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  1. Article ; Online: Ordered-domain unfolding of thermophilic isolated β subunit ATP synthase.

    López-Pérez, Edgar / de Gómez-Puyou, Marietta Tuena / Nuñez, Concepción José / Zapién, Denise Martínez / Guardado, Salomón Alas / Beltrán, Hiram Isaac / Pérez-Hernández, Gerardo

    Protein science : a publication of the Protein Society

    2023  Volume 32, Issue 7, Page(s) e4689

    Abstract: The flexibility of the ATP synthase's β subunit promotes its role in the ATP synthase rotational mechanism, but its domains stability remains unknown. A reversible thermal unfolding of the isolated β subunit (Tβ) of the ATP synthase from Bacillus ... ...

    Abstract The flexibility of the ATP synthase's β subunit promotes its role in the ATP synthase rotational mechanism, but its domains stability remains unknown. A reversible thermal unfolding of the isolated β subunit (Tβ) of the ATP synthase from Bacillus thermophilus PS3, tracked through circular dichroism and molecular dynamics, indicated that Tβ shape transits from an ellipsoid to a molten globule through an ordered unfolding of its domains, preserving the β-sheet residual structure at high temperature. We determined that part of the stability origin of Tβ is due to a transversal hydrophobic array that crosses the β-barrel formed at the N-terminal domain and the Rossman fold of the nucleotide-binding domain (NBD), while the helix bundle of the C-terminal domain is the less stable due to the lack of hydrophobic residues, and thus the more flexible to trigger the rotational mechanism of the ATP synthase.
    MeSH term(s) Protein Structure, Secondary ; Hot Temperature ; Molecular Dynamics Simulation ; Adenosine Triphosphate/chemistry ; Circular Dichroism ; Protein Folding ; Protein Denaturation
    Chemical Substances Adenosine Triphosphate (8L70Q75FXE)
    Language English
    Publishing date 2023-04-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1106283-6
    ISSN 1469-896X ; 0961-8368
    ISSN (online) 1469-896X
    ISSN 0961-8368
    DOI 10.1002/pro.4689
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  2. Article ; Online: Barotrauma in COVID 19: Incidence, pathophysiology, and effect on prognosis.

    Steinberger, Sharon / Finkelstein, Mark / Pagano, Andrew / Manna, Sayan / Toussie, Danielle / Chung, Michael / Bernheim, Adam / Concepcion, Jose / Gupta, Sean / Eber, Corey / Dua, Sakshi / Jacobi, Adam H

    Clinical imaging

    2022  Volume 90, Page(s) 71–77

    Abstract: Objectives: To investigate the incidence, risk factors, and outcomes of barotrauma (pneumomediastinum and subcutaneous emphysema) in mechanically ventilated COVID-19 patients. To describe the chest radiography patterns of barotrauma and understand the ... ...

    Abstract Objectives: To investigate the incidence, risk factors, and outcomes of barotrauma (pneumomediastinum and subcutaneous emphysema) in mechanically ventilated COVID-19 patients. To describe the chest radiography patterns of barotrauma and understand the development in relation to mechanical ventilation and patient mortality.
    Methods: We performed a retrospective study of 363 patients with COVID-19 from March 1 to April 8, 2020. Primary outcomes were pneumomediastinum or subcutaneous emphysema with or without pneumothorax, pneumoperitoneum, or pneumoretroperitoneum. The secondary outcomes were length of intubation and death. In patients with pneumomediastinum and/or subcutaneous emphysema, we conducted an imaging review to determine the timeline of barotrauma development.
    Results: Forty three out of 363 (12%) patients developed barotrauma radiographically. The median time to development of either pneumomediastinum or subcutaneous emphysema was 2 days (IQR 1.0-4.5) after intubation and the median time to pneumothorax was 7 days (IQR 2.0-10.0). The overall incidence of pneumothorax was 28/363 (8%) with an incidence of 17/43 (40%) in the barotrauma cohort and 11/320 (3%) in those without barotrauma (p ≤ 0.001). In total, 257/363 (71%) patients died with an increase in mortality in those with barotrauma 33/43 (77%) vs. 224/320 (70%). When adjusting for covariates, barotrauma was associated with increased odds of death (OR 2.99, 95% CI 1.25-7.17).
    Conclusion: Barotrauma is a frequent complication of mechanically ventilated COVID-19 patients. In comparison to intubated COVID-19 patients without barotrauma, there is a higher rate of pneumothorax and an increased risk of death.
    MeSH term(s) Barotrauma/complications ; Barotrauma/etiology ; COVID-19/epidemiology ; Humans ; Incidence ; Mediastinal Emphysema/diagnostic imaging ; Mediastinal Emphysema/epidemiology ; Mediastinal Emphysema/etiology ; Pneumothorax/diagnostic imaging ; Pneumothorax/epidemiology ; Pneumothorax/etiology ; Prognosis ; Retrospective Studies ; Subcutaneous Emphysema/diagnostic imaging ; Subcutaneous Emphysema/epidemiology ; Subcutaneous Emphysema/etiology
    Language English
    Publishing date 2022-06-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1028123-x
    ISSN 1873-4499 ; 0899-7071
    ISSN (online) 1873-4499
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2022.06.014
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  3. Article ; Online: Portable Chest Radiography as an Exclusionary Test for Adverse Clinical Outcomes During the COVID-19 Pandemic.

