S. Pacia, S. Azhar

Journal Articles

No abstract provided.

Cerebrovascular Complications Of Covid-19, J. M. Katz, R. B. Libman, J. J. Wang, P. Sanelli, C. G. Filippi, M. Gribko, S. V. Pacia, R. I. Kuzniecky, S. Najjar, S. Azhar

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No abstract provided.

Covid-19 And Solid Organ Transplant Outcomes, V. Nair, N. Jandovitz, K. D. Jhaveri, E. Molmenti

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No abstract provided.

Covid-19 As A Possible Cause Of Functional Exhaustion Of Cd4 And Cd8 T-Cells And Persistent Cause Of Methicillin-Sensitive Staphylococcus Aureus Bacteremia., I. Choudhury, H. Han, K. Manthani, S. Gandhi, R. Dabhi

Journal Articles

We report a case of a 73-year-old male with a history of diabetes mellitus, osteomyelitis, methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia who recently completed an extended intravenous course of cefazolin eight days back, and presented with MSSA bacteremia complicated by epidural abscess, endocarditis, and aortic root abscess. Meanwhile, the patient was tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse transcription-polymerase chain reaction (RT-PCR). Even with aggressive antibiotic treatment, the patient remained bacteremic and developed endocarditis with a worsening aortic root abscess. We suspect coronavirus disease 2019 (COVID-19) as a cause for the infectious paradox and will discuss …

Covid-19 Clinical Research., J. Chi, D. Chitty, M. Lee, N. Hakim, S. Lakhani, L. Rajdev, X. Zhu, M. W. Saif

Journal Articles

Introduction:While the global COVID-19 pandemic has challenged the entire humanity and health systems, it also triggered researchers to urgently perform clinical trials to assess the safety and efficacy of many agents and modalities to combat COVID-19. As of April 22, over 650 clinical studies have been registered both in USA and internationally. Results from these studies are also coming at a brisk pace in this unprecedented emergency. Areas covered:We searched the NCI website and Medline and summarize various national and international clinical trials and summarize few of the pivotal ones in this paper, including those specific to oncology population. Two …

Covid-19 In Hospitalized Patients On Chronic Peritoneal Dialysis: A Case Series, M. Sachdeva, N. N. Uppal, J. S. Hirsch, J. H. Ng, D. Malieckal, S. Fishbane, K. D. Jhaveri

Journal Articles

No abstract provided.

De Novo Anca-Associated Vasculitis With Glomerulonephritis In Covid-19., N. N. Uppal, N. Kello, H. H. Shah, Y. Khanin, I. R. De Oleo, E. Epstein, P. Sharma, C. P. Larsen, V. Bijol, K. D. Jhaveri

Journal Articles

No abstract provided.

Development Of A New Multiplex Real-Time Rt-Pcr Assay For Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) Detection., W. Zhen, G. J. Berry

Journal Articles

This research describes the development of a new multiplex real-time RT-PCR test for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with primers designed to amplify a 108 bp target on the spike surface glycoprotein (S gene) and a hydrolysis TaqMan probe designed to specifically detect SARS-CoV-2. The limit of detection (LOD) and clinical performance of this new assay were evaluated. A LOD study with inactivated virus exhibited performance equal to the modified CDC assay, with a final LOD of 1301 ± 13 genome equivalents/mL for the Northwell Health Laboratories laboratory-developed test (NWHL LDT) versus 1249 ± 14 genome …