Covid19-Sources

The effects of in-utero exposure to maternal SARS-CoV-2 infection on offspring's neurodevelopment are still unknown.We performed a prospective cohort …

Altogether, these results suggest that a single dose of XBB.1.5 monovalent vaccine may not be sufficient to induce effective antiviral humoral immunity in infection-naïve individuals and that a booster dose of XBB.1.5 monovalent vaccine may be required in some cases. 9/— The Sato Lab (Kei Sato) (@SystemsVirology) November 30, 2023

Introduction A chronic post-vaccination syndrome (PVS) after covid-19 vaccination has been reported but has yet to be well characterized. Methods We included 241 individuals aged 18 and older who self-reported PVS after covid-19 vaccination and who joined the online Yale Listen to Immune, Symptom and Treatment Experiences Now (LISTEN) Study from May 2022 to July 2023. We summarized their demographics, health status, symptoms, treatments tried, and overall experience. Results The median age of participants was 46 years (interquartile range [IQR]: 38 to 56), with 192 (80%) identifying as female, 209 (87%) as non-Hispanic White, and 211 (88%) from the United States. Among these participants with PVS, 127 (55%) had received the BNT162b2 [Pfizer-BioNTech] vaccine, and 86 (37%) received the mRNA-1273 [Moderna] vaccine. The median time from the day of index vaccination to symptom onset was three days (IQR: 1 day to 8 days). The time from vaccination to symptom survey completion was 595 days (IQR: 417 to 661 days). The median Euro-QoL visual analogue scale score was 50 (IQR: 39 to 70). The five most common symptoms were exercise intolerance (71%), excessive fatigue (69%), numbness (63%), brain fog (63%), and neuropathy (63%). In the week before survey completion, participants reported feeling unease (93%), fearfulness (82%), and overwhelmed by worries (81%), as well as feelings of helplessness (80%), anxiety (76%), depression (76%), hopelessness (72%), and worthlessness (49%) at least once. Participants reported a median of 20 (IQR: 13 to 30) interventions to treat their condition. Conclusions In this study, individuals who reported PVS after covid-19 vaccination had low health status, high symptom burden, and high psychosocial stress despite trying many treatments. There is a need for continued investigation to understand and treat this condition. ### Competing Interest Statement Harlan Krumholz received expenses and/or personal fees from Element Science, Eyedentify, and F-Prime in the past three years. He is a co-founder of Refactor Health and Ensight-AI. He and his spouse are co-founders of, and have equity in, Hugo Health, the personalized health data platform company that developed the Hugo Kindred platform. His spouse is an officer with Hugo Health. The Yale Conflict of Interest Committee oversees his involvement in this study. He is the editor of Journal Watch: Cardiology of the Massachusetts Medical Society and a section editor for UpToDate. He is associated with contracts, through Yale New Haven Hospital, from the Centers for Medicare & Medicaid Services, and through Yale University from Janssen, Johnson & Johnson Consumer, and Pfizer. Akiko Iwasaki co-founded RIGImmune, Xanadu Bio, and PanV, consults for Paratus Sciences and InvisiShield Technologies, and is a member of the Board of Directors of Roche Holding Ltd. Yuan Lu received research grants from the United States National Institutes of Health, the Patient-Centered Outcomes Research Institute, and the Sentara Research Foundation outside of the submitted work. Jeph Herrin receives funding from multiple institutes of the National Institutes of Health, from the Patient-Centered Outcomes Research Institute, the American Heart Association, and the Agency for Healthcare Research and Quality for research projects; from the Centers for Medicare & Medicaid Services for development of quality measures; and from Pfizer. Chenxi Huang receives K12 funding from the National Center for Advancing Translational Science of the National Institutes of Health (UL1TR001863). Bornali Bhattacharjee is supported by, and Cesar Caraballo was supported by, a grant from the Yale-Mayo Clinic Center of Excellence in Regulatory Science and Innovation (CERSI) (U01FD005938). The other authors have no financial relationships to disclose. ### Funding Statement This project was in part supported by the Howard Hughes Medical Institute Collaborative COVID-19 Initiative and in part supported by CTSA Grant Number UL1 TR001863 from the National Center for Advancing Translational Science, a component of the National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Yale University Institutional Review Board gave ethical approval to the LISTEN (Listen to Immune, Symptom and Treatment Experiences Now) study. STROBE reporting guidelines were followed. Harlan Krumholz, a co-founder of Hugo Health, developed the Hugo Kindred platform, and the Yale Conflict of Interest Committee oversees his involvement. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Deidentified data in the present study are available upon reasonable request to the authors.

