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<meta name="DC.Title" content="COVID-19 Stroke Apical Lung Examination Study: A Diagnostic and Prognostic Imaging Biomarker in Suspected Acute Stroke" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6832" />
<meta name="DC.Date" content="2021-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2021 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Diagnosis of coronavirus disease 2019 (COVID-19) relies on clinical features and reverse-transcriptase polymerase chain reaction testing, but the sensitivity is limited. Carotid CTA is a routine acute stroke investigation and includes the lung apices. We evaluated CTA as a potential COVID-19 diagnostic imaging biomarker.

MATERIALS AND METHODS: This was a multicenter, retrospective study ( n  = 225) including CTAs of patients with suspected acute stroke from 3 hyperacute stroke units (March-April 2020). We evaluated the reliability and accuracy of candidate diagnostic imaging biomarkers. Demographics, clinical features, and risk factors for COVID-19 and stroke were analyzed using univariate and multivariate statistics.

RESULTS: Apical ground-glass opacification was present in 22.2% (50/225) of patients. Ground-glass opacification had high interrater reliability (Fleiss κ = 0.81; 95% CI, 0.68–0.95) and, compared with reverse-transcriptase polymerase chain reaction, had good diagnostic performance (sensitivity, 75% [95% CI, 56–87]; specificity, 81% [95% CI, 71–88]; OR = 11.65 [95% CI, 4.14–32.78]; P  &lt; .001) on multivariate analysis. In contrast, all other contemporaneous demographic, clinical, and imaging features available at CTA were not diagnostic for COVID-19. The presence of apical ground-glass opacification was an independent predictor of increased 30-day mortality (18.0% versus 5.7%, P  = .017; hazard ratio = 3.51; 95% CI, 1.42–8.66; P  = .006).

CONCLUSIONS: We identified a simple, reliable, and accurate COVID-19 diagnostic and prognostic imaging biomarker obtained from CTA lung apices: the presence or absence of ground-glass opacification. Our findings have important implications in the management of patients presenting with suspected stroke through early identification of COVID-19 and the subsequent limitation of disease transmission.

BSTI
:   British Society of Thoracic Imaging
COVID-19
:   coronavirus disease 2019
GGO
:   ground-glass opacification
IRR
:   interrater reliability
RT-PCR
:   reverse-transcriptase polymerase chain reaction
SARS-CoV-2
:   Severe Acute Respiratory Syndrome coronavirus 2" />
<meta name="DC.Contributor" content="J. Siddiqui" />
<meta name="DC.Contributor" content="F. Bala" />
<meta name="DC.Contributor" content="S. Sciacca" />
<meta name="DC.Contributor" content="A.M. Falzon" />
<meta name="DC.Contributor" content="M. Benger" />
<meta name="DC.Contributor" content="S.A. Matloob" />
<meta name="DC.Contributor" content="F.N.A.C. Miller" />
<meta name="DC.Contributor" content="R.J. Simister" />
<meta name="DC.Contributor" content="I. Chatterjee" />
<meta name="DC.Contributor" content="L.K. Sztriha" />
<meta name="DC.Contributor" content="I. Davagnanam" />
<meta name="DC.Contributor" content="T.C. Booth" />
<meta name="article:published_time" content="2021-01-01" />
<meta name="article:section" content="Extracranial Vascular" />
<meta name="citation_title" content="COVID-19 Stroke Apical Lung Examination Study: A Diagnostic and Prognostic Imaging Biomarker in Suspected Acute Stroke" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Diagnosis of coronavirus disease 2019 (COVID-19) relies on clinical features and reverse-transcriptase polymerase chain reaction testing, but the sensitivity is limited. Carotid CTA is a routine acute stroke investigation and includes the lung apices. We evaluated CTA as a potential COVID-19 diagnostic imaging biomarker.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;This was a multicenter, retrospective study (&lt;i&gt;n&lt;/i&gt; = 225) including CTAs of patients with suspected acute stroke from 3 hyperacute stroke units (March-April 2020). We evaluated the reliability and accuracy of candidate diagnostic imaging biomarkers. Demographics, clinical features, and risk factors for COVID-19 and stroke were analyzed using univariate and multivariate statistics.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Apical ground-glass opacification was present in 22.2% (50/225) of patients. Ground-glass opacification had high interrater reliability (Fleiss κ = 0.81; 95% CI, 0.68–0.95) and, compared with reverse-transcriptase polymerase chain reaction, had good diagnostic performance (sensitivity, 75% [95% CI, 56–87]; specificity, 81% [95% CI, 71–88]; OR = 11.65 [95% CI, 4.14–32.78]; &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) on multivariate analysis. In contrast, all other contemporaneous demographic, clinical, and imaging features available at CTA were not diagnostic for COVID-19. The presence of apical ground-glass opacification was an independent predictor of increased 30-day mortality (18.0% versus 5.7%, &lt;i&gt;P &lt;/i&gt;= .017; hazard ratio = 3.51; 95% CI, 1.42–8.66; &lt;i&gt;P &lt;/i&gt;= .006).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;We identified a simple, reliable, and accurate COVID-19 diagnostic and prognostic imaging biomarker obtained from CTA lung apices: the presence or absence of ground-glass opacification. Our findings have important implications in the management of patients presenting with suspected stroke through early identification of COVID-19 and the subsequent limitation of disease transmission.&lt;/p&gt;" />
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<meta name="twitter:title" content="COVID-19 Stroke Apical Lung Examination Study: A Diagnostic and Prognostic Imaging Biomarker in Suspected Acute Stroke" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Diagnosis of coronavirus disease 2019 (COVID-19) relies on clinical features and reverse-transcriptase polymerase chain reaction testing, but the sensitivity is limited. Carotid CTA is a routine acute stroke investigation and includes the lung apices. We evaluated CTA as a potential COVID-19 diagnostic imaging biomarker.

