Setting Of COVID-19 Infection Research Articles

Racial, ethnic and sex disparity in acute heart failure patients with COVID-19: A nationwide analysis

BackgroundPatients with acute heart failure (AHF) exacerbation are susceptible to complications in the setting of COVID-19 infection. Data regarding the racial/ethnic and sex disparities in patients with AHF and COVID-19 remains limited. ObjectiveWe aim to evaluate the impact of race, ethnicity, and sex on the in-hospital outcomes of AHF with COVID-19 infection using the data from the National Inpatient Sample (NIS). MethodsWe extracted data from the NIS (2020) by using ICD-10-CM to identify all hospitalizations with a diagnosis of AHF and COVID-19 in the year 2020. The associations between sex, race/ethnicity, and outcomes were examined using a multivariable logistic regression model. ResultsWe identified a total of 158,530 weighted AHF hospitalizations with COVID-19 infection in 2020. The majority were White (63.9 %), 23.3 % were Black race, and 12.8 % were of Hispanic ethnicity, mostly males (n = 84,870 [53.5 %]). After adjustment, the odds of in-hospital mortality were lowest in White females (aOR 0.83, [0.78–0.98]) and highest in Hispanic males (aOR 1.27 [1.13–1.42]) compared with White males. Overall, the odds of cardiac arrest (aOR 1.54 [1.27–1.85]) and AKI (aOR 1.36 [1.26–1.47] were higher, while odds for procedural interventions such as PCI (aOR 0.23 [0.10–0.55]), and placement on a ventilator (aOR 0.85 [0.75–0.97]) were lower among Black males in comparison to White males. ConclusionMale sex was associated with a higher risk of in-hospital mortality in white and black racial groups, while no such association was noted in the Hispanic group. Hispanic males had the highest odds of death compared with White males.

Living in symbiosis with COVID: two delayed presentations of soft tissue infections in elderly patients with COVID-19 infection

Retroperitoneal and extensive breast abscesses in elderly patients are associated with a significant burden of comorbidities, insidious symptoms, and signs resulting in delayed diagnosis. We present two elderly COVID-19-positive patients with retroperitoneal and breast abscesses. Both patients underwent multiple procedures and , despite a protracted course, survived each two potentially lethal infections. A 72-year-old man presented to the emergency department (ED) with back pain. Labs showed a polymerase chain reaction (PCR)-positive COVID-19 test and leukocytosis. A computed tomography scan of the abdomen and pelvis (CTAP) showed a perirectal abscess spreading into the pelvis and retroperitoneum. The patient underwent an incision and drainage (I and D). Additional imaging found multiple collections with extension into the retroperitoneum. These were drained, and the patient was discharged after repeat imaging showed resolution. A 78-year-old female was admitted with swelling of the right breast. Labs showed a positive PCR COVID-19 test, and chest computed tomography (CT) showed a rim-enhancing collection extending from the right breast into the right pectoralis muscle. The patient was started on antibiotics and underwent an I and D of the right breast. She was discharged on post-operative day (POD) four on antibiotics. She was readmitted 32 days later with a left sided abscess overlying the left pectoralis and was successfully treated conservatively with a course of antibiotics. There are few studies on the formation of abscesses in the breast and retroperitoneum in the setting of COVID-19 infection. Thus, information on the topic can aid physicians in maintaining clinical suspicion of severe abscesses illness in elderly patients presenting with vague clinical symptoms or symptoms concerning soft-tissue infections in the setting of COVID-19 infections

Sinus venosus atrial septal defect presenting with platypnea-orthodeoxia syndrome in the setting of COVID-19 infection.

Platypnea-orthodeoxia syndrome is characterised by hypoxemia and dyspnoea while upright that resolves when supine, typically associated with an interatrial communication. We present a case of platypnea-orthodeoxia syndrome associated with a sinus venosus atrial septal defect in a patient with multiple possible aetiologies of hypoxemia, including COVID-19 infection. Cardiac catheterisation with provocative maneuvers confirmed the diagnosis and symptoms resolved following defect closure. We suggest that in patients with platypnea-orthodeoxia syndrome, it is useful to obtain haemodynamic data while supine and upright.

