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COVID-19 related neuroimaging findings: A signal of thromboembolic complications and a strong prognostic marker of poor patient outcome
Journal of the Neurological Sciences ( IF 3.6 ) Pub Date : 2020-07-01 , DOI: 10.1016/j.jns.2020.116923
Rajan Jain 1 , Matthew Young 2 , Siddhant Dogra 2 , Helena Kennedy 2 , Vinh Nguyen 2 , Simon Jones 3 , Seda Bilaloglu 3 , Katherine Hochman 4 , Eytan Raz 2 , Steven Galetta 5 , Leora Horwtiz 4
Affiliation  

Abstract Objective To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. Methods 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. Results 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). Conclusions 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.

中文翻译:

COVID-19 相关神经影像学发现:血栓栓塞并发症的信号和患者预后不良的强预后标志物

摘要 目的调查纽约市 COVID-19 住院患者中神经影像学检查结果的发生率和范围及其对预后的作用。方法 这是一项回顾性队列研究,对 2020 年 3 月 1 日至 2020 年 4 月 13 日期间在纽约市主要医疗保健系统(三家医院)收治的 3218 例 COVID-19 确诊患者进行了临床数据提取,特别是从电子病历中提取的临床数据。从影像报告中提取所有神经系统症状的数据。四位神经放射科医生评估了所有神经影像学研究,以发现与 COVID-19 相关的急性神经影像学结果。结果 14.1% 的 COVID-19 入院患者进行了神经影像学检查,这仅占总影像学研究的 5.5%。急性中风是神经影像学最常见的发现,见于 92。5% 的患者神经影像学检查呈阳性,1.1% 的住院 COVID-19 患者出现。与没有神经影像学检查的 COVID-19 患者相比,急性大面积缺血性和出血性卒中患者在调整年龄、BMI 和高血压后的死亡风险要高得多。(LR 的几率比 6.02;CRR 的危险比 2.28)。结论我们的研究表明,急性卒中是住院 COVID-19 患者中最常见的神经影像学发现。检测到急性中风是预后不良的一个强有力的预后标志。我们的研究还强调了一个事实,由于多种后勤限制,在这些患者中神经影像学的使用有限。与那些没有神经影像学检查的 COVID-19 患者相比,BMI 和高血压。(LR 的几率比 6.02;CRR 的危险比 2.28)。结论我们的研究表明,急性卒中是住院 COVID-19 患者中最常见的神经影像学发现。检测到急性中风是预后不良的一个强有力的预后标志。我们的研究还强调了一个事实,由于多种后勤限制,在这些患者中神经影像学的使用有限。与那些没有神经影像学检查的 COVID-19 患者相比,BMI 和高血压。(LR 的几率比 6.02;CRR 的危险比 2.28)。结论我们的研究表明,急性卒中是住院 COVID-19 患者中最常见的神经影像学发现。检测到急性中风是预后不良的一个强有力的预后标志。我们的研究还强调了一个事实,由于多种后勤限制,在这些患者中神经影像学的使用有限。
更新日期:2020-07-01
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