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  1. Article ; Online: Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations.

    Patel, Brijesh V / Arachchillage, Deepa J / Ridge, Carole A / Bianchi, Paolo / Doyle, James F / Garfield, Benjamin / Ledot, Stephane / Morgan, Cliff / Passariello, Maurizio / Price, Susanna / Singh, Suveer / Thakuria, Louit / Trenfield, Sarah / Trimlett, Richard / Weaver, Christine / Wort, S John / Xu, Tina / Padley, Simon P G / Devaraj, Anand /
    Desai, Sujal R

    American journal of respiratory and critical care medicine

    2020  Volume 202, Issue 5, Page(s) 690–699

    Abstract: Rationale: ...

    Abstract Rationale:
    MeSH term(s) Adult ; Aged ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Female ; Humans ; Lung/blood supply ; Lung/diagnostic imaging ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pulmonary Circulation/physiology ; SARS-CoV-2 ; Tomography, X-Ray Computed ; Vascular Diseases/diagnosis ; Vascular Diseases/etiology ; Vascular Diseases/physiopathology
    Keywords covid19
    Language English
    Publishing date 2020-07-15
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202004-1412OC
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Pulmonary Angiopathy in Severe COVID-19: Physiologic, Imaging, and Hematologic Observations

    Patel, Brijesh V / Arachchillage, Deepa J / Ridge, Carole A / Bianchi, Paolo / Doyle, James F / Garfield, Benjamin / Ledot, Stephane / Morgan, Cliff / Passariello, Maurizio / Price, Susanna / Singh, Suveer / Thakuria, Louit / Trenfield, Sarah / Trimlett, Richard / Weaver, Christine / Wort, S John / Xu, Tina / Padley, Simon P G / Devaraj, Anand /
    Desai, Sujal R

    Am J Respir Crit Care Med

    Abstract: ... hematologic, and imaging basis of lung injury in severe COVID-19 pneumonia.Methods: Clinical, physiologic, and ... mottled, n = 9; mixed pattern, n = 6).Conclusions: Physiologic, hematologic, and imaging data show not ... Rationale: Clinical and epidemiologic data in coronavirus disease (COVID-19) have accrued rapidly ...

    Abstract Rationale: Clinical and epidemiologic data in coronavirus disease (COVID-19) have accrued rapidly since the outbreak, but few address the underlying pathophysiology.Objectives: To ascertain the physiologic, hematologic, and imaging basis of lung injury in severe COVID-19 pneumonia.Methods: Clinical, physiologic, and laboratory data were collated. Radiologic (computed tomography (CT) pulmonary angiography [n = 39] and dual-energy CT [DECT, n = 20]) studies were evaluated: observers quantified CT patterns (including the extent of abnormal lung and the presence and extent of dilated peripheral vessels) and perfusion defects on DECT. Coagulation status was assessed using thromboelastography.Measurements and Results: In 39 consecutive patients (male:female, 32:7; mean age, 53 ± 10 yr [range, 29-79 yr]; Black and minority ethnic, n = 25 [64%]), there was a significant vascular perfusion abnormality and increased physiologic dead space (dynamic compliance, 33.7 ± 14.7 ml/cm H2O; Murray lung injury score, 3.14 ± 0.53; mean ventilatory ratios, 2.6 ± 0.8) with evidence of hypercoagulability and fibrinolytic "shutdown". The mean CT extent (±SD) of normally aerated lung, ground-glass opacification, and dense parenchymal opacification were 23.5 ± 16.7%, 36.3 ± 24.7%, and 42.7 ± 27.1%, respectively. Dilated peripheral vessels were present in 21/33 (63.6%) patients with at least two assessable lobes (including 10/21 [47.6%] with no evidence of acute pulmonary emboli). Perfusion defects on DECT (assessable in 18/20 [90%]) were present in all patients (wedge-shaped, n = 3; mottled, n = 9; mixed pattern, n = 6).Conclusions: Physiologic, hematologic, and imaging data show not only the presence of a hypercoagulable phenotype in severe COVID-19 pneumonia but also markedly impaired pulmonary perfusion likely caused by pulmonary angiopathy and thrombosis.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #646801
    Database COVID19

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  3. Article ; Online: Pulmonary angiopathy in severe COVID-19

    Patel, BV / Arachchillage, DJ / Ridge, CA / Bianchi, P / Doyle, JF / Garfield, B / Ledot, S / Morgan, C / Passariello, M / Price, S / Singh, S / Thakuria, L / Trenfield, S / Trimlett, R / Weaver, C / Wort, SJ / Xu, T / Padley, SPG / Devaraj, A /
    Desai, SR

    699 ; 690

    physiologic, imaging and hematologic observations

    2020  

    Abstract: ... the physiologic, hematologic and imaging basis of lung injury in severe Covid-19 pneumonia. Methods: Clinical ... imaging data show not only the presence of a hypercoagulable phenotype in severe Covid-19 pneumonia ... Rationale: Clinical and epidemiologic data in coronavirus disease 2019 (Covid-19) have accrued ...

    Abstract Rationale: Clinical and epidemiologic data in coronavirus disease 2019 (Covid-19) have accrued rapidly since the outbreak but few address the underlying pathophysiology. Objectives: To ascertain the physiologic, hematologic and imaging basis of lung injury in severe Covid-19 pneumonia. Methods: Clinical, physiologic and laboratory data were collated. Radiologic (computed tomography pulmonary angiography [CTPA, n=39] and dual-energy CT [DECT, n=20]) studies were evaluated: observers quantified CT patterns (including the extent of abnormal lung and the presence/extent of dilated peripheral vessels) and perfusion defects on DECT. Coagulation status was assessed using thromboelastography (TEG). Measurements and Results: In 39 consecutive patients (M:F 32:7; mean age, 53±10 years [range 29-79 years]; black and ethnic minority, n=25 [64%]), there was a significant vascular perfusion abnormality and increased physiologic dead-space (dynamic compliance, 33.7±14.7 mls/cmH2O; Murray Lung Injury Score, 3.14±0.53; mean ventilatory ratios, 2.6±0.8) with evidence of hypercoagulability and fibrinolytic ‘shutdown’. The mean CT extent (±SD) of normally-aerated lung, ground-glass opacification and dense parenchymal opacification were 23.5±16.7%, 36.3±24.7% and 42.7±27.1%, respectively. Dilated peripheral vessels were present in 21/33 (63.6%) patients with at least two assessable lobes (including 10/21 [47.6%] with no evidence of acute pulmonary emboli). Perfusion defects on DECT (assessable in 18/20 [90%]), were present in all patients (wedge-shaped, n=3; mottled, n= 9; mixed pattern, n=6). Conclusions: Physiologic, hematologic and imaging data show not only the presence of a hypercoagulable phenotype in severe Covid-19 pneumonia but also markedly impaired pulmonary perfusion likely caused by pulmonary angiopathy and thrombosis.
    Keywords acute respiratory distress syndrome ; mechanical ventilation ; novel coronavirus disease 2019 ; pulmonary perfusion ; thoracic imaging ; Respiratory System ; 11 Medical and Health Sciences ; covid19
    Language English
    Publishing date 2020-07-14
    Publisher American Thoracic Society
    Publishing country uk
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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