Epicardial ablation of an endomyocardial ventricular tachycardia in the setting of Covid-19 infection

Epicardial ablation of an endomyocardial ventricular tachycardia in the setting of Covid-19 infection

A novel pathophysiology of gestational gigantomastia in the setting of Covid-19 infection

A novel pathophysiology of gestational gigantomastia in the setting of Covid-19 infection

Successful Treatment of Kidney Transplant Rejection in the Setting of COVID-19 Infection

Successful Treatment of Kidney Transplant Rejection in the Setting of COVID-19 Infection

FRI468 The Needle And The Crown, Who Is The Culprit? A Case Of Transient Hyperthyroidism In The Setting Of COVID-19 Infection And Recent Thyroid Biopsy

Abstract Disclosure: D. Caesario: None. K.L. Hermayer: None. Introduction: Transient hyperthyroidism (TH) is most commonly associated with thyroiditis, such as subacute thyroiditis (SAT). However, TH has also been reported as a complication of thyroid fine needle aspiration biopsy (FNAB), called post-aspiration thyrotoxicosis (PAT). We report a case of TH in the setting of COVID-19 infection and recent thyroid FNAB. Case Report: A 52-year-old male with history of type 1 DM was evaluated for neck enlargement over the past year. Examination was remarkable for enlarged, nontender thyroid. Thyroid function tests were normal. Thyroid US revealed a 7 cm solid mass with calcifications on the right lobe, with extension to the isthmus. The extension was predominantly solid with cystic components. FNAB of the mass showed benign findings. Around 1 week after FNAB, patient developed cough, sore throat, anorexia, neck pain, and multiple vomiting episodes. He had no dyspnea. He was brought to the ED. He was tachycardic and hypertensive, with an enlarged thyroid that was tender. Labs showed leukocytosis with left shift, glucose 651, anion gap 30, TSH 0.03, and free T4 1.68. He tested positive for COVID-19. He was admitted with DKA and COVID-19 infection. He received no steroids due to not meeting the indications for COVID-19 treatment, and was mainly treated for the DKA. Thyroid antibodies were negative and repeat thyroid US revealed no post-biopsy hemorrhage. Hyperthyroidism was deemed to be secondary to SAT and no active intervention was given for it. Repeat free T4 during hospitalization continued to trend down and was subsequently normalized by the time of discharge and outpatient follow-up. Discussion: SAT is a self-limiting inflammatory disorder of the thyroid that typically presents with fever, myalgia, malaise, thyroid pain and tenderness. The usual course of the disease is hyperthyroidism, then hypothyroidism, followed by resolution. Some cases may persist for months or may reoccur. SAT is usually associated with infection of the upper respiratory tract by one of the several common respiratory viruses, and is diagnosed clinically, supported by lab findings of decreased TSH in the setting of negative thyroid antibodies. At the start of the COVID-19 pandemic, it was initially unknown if SARS-CoV-2 virus could also be associated with SAT. However, more cases of SAT following COVID-19 infection have been reported since then. The patient above has findings consistent with SAT in the setting of COVID-19 infection. However, recent FNAB resulting in PAT can also cause TH in his case. PAT was identified in around 1% of thyroid FNAB patients. The affected patients experienced neck pain. Interestingly, thyrotoxicosis occurred only in patients who had a cystic component in the nodule. This patient with a history of recent FNAB might have PAT as a complication, or even in combination with SAT. Although patient’s condition resolved, hyperthyroidism may reoccur in SAT in the future. Presentation: Friday, June 16, 2023

THU241 Novel PPARG Pathogenic Gene Variant In Newly Diagnosed Familial Partial Lipodystrophy With Childhood Onset

