Anesthesiology, Author Interviews, COVID -19 Coronavirus, Science, UCSF / 10.11.2021
COVID-19: Vaccine Protection and Deaths among US Veterans
MedicalResearch.com Interview with:
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Dr. Wallace[/caption]
Art Wallace, M.D., Ph.D.
Professor Emeritus, Anesthesia
School of Medicine, UCSF
Chief of the Anesthesia Service
Veterans Affairs Medical Center in San Francisco
MedicalResearch.com: What is the background for this study?
Response: I have spent the last 30 years working on perioperative risk reduction, developing medications and approaches to risk reduction. Part of this work utilized epidemiologic analysis of medication patterns of use to test if they are associated with reductions in morbidity and mortality. This work analyzed data in the VA Corporate Data Warehouse (CDW) which provides access to the VA, best in the world electronic health care record system, VISTA. With the COVID-19 pandemic I realized that the analytic techniques we had utilized for perioperative cardiac risk reduction could be used to search for medications to reduce the risks for acute COVID-19 infection.
We identified four classes of medications that reduced the risk of death in acute COVID-19 infection. We then turned our attention to medications to reduce the incidence, severity, and duration of long-term sequelae of COVID-19 infection also known as Long COVID or COVID Long Hauler Syndrome. One of the questions that people were asking was what was the effect of vaccination on Long COVID? We began that work by looking at the effect of vaccination on COVID infections and found the dramatic decrease in efficacy of vaccines with the spread of the Delta Variant. We published this work to notify the public and public health community of the decreased efficacy of the vaccines in the face of the Delta variant and reiterate the need for secondary public health prevention measures such as masks, social distancing, vaccination, and boosters.
Dr. Wallace[/caption]
Art Wallace, M.D., Ph.D.
Professor Emeritus, Anesthesia
School of Medicine, UCSF
Chief of the Anesthesia Service
Veterans Affairs Medical Center in San Francisco
MedicalResearch.com: What is the background for this study?
Response: I have spent the last 30 years working on perioperative risk reduction, developing medications and approaches to risk reduction. Part of this work utilized epidemiologic analysis of medication patterns of use to test if they are associated with reductions in morbidity and mortality. This work analyzed data in the VA Corporate Data Warehouse (CDW) which provides access to the VA, best in the world electronic health care record system, VISTA. With the COVID-19 pandemic I realized that the analytic techniques we had utilized for perioperative cardiac risk reduction could be used to search for medications to reduce the risks for acute COVID-19 infection.
We identified four classes of medications that reduced the risk of death in acute COVID-19 infection. We then turned our attention to medications to reduce the incidence, severity, and duration of long-term sequelae of COVID-19 infection also known as Long COVID or COVID Long Hauler Syndrome. One of the questions that people were asking was what was the effect of vaccination on Long COVID? We began that work by looking at the effect of vaccination on COVID infections and found the dramatic decrease in efficacy of vaccines with the spread of the Delta Variant. We published this work to notify the public and public health community of the decreased efficacy of the vaccines in the face of the Delta variant and reiterate the need for secondary public health prevention measures such as masks, social distancing, vaccination, and boosters.
Dr. Elwy[/caption]
Rani Elwy, PhD
Bridge Quality Enhancement Research Initiative Program, Center for Healthcare Organization and Implementation Research,
VA Bedford Healthcare System
Bedford, Massachusetts
Department of Psychiatry and Human Behavior, Alpert Medical School
Brown University, Providence, Rhode Island
MedicalResearch.com: What is the background for this study?
Response: The VA operates a very robust, embedded quality improvement and implementation science program, of which our team is involved. As the VA was one of the first US healthcare systems to rollout COVID-19 vaccination programs, we were asked to evaluate these efforts in real-time, to provide input to VA healthcare leaders on what was going well and what could be improved. This survey reported in JAMA Network Open is one of the quality improvement efforts we engaged in.
Dr. Hunter[/caption]
Jennifer Hunter, B.Med., M.Sc.P.H., Ph.D.
Adjunct Associate Professor
NICM Health Research Institute
Western Sydney University
Associate Professor Jennifer Hunter is an academic general practitioner with a clinical interest in integrative medicine, has received payment for providing expert advice about traditional, complementary and integrative medicine, including nutraceuticals, to industry, government bodies and non-government organisations, and spoken at workshops, seminars and conferences for which registration, travel and/or accommodation has been paid for by the organisers.
MedicalResearch.com: What is the background for this study?
Response: We decided to review the evidence for zinc in response to calls for rapid evidence reviews to inform self-care and clinical practice during the COVID-19 pandemic.
Laboratory studies have found that zinc can inhibit the replication of many respiratory viruses, including SARS-CoV-2 and other coronaviruses. Zinc plays a key role in immunity, inflammation, tissue injury, ACE-2 receptor activity, and also in tissue responses to a lack of oxygen. Low zinc status may be a risk factor for severe SARS-CoV-2 illness.
Additionally, there was some indirect evidence suggesting zinc might be effective for other respiratory tract infections such as the common cold and we wanted to verify this.
Dr. Dan P. Ly[/caption]
Division of General Internal Medicine and Health Services Research
David Geffen School of Medicine at UCLA
Los Angeles, CA
MedicalResearch.com: What is the background for this study?
Response: Lyme disease presents first on the skin with the classic “bull’s-eye” rash. But such rashes in Black patients aren’t well-represented in medical textbooks. This may lead to physicians not recognizing such rashes in Black patients.
As a result, Black patients are more likely to present with later complications of Lyme disease when first diagnosed such as neurologic complications.
Lara van der Schoot[/caption]
Lara van der Schoot
MD, PhD candidate
Department of Dermatology
Radboud University Medical Center
Nijmegen, The Netherlands
MedicalResearch.com: What is the background for this study?
Response: Psoriasis is a chronic, immune mediated skin disease for which effective targeted biological agents have become available the past years. Inherent to their immunomodulatory mechanism of action, biologics might increase infections risk. We know from clinical trial data that respiratory tract infections are among the most common adverse events during biologic treatment, but real-world data is sparse. Regarding the risk of serious infections among biologic users, mostly defined as infections requiring hospitalization, previous studies provided different results and there is limited comparative data for the newer biologics available.
The COVID-19 pandemic turned attention to the risk of infections among biologic users, especially for respiratory tract infections, as they might relate to susceptibility for viral respiratory tract infections such as COVID-19.
In our study, the primary aim was to determine the risk of respiratory tract infections among real-world psoriasis patients treated with biologics, including the newer IL-17 and IL-23 inhibitors. The secondary aim was to assess risk of serious infections in this cohort. Additionally, rates of SARS-CoV-2 infections were assessed.
Dr. Frost[/caption]
Holly Frost, MD
Assistant Professor Pediatrics
University of Colorado Anschutz School of Medicine
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Helen Trottier Ph.D
Assistant Professor, Department of Social and Preventive Medicine,
Researcher, CHU Sainte-Justine Research Center
Université de Montréal
Montréal, Québec, Canada
MedicalResearch.com: What is the background for this study?
Response: We know that HPV infection can have serious consequences such as the development of cancerous lesions in the cervix. HPV infection is also very prevalent in young women of childbearing age but the possible consequences of HPV in pregnancy have been poorly studied. Some population registers around the world have shown a reduction in the risk of preterm birth with HPV mass vaccination, but we must be careful with this kind of ecological correlation.
We have set up a large cohort study in pregnant women to study the association between HPV in pregnancy and preterm birth by targeting certain HPV genotypes and the duration of the infection.
