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Article: Corticosteroid treatment for persistent pulmonary infiltrates following COVID-19 infection: Clearing the fog?

Ntiamoah, Prince / Biehl, Michelle / Ruesch, Victoria / Mehta, Atul C / Farha, Samar

2024 Volume 19, Issue 1, Page(s) 74–80

Abstract: Background: Systemic corticosteroids have been shown to improve outcomes in severe coronavirus disease 2019 (COVID-19) pneumonia; however, their role in post-COVID-19 persistent lung abnormalities is not well defined. Here, we describe our experience ... ...

Abstract	Background: Systemic corticosteroids have been shown to improve outcomes in severe coronavirus disease 2019 (COVID-19) pneumonia; however, their role in post-COVID-19 persistent lung abnormalities is not well defined. Here, we describe our experience with corticosteroids in patients with persistent lung infiltrates following COVID-19 infection. Research question: What is the efficacy of systemic corticosteroids in improving lung function and radiological abnormalities in patients following COVID-19 pneumonia? Study design and methods: This is a single-center retrospective study evaluating patients with persistent respiratory symptoms and abnormal chest computed tomography findings. Patients were divided into two groups based on treatment with corticosteroids: "steroid group" and "nonsteroid group." Clinical data were collected from the electronic medical records. Results: Between March 2020 and December 2021, 227 patients were seen in the post-COVID-19 pulmonary clinic, of which 75 were included in this study. The mean age was 56 years, 63% were female, and 75% were white. The main physiologic deficit was reduced Diffusing capacity of the Lungs for Carbon Monoxide (DLCO) at 72% (±22). On chest imaging, the most common findings were ground-glass opacities (91%) and consolidation (29%). Thirty patients received corticosteroid (steroid group) and 45 did not (nonsteroid group). Patients treated with corticosteroids had lower DLCO (DLCO [%]: steroid group 63 ± 17, nonsteroid group 78 ± 23; Conclusion: The use of systemic corticosteroids in patients with persistent respiratory symptoms and radiological abnormalities post-COVID-19 was associated with significant improvement in pulmonary function testing and imaging. Prospective studies are needed to confirm whether these findings are the effect of corticosteroid therapy or disease evolution over time.
Language	English
Publishing date	2024-01-25
Publishing country	India
Document type	Journal Article
ZDB-ID	2241287-6
ISSN	1998-3557 ; 1817-1737
ISSN (online)	1998-3557
ISSN	1817-1737
DOI	10.4103/atm.atm_121_23
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Post-intensive care syndrome and COVID-19 - Implications post pandemic.

Biehl, Michelle / Sese, Denise

Cleveland Clinic journal of medicine

2020

Abstract: Post-intensive care syndrome (PICS) describes new or worsening physical, cognitive, or mental impairments in a patient following critical illness or intensive care. The COVID-19 pandemic will likely result in many more patients with PICS and its ... ...

Abstract	Post-intensive care syndrome (PICS) describes new or worsening physical, cognitive, or mental impairments in a patient following critical illness or intensive care. The COVID-19 pandemic will likely result in many more patients with PICS and its associated health and economic challenges. Screening and assessment tools done during hospitalization, at discharge, and post discharge should be utilized to facilitate services and strategies to improve PICS outcomes for patient and their families.
Keywords	covid19
Language	English
Publishing date	2020-08-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	639116-3
ISSN	1939-2869 ; 0891-1150
ISSN (online)	1939-2869
ISSN	0891-1150
DOI	10.3949/ccjm.87a.ccc055
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Article: A Cross-Sectional Survey of Pulmonologists Working at Non-ILD Centers in the United States.

Biehl, Rodney / Jeganathan, Niranjan / Imperio, Michelle / Becerra, Benjamin J / López, David / Alismail, Abdullah

Journal of multidisciplinary healthcare

2023 Volume 16, Page(s) 1939–1942

Abstract: The purpose of this cross-sectional short report study was to evaluate the perception of pulmonologist working in noninterstitial lung disease centers on challenges (COE) encountered in daily practice. Results of this survey revealed that only 40% of ... ...

Abstract	The purpose of this cross-sectional short report study was to evaluate the perception of pulmonologist working in noninterstitial lung disease centers on challenges (COE) encountered in daily practice. Results of this survey revealed that only 40% of their patients are referred to an ILD COE, out of 69% who have access to an ILDCOE. Of these patients who were referred, the perceived benefits were rated high when it comes to having an accurate diagnosis.
Language	English
Publishing date	2023-07-14
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2453343-9
ISSN	1178-2390
ISSN	1178-2390
DOI	10.2147/JMDH.S421089
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Article ; Online: Update to post-acute sequelae of SARS-CoV-2 infection: Caring for the 'long-haulers'.

Vehar, Susan / Boushra, Marina / Ntiamoah, Prince / Biehl, Michelle

Cleveland Clinic journal of medicine

2021

Abstract: An estimated 10% of COVID-19 survivors continue to experience symptoms several weeks to months after the appearance of initial symptoms, a condition termed post-acute sequelae of SARS-CoV-2 infection (PASC). These patients, also called "long-haulers," ... ...