    Pagano, Andrew / Finkelstein, Mark / Overbey, Jessica / Steinberger, Sharon / Ellison, Trevor / Manna, Sayan / Toussie, Danielle / Cedillo, Mario A / Jacobi, Adam / Gupta, Yogesh S / Bernheim, Adam / Chung, Michael / Eber, Corey / Fayad, Zahi A / Concepcion, Jose

    Chest

    2021  Volume 160, Issue 1, Page(s) 238–248

    Abstract: Background: Chest radiography (CXR) often is performed in the acute setting to help understand the extent of respiratory disease in patients with COVID-19, but a clearly defined role for negative chest radiograph results in assessing patients has not ... ...

    Abstract Background: Chest radiography (CXR) often is performed in the acute setting to help understand the extent of respiratory disease in patients with COVID-19, but a clearly defined role for negative chest radiograph results in assessing patients has not been described.
    Research question: Is portable CXR an effective exclusionary test for future adverse clinical outcomes in patients suspected of having COVID-19?
    Study design and methods: Charts of consecutive patients suspected of having COVID-19 at five EDs in New York City between March 19, 2020, and April 23, 2020, were reviewed. Patients were categorized based on absence of findings on initial CXR. The primary outcomes were hospital admission, mechanical ventilation, ARDS, and mortality.
    Results: Three thousand two hundred forty-five adult patients, 474 (14.6%) with negative initial CXR results, were reviewed. Among all patients, negative initial CXR results were associated with a low probability of future adverse clinical outcomes, with negative likelihood ratios of 0.27 (95% CI, 0.23-0.31) for hospital admission, 0.24 (95% CI, 0.16-0.37) for mechanical ventilation, 0.19 (95% CI, 0.09-0.40) for ARDS, and 0.38 (95% CI, 0.29-0.51) for mortality. Among the subset of 955 patients younger than 65 years and with a duration of symptoms of at least 5 days, no patients with negative CXR results died, and the negative likelihood ratios were 0.17 (95% CI, 0.12-0.25) for hospital admission, 0.09 (95% CI, 0.02-0.36) for mechanical ventilation, and 0.09 (95% CI, 0.01-0.64) for ARDS.
    Interpretation: Initial CXR in adult patients suspected of having COVID-19 is a strong exclusionary test for hospital admission, mechanical ventilation, ARDS, and mortality. The value of CXR as an exclusionary test for adverse clinical outcomes is highest among young adults, patients with few comorbidities, and those with a prolonged duration of symptoms.
    MeSH term(s) COVID-19/diagnosis ; COVID-19/mortality ; COVID-19/therapy ; Female ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; New York City/epidemiology ; Predictive Value of Tests ; Radiography, Thoracic/methods ; Radiography, Thoracic/standards ; Radiography, Thoracic/statistics & numerical data ; Respiration Disorders/diagnosis ; Respiration Disorders/etiology ; Respiration, Artificial/methods ; Respiration, Artificial/statistics & numerical data ; Retrospective Studies ; SARS-CoV-2
    Language English
    Publishing date 2021-01-29
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1032552-9
    ISSN 1931-3543 ; 0012-3692
    ISSN (online) 1931-3543
    ISSN 0012-3692
    DOI 10.1016/j.chest.2021.01.053
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  4. Article ; Online: Clinical and Chest Radiography Features Determine Patient Outcomes in Young and Middle-aged Adults with COVID-19.

