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Incidental CT findings in the lungs in COVID-19 patients presenting with abdominal pain [Case Report]

Voutsinas, Nicholas; Toussie, Danielle; Jacobi, Adam; Bernheim, Adam; Chung, Michael
As the 2019 novel coronavirus disease (COVID-19) continues to spread, some patients are presenting with abdominal symptoms without respiratory complaints. Our case series documents four patients who presented with abdominal symptoms whose abdominopelvic CT revealed incidental pulmonary parenchymal findings in the imaged lung bases and were subsequently confirmed positive for COVID-19 via laboratory testing. It remains to be seen whether these patients will eventually develop respiratory symptoms. While it is possible that the patients' abdominal complaints are coincidental with CT findings, it is interesting that patients can have such extensive incidental disease in the lungs on CT without respiratory symptoms.
PMCID:7255745
PMID: 32492557
ISSN: 1873-4499
CID: 4859032

Spontaneous subcutaneous emphysema and pneumomediastinum in non-intubated patients with COVID-19 [Case Report]

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
PURPOSE/OBJECTIVE: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/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/CONCLUSIONS: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.
PMCID:7448957
PMID: 32871424
ISSN: 1873-4499
CID: 4859052

Leveraging IR's Adaptability During COVID-19: A Multicenter Single Urban Health System Experience [Letter]

Manna, Sayan; Voutsinas, Nicholas; Maron, Samuel Z; Cedillo, Mario A; Toussie, Danielle; Nowakowski, F Scott; Lookstein, Robert A; Fischman, Aaron
PMCID:7196407
PMID: 32513549
ISSN: 1535-7732
CID: 4859042

COVID-19: A Multimodality Review of Radiologic Techniques, Clinical Utility, and Imaging Features

Manna, Sayan; Wruble, Jill; Maron, Samuel Z; Toussie, Danielle; Voutsinas, Nicholas; Finkelstein, Mark; Cedillo, Mario A; Diamond, Jamie; Eber, Corey; Jacobi, Adam; Chung, Michael; Bernheim, Adam
In this article we will review the imaging features of coronavirus disease 2019 (COVID-19) across multiple modalities, including radiography, CT, MRI, PET/CT, and US. Given that COVID-19 primarily affects the lung parenchyma by causing pneumonia, our directive is to focus on thoracic findings associated with COVID-19. We aim to enhance radiologists' understanding of this disease to help guide diagnosis and management. Supplemental material is available for this article. © RSNA, 2020.
PMCID:7325394
PMID: 33778588
ISSN: 2638-6135
CID: 4859102

The right upper lobe bronchus angle: A tool for differentiating fibrotic and non-fibrotic sarcoidosis

Salvatore, Mary; Toussie, Danielle; Pavlishyn, Nadiya; Yankelevitz, David; O'Connor, Timothy; Henschke, Claudia; Padilla, Maria
Purpose/UNASSIGNED:To evaluate the Right Upper Lobe Bronchus Angle (RUL-BA) on chest CT in patients with Stage 4 sarcoidosis and compare to others with non-fibrotic sarcoidosis. Methods/UNASSIGNED:IRB approval was obtained for review of all chest CT scans performed from January 2015 through December 2017 that contained the word sarcoidosis using the computer program Montage. The most recent CT scans of 633 people were reviewed. The patients' age and sex at the time of their most recent CT scan were recorded. The radiographic diagnosis and the Right Upper Lobe Bronchus Angle (RUL-BA) were determined by a chest radiologist with 20 years of experience. Results/UNASSIGNED:The RUL-BA increased with Stage 4 sarcoidosis, measuring on average 104 degrees, compared to the average angle of 88 degrees for those without fibrotic sarcoid. More often men's CT scans exhibited the earlier stages of sarcoidosis, and a higher number of women's scans showed fibrotic sarcoidosis. As would be expected, scans with advanced disease were typically from older patients; however, there was no correlation between age and degree of fibrosis as measured by increasing RUL-BA. Conclusion/UNASSIGNED:.
PMCID:7569551
PMID: 33093775
ISSN: 2532-179x
CID: 4859072