Abstract	An estimated 10% of COVID-19 survivors continue to experience symptoms several weeks to months after the appearance of initial symptoms, a condition termed post-acute sequelae of SARS-CoV-2 infection (PASC). These patients, also called "long-haulers," most commonly report protracted symptoms of fatigue, cough, dyspnea, chest tightness, difficulty concentrating, arthralgia, olfactory dysfunction, and headache. While age, comorbid medical conditions, and COVID-19 severity are suspected risk factors for PASC, young and previously healthy individuals with mild COVID-19 are also at risk. Recognition of symptoms, evaluation, supportive treatment, and attention to medical comorbidities are the cornerstones of medical management.
Language	English
Publishing date	2021-10-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	639116-3
ISSN	1939-2869 ; 0891-1150
ISSN (online)	1939-2869
ISSN	0891-1150
DOI	10.3949/ccjm.88a.21010-up
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Article ; Online: Post-acute sequelae of SARS-CoV-2 infection: Caring for the 'long-haulers'.

Vehar, Susan / Boushra, Marina / Ntiamoah, Prince / Biehl, Michelle

Cleveland Clinic journal of medicine

2021 Volume 88, Issue 5, Page(s) 267–272

Abstract	An estimated 10% of COVID-19 survivors continue to experience symptoms several weeks to months after the appearance of initial symptoms, a condition termed post-acute sequelae of SARS-CoV-2 infection (PASC). These patients, also called "long-haulers," most commonly report protracted symptoms of fatigue, cough, dyspnea, chest tightness, difficulty concentrating, arthralgia, olfactory dysfunction, and headache. While age, comorbid medical conditions, and COVID-19 severity are risk factors, young and previously healthy individuals with mild COVID-19 are also at risk. Recognition of symptoms, evaluation, supportive treatment, and attention to medical comorbidities are the cornerstones of medical management.
MeSH term(s)	COVID-19/complications ; COVID-19/diagnosis ; COVID-19/etiology ; COVID-19/physiopathology ; COVID-19/therapy ; Chronic Disease ; Disease Progression ; Humans ; Risk Factors
Language	English
Publishing date	2021-05-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	639116-3
ISSN	1939-2869 ; 0891-1150
ISSN (online)	1939-2869
ISSN	0891-1150
DOI	10.3949/ccjm.88a.21010
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Article ; Online: Neuropsychiatric assessment and management of the ICU survivor.

Dean, Erin A / Biehl, Michelle / Bash, Kathryn / Weleff, Jeremy / Pozuelo, Leopoldo

Cleveland Clinic journal of medicine

2021 Volume 88, Issue 12, Page(s) 669–679

Abstract: Any survivor among the millions of patients admitted to the intensive care unit (ICU) for critical illness each year is susceptible to persistent health problems that continue after discharge and may lead to post-intensive care syndrome (PICS), defined ... ...

Abstract	Any survivor among the millions of patients admitted to the intensive care unit (ICU) for critical illness each year is susceptible to persistent health problems that continue after discharge and may lead to post-intensive care syndrome (PICS), defined as new or worsening dysfunction from physical impairment, cognitive impairment, or emotional impairment, or a combination. Considering the increased rates of ICU survival and the growing elderly population more likely to utilize ICU resources, critical care practitioners have broadened their focus on outcomes and care of ICU survivors to include the acute post-ICU survival period as well as months and even years after ICU discharge. This review focuses on the neuropsychiatric aspects of PICS in ICU survivors including diagnostic, screening, and treatment recommendations. It also highlights the value of post-ICU clinics and the unique role of the consultation psychiatrist in the care of this patient population.
MeSH term(s)	Aged ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/therapy ; Critical Care ; Critical Illness ; Humans ; Intensive Care Units ; Survivors
Language	English
Publishing date	2021-12-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639116-3
ISSN	1939-2869 ; 0891-1150
ISSN (online)	1939-2869
ISSN	0891-1150
DOI	10.3949/ccjm.88a.20169
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Article ; Online: Severe covid-19 pneumonia: pathogenesis and clinical management.

Attaway, Amy H / Scheraga, Rachel G / Bhimraj, Adarsh / Biehl, Michelle / Hatipoğlu, Umur

BMJ (Clinical research ed.)

2021 Volume 372, Page(s) n436

Abstract: Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 ... ...

Abstract	Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 associated acute respiratory distress syndrome (CARDS). Autopsy studies of patients who died of severe SARS CoV-2 infection reveal presence of diffuse alveolar damage consistent with ARDS but with a higher thrombus burden in pulmonary capillaries. When used appropriately, high flow nasal cannula (HFNC) may allow CARDS patients to avoid intubation, and does not increase risk for disease transmission. During invasive mechanical ventilation, low tidal volume ventilation and positive end expiratory pressure (PEEP) titration to optimize oxygenation are recommended. Dexamethasone treatment improves mortality for the treatment of severe and critical covid-19, while remdesivir may have modest benefit in time to recovery in patients with severe disease but shows no statistically significant benefit in mortality or other clinical outcomes. Covid-19 survivors, especially patients with ARDS, are at high risk for long term physical and mental impairments, and an interdisciplinary approach is essential for critical illness recovery.
MeSH term(s)	COVID-19/complications ; COVID-19/diagnosis ; COVID-19/therapy ; Humans ; Respiration, Artificial ; Respiratory Distress Syndrome/diagnosis ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/virology ; SARS-CoV-2/pathogenicity
Language	English
Publishing date	2021-03-10
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.n436
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Article ; Online: The safety and efficacy of the IPACK block in primary total knee arthroplasty: a retrospective chart review.

