Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs / 11.02.2021
COVID-19 Patients Much Sicker and More Likely to Die than Flu Patients
MedicalResearch.com Interview with:
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Tejasvi Hora[/caption]
Tejasvi Hora, PhD Candidate
Department of Geography and Environmental Management, University of Waterloo
Data Analyst, GEMINI, Unity Health Toronto
MedicalResearch.com: What is the background for this study?
Response: Death rates and resource use for COVID-19 hospitalization vary significantly worldwide, however, the characteristics and outcomes of COVID-19 hospitalizations in Canada have not been described in detail. Further, there is considerable uncertainty about how COVID-19 compares with influenza. In some circles, COVID-19 has been dismissed as being not more severe than “the flu”. We used data extracted from electronic health records of 7 hospitals in Ontario, Canada to describe characteristics and outcomes of hospitalization for COVID-19 and influenza.
Tejasvi Hora[/caption]
Tejasvi Hora, PhD Candidate
Department of Geography and Environmental Management, University of Waterloo
Data Analyst, GEMINI, Unity Health Toronto
MedicalResearch.com: What is the background for this study?
Response: Death rates and resource use for COVID-19 hospitalization vary significantly worldwide, however, the characteristics and outcomes of COVID-19 hospitalizations in Canada have not been described in detail. Further, there is considerable uncertainty about how COVID-19 compares with influenza. In some circles, COVID-19 has been dismissed as being not more severe than “the flu”. We used data extracted from electronic health records of 7 hospitals in Ontario, Canada to describe characteristics and outcomes of hospitalization for COVID-19 and influenza.
Dr. Gordon[/caption]
Terry Gordon PhD
Professor, Department of Environmental Medicine
NYU Grossman School of Medicine
NYU Langone Health
MedicalResearch.com: What is the background for this study?
Response: We are air pollution researcher and interested in unique exposure scenarios. Based on the work by Dr. Steve Chillrud, Columbia University, we did a study 5 years ago to assess air quality in over 30 subway stations in NYC. We found poor air quality in all of the underground stations but the air quality was better in some locations. So we wondered what would be air quality in different transit systems in NE United States. David Luglio, pre-doctoral candidate, led a team of students to monitor particles in the air of subway stations in metropolitan NYC's MTA, LIRR, and PATH systems, Boston, Philadelphia, and Washington, DC.
Dr. Leonard[/caption]
Dr. Cathy Leonard PhD
Department of Infection and Immunity
Luxembourg Institute of Health
Luxembourg
MedicalResearch.com: What is the background for this study?
Response: Cat allergy is a rapidly increasing phenomenon characterized by hypersensitivity and an excessive immune response to certain allergens associated with cats, among which the major allergen Fel d 1, a protein typically found in their saliva, on their skin and fur. Cat allergy manifestations can range from mild forms like itchy nose or sneezing to the development of severe symptoms such as rhinitis and asthma, with potentially fatal outcomes.
Only Allergen‐specific immunotherapy (AIT )can ensure an effective and longer lasting treatment in the more advanced cases. AIT typically consists in the subcutaneous injection of gradually increasing doses of the allergen of interest, until a critical quantity is reached that induces long-term immune tolerance. Nevertheless, there is still the need to improve cat AIT in terms of efficacy and safety. We hypothesized that immune tolerance to the allergen could be boosted by improving the adjuvanticity of AIT solutions, thereby optimizing the production of antibodies against Fel d 1, while minimizing inflammation.
Jill Sommerville[/caption]
Jill Sommerville M.Sc
Director of Medical at WaterWipes
MedicalResearch.com: What is the background for this study? How prevalent is diaper dermatitis? Is it more severe in some babies?