Immune imprinting - also known as ‘original antigenic sin’ - describes how the first exposure to a virus shapes the immunological outcome of subsequent exposures to antigenically related strains. SARS-CoV-2 Omicron breakthrough infections and bivalent COVID-19 vaccination were shown to primarily recall cross-reactive memory B cells and antibodies induced by prior mRNA vaccination with the Wuhan-Hu-1 spike rather than priming naive B cells that recognize Omicron-specific epitopes. These findings underscored a strong immune imprinting resulting from repeated Wuhan-Hu-1 spike exposures. To understand if immune imprinting can be overcome, we investigated memory and plasma antibody responses after administration of the updated XBB.1.5 COVID mRNA vaccine booster. Our data show that the XBB.1.5 booster elicits neutralizing antibody responses against current variants that are dominated by recall of pre-existing memory B cells previously induced by the Wuhan-Hu-1 spike. These results indicate that immune imprinting persists even after multiple exposures to Omicron spikes through vaccination and infection, including post XBB.1.5 spike booster mRNA vaccination, which will need to be considered to guide the design of future vaccine boosters. ### Competing Interest Statement The authors have declared no competing interest.

COVID seriously harms babiesThey have‼️the highest‼️ ICU admission rate among all the age groupsAnd 3x higher hospitalization rate than 60-69 y/o pic.twitter.com/c4pI0KlJzD— Malgorzata (Gosia) Gasperowicz (@GosiaGasperoPhD) December 2, 2023

Photo by Gustavo Fring via pexels.As the number of hospitalized children with influenza, RSV, COVID-19 and other infections continues to soar,…

Many countries, including the UK, have continued to experience an apparent excess of deaths long after the peaks associated with the COVID-19 pandemic in 2020 and 2021.1,2 Numbers of excess deaths estimated in this period are considerable. The UK Office for National Statistics (ONS) has calculated that there were 7.2% or 44,255 more deaths registered in the UK in 2022 based on comparison with the five-year average (excluding 2020).1 This persisted into 2023 with 8.6% or 28,024 more deaths registered in the first six months of the year than expected.

Memory B cells (MBCs) formed over the individual’s lifetime constitute nearly half of the adult peripheral blood B cell repertoire in humans. To assess their response to novel antigens, we tracked the origin and followed the differentiation paths of MBCs in the early anti-S response to mRNA vaccination in SARS-CoV-2-naïve individuals on single-cell and monoclonal antibody level. Newly generated and pre-existing MBCs differed in their differentiation paths despite similar levels of SARS-CoV-2 and common corona virus S-reactivity. Pre-existing highly mutated MBCs showed no signs of germinal center re-entry and rapidly developed into mature antibody secreting cells (ASCs). In contrast, newly generated MBCs derived from naïve precursors showed strong signs of antibody affinity maturation before differentiating into ASCs. Thus, although pre-existing human MBCs have an intrinsic propensity to differentiate into ASCs, the quality of the anti-S antibody and MBC response improved through the clonal selection and affinity maturation of naïve precursors. Highlights ### Competing Interest Statement The authors have declared no competing interest.

This cohort study explores clinical symptoms and changes to gray matter thickness and subcortical nuclear volume in the acute and 3-month follow-up phases of SARS-CoV-2 Omicron infection among adult male patients.