Abstract Disclosure: E.K. Chang: None. K. Greve: None. L. Escobar: None. Background: Familial partial lipodystrophy (FPL) is characterized by progressive, selective body fat loss and is often associated with various metabolic complications including insulin resistance. In particular, FPL Type 3 due to PPARG (peroxisome proliferator-activated receptor gamma) mutations is a very rare subtype with a prevalence of less than 1 per 1,000,000 people overall. This case report describes a clinical case of a child presenting with genetic testing revealing a novel PPARG pathogenic gene variant. Clinical Case: A 9 year old female with history of adoption and unknown family history presented with severe abdominal pain and intractable emesis in the setting of COVID19 infection. Her hospital CT scan of the abdomen was remarkable for pancreatitis and hepatosplenomegaly. Glucose was elevated at 356 mg/dL with normal liver function tests. HgA1c was 11%. Triglycerides were above 4425 mg/dL. Her overall clinical picture was consistent with new onset diabetes mellitus and acute pancreatitis. Physical exam was notable for xanthomatosis and acanthosis nigricans. She was later noted to have partial subcutaneous fat loss of the upper and lower extremities, with preserved fat in the face, neck, and truncal region. She was initiated on insulin therapy and discharged to home once symptomatically improved from her pancreatitis with downtrending triglycerides to less than 450 mg/dL. Her diabetes autoantibodies (Glutamic acid decarboxylase, Islet Antigen-2, Zinc transporter 8 antibodies) resulted as normal, and she was able to discontinue insulin with HgA1c trending down to 4.8% within 4 months of hospital discharge. She underwent whole exome sequencing per recommendation of her lipid specialist and geneticist, which identified a likely pathogenic, previously undescribed variant of PPARG: c.1050_1054dup, p.(Glu352Alafs*12) and a variant of uncertain significance for MC4R: c.409A>G, p.(Ile137Val). This particular variant of PPARG represents a frameshift mutation, resulting in a premature stop codon, likely leading to a loss of normal PPARG function. PPARG mutations are specific to FPL Type 3, which is reportedly associated with atypical fat distribution, diabetes mellitus, hypertriglyceridemia, hypertension, and pancreatitis, consistent with many features of this case. Conclusion: This is the first case to describe the unique PPARG variant c.1050_1054dup, p.(Glu352Alafs*12) which is associated with FPL Type 3. This child's clinical course and evaluation can help with identifying affected individuals of this very rare type of FPL. Presentation: Thursday, June 15, 2023

Henoch-Schönlein purpura in the setting of COVID-19 infection: Two pediatrics cases and review of the literature.

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children, often following a viral infection. Various types of rashes attributed to COVID-19 infection have been described in the literature; however, HSP has rarely been reported. We report two children with HSP associated with acute COVID-19 infection with a review of the available literature. We highlight the clinical presentation, medical management, outcome and age-related difference of reported patients. A limitation of this article is the retrospective nature, limiting full patient history and associated conditions. The findings of this review show that HSP in the setting of COVID-19 is more common in children than adults, with a male predominance, involving various body systems creating a constellation of presentations. Given that HSP can have long-term morbidity from renal disease if untreated, this review may help guide the practitioner's approach to HSP and recognition in the setting of COVID-19 infection.

Gestational gigantomastia complicated by breast infarctive necrosis in the setting of COVID-19 infection: a case report

Naomi S. Ecanow, Anna M. Chichura, Katherine Kopkash, Catherine Pesce, Megan E. Sullivan, Katharine Yao

Supraventricular Tachycardia in the Setting of Neonatal COVID-19 Infection: A Case Report.

COVID-19 infection, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may present with a wide range of clinical presentations and a variety of symptoms in neonates. The cardiovascular manifestations that have been described in the setting of COVID-19 infection in neonates are tachycardia and hypotension, but information regarding cardiac arrhythmias is scarce, while the effect of SARS-CoV-2 on myocardial function is still not well established. We present a case of a neonate admitted with fever and nasal congestion. The neonate was tested positive for SARS-CoV-2. Supraventricular tachycardia (SVT) was diagnosed during his hospitalization in the neonatal intensive care unit. The neonate was under treatment with intravenous fluid repletion, intravenous broad-spectrum antibiotics, and continuous hemodynamic monitoring. SVT resolved spontaneously, while the team was preparing application of further supportive measures with a bag of ice on the infant's face. The neonate was discharged in good condition on day 14 post-admission, with no further recurrence of SVT. Follow-up visits were scheduled with the cardiologist. SVT in full-term or premature neonates can be a clinical manifestation of COVID-19 infection. Both neonatologists and neonatal nurse practitioners should be prepared to deal with cardiological manifestations of COVID-19 infection in neonates.

Cerebrovascular disease in patients with COVID-19 infection: a case series from Lebanon.

COVID-19 has been associated with a variety of multi-organs complications, with an increasing proportion of patients presenting with neurologic manifestations. There is still an uncertainty in the relationship between stroke and COVID-19. Therefore, in this study, the authors report 18 cases of acute stroke occurring in the setting of COVID-19 infection, including 11 ischaemic strokes and 7 haemorrhagic strokes and identified in a Lebanese tertiary hospital. In this case series, patients with ischaemic and haemorrhagic stroke had elevated markers of inflammation and coagulation. Ischaemic stroke patients were treated with different regimens of anti-platelets, anticoagulants, and thrombolytic therapies. Death was the most common outcome observed and was associated with the severity of COVID-19 infection.

