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Frontera JA, Yang D, Medicherla C, Baskharoun S, Bauman K, Bell L, Bhagat D, Bondi S, Chervinsky A, Dygert L, Fuchs B, Gratch D, Hasanaj L, Horng J, Huang J, Jauregui R, Ji Y, Kahn DE, Koch E, Lin J, Liu S, Olivera A, Rosenthal J, Snyder T, Stainman R, Talmasov D, Thomas B, Valdes E, Zhou T, Zhu Y, Lewis A, Lord AS, Melmed K, Meropol SB, Thawani S, Troxel AB, Yaghi S, Balcer LJ, Wisniewski T, Galetta S. Trajectories of Neurologic Recovery 12 Months After Hospitalization for COVID-19: A Prospective Longitudinal Study. Neurology 2022; 99:e33-e45. [PMID: 35314503 PMCID: PMC9259089 DOI: 10.1212/wnl.0000000000200356] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/22/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Little is known about trajectories of recovery 12 months after hospitalization for severe COVID-19. METHODS We conducted a prospective, longitudinal cohort study of patients with and without neurologic complications during index hospitalization for COVID-19 from March 10, 2020, to May 20, 2020. Phone follow-up batteries were performed at 6 and 12 months after COVID-19 onset. The primary 12-month outcome was the modified Rankin Scale (mRS) score comparing patients with or without neurologic complications using multivariable ordinal analysis. Secondary outcomes included activities of daily living (Barthel Index), telephone Montreal Cognitive Assessment (t-MoCA), and Quality of Life in Neurologic Disorders (Neuro-QoL) batteries for anxiety, depression, fatigue, and sleep. Changes in outcome scores from 6 to 12 months were compared using nonparametric paired-samples sign test. RESULTS Twelve-month follow-up was completed in 242 patients (median age 65 years, 64% male, 34% intubated during hospitalization) and 174 completed both 6- and 12-month follow-up. At 12 months, 197/227 (87%) had ≥1 abnormal metric: mRS >0 (75%), Barthel Index <100 (64%), t-MoCA ≤18 (50%), high anxiety (7%), depression (4%), fatigue (9%), or poor sleep (10%). Twelve-month mRS scores did not differ significantly among those with (n = 113) or without (n = 129) neurologic complications during hospitalization after adjusting for age, sex, race, pre-COVID-19 mRS, and intubation status (adjusted OR 1.4, 95% CI 0.8-2.5), although those with neurologic complications had higher fatigue scores (T score 47 vs 44; p = 0.037). Significant improvements in outcome trajectories from 6 to 12 months were observed in t-MoCA scores (56% improved, median difference 1 point; p = 0.002) and Neuro-QoL anxiety scores (45% improved; p = 0.003). Nonsignificant improvements occurred in fatigue, sleep, and depression scores in 48%, 48%, and 38% of patients, respectively. Barthel Index and mRS scores remained unchanged between 6 and 12 months in >50% of patients. DISCUSSION At 12 months after hospitalization for severe COVID-19, 87% of patients had ongoing abnormalities in functional, cognitive, or Neuro-QoL metrics and abnormal cognition persisted in 50% of patients without a history of dementia/cognitive abnormality. Only fatigue severity differed significantly between patients with or without neurologic complications during index hospitalization. However, significant improvements in cognitive (t-MoCA) and anxiety (Neuro-QoL) scores occurred in 56% and 45% of patients, respectively, between 6 and 12 months. These results may not be generalizable to those with mild or moderate COVID-19.
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Affiliation(s)
- Jennifer A Frontera
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Dixon Yang
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Chaitanya Medicherla
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Samuel Baskharoun
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Kristie Bauman
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Lena Bell
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Dhristie Bhagat
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Steven Bondi
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Alexander Chervinsky
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Levi Dygert
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Benjamin Fuchs
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Daniel Gratch
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Lisena Hasanaj
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Jennifer Horng
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Joshua Huang
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Ruben Jauregui
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Yuan Ji
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - D Ethan Kahn
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Ethan Koch
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Jessica Lin
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Susan Liu
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Anlys Olivera
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Jonathan Rosenthal
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Thomas Snyder
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Rebecca Stainman
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Daniel Talmasov
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Betsy Thomas
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Eduard Valdes
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Ting Zhou
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Yingrong Zhu
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Ariane Lewis
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Aaron S Lord
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Kara Melmed
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Sharon B Meropol
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Sujata Thawani
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Andrea B Troxel
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Shadi Yaghi
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Laura J Balcer
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Thomas Wisniewski
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
| | - Steven Galetta
- From the Department of Neurology (J.A.F., C.M., S.B., K.B., L.B., D.B., S.B., A.C., L.D., B.F., G.G., L.H., J. Horng, R.J., Y.J., D.E.K., E.K., J.L., S.L., A.O., J.R., T.S., D.T., B.T., E.V., T.Z., Y.Z., A.L., A.S.L., K.M., S.T., L.J.B., T.W., S.G.), New York University Grossman School of Medicine; Department of Neurology (D.Y.), New York Presbyterian, Columbia Medical Center, New York; Medical Informatics (J. Huang), NYU Langone Hospitals, New York, NY; Department of Neurology (R.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Population Health (S.B.M., A.B.T.), New York University, New York; and Department of Neurology (S.Y.), Brown University School of Medicine, Providence, RI
