Author Interviews, COVID -19 Coronavirus, Race/Ethnic Diversity, Vaccine Studies / 03.03.2021

MedicalResearch.com Interview with: Laura M. Bogart, PhD Senior Behavioral Scientist RAND Corporation Santa Monica, CA 90407-2138 MedicalResearch.com: What is the background for this study? Response: Recent media polls continue to show that Black Americans are less likely to intend to get the COVID-19 vaccine than White Americans, and initial state data show a similar racial/ethnic disparity in vaccination rates. Initial uptake of the vaccine has been significantly affected by inequities in vaccine access and supply. In addition to these challenges, other factors contribute to hesitancy around vaccination, including self-perceived risk of infection, trust in the vaccine itself, trust in healthcare systems, healthcare providers, and policymakers who support the vaccine, and trust in the pharmaceutical industry and clinical research. In this study, we conducted a survey of a nationally representative sample of 207 Black Americans in late 2020, after initial COVID-19 vaccine effectiveness and safety data were released to the public. We also did in-depth interviews with a subsample of those surveyed who said that they would not get vaccinated. In addition, we engaged with a stakeholder advisory committee comprised of individuals who represent different subgroups and organizations in Black communities in the U.S., in order to discuss the results and make recommendations for policies to increase COVID-19 vaccination among Black Americans. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, Nature, Statins / 27.02.2021

MedicalResearch.com Interview with: Aakriti Gupta MD MS Fellow, Interventional Cardiology Columbia University Irving Medical Center NewYork-Presbyterian Hospital  MedicalResearch.com: What is the background for this study? Response: While taking care of patients with COVID-19 last spring and summer at the height of the pandemic, we observed that patients who got very sick and required hospitalization had high rates of hyperinflammation with elevated CRP levels, and thromboembolic phenomena. As cardiologists who frequently prescribe statins for hyperlipidemia, they were a class of drugs that came naturally to mind for their anti-inflammatory, anticoagulant and immunomodulatory properties in addition to their cholesterol lowering properties. As such, we decided to look at the association of statin use with in-hospital mortality in patients who are hospitalized with COVID-19. (more…)
Author Interviews, COVID -19 Coronavirus, Education, JAMA, UCLA / 22.02.2021

MedicalResearch.com Interview with: Frederick Zimmerman, PhD Professor, Department of Health Policy and Management Fielding School of Public Health UCLA   MedicalResearch.com: What is the background for this study? Response: The science on school transmissions of COVID is becoming clearer all the time in its conclusion that there is little to no transmission in school environments as long as reasonable precautions are taken.  Yet one recent study got a lot of attention for claiming that states that allowed their schools to remain open in the early days of the pandemic saw more cases.  That study did not control for several important factors that might explain this association, so our study aimed to correct that work. (more…)
Author Interviews, COVID -19 Coronavirus, Nature, Pediatrics / 19.02.2021

MedicalResearch.com Interview with: Dr Melanie Neeland PhD Research Fellow Murdoch Children's Research Institute Royal Children's Hospital Flemington Road, Parkville Victoria Australia  MedicalResearch.com: What is the background for this study? Response: Children generally have mild COVID-19 disease compared to adults, however the immune mechanisms underpinning this response are unclear. Understanding the underlying age-related differences in the severity of COVID-19 will provide important insights and opportunities for prevention and treatment of COVID-19. (more…)
Author Interviews, Blood Pressure - Hypertension, COVID -19 Coronavirus / 17.02.2021