MATERIALS AND METHODS: This was a multicenter, retrospective study ( n  = 225) including CTAs of patients with suspected acute stroke from 3 hyperacute stroke units (March-April 2020). We evaluated the reliability and accuracy of candidate diagnostic imaging biomarkers. Demographics, clinical features, and risk factors for COVID-19 and stroke were analyzed using univariate and multivariate statistics.

RESULTS: Apical ground-glass opacification was present in 22.2% (50/225) of patients. Ground-glass opacification had high interrater reliability (Fleiss κ = 0.81; 95% CI, 0.68–0.95) and, compared with reverse-transcriptase polymerase chain reaction, had good diagnostic performance (sensitivity, 75% [95% CI, 56–87]; specificity, 81% [95% CI, 71–88]; OR = 11.65 [95% CI, 4.14–32.78]; P  &lt; .001) on multivariate analysis. In contrast, all other contemporaneous demographic, clinical, and imaging features available at CTA were not diagnostic for COVID-19. The presence of apical ground-glass opacification was an independent predictor of increased 30-day mortality (18.0% versus 5.7%, P  = .017; hazard ratio = 3.51; 95% CI, 1.42–8.66; P  = .006).

CONCLUSIONS: We identified a simple, reliable, and accurate COVID-19 diagnostic and prognostic imaging biomarker obtained from CTA lung apices: the presence or absence of ground-glass opacification. Our findings have important implications in the management of patients presenting with suspected stroke through early identification of COVID-19 and the subsequent limitation of disease transmission.

BSTI
:   British Society of Thoracic Imaging
COVID-19
:   coronavirus disease 2019
GGO
:   ground-glass opacification
IRR
:   interrater reliability
RT-PCR
:   reverse-transcriptase polymerase chain reaction
SARS-CoV-2
:   Severe Acute Respiratory Syndrome coronavirus 2" />
<meta name="og-title" property="og:title" content="COVID-19 Stroke Apical Lung Examination Study: A Diagnostic and Prognostic Imaging Biomarker in Suspected Acute Stroke" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/42/1/138" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Diagnosis of coronavirus disease 2019 (COVID-19) relies on clinical features and reverse-transcriptase polymerase chain reaction testing, but the sensitivity is limited. Carotid CTA is a routine acute stroke investigation and includes the lung apices. We evaluated CTA as a potential COVID-19 diagnostic imaging biomarker.

MATERIALS AND METHODS: This was a multicenter, retrospective study ( n  = 225) including CTAs of patients with suspected acute stroke from 3 hyperacute stroke units (March-April 2020). We evaluated the reliability and accuracy of candidate diagnostic imaging biomarkers. Demographics, clinical features, and risk factors for COVID-19 and stroke were analyzed using univariate and multivariate statistics.

RESULTS: Apical ground-glass opacification was present in 22.2% (50/225) of patients. Ground-glass opacification had high interrater reliability (Fleiss κ = 0.81; 95% CI, 0.68–0.95) and, compared with reverse-transcriptase polymerase chain reaction, had good diagnostic performance (sensitivity, 75% [95% CI, 56–87]; specificity, 81% [95% CI, 71–88]; OR = 11.65 [95% CI, 4.14–32.78]; P  &lt; .001) on multivariate analysis. In contrast, all other contemporaneous demographic, clinical, and imaging features available at CTA were not diagnostic for COVID-19. The presence of apical ground-glass opacification was an independent predictor of increased 30-day mortality (18.0% versus 5.7%, P  = .017; hazard ratio = 3.51; 95% CI, 1.42–8.66; P  = .006).

