COVID-19 related neuroimaging findings: A signal of thromboembolic complications and a strong prognostic marker of poor patient outcome

To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. This is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between M...

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Published in:Journal of the neurological sciences Vol. 414; p. 116923
Main Authors: Jain, Rajan, Young, Matthew, Dogra, Siddhant, Kennedy, Helena, Nguyen, Vinh, Jones, Simon, Bilaloglu, Seda, Hochman, Katherine, Raz, Eytan, Galetta, Steven, Horwtiz, Leora
Format: Journal Article
Language:English
Published: Netherlands Elsevier B.V 15.07.2020
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ISSN:0022-510X, 1878-5883, 1878-5883
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Abstract To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. This is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuroradiologists evaluated all neuroimaging studies for acute neuroimaging findings related to COVID-19. 14.1% of admitted COVID-19 patients had neuroimaging and this accounted for only 5.5% of the total imaging studies. Acute stroke was the most common finding on neuro-imaging, seen in 92.5% of patients with positive neuro-imaging studies, and present in 1.1% of hospitalized COVID-19 patients. Patients with acute large ischemic and hemorrhagic stroke had much higher mortality risk adjusted for age, BMI and hypertension compared to those COVID-19 patients without neuroimaging. (Odds Ratio 6.02 by LR; Hazard Ratio 2.28 by CRR). Our study demonstrates acute stroke is the most common neuroimaging finding among hospitalized COVID-19 patients. Detection of an acute stroke is a strong prognostic marker of poor outcome. Our study also highlights the fact there is limited use of neuroimaging in these patients due to multiple logistical constraints.
AbstractList To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. This is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuroradiologists evaluated all neuroimaging studies for acute neuroimaging findings related to COVID-19. 14.1% of admitted COVID-19 patients had neuroimaging and this accounted for only 5.5% of the total imaging studies. Acute stroke was the most common finding on neuro-imaging, seen in 92.5% of patients with positive neuro-imaging studies, and present in 1.1% of hospitalized COVID-19 patients. Patients with acute large ischemic and hemorrhagic stroke had much higher mortality risk adjusted for age, BMI and hypertension compared to those COVID-19 patients without neuroimaging. (Odds Ratio 6.02 by LR; Hazard Ratio 2.28 by CRR). Our study demonstrates acute stroke is the most common neuroimaging finding among hospitalized COVID-19 patients. Detection of an acute stroke is a strong prognostic marker of poor outcome. Our study also highlights the fact there is limited use of neuroimaging in these patients due to multiple logistical constraints.
To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City.OBJECTIVETo investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City.This is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuroradiologists evaluated all neuroimaging studies for acute neuroimaging findings related to COVID-19.METHODSThis is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuroradiologists evaluated all neuroimaging studies for acute neuroimaging findings related to COVID-19.14.1% of admitted COVID-19 patients had neuroimaging and this accounted for only 5.5% of the total imaging studies. Acute stroke was the most common finding on neuro-imaging, seen in 92.5% of patients with positive neuro-imaging studies, and present in 1.1% of hospitalized COVID-19 patients. Patients with acute large ischemic and hemorrhagic stroke had much higher mortality risk adjusted for age, BMI and hypertension compared to those COVID-19 patients without neuroimaging. (Odds Ratio 6.02 by LR; Hazard Ratio 2.28 by CRR).RESULTS14.1% of admitted COVID-19 patients had neuroimaging and this accounted for only 5.5% of the total imaging studies. Acute stroke was the most common finding on neuro-imaging, seen in 92.5% of patients with positive neuro-imaging studies, and present in 1.1% of hospitalized COVID-19 patients. Patients with acute large ischemic and hemorrhagic stroke had much higher mortality risk adjusted for age, BMI and hypertension compared to those COVID-19 patients without neuroimaging. (Odds Ratio 6.02 by LR; Hazard Ratio 2.28 by CRR).Our study demonstrates acute stroke is the most common neuroimaging finding among hospitalized COVID-19 patients. Detection of an acute stroke is a strong prognostic marker of poor outcome. Our study also highlights the fact there is limited use of neuroimaging in these patients due to multiple logistical constraints.CONCLUSIONSOur study demonstrates acute stroke is the most common neuroimaging finding among hospitalized COVID-19 patients. Detection of an acute stroke is a strong prognostic marker of poor outcome. Our study also highlights the fact there is limited use of neuroimaging in these patients due to multiple logistical constraints.