MedicalResearch.com Interview with: Pam R. Taub, MD, FACC, FASPC Director of  Step Family Foundation Cardiovascular Rehabilitation and Wellness Center Associate Professor of Medicine UC San Diego Health System Division of Cardiovascular Medicine MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by postural orthostatic tachycardia syndrome?  Is it more common in patients who have incompletely recovered from a COVID-19 infection?  Response: Postural Orthostatic Tachycardia Syndrome (POTS) is a, complex multisystem clinical syndrome Patients experience a wide spectrum of symptoms of varying severity, which are often debilitating.  Upon assuming an upright standing position from being supine, patients experience an increase in heart rate by 30 beats per minute (bpm) from supine position, This is often accompanied by lightheadedness, palpitations, dyspnea, mental clouding (“brain fog”), headaches. POTS can occur after infections as it thought to be triggered by the immune system .  The hypothesis is that when the body is fighting an infection some of the antibodies it produces can attack our regulatory systems that control heart rate and blood pressure. We are seeing an increase in POTS cases occurring after COVID-19 infection.  These patient are referred to as the “long haulers” These long haulers have elevated heart rate, fatigue, brain fog and shortness of breath with activity consistent with POTS. We are seeing that  COVID-19 is another infection that can lead to POTS. Some articles on this https://www.thedenverchannel.com/news/national/coronavirus/some-covid-19-survivors-being-diagnosed-with-syndrome-called-pots (more…)
Author Interviews, COVID -19 Coronavirus / 16.02.2021

MedicalResearch.com Interview with: Rahul Subramanian PhD candidate Department of Ecology and Evolution Biological Sciences Division University of Chicago Chicago, IL 60637 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Understanding the proportion of COVID-19 cases that become symptomatic, as well as the extent to which people without symptoms contribute to COVID-19 transmission, has important public health implications. However, changes in PCR testing capacity over time have made these quantities hard to estimate precisely. We used a model that incorporates daily changes in PCR testing capacity, cases, and serology to precisely estimate the proportion of cases that were symptomatic in New York City during the initial wave of the outbreak. Only 1 in 7 to 1 in 5 cases were symptomatic. Furthermore, non-symptomatic cases of the virus (this includes people who are either pre-symptomatic or asymptomatic) substantially contribute to community transmission, making up at least 50% of the driving force of SARS-CoV-2 infection.  (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs / 11.02.2021

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, CMAJ, COVID -19 Coronavirus, Kidney Disease / 05.02.2021

MedicalResearch.com Interview with: Peter G. Blake MD, FRCPC, FRCPI,MSc MB Professor of Medicine in the Division of Nephrology Ontario Renal Network University of Western Ontario and London Health Sciences Centre London, Ontario  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Covid-19 pandemic has been very difficult for people on dialysis with reports of high infection rates and high mortality. We prospectively collected data on SARS-CoV-2 infection every week from all renal programs in the province of Ontario, Canada from the start of the pandemic. Between March and August 2020, 187 people on dialysis, equivalent to 1.5% of all those in the province, were infected with the SARS-CoV-2 virus. Over 60% were hospitalized, 20% required ICU and the mortality rate was very high at over 28%. Risk factors for infection included center hemodialysis versus home dialysis, residing in long term care, black, south Asian and other non-white ethnicity, and low neighbourhood income. (more…)
Author Interviews, COVID -19 Coronavirus, Education, Race/Ethnic Diversity, Social Issues / 04.02.2021

MedicalResearch.com Interview with: 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.  (more…)
Author Interviews, Dengue, PLoS, Zika / 04.02.2021

MedicalResearch.com Interview with: 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. mosquito-Aedes aegypti-feeding-human.jpgThe Zika pandemic of 2015-2016 resulted in 1000s of babies born with microcephaly and damage to their brains and eyes. For 1000s of other children, the impacts of Zika on their cognitive development did not manifest in their first, formative years.  Chikungunya is endemic in Asia and Africa but between 2010 and 2014, outbreaks and epidemics spread across the Indian Ocean, the Caribbean, the Americas and the Pacific Islands. It causes severe, often debilitating joint pain in infected patients. Those affected also suffer from headaches, fever, severe muscle pain and conjunctivitis. Joint pain can persist in subacute or chronic form for several months or even years, particularly in older patients. The ubiquity of the mosquito Aedes aegypti across the tropics and sub tropics ensures that further epidemics of Zika and chikungunya will occur, outside their usual ranges. It’s simply impossible to predict when that will occur. (more…)
Author Interviews, BMJ, COVID -19 Coronavirus, Gout, Rheumatology / 03.02.2021

