Publications by authors named "Claire McGroder"

9 Publications

  • Page 1 of 1

COVID-19-induced pulmonary sarcoid: A case report and review of the literature.

Clin Imaging 2022 Mar 13;83:152-158. Epub 2022 Jan 13.

Division of Cardiothoracic Imaging, Department of Radiology, Columbia University Irving Medical Center, New York, NY, United States of America.

Background: The COVID-19 pandemic has resulted in dramatic loss of life worldwide, but as the large number of acutely ill patients subsides, the emerging group of "COVID-19 long-haulers" present a clinical challenge. Studies have shown that many of these patients suffer long-term pulmonary disease related to residual fibrosis. Prior studies have shown that while many patients have non-specific findings of fibrotic-like changes, others develop specific patterns of interstitial lung disease.

Case Report: Here, we present the first case of a patient developing pulmonary sarcoidosis one year after critical illness from COVID-19. He developed numerous non-necrotizing and well-formed granulomas in mediastinal lymph nodes and pulmonary nodules, compatible radiographically and pathologically with sarcoid.

Conclusions: While the pathophysiology of sarcoid is incompletely understood, inflammation is mediated through the dysregulation of a number of different cytokines (IFNγ, IL-2, IL-12, IL-17, IL-22). This case provides valuable clues for better understanding of the shared pathophysiology of cytokine dysregulation seen in COVID-19 and other interstitial lung diseases such as sarcoidosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clinimag.2021.12.021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755635PMC
March 2022

Clinico-histopathologic and single-nuclei RNA-sequencing insights into cardiac injury and microthrombi in critical COVID-19.

JCI Insight 2022 01 25;7(2). Epub 2022 Jan 25.

Division of Cardiology, Columbia University Irving Medical Center (CUIMC), New York, New York, USA.

Acute cardiac injury is prevalent in critical COVID-19 and associated with increased mortality. Its etiology remains debated, as initially presumed causes - myocarditis and cardiac necrosis - have proved uncommon. To elucidate the pathophysiology of COVID-19-associated cardiac injury, we conducted a prospective study of the first 69 consecutive COVID-19 decedents at CUIMC in New York City. Of 6 acute cardiac histopathologic features, presence of microthrombi was the most commonly detected among our cohort. We tested associations of cardiac microthrombi with biomarkers of inflammation, cardiac injury, and fibrinolysis and with in-hospital antiplatelet therapy, therapeutic anticoagulation, and corticosteroid treatment, while adjusting for multiple clinical factors, including COVID-19 therapies. Higher peak erythrocyte sedimentation rate and C-reactive protein were independently associated with increased odds of microthrombi, supporting an immunothrombotic etiology. Using single-nuclei RNA-sequencing analysis on 3 patients with and 4 patients without cardiac microthrombi, we discovered an enrichment of prothrombotic/antifibrinolytic, extracellular matrix remodeling, and immune-potentiating signaling among cardiac fibroblasts in microthrombi-positive, relative to microthrombi-negative, COVID-19 hearts. Non-COVID-19, nonfailing hearts were used as reference controls. Our study identifies a specific transcriptomic signature in cardiac fibroblasts as a salient feature of microthrombi-positive COVID-19 hearts. Our findings warrant further mechanistic study as cardiac fibroblasts may represent a potential therapeutic target for COVID-19-associated cardiac microthrombi.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1172/jci.insight.154633DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8855793PMC
January 2022

Molecular Pathophysiology of Cardiac Injury and Cardiac Microthrombi in Fatal COVID-19: Insights from Clinico-histopathologic and Single Nuclei RNA Sequencing Analyses.

bioRxiv 2021 Jul 27. Epub 2021 Jul 27.

Cardiac injury is associated with critical COVID-19, yet its etiology remains debated. To elucidate the pathogenic mechanisms of COVID-19-associated cardiac injury, we conducted a single-center prospective cohort study of 69 COVID-19 decedents. Of six cardiac histopathologic features, microthrombi was the most commonly detected (n=48, 70%). We tested associations of cardiac microthrombi with biomarkers of inflammation, cardiac injury, and fibrinolysis and with in-hospital antiplatelet therapy, therapeutic anticoagulation, and corticosteroid treatment, while adjusting for multiple clinical factors, including COVID-19 therapies. Higher peak ESR and CRP during hospitalization were independently associated with higher odds of microthrombi. Using single nuclei RNA-sequence analysis, we discovered an enrichment of pro-thrombotic/anti-fibrinolytic, extracellular matrix remodeling, and immune-potentiating signaling amongst cardiac fibroblasts in microthrombi-positive COVID-19 hearts relative to microthrombi-negative COVID-19. Non-COVID-19 non-failing hearts were used as reference controls. Our cumulative findings identify the specific transcriptomic changes in cardiac fibroblasts as salient features of COVID-19-associated cardiac microthrombi.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1101/2021.07.27.453843DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328056PMC
July 2021

Pulmonary fibrosis 4 months after COVID-19 is associated with severity of illness and blood leucocyte telomere length.