Biehl, Michelle / Wild, Lisa / Waldman, Kyle / Haq, Farzana / Easteal, Ronald A / Sawhney, Monakshi

Canadian journal of anaesthesia = Journal canadien d'anesthesie

2020 Volume 67, Issue 9, Page(s) 1271–1273

MeSH term(s)	Arthroplasty, Replacement, Knee ; Humans ; Nerve Block/adverse effects ; Pain, Postoperative/prevention & control ; Retrospective Studies
Language	English
Publishing date	2020-04-06
Publishing country	United States
Document type	Letter ; Review
ZDB-ID	91002-8
ISSN	1496-8975 ; 0832-610X
ISSN (online)	1496-8975
ISSN	0832-610X
DOI	10.1007/s12630-020-01652-1
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Conference proceedings: Zelluläre Verträglichkeit des neuentwickelten Polymers Polyamid-ε-Caprolacton als Material für im 3D-Druck hergestellte Implantate für osteochondrale Defekte

Lips, Katrin Susanne / Fibbe, Mona / Lehner, Veronika / Plit, Felix / Wunderer, Michelle / Biehl, Christoph / Liefeith, Klaus

2023 , Page(s) AB39–2371

Event/congress	Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2023); Berlin; ; Berufsverband für Orthopädie und Unfallchirurgie; 2023
Keywords	Medizin, Gesundheit ; Implantat ; 3D-Druck ; Polymer ; Knochen ; Knorpel ; Zytokompatibilität ; in vitro ; osteochondrale Defekte ; Osteoblasten ; Osteoklasten ; osteogene Differenzierung ; chondrogene Differenzierung ; MSC
Publishing date	2023-10-23
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/23dkou173
Database	German Medical Science

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Article ; Online: The Incremental Burden of Acute Respiratory Distress Syndrome: Long-term Follow-up of a Population-Based Nested Case-Control Study.

Biehl, Michelle / Ahmed, Adil / Kashyap, Rahul / Barwise, Amelia / Gajic, Ognjen

Mayo Clinic proceedings

2018 Volume 93, Issue 4, Page(s) 445–452

Abstract: Objective: To evaluate the long-term survival of patients at similar risk for hospital-acquired acute respiratory distress syndrome (ARDS) who did and did not develop ARDS.: Methods: We conducted long-term follow-up of a population-based nested case- ... ...

Abstract	Objective: To evaluate the long-term survival of patients at similar risk for hospital-acquired acute respiratory distress syndrome (ARDS) who did and did not develop ARDS. Methods: We conducted long-term follow-up of a population-based nested case-control study in a consecutive cohort of adult Olmsted County, Minnesota, patients admitted from January 1, 2001, through December 31, 2010. Patients in whom ARDS developed during their hospital stay (cases) were matched to similar-risk patients without ARDS (controls) by 6 characteristics: age, sex, sepsis, high-risk surgery, ratio of oxygen saturation to fraction of inspired oxygen, and ARDS risk according to the Lung Injury Prediction Score. Hospital mortality, discharge disposition, and long-term survival were compared. Results: Patients who developed hospital-acquired ARDS (n=400) had higher hospital mortality than at-risk controls (n=400) (35% vs 5%; P<.001). Among hospital survivors (252 matched pairs), ARDS cases were more likely to be discharged to rehabilitation (13% vs 4%) and long-term care (30% vs 15%) facilities, whereas more controls were discharged home (71% vs 41%). After discharge, differences in survival persisted beyond 90 days (adjusted hazard ratio [HR], 1.76; 95% CI, 1.2-2.5; P=.002) and 6 months (adjusted HR, 1.73; 95% CI, 1.2-2.6; P<.001). Conclusion: These results suggest that in a population-based matched case-control study of patients with similar characteristics at the time of hospital admission, those who developed hospital-acquired ARDS had worse long-term survival.
MeSH term(s)	Adult ; Aged ; Case-Control Studies ; Cost of Illness ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Outcome Assessment (Health Care)/statistics & numerical data ; Patient Discharge/statistics & numerical data ; Respiratory Distress Syndrome, Adult/mortality ; Time Factors
Language	English
Publishing date	2018-03-01
Publishing country	England
Document type	Journal Article
ZDB-ID	124027-4
ISSN	1942-5546 ; 0025-6196
ISSN (online)	1942-5546
ISSN	0025-6196
DOI	10.1016/j.mayocp.2017.11.025
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