AbstractObjectiveTo investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. MethodsThis is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuroradiologists evaluated all neuroimaging studies for acute neuroimaging findings related to COVID-19. Results14.1% of admitted COVID-19 patients had neuroimaging and this accounted for only 5.5% of the total imaging studies. Acute stroke was the most common finding on neuro-imaging, seen in 92.5% of patients with positive neuro-imaging studies, and present in 1.1% of hospitalized COVID-19 patients. Patients with acute large ischemic and hemorrhagic stroke had much higher mortality risk adjusted for age, BMI and hypertension compared to those COVID-19 patients without neuroimaging. (Odds Ratio 6.02 by LR; Hazard Ratio 2.28 by CRR). ConclusionsOur study demonstrates acute stroke is the most common neuroimaging finding among hospitalized COVID-19 patients. Detection of an acute stroke is a strong prognostic marker of poor outcome. Our study also highlights the fact there is limited use of neuroimaging in these patients due to multiple logistical constraints.
ArticleNumber 116923
Author Jones, Simon
Dogra, Siddhant
Nguyen, Vinh
Bilaloglu, Seda
Horwtiz, Leora
Jain, Rajan
Hochman, Katherine
Raz, Eytan
Kennedy, Helena
Galetta, Steven
Young, Matthew
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  givenname: Matthew
  surname: Young
  fullname: Young, Matthew
  organization: Department of Radiology, New York University Langone Health, New York, NY, United States of America
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  surname: Dogra
  fullname: Dogra, Siddhant
  organization: Department of Radiology, New York University Langone Health, New York, NY, United States of America
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  givenname: Helena
  surname: Kennedy
  fullname: Kennedy, Helena
  organization: Department of Radiology, New York University Langone Health, New York, NY, United States of America
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  givenname: Steven
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  surname: Horwtiz
  fullname: Horwtiz, Leora
  organization: Department of Medicine, New York University Langone Health, New York, NY, United States of America
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Keywords COVID-19
Neuro-imaging
Stroke
Language English
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Snippet To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. This is a...
AbstractObjectiveTo investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York...
To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City.OBJECTIVETo...
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StartPage 116923
SubjectTerms Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Betacoronavirus
Brain Ischemia - diagnostic imaging
Brain Ischemia - epidemiology
Brain Ischemia - etiology
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - epidemiology
Cerebral Hemorrhage - etiology
Child
Child, Preschool
Comorbidity
Coronavirus Infections - complications
Coronavirus Infections - epidemiology
COVID-19
Female
Hospitals, Urban - statistics & numerical data
Humans
Hypertension - epidemiology
Infant
Infant, Newborn
Inpatients
Male
Middle Aged
Neuro-imaging
Neuroimaging
Neurology
New York City - epidemiology
Obesity - epidemiology
Pandemics
Pneumonia, Viral - complications
Pneumonia, Viral - epidemiology
Procedures and Techniques Utilization
Prognosis
Retrospective Studies
SARS-CoV-2
Stroke
Stroke - diagnostic imaging
Stroke - epidemiology
Stroke - etiology
Tertiary Care Centers - statistics & numerical data
Young Adult
Title COVID-19 related neuroimaging findings: A signal of thromboembolic complications and a strong prognostic marker of poor patient outcome
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0022510X20302604
https://www.clinicalkey.es/playcontent/1-s2.0-S0022510X20302604
https://dx.doi.org/10.1016/j.jns.2020.116923
https://www.ncbi.nlm.nih.gov/pubmed/32447193
https://www.proquest.com/docview/2406570052
https://pubmed.ncbi.nlm.nih.gov/PMC7236667
Volume 414
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