BACKGROUND:Authors have noticed an increase in lung apex abnormalities on CT angiography (CTA) of the head and neck performed for stroke workup during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVE:To evaluate the incidence of these CTA findings and their relation to COVID-19 infection. METHODS:In this retrospective multicenter institutional review board-approved study, assessment was made of CTA findings of code patients who had a stroke between March 16 and April 5, 2020 at six hospitals across New York City. Demographic data, comorbidities, COVID-19 status, and neurological findings were collected. Assessment of COVID-19 related lung findings on CTA was made blinded to COVID-19 status. Incidence rates of COVID-19 related apical findings were assessed in all code patients who had a stroke and in patients with a stroke confirmed by imaging. RESULTS:The cohort consisted of a total of 118 patients with mean±SD age of 64.9±15.7 years and 57.6% (68/118) were male. Among all code patients who had a stroke, 28% (33/118) had COVID-19 related lung findings. RT-PCR was positive for COVID-19 in 93.9% (31/33) of these patients with apical CTA findings.Among patients who had a stroke confirmed by imaging, 37.5% (18/48) had COVID-19 related apical findings. RT-PCR was positive for COVID-19 in all (18/18) of these patients with apical findings. CONCLUSION:The incidence of COVID-19 related lung findings in stroke CTA scans was 28% in all code patients who had a stroke and 37.5% in patients with a stroke confirmed by imaging. Stroke teams should closely assess the lung apices during this COVID-19 pandemic as CTA findings may be the first indicator of COVID-19 infection.

译文

背景:作者注意到在2019年冠状病毒病(COVID-19)大流行期间,进行中风检查的头部和颈部的CT血管造影(CTA)肺尖异常增加。
目的:评估这些CTA发现的发生率及其与COVID-19感染的关系。
方法:在这项回顾性多中心机构审查委员会批准的研究中,评估了2020年3月16日至4月5日在纽约市六家医院中风的规范患者的CTA检查结果。收集人口统计学数据,合并症,COVID-19状况和神经系统检查结果。对CTA上COVID-19相关的肺部发现的评估不了解COVID-19的状态。在所有中风的代码患者和经影像学证实为中风的患者中,评估了与COVID-19相关的根尖发现的发生率。
结果:该队列共有118例患者,平均±SD年龄为64.9±15.7岁,男性为57.6%(68/118)。在所有中风的规范患者中,有28%(33/118)患有COVID-19相关的肺部发现。 RT-PCR在93.9%(31/33)有心尖CTA的患者中COVID-19阳性。在影像学确诊的中风患者中,有37.5%(18/48)的患者具有COVID-19相关的心尖发现。所有这些(18/18)具有根尖发现的患者,RT-PCR的COVID-19均为阳性。
结论:在所有中风的规范患者中,卒中CTA扫描中COVID-19相关肺部发现的发生率为28%,经影像学证实为中风的患者为37.5%。脑卒中小组应在这种COVID-19大流行期间密切评估肺尖,因为CTA检查结果可能是COVID-19感染的首个指标。

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