    Toussie, Danielle / Voutsinas, Nicholas / Finkelstein, Mark / Cedillo, Mario A / Manna, Sayan / Maron, Samuel Z / Jacobi, Adam / Chung, Michael / Bernheim, Adam / Eber, Corey / Concepcion, Jose / Fayad, Zahi A / Gupta, Yogesh Sean

    Radiology

    2020  Volume 297, Issue 1, Page(s) E197–E206

    Abstract: Background Chest radiography has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose To analyze the prognostic value of a chest radiograph severity scoring system for younger (nonelderly) ...

    Abstract Background Chest radiography has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose To analyze the prognostic value of a chest radiograph severity scoring system for younger (nonelderly) patients with COVID-19 at initial presentation to the emergency department (ED); outcomes of interest included hospitalization, intubation, prolonged stay, sepsis, and death. Materials and Methods In this retrospective study, patients between the ages of 21 and 50 years who presented to the ED of an urban multicenter health system from March 10 to March 26, 2020, with COVID-19 confirmation on real-time reverse transcriptase polymerase chain reaction were identified. Each patient's ED chest radiograph was divided into six zones and examined for opacities by two cardiothoracic radiologists, and scores were collated into a total concordant lung zone severity score. Clinical and laboratory variables were collected. Multivariable logistic regression was used to evaluate the relationship between clinical parameters, chest radiograph scores, and patient outcomes. Results The study included 338 patients: 210 men (62%), with median age of 39 years (interquartile range, 31-45 years). After adjustment for demographics and comorbidities, independent predictors of hospital admission (
    MeSH term(s) Adult ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/epidemiology ; Coronavirus Infections/pathology ; Female ; Hospitalization/statistics & numerical data ; Humans ; Intubation, Intratracheal/statistics & numerical data ; Lung/diagnostic imaging ; Lung/pathology ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/pathology ; Predictive Value of Tests ; Prognosis ; Radiography, Thoracic ; Retrospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult
    Keywords covid19
    Language English
    Publishing date 2020-05-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.2020201754
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  5. Article ; Online: Spontaneous subcutaneous emphysema and pneumomediastinum in non-intubated patients with COVID-19.

    Manna, Sayan / Maron, Samuel Z / Cedillo, Mario A / Voutsinas, Nicholas / Toussie, Danielle / Finkelstein, Mark / Steinberger, Sharon / Chung, Michael / Bernheim, Adam / Eber, Corey / Gupta, Yogesh Sean / Concepcion, Jose / Libes, Richard / Jacobi, Adam

    Clinical imaging

    2020  Volume 67, Page(s) 207–213

    Abstract: Purpose: We describe the presenting characteristics and hospital course of 11 novel coronavirus (COVID-19) patients who developed spontaneous subcutaneous emphysema (SE) with or without pneumomediastinum (SPM) in the absence of prior mechanical ... ...