Background COVID-19 survivors may suffer from a wide range of chronic cognitive symptoms for months or years as part of post-COVID-19 conditions (PCC). To date, there is no definitive objective cognitive marker for PCC. We hypothesised that a key common deficit in people with PCC might be generalised cognitive slowing. Methods To examine cognitive slowing, PCC patients completed two short web-based cognitive tasks, Simple Reaction Time (SRT) and Number Vigilance Test (NVT). 270 patients diagnosed with PCC at two different clinics in UK and Germany were compared to two control groups: individuals who contracted COVID-19 before but did not experience PCC after recovery (No-PCC group) and uninfected individuals (No-COVID group). Findings We identified pronounced cognitive slowing in PCC patients, which distinguished them from age-matched healthy individuals who previously had symptomatic COVID-19 but did not manifest PCC. Cognitive slowing was evident even on a 30-second task measuring simple reaction time (SRT), with PCC patients responding to stimuli ~3 standard deviations slower than healthy controls. This finding was replicated across two clinic samples in Germany and the UK. Comorbidities such as fatigue, depression, anxiety, sleep disturbance, and post-traumatic stress disorder did not account for the extent of cognitive slowing in PCC patients. Furthermore, cognitive slowing on the SRT was highly correlated with the poor performance of PCC patients on the NVT measure of sustained attention. Interpretation Together, these results robustly demonstrate pronounced cognitive slowing in people with PCC, which distinguishes them from age-matched healthy individuals who previously had symptomatic COVID-19 but did not manifest PCC. This might be an important factor contributing to some of the cognitive impairments reported in PCC patients. Funding Wellcome Trust (206330/Z/17/Z), NIHR Oxford Health Biomedical Research Centre, the Thuringer Aufbaubank (2021 FGI 0060), German Forschungsgemeinschaft (DFG, FI 1424/2-1) and the Horizon 2020 Framework Programme of the European Union (ITN SmartAge, H2020-MSCA-ITN-2019-859890). ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was supported by funding from the Wellcome Trust, NIHR Oxford Health Biomedical Research Centre, and the Thuringer Aufbaubank (2021 FGI 0060). S.Z. and M.H. were funded by the Wellcome Trust (206330/Z/17/Z). E.M.M. was funded by Ph.D. scholarship Landesgraduiertenstipendium of Friedrich-Schiller-University Jena. K.F. was funded by German Forschungsgemeinschaft (DFG, FI 1424/2-1) and the Horizon 2020 Framework Programme of the European Union (ITN SmartAge, H2020-MSCA-ITN-2019-859890). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The ethics committee of Jena University Hospital (Approval Reference: 5082-02/17) and South Central Oxford A Research Ethics Committee (Approval Reference: 18/SC/0448) gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes De-identified data supporting this study may be shared based on reasonable written requests to the corresponding author. Access to de-identified data will require a Data Access Agreement and IRB clearance, which will be considered by the institutions who provided the data for this research. The simple reaction time task and the number vigilance task can be tried online at [https://octalportal.com/pcc]. The source code is shared using a Creative Commons NC-ND 4.0 international licence upon reasonable written request to the corresponding author and publicly available at [https://octalportal.com/pcc].

COVID-19 vaccines have recently been updated with the spike protein of SARS-Co-V-2 XBB.1.5 subvariant alone, but their immunogenicity in humans has yet to be fully evaluated and reported, particularly against emergent viruses that are rapidly expanding. We now report that administration of an updated monovalent mRNA vaccine (XBB.1.5 MV) to uninfected individuals boosted serum virus-neutralization antibodies significantly against not only XBB.1.5 (27.0-fold) and the currently dominant EG.5.1 (27.6-fold) but also key emergent viruses like HV.1, HK.3, JD.1.1, and JN.1 (13.3-to-27.4-fold). In individuals previously infected by an Omicron subvariant, serum neutralizing titers were boosted to highest levels (1,764-to-22,978) against all viral variants tested. While immunological imprinting was still evident with the updated vaccines, it was not nearly as severe as the previously authorized bivalent BA.5 vaccine. Our findings strongly support the official recommendation to widely apply the updated COVID-19 vaccines to further protect the public. ### Competing Interest Statement D.D.H. co-founded TaiMed Biologics and RenBio, and he serves as a consultant for WuXi Biologics and Brii Biosciences and is a board director at Vicarious Surgical. A.G. served as a member of the scientific advisory board for Janssen Pharmaceuticals. The remaining authors declare no conflicts of interest.

