August 5, 2020 — The U.S.
This page contains medical information for clinicians on the 2019 Novel Coronavirus (COVID-19, also called 2019-nCoV, and now clinically SARS‐CoV‐2). This section includes articles that pertain to clinicians and cardiologists on the virus, new technologies being deployed to fight the virus and clinical information from various sources. Here are direct links for medical professionals to COVID-19 resources from the U.S. Food and Drug Administration (FDA), Centers for Disease Control (CDC) and the World Health Organization (WHO). Daily world-wide statistics on the coronavirus outbreak are available from the WHO Situations Reports. Here is the Centers for Medicare and Medicaid Services (CMS) frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory tests and other services related to the COVID-19.
Part of a CDC inforgraphic on MIS-C based on reports from U.S. cases March-May 2020. The full inforgraphic can be found at https://www.cdc.gov/coronavirus/2019-ncov/covid-data/infographic-mis-c.html
Left, a 3-D rendering of a heart from a cardiac CT exam. Right, a lung-CT exam showing the heart and ground glass lesions in the lungs of a COVID-19 patient. CT has become a front-line imaging modality in the COVID era because it offers both cardiac and lung information to help determine a patients disposition with chest pain, COVID-19 and COVID-caused myocarditis and pulmonary embolism.
Figure B — Top panel, neutrophils noted in collections within small vessels (blue arrow), plump endothelial cells (yellow arrowhead) and a single perivascular dying myocyte (blue arrowhead). Bottom panel, single myocyte undergoing degeneration (blue arrowhead) and plump endothelial cell (yellow arrowhead). Figure C — Electron microscopy, showing particles of SARS-CoV-2 virus present within a cardiac endothelial cell (blue arrowheads), but not present in neighboring cardiac myocyte (left side of image). Images from Circulation.
Cardiac MRI for four children with clinical diagnosis of acute myocarditis in the setting of COVID-19–related Kawasaki-like symptoms of MIS-C. The top panel demonstrates minimal pericardial effusion on cine images. The second panel demonstrates increased T2-STIR signal intensity with average ratios between myocardium and muscle > 2 in patient 2 (12-year-old male), patient 3 (11-year-old female) and patient 4 (6-year-old female). The third panel demonstrates abnormal native-T1 mapping, which was > 1,100 ms in patients 2, 3 and 4 and normal in patient 1 (8-year-old female). The bottom panel demonstrates absence of late gadolinium enhancement (LGE) in patients 2 and 3. Myocardial null times were recognized as too short in patient 4 but could not be repeated due to lack of further patient cooperation; however review of Look Locker images and additional sequences revealed no LGE. Image courtesy of RSNA.
The Linq II implantable cardiac monitor (ICM) system delivers improved device longevity compared to other ICMs and enhanced accuracy to correctly detect abnormal heart rhythms, simplifying the diagnosis and monitoring of patients. The new devices allows continuous cardiac monitoring for up to 4.5 years.
Thoracic findings in a 15-year-old girl with Multisystem Inflammatory Syndrome in Children (MIS-C). (a) Chest radiograph on admission shows mild perihilar bronchial wall cuffing. (b) Chest radiograph on the third day of admission demonstrates extensive airspace opacification with a mid and lower zone predominance. (c, d) Contrast-enhanced axial CT chest of the thorax at day 3 shows areas of ground-glass opacification (GGO) and dense airspace consolidation with air bronchograms. (c) This conformed to a mosaic pattern with a bronchocentric distribution to the GGO (white arrow, d) involving both central and peripheral lung parenchyma with pleural effusions (black small arrow, d). image courtesy of Radiological Society of North America