    Abstract Purpose: We describe the presenting characteristics and hospital course of 11 novel coronavirus (COVID-19) patients who developed spontaneous subcutaneous emphysema (SE) with or without pneumomediastinum (SPM) in the absence of prior mechanical ventilation.
    Materials and methods: A total of 11 non-intubated COVID-19 patients (8 male and 3 female, median age 61 years) developed SE and SPM between March 15 and April 30, 2020 at a multi-center urban health system in New York City. Demographics (age, gender, smoking status, comorbid conditions, and body-mass index), clinical variables (temperature, oxygen saturation, and symptoms), and laboratory values (white blood cell count, C-reactive protein, D-dimer, and peak interleukin-6) were collected. Chest radiography (CXR) and computed tomography (CT) were analyzed for SE, SPM, and pneumothorax by a board-certified cardiothoracic-fellowship trained radiologist.
    Results: Eleven non-intubated patients developed SE, 36% (4/11) of whom had SE on their initial CXR. Concomitant SPM was apparent in 91% (10/11) of patients, and 45% (5/11) also developed pneumothorax. Patients developed SE on average 13.3 days (SD: 6.3) following symptom onset. No patients reported a history of smoking. The most common comorbidities included hypertension (6/11), diabetes mellitus (5/11), asthma (3/11), dyslipidemia (3/11), and renal disease (2/11). Four (36%) patients expired during hospitalization.
    Conclusion: SE and SPM were observed in a cohort of 11 non-intubated COVID-19 patients without any known cause or history of invasive ventilation. Further investigation is required to elucidate the underlying mechanism in this patient population.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Betacoronavirus ; COVID-19 ; Comorbidity ; Coronavirus Infections/complications ; Coronavirus Infections/virology ; Female ; Fibrin Fibrinogen Degradation Products/metabolism ; Hospitalization ; Humans ; Male ; Mediastinal Emphysema/epidemiology ; Mediastinal Emphysema/etiology ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/virology ; Pneumothorax/epidemiology ; Pneumothorax/etiology ; Respiration, Artificial/adverse effects ; SARS-CoV-2 ; Subcutaneous Emphysema/epidemiology ; Subcutaneous Emphysema/etiology ; Tomography, X-Ray Computed/methods
    Chemical Substances Fibrin Fibrinogen Degradation Products ; fibrin fragment D
    Keywords covid19
    Language English
    Publishing date 2020-08-26
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1028123-x
    ISSN 1873-4499 ; 0899-7071
    ISSN (online) 1873-4499
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2020.08.013
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  6. Article ; Online: Coronary artery calcification in COVID-19 patients: an imaging biomarker for adverse clinical outcomes.

    Gupta, Yogesh Sean / Finkelstein, Mark / Manna, Sayan / Toussie, Danielle / Bernheim, Adam / Little, Brent P / Concepcion, Jose / Maron, Samuel Z / Jacobi, Adam / Chung, Michael / Kukar, Nina / Voutsinas, Nicholas / Cedillo, Mario A / Fernandes, Ajit / Eber, Corey / Fayad, Zahi A / Hota, Partha

    Clinical imaging

    2021  Volume 77, Page(s) 1–8

    Abstract: Background: Recent studies have demonstrated a complex interplay between comorbid cardiovascular disease, COVID-19 pathophysiology, and poor clinical outcomes. Coronary artery calcification (CAC) may therefore aid in risk stratification of COVID-19 ... ...

    Abstract Background: Recent studies have demonstrated a complex interplay between comorbid cardiovascular disease, COVID-19 pathophysiology, and poor clinical outcomes. Coronary artery calcification (CAC) may therefore aid in risk stratification of COVID-19 patients.
    Methods: Non-contrast chest CT studies on 180 COVID-19 patients ≥ age 21 admitted from March 1, 2020 to April 27, 2020 were retrospectively reviewed by two radiologists to determine CAC scores. Following feature selection, multivariable logistic regression was utilized to evaluate the relationship between CAC scores and patient outcomes.
    Results: The presence of any identified CAC was associated with intubation (AOR: 3.6, CI: 1.4-9.6) and mortality (AOR: 3.2, CI: 1.4-7.9). Severe CAC was independently associated with intubation (AOR: 4.0, CI: 1.3-13) and mortality (AOR: 5.1, CI: 1.9-15). A greater CAC score (UOR: 1.2, CI: 1.02-1.3) and number of vessels with calcium (UOR: 1.3, CI: 1.02-1.6) was associated with mortality. Visualized coronary stent or coronary artery bypass graft surgery (CABG) had no statistically significant association with intubation (AOR: 1.9, CI: 0.4-7.7) or death (AOR: 3.4, CI: 1.0-12).
    Conclusion: COVID-19 patients with any CAC were more likely to require intubation and die than those without CAC. Increasing CAC and number of affected arteries was associated with mortality. Severe CAC was associated with higher intubation risk. Prior CABG or stenting had no association with elevated intubation or death.
    MeSH term(s) Adult ; Biomarkers ; COVID-19 ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Vessels/diagnostic imaging ; Humans ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; SARS-CoV-2 ; Vascular Calcification/diagnostic imaging ; Vascular Calcification/epidemiology ; Young Adult
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-02-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1028123-x
    ISSN 1873-4499 ; 0899-7071
    ISSN (online) 1873-4499
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2021.02.016
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  7. Article: Spontaneous subcutaneous emphysema and pneumomediastinum in non-intubated patients with COVID-19