MedicalResearch.com Interview with: Dr Rene Oliveira Department of Internal Medicine Ribeirao Preto Medical School University of Sao Paulo Ribeirao Preto, Brazil  MedicalResearch.com: What is the background for this study? Response: As rheumatologists our background for testing colchicine for COVID-19 was the effect of the drug on gout, Behçet's disease and familial Mediterranean fever. For these diseases, the drug is able to reduce systemic inflammation by acting in some cytokine pathways which the first reports in COVID-19 suggested being the same. We found that colchicine was able to reduce systemic inflammation and diminish the length of need for supplemental oxygen and hospitalisation. (more…)
Author Interviews, COVID -19 Coronavirus, Heart Disease, JAMA, Social Issues, University of Pennsylvania / 02.02.2021

MedicalResearch.com Interview with: Sameed Khatana MD, MPH Instructor, Cardiovascular Medicine Perelman School of Medicine, University of Pennsylvania Physician, Philadelphia VA Medical Center  MedicalResearch.com: What is the background for this study? Response: After declining for decades, the fall in cardiovascular mortality rates in the US has started to slow down and rates may be rising in certain groups. This stagnation in mortality has been most start among middle-aged adults. These trends have occurred at the same time as growing economic inequality. Our analysis aimed to study the relationship between change in cardiovascular mortality rates between 2010 and 2017 for middle-aged adults across the US and change in economic prosperity levels. (more…)
Author Interviews, Brigham & Women's - Harvard, Cancer Research, COVID -19 Coronavirus, Prostate, Prostate Cancer, Surgical Research, Urology / 01.02.2021

MedicalResearch.com Interview with: David-Dan Nguyen Research Fellow | Center for Surgery and Public Health, Brigham and Women's Hospital MPH (Health Policy) Student | Harvard T.H. Chan School of Public Health Medical Student | McGill University MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has forced hospitals to delay the definitive treatment of cancers via surgery or radiation therapy. While previous evidence has shown that delaying the treatment of low-risk prostate cancer is not associated with worse outcomes, treatment delays for intermediate-risk and high-risk prostate cancer are more controversial. As such, we sought to determine if delays for these disease states negatively impacted oncological outcomes. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity, Social Issues / 29.01.2021

MedicalResearch.com Interview with: Renuka Tipirneni, MD, MSc, FACP Assistant Professor Holder of the Grace H. Elta MD Department of Internal Medicine Early Career Endowment Award 2019-2024 University of Michigan Department of Internal Medicine, Divisions of General Medicine and Hospital Medicine, and Institute for Healthcare Policy & Innovation Ann Arbor, MI MedicalResearch.com: What is the background for this study? Response: As there have been significant racial/ethnic disparities in US COVID-19 infections and health outcomes including death, we investigated county-level social factors that may explain these inequities. Specifically, we examined the association between the Centers for Disease Control and Prevention’s Social Vulnerability Index (a composite measure of social disadvantage) and COVID-19 incidence and mortality rates. We found that with just a one-point increase in the ten-point scale, there was a 14% increase in incidence rate and 14% increase in mortality rate. This equated to approximately 87 excess COVID-19 infections and 3 deaths per 100,000 population.  (more…)
Author Interviews, Biomarkers, COVID -19 Coronavirus / 25.01.2021

MedicalResearch.com Interview with: Marlene Cano MD. PhD. Post-Doctoral Research Fellow in Pulmonary Transplant Immunology Division of Pulmonary and Critical Care Department of Medicine Washington University/Barnes-Jewish Hospital Saint Louis, MO MedicalResearch.com: What is the background for this study? How does this test differ from other tests for COVID-19?   Response: We know COVID-19 causes a wide spectrum of disease, and that while many develop only mild uncomplicated illness, others develop severe respiratory failure, multi-organ failure and death. These patients often require prolonged hospitalization, ICU level care and even mechanical intubation for respiratory support. However, we still do not have a great way to identify which patients are likely to develop severe disease. We felt it was important to have a test that could act as sort of a ‘biomarker’ that we could measure early in COVID-19 patients and would help predict which patients would develop severe disease. From prior work, we knew that mitochondrial DNA, which are proinflammatory molecules that are released into the circulation from damaged organs could be this such ‘biomarker’. So, we measured the levels of mitochondrial DNA circulating in the plasma of patients with COVID-19 at the time they first presented to the hospital. Then we investigated if higher levels of mitochondrial DNA indeed predict the development of more severe disease. Currently there are no ‘biomarker’ tests specific for COVID-19. We do currently measure levels of other markers in the hospital that we feel might help us assess overall how sick patients may be, but these are very non-specific and assess only level of inflammation. This test instead can measure level of tissue injury. (more…)
Author Interviews, Infections, OBGYNE, Pharmaceutical Companies / 21.01.2021