CONCLUSIONS: We identified a simple, reliable, and accurate COVID-19 diagnostic and prognostic imaging biomarker obtained from CTA lung apices: the presence or absence of ground-glass opacification. Our findings have important implications in the management of patients presenting with suspected stroke through early identification of COVID-19 and the subsequent limitation of disease transmission.

BSTI
:   British Society of Thoracic Imaging
COVID-19
:   coronavirus disease 2019
GGO
:   ground-glass opacification
IRR
:   interrater reliability
RT-PCR
:   reverse-transcriptase polymerase chain reaction
SARS-CoV-2
:   Severe Acute Respiratory Syndrome coronavirus 2" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J. Siddiqui</span>, <span class="highwire-citation-author" data-delta="1">F. Bala</span>, <span class="highwire-citation-author" data-delta="2">S. Sciacca</span>, <span class="highwire-citation-author" data-delta="3">A.M. Falzon</span>, <span class="highwire-citation-author" data-delta="4">M. Benger</span>, <span class="highwire-citation-author" data-delta="5">S.A. Matloob</span>, <span class="highwire-citation-author" data-delta="6">F.N.A.C. Miller</span>, <span class="highwire-citation-author" data-delta="7">R.J. Simister</span>, <span class="highwire-citation-author" data-delta="8">I. Chatterjee</span>, <span class="highwire-citation-author" data-delta="9">L.K. Sztriha</span>, <span class="highwire-citation-author" data-delta="10">I. Davagnanam</span> and <span class="highwire-citation-author" data-delta="11">T.C. Booth</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2021,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">138-143; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6832 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-88223--6679720836" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J. Siddiqui </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroradiology (J.S., F.B., T.C.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BSiddiqui%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Siddiqui%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BSiddiqui%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4735-8339" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Siddiqui</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">F. Bala </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroradiology (J.S., F.B., T.C.B.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BBala%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bala%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.%2BBala%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6748-2081" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Bala</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">S. Sciacca </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Lysholm Department of Neuroradiology (S.S., A.M.F., I.D.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BSciacca%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sciacca%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BSciacca%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5263-0392" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Sciacca</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A.M. Falzon </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Lysholm Department of Neuroradiology (S.S., A.M.F., I.D.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.M.%2BFalzon%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Falzon%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.M.%2BFalzon%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2212-6635" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.M. Falzon</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M. Benger </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (M.B., L.K.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BBenger%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Benger%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BBenger%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3109-3188" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Benger</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">S.A. Matloob </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>e</span>Department of Neurosurgery (S.A.M.), National Hospital for Neurology and Neurosurgery, University College London Hospitals, National Health Service Foundation Trust, London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.A.%2BMatloob%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Matloob%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.A.%2BMatloob%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0823-9687" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.A. Matloob</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">F.N.A.C. Miller </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Radiology (F.N.A.C.M.), King’s College Hospital, National Health Service Foundation Trust, London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.N.A.C.%2BMiller%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Miller%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.N.A.C.%2BMiller%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6379-1757" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F.N.A.C. Miller</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">R.J. Simister </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Comprehensive Stroke Service (R.J.S., I.C.), University College London Hospitals, National Health Service Foundation Trust, London, UK</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Stroke Research Centre (R.J.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.J.%2BSimister%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Simister%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.J.%2BSimister%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-0578-6711" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.J. Simister</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">I. Chatterjee </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>Comprehensive Stroke Service (R.J.S., I.C.), University College London Hospitals, National Health Service Foundation Trust, London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=I.%2BChatterjee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chatterjee%20I&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AI.%2BChatterjee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9173-4821" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for I. Chatterjee</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">L.K. Sztriha </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurology (M.B., L.K.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.K.%2BSztriha%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Sztriha%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.K.%2BSztriha%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4639-3180" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L.K. 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Davagnanam </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Lysholm Department of Neuroradiology (S.S., A.M.F., I.D.)</div><div class='author-affiliation'><span class='nlm-sup'>h</span>Brain Repair and Rehabilitation Unit (I.D.), University College London Queen Square Institute of Neurology, London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=I.%2BDavagnanam%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Davagnanam%20I&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AI.%2BDavagnanam%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-0363-1911" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for I. Davagnanam</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">T.C. Booth </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Neuroradiology (J.S., F.B., T.C.B.)</div><div class='author-affiliation'><span class='nlm-sup'>i</span>School of Biomedical Engineering and Imaging Sciences (T.C.B.), King’s College London, Rayne Institute, St. Thomas’ Hospital, London, UK</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.C.