    Manna, Sayan / Maron, Samuel Z / Cedillo, Mario A / Voutsinas, Nicholas / Toussie, Danielle / Finkelstein, Mark / Steinberger, Sharon / Chung, Michael / Bernheim, Adam / Eber, Corey / Gupta, Yogesh Sean / Concepcion, Jose / Libes, Richard / Jacobi, Adam

    Clin Imaging

    Abstract: PURPOSE: We describe the presenting characteristics and hospital course of 11 novel coronavirus (COVID-19) patients who developed spontaneous subcutaneous emphysema (SE) with or without pneumomediastinum (SPM) in the absence of prior mechanical ... ...

    Abstract PURPOSE: We describe the presenting characteristics and hospital course of 11 novel coronavirus (COVID-19) patients who developed spontaneous subcutaneous emphysema (SE) with or without pneumomediastinum (SPM) in the absence of prior mechanical ventilation. MATERIALS AND METHODS: A total of 11 non-intubated COVID-19 patients (8 male and 3 female, median age 61 years) developed SE and SPM between March 15 and April 30, 2020 at a multi-center urban health system in New York City. Demographics (age, gender, smoking status, comorbid conditions, and body-mass index), clinical variables (temperature, oxygen saturation, and symptoms), and laboratory values (white blood cell count, C-reactive protein, D-dimer, and peak interleukin-6) were collected. Chest radiography (CXR) and computed tomography (CT) were analyzed for SE, SPM, and pneumothorax by a board-certified cardiothoracic-fellowship trained radiologist. RESULTS: Eleven non-intubated patients developed SE, 36% (4/11) of whom had SE on their initial CXR. Concomitant SPM was apparent in 91% (10/11) of patients, and 45% (5/11) also developed pneumothorax. Patients developed SE on average 13.3 days (SD: 6.3) following symptom onset. No patients reported a history of smoking. The most common comorbidities included hypertension (6/11), diabetes mellitus (5/11), asthma (3/11), dyslipidemia (3/11), and renal disease (2/11). Four (36%) patients expired during hospitalization. CONCLUSION: SE and SPM were observed in a cohort of 11 non-intubated COVID-19 patients without any known cause or history of invasive ventilation. Further investigation is required to elucidate the underlying mechanism in this patient population.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #733899
    Database COVID19

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  8. Article: Clinical and Chest Radiography Features Determine Patient Outcomes In Young and Middle Age Adults with COVID-19

    Toussie, Danielle / Voutsinas, Nicholas / Finkelstein, Mark / Cedillo, Mario A / Manna, Sayan / Maron, Samuel Z / Jacobi, Adam / Chung, Michael / Bernheim, Adam / Eber, Corey / Concepcion, Jose / Fayad, Zahi / Gupta, Yogesh Sean

    Radiology

    Abstract: Background Chest radiography (CXR) has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose The purpose of this study was to analyze the prognostic value of a CXR severity scoring system ... ...