Response: The Utah study is an independent clinical study conducted by the University of Utah Hospital NICU, Salt Lake City and recently published in Advances in Neonatal Care journal. It was a year-long study conducted between January 2018 – March 2019. The NICU staff were interested in exploring a new Perineal Skin Care Guideline in their unit, encompassing use of WaterWipes, to decrease the incidence of diaper dermatitis. Their stated aim was to reduce diaper dermatitis by 20% within a 1-year period. The study involved 1,070 premature babies, 11% of which were born at less than 30 weeks of gestational age. The inclusion criteria for the study were all babies who stayed for more than 1 day in the NICU.
Diaper dermatitis is known to cause discomfort and emotional distress in all babies and can be a possible source of infection among NICU babies. Diaper dermatitis remains prevalent, especially in preterm babies. The reported incidence varies from 21% to 25% among newborn intensive care babies. 1
Diaper dermatitis in pre term babies can be multifactorial especially as babies born early have a less well developed stratum corneum, the outer most layer of skin. NICU babies are often exposed to antibiotics and fortified milk to help them catch up growth. Other medical complications in addition can lead to altered gut flora and altered stool composition resulting in more frequency of stool.
The presence of urine and frequent stools necessitates regular cleaning which can result in excessive rubbing of the skin or the use of wipes containing harsh ingredients that can damage the skin.
One example of actinic keratoses on scalp
Response: The background for the study is the steady rise of cannabis use as a therapeutic in Israel and in many countries around the world. This largest increasing population of patients treated with medical cannabis is the older adults. However, very little data was published about cannabis treatment in older adults, and specifically about the cardiovascular and metabolic implications. T
he main finding of the study is that cannabis treatment for 3 months was associated with a reduction in both systolic and diastolic blood pressure values, as measured by consequent 24-hours ABPM tests. In addition, no significant changes were found in blood lipids profile, hemoglobin A1C, fasting insulin, C-reactive protein, kidney function tests, electrolytes, anthropometric measurements, and ECG parameters.
Dr. Garantziotis[/caption]
Stavros Garantziotis MD
Division of Intramural Research
National Institute of Environmental Health Sciences
Research Triangle Park, NC
MedicalResearch.com: What is the background for this study? How does hyaluronan differ from other medications for COPD? Is it used for other medical conditions?
Response: Hyaluronan is a natural sugar found in the human body, including in the lung. We have found that when the lungs are exposed to pollution, this sugar breaks down, and the breakdown fragments cause inflammation in the lung. We also found that if we give back the natural form of hyaluronan, it protects the lung from inflammation. Patients suffering from COPD also have a lot of hyaluronan breakdown in their lungs. We therefore reasoned, that giving them back the natural form of hyaluronan, as an inhalation treatment, would help them reduce inflammation. We tested this, as a first step, in the treatment acute inflammation of the lungs in COPD patients who are suffering an exacerbation of their disease.
Hyaluronan is different from existing medications in that it is a natural product of the body. It is used in Europe for conditions like cystic fibrosis, and after sinus surgery to humidify the airways. Because it is given by inhalation, it acts locally in the lungs.
Elodie Warren[/caption]
Elodie C. Warren, MPH
Columbia University Mailman School of Public Health Graduate
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that the US has been experiencing an opioid crisis for the past two decades. And we know that among communities of color, rates of overdose deaths are continuing to increase, even though overall national rates decreased between 2017 and 2018.
To better understand how the opioid crisis has differently affected racial/ethnic groups, we looked at how heroin treatment admissions changed over time by race/ethnicity, age, and sex. We found that there were stark differences when comparing non-Hispanic Black men and women to non-Hispanic White men and women.
Importantly, our study suggests the existence of an aging cohort of Black men and women (likely including survivors of a heroin epidemic that hit urban areas more than 40 years ago) that continues to struggle with heroin addiction. This points to the need for targeted interventions in chronically underserved communities.
Ankur Dalsania[/caption]
Ankur Dalsania
Rutgers New Jersey Medical School (NJMS)
M.D. Candidate 2021
MedicalResearch.com: What is the background for this study?
Response: Similar to past pandemics, prior studies and news articles have highlighted the disproportionate impact of COVID-19 mortality in marginalized populations, especially Black Americans. Rather than biological differences, other factors like neighborhood conditions, educational attainment, economic stability, healthcare access, and social contexts have been hypothesized to influence the racial disparities.
