To characterize CT-ndings of COVID-19 pneumonia and their value in diagnosis and outcome prediction. METHODS Chest CTs of 182 patients with a con rmed diagnosis of COVID-19 infection by RT-PCR were evaluated for the presence of CT-abnormalities and their frequency. Regarding the patient outcome each patient was categorized in 5 progressive stages and the duration of hospitalization was determined. Regression analysis was performed to nd which CT ndings are predictive for patient outcome and to assess prognostic factors for the hospitalization duration. RESULTS Multivariate statistical analysis con rmed a higher age (OR= 1.023, p= 0.025), a higher total visual severity score (OR= 1.038, p= 0.002) and the presence of crazy paving (OR= 2.160, p= 0.034) as predictive parameters for patient outcome. A higher total visual severity score (+ 0.134 days; p= 0.012) and the presence of pleural effusion (+ 13.985 days, p= 0.005) were predictive parameters for a longer hospitalization duration. CONCLUSIONS An increasing percentage of lung opacity as well as the presence of crazy paving and a higher age are associated with a worse patient outcome. The presence of a higher total visual severity score and pleural effusion are signi cant predictors for a longer hospitalization duration.

Hormonal replacement therapy (HRT) has recently been shown to increase the risk of cardiovascular events in women. However, it is not clear whether the adverse effect of HRT is related to dosage and/or the presence of progestin. Using a mouse model of myocardial infarction (MI), we studied the dose-effect of oestrogen replacement on mortality and cardiac remodelling and dysfunction post-MI in the absence of progestin. Six-week-old females were subjected to ovariectomy (OVX). A pellet containing a low, moderate or high dose of 17β-oestradiol (E 2 ; 0.42, 4.2 or 18.8 μg day −1 ) or placebo was implanted subcutaneously on the day of OVX. Myocardial infarction was induced 8 weeks later, and cardiac morphology and function were evaluated 8 weeks after MI. We found that E 2 at moderate and high doses adversely affected mortality. A low dose of E 2 that restored plasma oestrogen close to physiological levels had no significant effect on mortality but tended to improve cardiac function and remodelling, associated with reduced fibrosis and increased capillary density. At the moderate dose, E 2 exacerbated cardiac fibrosis, hypertrophy, dysfunction and dilatation, associated with liver and kidney enlargement and ascites. Protein kinase C and extracellular signal-regulated kinase were increased by MI but were not affected by E 2 . In summary, E 2 at a low dose tended to be cardioprotective. At increased doses that raised plasma oestrogen far beyond the physiological level, E 2 was detrimental to the heart. Our data suggest that dosage should be an important consideration when studying the effect of oestrogen replacement on the heart.

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We present a case of Takotsubo (stress-induced) cardiomyopathy (TCM) in a healthcare worker that occurred during the COVID-19 pandemic. TCM, or broken-heart syndrome, has various presentations. This case sheds light on how stress due to the COVID-19 pandemic may cause cardiac illness in healthcare workers.

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