    Abstract Background Chest radiography (CXR) has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose The purpose of this study was to analyze the prognostic value of a CXR severity scoring system for younger (non-elderly) patients with COVID-19 upon initial presentation to the emergency department (ED). Outcomes of interest included hospitalization, intubation, prolonged stay, sepsis, and death. Materials & Methods In this retrospective study, patients between the ages of 21 and 50 years who presented to EDs of an urban multicenter health system from March 10 - 26, 2020 with COVID-19 confirmation on real-time reverse transcriptase polymerase chain reaction (RT-PCR) were identified. Each patient's ED CXR was divided into 6 zones and examined for opacities by two cardiothoracic radiologists with scores collated into a total concordant lung zone severity score. Clinical and laboratory variables were collected. Multivariable logistic regression was utilized to evaluate the relationship between clinical parameters, CXR scores, and patient outcomes. Results The study included 338 patients: 210 males (62%), median age 39 [31-45]. After adjustment for demographics and co-morbidities, independent predictors of hospital admission (n=145, 43%) were CXR severity score ≥ 2 (OR: 6.2, 95% CI 3.5-11, p<0.001) and obesity (OR 2.4 (1.1-5.4) or morbid obesity. Of patients who were admitted, a CXR score ≥3 was an independent predictor of intubation (n=28) (OR: 4.7, 95% CI 1.8-13, p=0.002) as was hospital site. We found no significant difference in primary outcomes across race/ethnicity, those with a history of tobacco use, asthma or diabetes mellitus type II. Conclusion For patients aged 21-50 with COVID-19 presenting to the emergency department, a chest x-ray severity score was predictive of risk for hospital admission and intubation.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #32407255
    Database COVID19

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  9. Article: Clinical and Chest Radiography Features Determine Patient Outcomes in Young and Middle-aged Adults with COVID-19

    Toussie, Danielle / Voutsinas, Nicholas / Finkelstein, Mark / Cedillo, Mario A / Manna, Sayan / Maron, Samuel Z / Jacobi, Adam / Chung, Michael / Bernheim, Adam / Eber, Corey / Concepcion, Jose / Fayad, Zahi A / Gupta, Yogesh Sean

    Radiology

    Abstract: Background Chest radiography has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose To analyze the prognostic value of a chest radiograph severity scoring system for younger (nonelderly) ...

    Abstract Background Chest radiography has not been validated for its prognostic utility in evaluating patients with coronavirus disease 2019 (COVID-19). Purpose To analyze the prognostic value of a chest radiograph severity scoring system for younger (nonelderly) patients with COVID-19 at initial presentation to the emergency department (ED); outcomes of interest included hospitalization, intubation, prolonged stay, sepsis, and death. Materials and Methods In this retrospective study, patients between the ages of 21 and 50 years who presented to the ED of an urban multicenter health system from March 10 to March 26, 2020, with COVID-19 confirmation on real-time reverse transcriptase polymerase chain reaction were identified. Each patient's ED chest radiograph was divided into six zones and examined for opacities by two cardiothoracic radiologists, and scores were collated into a total concordant lung zone severity score. Clinical and laboratory variables were collected. Multivariable logistic regression was used to evaluate the relationship between clinical parameters, chest radiograph scores, and patient outcomes. Results The study included 338 patients: 210 men (62%), with median age of 39 years (interquartile range, 31-45 years). After adjustment for demographics and comorbidities, independent predictors of hospital admission (n = 145, 43%) were chest radiograph severity score of 2 or more (odds ratio, 6.2; 95% confidence interval [CI]: 3.5, 11; P < .001) and obesity (odds ratio, 2.4 [95% CI: 1.1, 5.4] or morbid obesity). Among patients who were admitted, a chest radiograph score of 3 or more was an independent predictor of intubation (n = 28) (odds ratio, 4.7; 95% CI: 1.8, 13; P = .002) as was hospital site. No significant difference was found in primary outcomes across race and ethnicity or those with a history of tobacco use, asthma, or diabetes mellitus type II. Conclusion For patients aged 21-50 years with coronavirus disease 2019 presenting to the emergency department, a chest radiograph severity score was predictive of risk for hospital admission and intubation. © RSNA, 2020 Online supplemental material is available for this article.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #817842
    Database COVID19

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  10. Article ; Online: Spontaneous subcutaneous emphysema and pneumomediastinum in non-intubated patients with COVID-19

    Manna, Sayan / Maron, Samuel Z. / Cedillo, Mario A. / Voutsinas, Nicholas / Toussie, Danielle / Finkelstein, Mark / Steinberger, Sharon / Chung, Michael / Bernheim, Adam / Eber, Corey / Gupta, Yogesh Sean / Concepcion, Jose / Libes, Richard / Jacobi, Adam

    Clinical Imaging

    2020  Volume 67, Page(s) 207–213

    Keywords Radiology Nuclear Medicine and imaging ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 1028123-x
    ISSN 0899-7071
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2020.08.013
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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