PROFILE OF ACUTE KIDNEY INJURY IN PATIENTS WITH COVID-19 INFECTION

Background: COVID-19 infection has shown to be a multi-system disease and kidneys are commonly affected. AKI is the main risk factor for mortality in COVID-19 infection. There is limited data on Covid-19 infection and kidney involvement among the Nepalese population. Hence this study aims to describe the prevalence, risk factors, and outcomes in the setting of Covid-19 infection and acute kidney injury. Methods: This was a hospital-based cross-sectional study conducted at the National Academy of Medical Sciences (NAMS), Bir Hospital, Kathmandu, Nepal from January 2021 to June 2021. Ethical approval was obtained from the Institutional Review Board, NAMS (Reference number: 452/2077/78) Convenience sampling method was used. Data obtained was entered in MS Excel 2010 and statistical analysis was done by SPSS version 21. Results: Out of 101 patients, 73(72%) were male and 28(28%) were female. The mean age of the total study participants was 51.50 years. The prevalence of AKI among patients with COVID-19 in the ICU and ward of Bir Hospital was found to be 13.9%. A statistically significant association between liver disease and AKI with p-value of 0.018 was observed. The majority of death i.e., 57.14% was for KDIGO stage 3 patients. 3(100%) patients requiring renal replacement observed mortality. Conclusions: CLD, higher KDIGO staging of AKI, and the need for renal replacement therapy have been associated with mortality in patients with COVID-19 infections.

(066) STI Co-infection Among Pregnant Women with SARS-CoV-2

Abstract Introduction Although information on COVID-19 infection during pregnancy is still limited, existing evidence does not support increased susceptibility to infection or increased risk of developing severe disease during pregnancy, and the occurrence of intrauterine transmission has not been proven conclusively. However, to our knowledge, there is even less information available on co-infection with sexually transmitted infections in pregnant patients with COVID-19. The prevalence of any curable STI (gonorrhea, chlamydia, trichomoniasis, or syphilis) during pregnancy is estimated to be 3.3% (95% CI 2.9-3.7). Objectives STIprevalence may be correlated with COVID-19 infection in pregnant women, since both are influenced by risk-taking behaviors (i.e. condom use, mask-wearing, handwashing, and social distancing). On the other hand, an upregulated immune response in the setting of COVID-19 infection may in fact provide immunological protection against co-infection with STI’s or Group B Streptococcus (GBS), a non-sexually transmitted infection with a prevalence of 17.9% (95% CI 16.2-19.7) in pregnant patients. Our goal was to further explore this relationship. Methods We conducted a chart review of 34 pregnant patients with COVID-19, specifically looking at the incidence of antenatal STI’s and GBS. Results The mean age of the participants was 28.9 (SD 5.7) years, the mean gestational age at infection was 33.9 (SD 7.3) weeks, and the mean gestational age at delivery was 37.2 (SD 4.4) weeks. 26.5% (n=9) of patients tested positive for an STI, including gonorrhea (n=3), chlamydia (n=3), HPV (n=3), and trichomoniasis (n=2). 23.5% (n=8) tested positive for GBS infection. Conclusions The increased incidence of STI’s among pregnant women with COVID-19 compared to the expected incidence for any pregnant woman may suggest increased risks to this particular population that are worth investigating further. Disclosure No.

COVID-19 Infection Is Associated With Increased In-Hospital Mortality and Complications in Patients With Acute Heart Failure: Insight From National Inpatient Sample (2020).