Thorax 2021 12 29;76(12):1242-1245. Epub 2021 Apr 29.

Medicine/PACC, Columbia University Irving Medical Center, New York, New York, USA

The risk factors for development of fibrotic-like radiographic abnormalities after severe COVID-19 are incompletely described and the extent to which CT findings correlate with symptoms and physical function after hospitalisation remains unclear. At 4 months after hospitalisation, fibrotic-like patterns were more common in those who underwent mechanical ventilation (72%) than in those who did not (20%). We demonstrate that severity of initial illness, duration of mechanical ventilation, lactate dehydrogenase on admission and leucocyte telomere length are independent risk factors for fibrotic-like radiographic abnormalities. These fibrotic-like changes correlate with lung function, cough and measures of frailty, but not with dyspnoea.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/thoraxjnl-2021-217031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103561PMC
December 2021

Post-acute COVID-19 syndrome.

Nat Med 2021 04 22;27(4):601-615. Epub 2021 Mar 22.

Department of Neurology, Vagelos College of Physicians and Surgeons, New York-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41591-021-01283-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8893149PMC
April 2021

Circulating adhesion molecules and subclinical interstitial lung disease: the Multi-Ethnic Study of Atherosclerosis.

Eur Respir J 2019 09 30;54(3). Epub 2019 Sep 30.

Dept of Medicine, Columbia University Medical Center, New York, NY, USA

Adhesion molecules may contribute to the development of interstitial lung disease (ILD) and have been proposed as prognostic biomarkers in idiopathic pulmonary fibrosis. Our objective was to determine whether the circulating adhesion molecules soluble intracellular adhesion molecule (sICAM)-1, soluble vascular cell adhesion molecule (sVCAM)-1 and P-selectin are associated with subclinical ILD in community-dwelling adults.The Multi-Ethnic Study of Atherosclerosis enrolled males and females aged 45-84 years from six communities in the United States in 2000-2002. High attenuation areas were defined as the percentage of imaged lung volume with attenuation -600--250 HU on cardiac computed tomography (CT). Interstitial lung abnormalities were visually assessed on full-lung CT. Spirometry was performed on a subset of individuals. ILD hospitalisations and deaths were adjudicated.In fully adjusted analyses, higher levels of sICAM-1, sVCAM-1 and P-selectin were associated with greater high attenuation areas (2.94%, 95% CI 1.80-4.07%; 1.24%, 95% CI 0.14-2.35%; and 1.58%, 95% CI 0.92-2.23%, respectively), and greater rate of ILD hospitalisations (HR 1.36, 95% CI 1.03-1.80; 1.40, 95% CI 1.07-1.85; and 2.03, 95% CI 1.16-3.5, respectively). sICAM-1 was associated with greater prevalence of interstitial lung abnormalities (OR 1.39, 95% CI 1.13-1.71). sICAM-1 and P-selectin were associated with lower forced vital capacity (44 mL, 95% CI 12-76 mL and 29 mL, 95% CI 8-49 mL, respectively). sVCAM-1 and P-selectin were associated with increased risk of ILD death (HR 2.15, 95% CI 1.26-3.64 and 3.61, 95% CI 1.54-8.46, respectively).Higher levels of circulating sICAM-1, sVCAM-1 and P-selectin are independently associated with CT and spirometric measures of subclinical ILD, and increased rate of adjudicated ILD events among community-dwelling adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1183/13993003.00295-2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003619PMC
September 2019

Accuracy of palpation-directed intra-articular glenohumeral injection confirmed by magnetic resonance arthrography.

Arthroscopy 2015 Feb 11;31(2):205-8. Epub 2014 Oct 11.

Stetson Powell Orthopaedics and Sports Medicine, Burbank, U.S.A.. Electronic address:

Purpose: The aim of this study was to determine the accuracy of anatomic palpation-directed injections in the office setting.

Methods: Two hundred twenty-six shoulders in 208 patients were studied using a 0.2-Tesla extremity scanner after the injection of gadolinium-diethylene triamine pentaacetic acid-saline. All patients were injected in a sterile fashion by a single board-certified shoulder surgeon using an anterior approach by palpating the rotator interval anterior to the acromioclavicular joint and angling the needle 45° lateral and 45° caudad. All injections, successful or otherwise, were single injections. Magnetic resonance (MR) arthrograms were retrospectively read by 2 musculoskeletal fellowship-trained, board certified radiologists to determine whether the injection was in the glenohumeral joint.