%2BBooth%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Booth%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.C.%2BBooth%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-0984-3998" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T.C. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-web" id="cit-42.1.138.1"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">World Health Organization.</span> <span class="cit-article-title">Naming the coronavirus disease (COVID-19) and the virus that causes it</span>. <a href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it">https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it</a>. <span class="cit-date-in-citation">Accessed June 20, 2020</span></cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-web" id="cit-42.1.138.2"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">World Health Organization.</span> <span class="cit-article-title">WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020</span>. <a href="http://WHODirector-General'sopeningremarksatthemediabriefingonCOVID-19-11March2020">WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020</a>. <span class="cit-date-in-citation">Accessed June 20, 2020</span></cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-journal" id="cit-42.1.138.3" data-doi="10.1016/S0140-6736(20)30183-5"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Huang</span>  <span class="cit-name-given-names">C</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wang</span>  <span class="cit-name-given-names">Y</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Li</span>  <span class="cit-name-given-names">X</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China</span>. <abbr class="cit-jnl-abbrev">Lancet</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">395</span>:<span class="cit-fpage">497</span>–<span class="cit-lpage">506</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/S0140-6736(20)30183-5</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>31986264</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/S0140-6736(20)30183-5&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=31986264&amp;link_type=MED&amp;atom=%2Fajnr%2F42%2F1%2F138.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-journal" id="cit-42.1.138.4" data-doi="10.1001/jama.2020.4031"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Grasselli</span>  <span class="cit-name-given-names">G</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Pesenti</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Cecconi</span>  <span class="cit-name-given-names">M</span></span></li></ol><cite>. <span class="cit-article-title">Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response</span>. <abbr class="cit-jnl-abbrev">JAMA</abbr> <span class="cit-pub-date">2020</span> <span class="cit-month">Mar</span> <span class="cit-day">13</span>. 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Text</span></span></a></div></div></li><li><span class="ref-label">32.</span><a class="rev-xref-ref" href="#xref-ref-32-1" title="View reference 32. in text" id="ref-32">↵</a><div class="cit ref-cit ref-journal" id="cit-42.1.138.32" data-doi="10.1007/s10140-020-01822-0"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Applewhite</span>  <span class="cit-name-given-names">BP</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Buch</span>  <span class="cit-name-given-names">K</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Yoon</span>  <span class="cit-name-given-names">BC</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Lung apical findings in coronavirus disease (COVID-19) infection on neck and cervical spine CT</span>. <abbr class="cit-jnl-abbrev">Emegr Radiol</abbr> <span class="cit-pub-date">2020</span> Jul <span 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id="cit-42.1.138.33"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Public Health England.</span></span></li></ol><cite> <span class="cit-article-title">COVID-19: Guidance for the remobilisation of services within health and care settings: infection prevention and control recommendations</span>. <a href="https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/886668/COVID-19_Infection_prevention_and_control_guidance_complete.pdf">https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/886668/COVID-19_Infection_prevention_and_control_guidance_complete.pdf</a>. <span class="cit-date-in-citation">Accessed June 20, 2020</span></cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">34.</span><a class="rev-xref-ref" href="#xref-ref-34-1" title="View reference 34. in text" id="ref-34">↵</a><div class="cit ref-cit ref-journal" id="cit-42.1.138.34" data-doi="10.1136/bmj.m1391"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Sayburn</span>  <span class="cit-name-given-names">A</span></span></li></ol><cite>. <span class="cit-article-title">Covid-19: PHE upgrades PPE advice for all patient contacts with risk of infection</span>. <abbr class="cit-jnl-abbrev">Br Med J</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">369</span>:<span class="cit-fpage">m1391</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1136/bmj.m1391</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32245770</span></cite></div><div class="cit-extra"><a 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 42</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 1 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jan 2021 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Siddiqui</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Bala</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Sciacca</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Falzon</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Benger</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">S.A.</span> <span class="nlm-surname">Matloob</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">F.N.A.C.</span> <span class="nlm-surname">Miller</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">R.J.</span> <span class="nlm-surname">Simister</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Chatterjee</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">L.K.</span> <span class="nlm-surname">Sztriha</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Davagnanam</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">T.C.</span> <span class="nlm-surname">Booth</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">138-143; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6832 </span></div>
  
  
  
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      <div class="highwire-cite-title">COVID-19 Stroke Apical Lung Examination Study: A Diagnostic and Prognostic Imaging Biomarker in Suspected Acute Stroke</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Siddiqui</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Bala</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Sciacca</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">A.M.</span> <span class="nlm-surname">Falzon</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Benger</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">S.A.</span> <span class="nlm-surname">Matloob</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">F.N.A.C.</span> <span class="nlm-surname">Miller</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">R.J.</span> <span class="nlm-surname">Simister</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Chatterjee</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">L.K.</span> <span class="nlm-surname">Sztriha</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">I.</span> <span class="nlm-surname">Davagnanam</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">T.C.</span> <span class="nlm-surname">Booth</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2021, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">42 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">138-143; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6832 </span></div>
  
  
  
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