Objective To investigate the effectiveness of primary covid-19 vaccination (first two doses and first booster dose within the recommended schedule) against post-covid-19 condition (PCC). Design Population based cohort study. Setting Swedish Covid-19 Investigation for Future Insights—a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL) project, a register based cohort study in Sweden. Participants All adults (≥18 years) with covid-19 first registered between 27 December 2020 and 9 February 2022 (n=589 722) in the two largest regions of Sweden. Individuals were followed from a first infection until death, emigration, vaccination, reinfection, a PCC diagnosis (ICD-10 diagnosis code U09.9), or end of follow-up (30 November 2022), whichever came first. Individuals who had received at least one dose of a covid-19 vaccine before infection were considered vaccinated. Main outcome measure The primary outcome was a clinical diagnosis of PCC. Vaccine effectiveness against PCC was estimated using Cox regressions adjusted for age, sex, comorbidities (diabetes and cardiovascular, respiratory, and psychiatric disease), number of healthcare contacts during 2019, socioeconomic factors, and dominant virus variant at time of infection. Results Of 299 692 vaccinated individuals with covid-19, 1201 (0.4%) had a diagnosis of PCC during follow-up, compared with 4118 (1.4%) of 290 030 unvaccinated individuals. Covid-19 vaccination with any number of doses before infection was associated with a reduced risk of PCC (adjusted hazard ratio 0.42, 95% confidence interval 0.38 to 0.46), with a vaccine effectiveness of 58%. Of the vaccinated individuals, 21 111 received one dose only, 205 650 received two doses, and 72 931 received three or more doses. Vaccine effectiveness against PCC for one dose, two doses, and three or more doses was 21%, 59%, and 73%, respectively. Conclusions The results of this study suggest a strong association between covid-19 vaccination before infection and reduced risk of receiving a diagnosis of PCC. The findings highlight the importance of primary vaccination against covid-19 to reduce the population burden of PCC.

Norway and Sweden picked two different ways to mitigate the dissemination of the SARS-CoV-2 virus. Norway introduced the strictest lockdown in Europe …

Freiburg – Patienten, die sich nach einer Erkrankung an COVID-19 nicht oder nur schleppend erholen, haben Veränderungen in der Mikrostruktur des Gehirns, die in...

Interaktive Grafik zur Entwicklung von Arbeitsunfähigkeiten wegen Atemwegserkrankungen (COVID-19, Grippe, Pneumonie, Exacerbation, akuter oder banaler Infekt)

Outpatient treatment with metformin reduced long COVID incidence by about 41%, with an absolute reduction of 4·1%, compared with placebo. Metformin has clinical benefits when used as outpatient treatment for COVID-19 and is globally available, low-cost, and safe.

Our findings suggested that COVID-19 is associated with an increased risk of developing various ADs and the risk could be attenuated by COVID-19 vaccination. Future studies investigating pathology and mechanisms would be valuable to interpreting our findings.

This special communication evaluates the evidence on the association of face mask use with the spread of SARS-CoV-2.