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Frontera JA, Sabadia S, Lalchan R, Fang T, Flusty B, Millar-Vernetti P, Snyder T, Berger S, Yang D, Granger A, Morgan N, Patel P, Gutman J, Melmed K, Agarwal S, Bokhari M, Andino A, Valdes E, Omari M, Kvernland A, Lillemoe K, Chou SHY, McNett M, Helbok R, Mainali S, Fink EL, Robertson C, Schober M, Suarez JI, Ziai W, Menon D, Friedman D, Friedman D, Holmes M, Huang J, Thawani S, Howard J, Abou-Fayssal N, Krieger P, Lewis A, Lord AS, Zhou T, Kahn DE, Czeisler BM, Torres J, Yaghi S, Ishida K, Scher E, de Havenon A, Placantonakis D, Liu M, Wisniewski T, Troxel AB, Balcer L, Galetta S. A Prospective Study of Neurologic Disorders in Hospitalized Patients With COVID-19 in New York City. Neurology 2021; 96:e575-e586. [PMID: 33020166 PMCID: PMC7905791 DOI: 10.1212/wnl.0000000000010979] [Citation(s) in RCA: 187] [Impact Index Per Article: 62.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/14/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To determine the prevalence and associated mortality of well-defined neurologic diagnoses among patients with coronavirus disease 2019 (COVID-19), we prospectively followed hospitalized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients and recorded new neurologic disorders and hospital outcomes. METHODS We conducted a prospective, multicenter, observational study of consecutive hospitalized adults in the New York City metropolitan area with laboratory-confirmed SARS-CoV-2 infection. The prevalence of new neurologic disorders (as diagnosed by a neurologist) was recorded and in-hospital mortality and discharge disposition were compared between patients with COVID-19 with and without neurologic disorders. RESULTS Of 4,491 patients with COVID-19 hospitalized during the study timeframe, 606 (13.5%) developed a new neurologic disorder in a median of 2 days from COVID-19 symptom onset. The most common diagnoses were toxic/metabolic encephalopathy (6.8%), seizure (1.6%), stroke (1.9%), and hypoxic/ischemic injury (1.4%). No patient had meningitis/encephalitis or myelopathy/myelitis referable to SARS-CoV-2 infection and 18/18 CSF specimens were reverse transcriptase PCR negative for SARS-CoV-2. Patients with neurologic disorders were more often older, male, white, hypertensive, diabetic, intubated, and had higher sequential organ failure assessment (SOFA) scores (all p < 0.05). After adjusting for age, sex, SOFA scores, intubation, history, medical complications, medications, and comfort care status, patients with COVID-19 with neurologic disorders had increased risk of in-hospital mortality (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.17-1.62, p < 0.001) and decreased likelihood of discharge home (HR 0.72, 95% CI 0.63-0.85, p < 0.001). CONCLUSIONS Neurologic disorders were detected in 13.5% of patients with COVID-19 and were associated with increased risk of in-hospital mortality and decreased likelihood of discharge home. Many observed neurologic disorders may be sequelae of severe systemic illness.
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Affiliation(s)
- Jennifer A Frontera
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK.
| | - Sakinah Sabadia
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Rebecca Lalchan
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Taolin Fang
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Brent Flusty
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Patricio Millar-Vernetti
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Thomas Snyder
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Stephen Berger
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Dixon Yang
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Andre Granger
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Nicole Morgan
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Palak Patel
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Josef Gutman
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Kara Melmed
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Shashank Agarwal
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Matthew Bokhari
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Andres Andino
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Eduard Valdes
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Mirza Omari
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Alexandra Kvernland
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Kaitlyn Lillemoe
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Sherry H-Y Chou
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Molly McNett
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Raimund Helbok
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Shraddha Mainali
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Ericka L Fink
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Courtney Robertson
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Michelle Schober
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Jose I Suarez
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Wendy Ziai
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - David Menon
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Daniel Friedman
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - David Friedman
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Manisha Holmes
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Joshua Huang
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Sujata Thawani
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Jonathan Howard
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Nada Abou-Fayssal
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Penina Krieger
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Ariane Lewis
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Aaron S Lord
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Ting Zhou
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - D Ethan Kahn
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Barry M Czeisler
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Jose Torres
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Shadi Yaghi
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Koto Ishida
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Erica Scher
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Adam de Havenon
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Dimitris Placantonakis
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Mengling Liu
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Thomas Wisniewski
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Andrea B Troxel
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Laura Balcer
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
| | - Steven Galetta
- From the New York University Grossman School of Medicine (J.A.F., S.S., R.L., T.F., B.F., P.M.-V., T.S., S.B., D.Y., A.G., N.M., P.P., J.G., K.M., S.A., M.B., A.A., E.V., M.O., A.K., K.L., Daniel Friedman, David Friedman, M.H., J.H., S.T., J.H., N.A.-F., P.K., A.L., A.S.L., T.Z., D.E.K., B.M.C., J.T., S.Y., K.I., E.S., D.P., M.L., T.W., A.B.T., L.B., S.G.), New YorkUniversity of Pittsburgh School of Medicine (S.H.-Y.C., E.L.F.), PAThe Ohio State University (M.M., S.M.), ColumbusMedical University of Innsbruck (R.H.), AustriaThe Johns Hopkins University School of Medicine (C.R., J.I.S., W.Z.), Baltimore, MDUniversity of Utah School of Medicine (M.S., A.d.H.), Salt Lake CityUniversity of Cambridge (D.M.), UK
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