Results: Two hundred one of the 226 injections were successful (88.9%). Of the 25 unsuccessful injections, the contrast material extravasated out of the capsule in 5 cases and into the subscapularis tendon in 10 cases. The contrast material was injected into the subacromial space in 9 cases, into the rotator interval fat in 9 cases, and into extracapsular tissue in 6 cases. There was insufficient volume of contrast material in 10 cases. The accuracy rate was 88.9%. There were no complications.

Conclusions: The palpation-directed rotator interval anterior approach technique for intra-articular glenohumeral MR arthrogram injections performed by a single surgeon was 88.9% accurate.

Level Of Evidence: Level IV, therapeutic case series.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.arthro.2014.08.013DOI Listing
February 2015

Analysis of Low-Field MRI Scanners for Evaluation of Shoulder Pathology Based on Arthroscopy.

Orthop J Sports Med 2014 Jul 2;2(7):2325967114540407. Epub 2014 Jul 2.

Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA.

Background: Many studies have compared the diagnostic capabilities of low-field magnetic resonance imaging (MRI) scanners to high-field MRI scanners; however, few have evaluated the low-field MRI diagnoses compared with intraoperative findings.

Purpose: To determine the accuracy and sensitivity of low-field MRI scanners in diagnosing lesions of the rotator cuff and glenoid labrum.

Study Design: Cohort study (diagnosis); Level of evidence, 3.

Methods: Over a 2-year period, MRI examinations without intra-articular contrast were performed on 79 patients for shoulder pathologies using an in-office 0.2-T extremity scanner. The MRI examinations were read by board-certified, musculoskeletal fellowship-trained radiologists. All patients underwent shoulder arthroscopy performed by a single sports fellowship-trained orthopaedic surgeon within a mean time of 56 days (range, 8-188 days) after the MRI examination. The mean patient age was 54 years (range, 18-81 years). Operative notes from the shoulder arthroscopies were then retrospectively reviewed by a single blinded observer, and the intraoperative findings were compared with the MRI reports.

Results: For partial-thickness rotator cuff tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 85%, 89%, 79%, and 92%, respectively. For full-thickness rotator cuff tears, the respective values were 97%, 100%, 100%, and 98%. For anterior labral lesions, the values were 86%, 99%, 86%, and 99%, and for superior labral anterior-posterior (SLAP) lesions, the values were 20%, 100%, 100%, and 79%, respectively.

Conclusion: Low-field MRI is an accurate tool for evaluation of partial- and full-thickness rotator cuff tears; however, it is not effective in diagnosing SLAP lesions. More information is needed to properly assess its ability to diagnose anterior and posterior labral lesions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2325967114540407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4588525PMC
July 2014

Analysis of Low-Field Magnetic Resonance Imaging Scanners for Evaluation of Knee Pathology Based on Arthroscopy.

Orthop J Sports Med 2013 Dec 5;1(7):2325967113513423. Epub 2013 Dec 5.

Stetson Powell Orthopaedics and Sports Medicine, Burbank, California, USA.

Background: In recent years, few studies have evaluated low-field magnetic resonance imaging (MRI) diagnoses compared with intraoperative findings of the knee.

Purpose: To determine the accuracy and sensitivity of low-field MRI scanners in diagnosing pathology of the menisci, cruciate ligaments, and osteochondral surfaces.

Study Design: Cohort study (diagnosis); Level of evidence, 2.

Methods: MRI examinations without intra-articular contrast were performed on 379 patients for knee pathologies over a 4-year period. The MRI examinations were done using a 0.2-tesla scanner utilizing a dedicated knee coil and read by 1 of 3 board-certified, musculoskeletal fellowship-trained radiologists. Within a mean time of 50 days after MRI, all patients underwent knee arthroscopy performed by 1 of 2 sports fellowship-trained orthopaedic surgeons. Operative notes from the knee arthroscopies were then reviewed by a single independent observer, and the intraoperative findings were compared with the MRI reports.

Results: For medial meniscus tears, the sensitivity, specificity, positive predictive value, and negative predictive value were 83%, 81%, 89%, and 71%, respectively. For lateral meniscus tears, the values were 51%, 93%, 84%, and 73%, respectively. For anterior cruciate ligament (ACL) tears, the values were 85%, 94%, 69%, and 97%, respectively. For osteochondral lesions, the values were 8%, 99%, 29%, and 94%, respectively. For posterior cruciate ligament (PCL) tears, the specificity and negative predictive value were 99% and 100%, respectively.

Conclusion: Low-field MRI was an accurate tool for evaluation of medial meniscus and ACL tears. However, within the study population, it is not as effective in diagnosing lateral meniscus tears and showed a poor ability to detect osteochondral lesions. More information is needed to properly assess its ability to diagnose PCL tears.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2325967113513423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555514PMC
December 2013
-->