Medical Specialties Commons^™

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

Journal Articles

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

Journal Articles

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

Journal Articles

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

Journal Articles

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

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

Journal Articles

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 …