In January 2023, the United States Food and Drug Administration and the Centers for Disease Control and Prevention noted a safety concern for ischemic stroke in adults ≥65 years receiving the BNT162b2; WT/OMI BA.4/BA.5 COVID-19 bivalent vaccine. This self-controlled case series analysis evaluated stroke risk among Medicare fee-for-service beneficiaries aged ≥65 years receiving: 1) a Pfizer-BioNTech (BNT162b2; WT/OMI BA.4/BA.5) or Moderna (mRNA-1273.222) COVID-19 bivalent vaccine, 2) high- dose/adjuvanted influenza vaccines, and 3) concomitant COVID-19 bivalent vaccines and influenza vaccines, from August 31 to November 6, 2022. The primary analysis did not find elevated stroke risk following COVID-19 bivalent vaccines. In the age subgroup analyses, only the ≥85 year age group had a risk of NHS (Incident Rate Ratio (IRR)=1.36, 95% CI 1.09 – 1.69 [1-21 days]) and NHS/TIA (IRR=1.28, 95% CI 1.08 – 1.52 [1-21 days]) with BNT162b2 Bivalent WT/OMI BA.4/BA.5. Among beneficiaries receiving a concomitant COVID-19 bivalent vaccine and a high-dose/adjuvanted influenza vaccine, an increased risk was observed for NHS (IRR=1.20, 95% CI 1.01 – 1.42 [22-42 days]) with BNT162b2 Bivalent WT/OMI BA.4/BA.5 and for TIA (IRR=1.35, 95% CI 1.06 – 1.74 [1-21 days]) with mRNA-1273.222.

The U.S. infant mortality rose 3% last year, marking the first statistically significant jump in two decades, according to a new CDC report.

Dies ist kein klassischer lessons-learnt Beitrag. Vielmehr nimmt dieser Artikel eine Metaperspektive ein und zeigt anhand verschiedener Studien auf, dass die zurückschauende Bewertung in diesem lessons-learnt Prozess durch systematische und motivierte Erinnerungsverzerrungen beeinflusst ist. Ferner zeigen wir, wie die dahinterliegenden Prozesse bis heute zu Konflikten und gesellschaftlichen Spannungen beitragen. Die Erkenntnisse und Schlussfolgerungen aus diesen Ergebnissen können sowohl den Prozess des Lernens aus der Pandemie unterstützen als auch im Umgang mit weiteren Krisen helfen, Polarisierung zu vermeiden.

DMZ – GESUNDHEIT / WISSEN ¦ David Aebischer ¦ In den letzten Monaten ist uns eine besorgniserregende Tendenz aufgefallen: Die Verharmlosung des Coronavirus, die nicht nur unter Experten und Politikern, sondern auch in den Medien zunehmend Raum zu finden scheint. Während die Welt weiterhin mit den Auswirkungen der Pandemie zu kämpfen hat, scheint die Ernsthaftigkeit des Virus in einigen Kreisen in den Hintergrund zu rücken. Diese Entwicklung wirft wichtige Fragen auf und fordert zum Nachdenken über die Auswirkungen und Herausforderungen auf, denen wir in diesem neuen Stadium der Pandemie gegenüberstehen. Um sicherzustellen, dass unsere Berichterstattung sachlich, unaufgeregt und auf Fakten basiert, haben wir erneut Expertenrat eingeholt und uns mit unseren dringenden Fragen an den renommierten Prof. Antoine Flahault, MD, PhD, Epidemiologe und Direktor des Instituts für globale Gesundheit in Genf, gewandt. DMZ: In welchem Maße stellen Sie eine Tendenz zur Verharmlosung des Coronavirus innerhalb der Expertengemeinschaft fest? Prof. Antoine Flahault: Die durch COVID-19 verursachte übermäßige Sterblichkeit wird bisher auf weltweit über 27 Millionen Todesfälle geschätzt (https://ourworldindata.org/grapher/excess-deaths-cumulative-economist-single-entity), und sowohl die Expertengemeinschaft als auch die Bevölkerung und die politischen Führer haben offenbar nicht aus einer solchen Tragödie gelernt. Die Welt wollte die Seite wenden, sobald die WHO im letzten Frühling das Ende der „gesundheitliche Notlage internationaler Tragweite“ erklärt hat. Natürlich haben wir den Gesundheitsnotstand verlassen, der zu Beginn der Pandemie strenge Einschränkungen unserer Bewegungen und unserer öffentlichen Freiheiten auferlegte. Dennoch bleibt COVID-19 für einige nach wie vor eine gefürchtete und tödliche Krankheit, und das SARS-CoV-2 breitet sich nach wie vor aktiv auf dem Planeten aus, in allen Ländern, wobei es anhaltende Formen verursacht, die als Langzeit-COVID bezeichnet werden und die wir schlecht behandeln können. Es mutiert auch weiterhin in raschem Tempo und erzeugt neue Varianten, die zu neuen Wellen von Neuinfektionen, Krankenhauseinweisungen und Todesfällen zu jeder Jahreszeit führen.