Introduction: Patients with acute heart failure (AHF) exacerbation are susceptible to complications in the setting of COVID-19 infection. Data regarding the clinical outcomes of COVID-19 in patients admitted with AHF is limited. Methods: We used the national inpatient sample database by utilizing ICD-10 codes to identify all hospitalizations with a diagnosis of AHF in 2020. We classified the sample into AHF with COVID-19 infection versus those without COVID-19. Primary outcome was in-hospital mortality. Secondary outcomes were acute myocardial infarction, need for pressors, mechanical cardiac support, cardiogenic shock, and cardiac arrest. Also, we evaluated for acute pulmonary embolism (PE), bacterial pneumonia, need for a ventilator, and acute kidney injury (AKI). Results: We identified a total of 694,920 of AHF hospitalizations, 660,463 (95.04%) patients without COVID-19 and 34,457 (4.96%) with COVID-19 infection. For baseline comorbidities, diabetes mellitus, chronic heart failure, ESRD, and coagulopathy were significantly higher among AHF patients with COVID-19 (P < .01). While CAD, prior MI, percutaneous coronary intervention, and coronary artery bypass graft, atrial fibrillation, chronic obstructive pulmonary disease, and peripheral vascular disease were higher among those without COVID-19. After adjustment for baseline comorbidities, in-hospital mortality (aOR 5.08 [4.81 to 5.36]), septic shock (aOR 2.54 [2.40 to 2.70]), PE (aOR 1.75 [1.57 to 1.94]), and AKI (aOR 1.33 [1.30 to 1.37]) were significantly higher among AHF with COVID-19 patients. The mean length of stay (5 vs 7 days, P < .01) and costs of hospitalization ($42,143 vs $60,251, P < .01) were higher among AHF patients with COVID-19 infection. Conclusion: COVID-19 infection in patients with AHF is associated with significantly higher in-hospital mortality, need for mechanical ventilation, septic shock, and AKI along with higher resource utilization. Predictors for mortality in AHF patients during the COVID-19 pandemic, COVID-19 infection, patients with end-stage heart failure, and atrial fibrillation. Studies on the impact of vaccination against COVID-19 in AHF patients are needed.

The impact of COVID-19 on mortality, length of stay, and cost of care among patients with gastrointestinal malignancies: A propensity score-matched analysis.

e15510 Background: The SARS-CoV-2 (COVID-19) pandemic has had a lasting impact on the care of cancer patients. Multiple studies have shown that individuals with cancer are at high risk of serious complications in the setting of COVID-19 infection, but the impact in patients with gastrointestinal (GI) malignancies remain incompletely understood. We aimed to assess the impact of COVID-19 infection on mortality, length of stay (LOS), and cost of care among patients with GI malignancies, and identify differences in outcomes based on primary tumor site. Methods: We analyzed discharge encounters collected from the National Inpatient Sample (NIS) between March 2020 and December 2020, using propensity score-matching (PSM), and COVID- 19 as treatment effect. Results: Of the 87,684 patient discharges with GI malignancies, 1,892 were positive for COVID-19 (C+ve) and eligible for matching in the PSM model. Proportion for C+ve; male (61.2%), female (38.8%), White (55.8%), Black (17.9%), Hispanic (18.6%) and other (7.6%). Median age was 69 years (1QR: 61-77). Monthly variation reflected the wave and plateau dynamics of the spread of COVID-19. Following PSM analysis, C+ve patients with GI tumors demonstrated increased mortality compared to their COVID-19-negative (C-ve) counterparts (21.3% versus 11.9%, p &lt; 0.001). C+ve patients with colorectal cancer (CRC) had significantly higher mortality compared to those who were C-ve; 39.95% [161/403] versus 24% [54/225], p = 0.035). In addition, C+ve patients with GI tumors had a longer LOS (9.42 days versus 6.95 days, p &lt; 0.001) and increased cost of care ($26,048.29 versus $21,625.24, p = 0.001) compared to C-ve. Higher odds of mortality from myocardial infarction among C+ve(OR = 3.54, P = 0.001) while mortality due to pulmonary embolism or liver failure was not significantly different between C+ve and C-ve groups. Conclusions: This PSM analysis suggests that prior to the introduction of vaccines, C+ve patients with GI tumors faced approximately double the odds of mortality, an increased LOS of 2.5 days, and increased cost of care of about $4,400 compared to their C-ve counterparts. The disparity of outcomes was most pronounced among CRC patients. It is possible that the direct effects of the SARS-CoV-2 virus on the GI tract may predispose to mortality and disease severity, warranting further investigation. [Table: see text]

Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series.