Using county-level data, we sought to quantitatively determine how these factors, collectively referred to as social determinants of health, impact COVID-19 mortality in Black Americans.
Dr. Devine[/caption]
Gregor J. Devine, Ph.D
Mosquito Control LaboratoryQIMR Berghofer Medical Research Institute
Brisbane, Queensland, Australia
MedicalResearch.com: What is the background for this study?
Scale of the problem: Dengue, Zika and chikungunya are all transmitted by the same mosquito species. That mosquito, Aedes aegypti, is superbly adapted to the human, urban environment – it lays its eggs and develops in the standing water that collects in the myriad containers associated with modern living (plastic bottles, food packaging, buckets, planters, crumpled tarpaulins etc.). Unusually they rely almost entirely on human blood for their nutritional requirements and they subsequently bite multiple times during each egg laying cycle. That reliance on human blood means that they are usually found resting indoors, a behaviour that also offers them some protection from weather extremes and predators. Once infected, and having incubated the virus until it is transmissible, a mosquito that survives for just a couple of weeks can infect many humans within the same and neighbouring households.
In poorer tropical urban environments with dense human populations, unscreened houses, no air-conditioning, and innumerable rain-filled containers to develop in, Aedes aegypti proliferates and so do those diseases, causing ca 400M annual infections of dengue alone by some estimates. The economic impact of the dengue, which normally causes a high fever, muscle and joint pains and nausea, is pronounced; especially in poor households with few savings and no welfare system. Every year, about 500,000 of those dengue cases develop into severe dengue, or dengue haemorrhagic fever (typified by plasma leakage, severe bleeding and organ impairment). There are about 25,000 deaths annually.
Dr. Warnick[/caption]
Benjamin J. Warnick, PhD
Assistant Professor of Entrepreneurship
Carson College of Business
Washington State University Vancouver
MedicalResearch.com: What is the background for this study?
Response: Popular culture has perpetuated a notion that cannabis users are more creative. Along these lines, some successful CEOs and entrepreneurs—like Steve Jobs, for example—have claimed that cannabis use has benefitted their creativity at work.
Despite such claims and increased legalization and use of cannabis, the implications of cannabis use for entrepreneurs’ creativity has yet to be rigorously tested. My coauthors and I were very intrigued to dive into the implications of cannabis use for entrepreneurs, whether good or bad. This seemed all the more relevant given the increasing legalization, destigmatization, and use of cannabis.
Dr. Master[/caption]
Christina L. Master, MD, FAAP, CAQSM, FACSM
Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Co-Director, Minds Matter Concussion Program
Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics
Attending Physician, Care Network - Karabots Center
The Children's Hospital of Philadelphia
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study?
Response: There have been multiple studies investigating potential sex differences in outcomes from concussion which have sometimes had conflicting results with some studies indicating that females take longer to recover than males and some studies reporting no difference in recovery between females and males, with most of these studies being conducted either retrospectively or prospectively in smaller cohorts. This large-scale multi-center prospective study in collegiate athletes provided an opportunity to compare females and males across comparable sports to examine both potential intrinsic or biologic factors (sex differences) or extrinsic (environmental or gender differences) that contribute to outcomes.
Dr. Kovács[/caption]
Balázs Kovács PhD
Associate Professor of Organizational Behavior
Yale School of Management
MedicalResearch.com: What is the background for this study?
Response: Our study looks at the association between the prevalence of legal cannabis stores, called “dispensaries”, and opioid-related mortality rates in the U.S. We find that higher cannabis dispensary counts are associated with reduced opioid-related mortality rates. We find this relationship holds for both medical dispensaries, which only serve patients who have a state-approved medical card or doctor’s recommendation, as well as for recreational dispensaries, which sell to adults 21 years and older. The statistical associations we find appears most pronounced with the class of opioids that includes fentanyl and its analogs.