In late 2023, a lineage of SARS-CoV-2 emerged and was named the BA.2.86 variant. BA.2.86 is phylogenetically distinct from other Omicron sublineages identified so far, displaying an accumulation of over 30 amino acid mutations in its spike protein. Here, we performed multiscale investigations to reveal the virological characteristics of the BA.2.86 variant. Our epidemic dynamics modeling suggested that the relative reproduction number of BA.2.86 is significantly higher than that of EG.5.1. Experimental studies showed that four clinically-available antivirals were effective against BA.2.86. Although the fusogenicity of BA.2.86 spike is similar to that of the parental BA.2 spike, the intrinsic pathogenicity of BA.2.86 in hamsters was significantly lower than that of BA.2. Since the growth kinetics of BA.2.86 is significantly lower than that of BA.2 in both in vitro cell cultures and in vivo , it is suggested that the attenuated pathogenicity of BA.2.86 is due to its decreased replication capacity. ### Competing Interest Statement Jumpei Ito has consulting fees and honoraria for lectures from Takeda Pharmaceutical Co. Ltd. Kei Sato has consulting fees from Moderna Japan Co., Ltd. and Takeda Pharmaceutical Co. Ltd. and honoraria for lectures from Gilead Sciences, Inc., Moderna Japan Co., Ltd., and Shionogi & Co., Ltd.

A common trait amongst severely affected COVID-19 patients is lung damage and respiratory failure, the most common cause of death.1,2 In addition, the persistence of lung lesions in COVID-19 survivors could be related to prolonged symptoms.2 Lung disease begins with an initial stage of early epithelial lesions, edema, and endothelial inflammation, followed by diffuse alveolar damage, before the onset of proliferation and fibrosis.1,2 Because epigenetic shifts are underpin many human diseases,3 these chemical modifications could be linked to COVID-19 lung pathology. Our data suggest that DNA methylation signatures in the blood of COVID-19 patients provides clinical value.4,5 Thus, we sought to characterize the DNA methylation landscape of lung tissues from COVID-19 patients, to unveil targets of epigenetic dysregulation that can explain the described histopathological findings.

Adults attending the ED with an Omicron infection had more severe outcomes compared with patients with seasonal influenza, particularly among unvaccinated indiv

Recently a claim that the efficacy of the Pfizer COVID-19 vaccine is only 12% went viral. It's a slasher stat. Even when it appears to be dead it rises again.

Genf – Als Folge der Coronapandemie ist die Zahl der neuen Tuberkuloseerkrankungen voriges Jahr auf geschätzte 10,6 Millionen gestiegen. Das teilte die... #WHO #Tuberkulose

Correspondence from The New England Journal of Medicine — Association of SARS-CoV-2 Infection during Early Weeks of Gestation with Situs Inversus

Despite considerable progress, it remains unclear why some patients admitted for COVID-19 develop adverse outcomes while others recover spontaneously. Clues may lie with the predisposition to hypoxemia or unexpected absence of dyspnea (‘silent ...

Radiotranscriptomic analysis of CT angiography scans introduces a potentially powerful new platform for the development of non-invasive imaging biomarkers. Application of this platform in routine CT pulmonary angiography scans done in patients with COVID-19 produced the radiotranscriptomic signature C19-RS, a marker of cytokine-driven inflammation driving systemic activation of coagulation and responsible for adverse clinical outcomes, which predicts in-hospital mortality and might allow targeted therapy.