Cochrane COVID-19 Study Register
Kihira 2020

Incidental COVID-19 related lung apical findings on stroke CTA during the COVID-19 pandemic

  1. Study Type
  2. Observational
  1. Study Aim
  2. Diagnostic/Prognostic
  1. Study Design
  2. Case series/Case control/Cohort
  1. Intervention Assignment
  2. Not Applicable

Incidental COVID-19 related lung apical findings on stroke CTA during the COVID-19 pandemic

Kihira S, Schefflein J, Chung M, Mahmoudi K, Rigney B, Delman BN, Mocco J, Doshi A, Belani P
Journal article
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
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