Saddle pulmonary embolism (SPE) is a rare type of pulmonary embolism that can lead to hemodynamic compromise causing sudden deaths. Due to a dearth of large prospective studies in this area, little is known regarding the epidemiology, and prognosis and factors affecting the latter for COVID-19-associated SPE. We aimed to describe COVID-19-associated SPE and quantify and compare mortality and factors affecting mortality among the cases. We included a total of 25 publications with a total of 35 cases. The average age was 45 ± 16.3 years with 11 females and 24 males. Dyspnoea (82.5%), orthopnoea (43.5%), and cough (43.5%) were the most common symptoms, and obstructive shock was present in five (21.7%) patients. The average reported oxygen (O2) saturation was 85.8% ± 11.9 mm Hg. Hypertension (26.1%), diabetes (21.7%), and deep vein thrombosis (21.7%) were the most commonly reported comorbidities. Right heart strain was recognized in seven (30%) patients on electroencephalogram (S1QIIITIII) and 12 (52.2%) patients on echocardiogram. Anticoagulation, thrombolysis, and percutaneous intervention were tried in 21 (91.3%), 13 (56.5%), and 6 (26.1%) cases, respectively. Despite the aggressive management, 2 of 25 (8.7%) patients died in our smaller case report cohort. We conclude that despite aggressive management modalities, the mortality of SPE remains high in COVID-19.

New-Onset Atrial Fibrillation in the Setting of COVID-19 Infection Is a Predictor of Mortality in Hospitalized Patients: CovAF-Study.

Recent studies show that hospitalized COVID-19 patients have an increased incidence of arrhythmia, especially atrial fibrillation (AF). This single-center study included 383 hospitalized patients with positive polymerase chain reaction tests for COVID-19 from March 2020 to April 2021. Patient characteristics were documented, and data were analyzed for episodes of AF on admission or during the hospital stay, intrahospital mortality, need for intensive care and/or invasive ventilation, inflammatory parameters (hs-CRP, IL-6, and procalcitonin), and differential blood count. We demonstrated that in the setting of hospitalized cases of COVID-19 infection, there is an incidence of 9.8% (n = 36) for the occurrence of new-onset AF. Furthermore, it was shown that a total of 21% (n = 77) had a history of episodes of paroxysmal/persistent AF. However, only about one-third of patients with pre-existing AF had relevant documented tachycardic episodes during the hospital stay. Patients with new-onset AF had a significantly increased intrahospital mortality compared to the control and the pre-existing AF without rapid ventricular rate (RVR) group. Patients with new-onset AF required intensive care and invasive ventilation more frequently. Further analysis examined patients with episodes of RVR and demonstrated that they had significantly elevated CRP (p < 0.05) and PCT (p < 0.05) levels on the day of hospital admission compared to patients without RVR.

Co-Occurring Catatonia and COVID-19 Diagnoses Among Hospitalized Individuals in 2020: A National Inpatient Sample Analysis.

COVID-19 is associated with a range of neuropsychiatric manifestations. While case reports and case series have reported catatonia in the setting of COVID-19 infection, its rate has been poorly characterized. This study reports the co-occurrence of catatonia and COVID-19 diagnoses among acute care hospital discharges in the United States in 2020. The National Inpatient Sample, an all-payors database of acute care hospital discharges, was queried for patients of any age discharged with a diagnosis of catatonia and COVID-19 in2020. Among 32,355,827 hospitalizations in the 2020 National Inpatient Sample, an estimated 15,965 (95% confidence interval: 14,992-16,938) involved a diagnosis of catatonia without COVID-19 infection, 1,678,385 (95% confidence interval: 1,644,738-1,712,022) involved a diagnosis of COVID-19 without a co-occurring catatonia diagnosis, and 610 (95% confidence interval: 578-642) involved both catatonia and COVID-19 infection. In an adjusted model, a diagnosis of COVID-19, but not a diagnosis of catatonia or the combination of catatonia and COVID-19, was associated with increased mortality. Patients with catatonia and COVID-19 were frequently diagnosed with encephalopathy and delirium codes. Catatonia and COVID-19 were rarely co-diagnosed in 2020, and catatonia diagnosis was not associated with increased mortality in patients with COVID-19. Further research is needed to better characterize the phenomenology of catatonia in the setting of COVID-19 infection and its optimal treatment.

Case 313: Cerebral Venous Infarct Due to Internal Cerebral Vein Thrombosis in the Setting of COVID-19 Infection

A 45-year-old woman presented to the emergency department of an outside hospital with shortness of breath and cough. Five days after initial presentation, the patient presented again to the same emergency department with worsening headache and progressive left arm and left leg weakness. She was transferred to the neuroscience intensive care unit of our hospital with concern for an intracranial abnormality based on her work-up at the outside hospital. Her past medical history was notable only for a large uterine fibroid. In our hospital, CT of the brain and chest and MRI of the brain, including perfusion studies, were performed. Additionally, CT venography of the brain was performed.