MedicalResearch.com interview with: Dr. Stephen Brand, Chief Development Officer Mycovia Pharmaceuticals  Dr. Stephen Brand discusses the results of Mycovia’s three Phase 3 studies for recurrent vaginal yeast infections (RVVC )and what’s next for the company.  MedicalResearch.com: What is the background for these Phase 3 studies? Answer: Our Phase 3 clinical program for our oral therapy oteseconazole was comprised of three trials enrolling more than 870 patients at 176 sites across 11 different countries. Two of these trials, referred to as VIOLET were identical Phase 3 randomized, double-blind, placebo-controlled clinical trials to evaluate the safety of oteseconazole and its ability to prevent episodes of recurrent vulvovaginal candidiasis (RVVC), commonly referred to as chronic yeast infection. The trials took place over 48 weeks in subjects with an established disease history of at least three episodes of acute VVC in the past 12 months. More than 650 patients randomized at 125 sites across 11 countries. The VIOLET trials consisted of two parts: During the first part of the study which lasted two weeks after patients presented with an active VVC episode, patients were treated with three sequential 150mg doses of fluconazole. The second part consisted of 12 weeks, when the patient either took oteseconazole 150mg or a placebo once weekly (according to a random assignment), and then a 36-week follow-up period. In addition, subjects participating in the VIOLET trials in the U.S. who remained infection-free at their Week 48 visit were offered the opportunity to participate in an extension study and are being monitored for an additional 48 weeks to further define the long-term protection profile of oteseconazole. Eighty-five subjects are enrolled. The third Phase 3 study, called ultraVIOLET, was designed to complement and extend VIOLET as a 50-week randomized, double-blind, placebo-controlled clinical trial to evaluate the safety and efficacy of oteseconazole. In addition the study compared the effectiveness of oteseconazole compared to fluconazole, the current standard of care, to treat an acute VVC infection in the RVVC population. A total of 220 patients were randomized at 51 sites in the U.S. for the ultraVIOLET trial. The ultraVIOLET trial consisted of two parts: In the first part of the study RVVC subjects presenting with an active infection were randomized to receive either 2 days of dosing with oteseconazole or 3 sequential 150 mg doses of fluconazole (every 72 hours). The second part consisted of 11 weeks, when the patient took either oteseconazole or a placebo weekly (according to the random assignment from the first part of the study), and then a 37-week follow-up period. (more…)
Author Interviews, COVID -19 Coronavirus / 20.01.2021

MedicalResearch.com Interview with: Dr Caroline Wei Shan Hoong, MBBS, MRCP Associate Consultant Endocrinologist Department of General Medicine Woodlands Health Campus National Healthcare Group, Singapore MedicalResearch.com: What is the background for this study? Response: In the course of our clinical work, we have noticed a predominance of musculoskeletal complaints among some of COVID-19 patients who are otherwise clinically well, and a small subset of them who develop a viral arthralgia (joint pains) sometimes occurring separately from the onset of acute respiratory symptoms. Besides a few isolated case reports, there was not much described about COVID-19 associated viral arthralgia in the literature. Clinicians are well aware of the need to test for COVID-19 when patients present with cough or shortness of breath. However, when they present as joint pains without any respiratory symptoms, a diagnosis of COVID-19 could easily be missed. Due to overlapping clinical features like low platelet count and elevated liver enzymes, they could easily be misdiagnosed as having other vector-borne infections such as dengue fever, if clinicians do not have a high clinical suspicion of COVID-19. Hence we decided to describe the epidemiology and various presentations of musculoskeletal manifestations of COVID-19 in our cohort of patients.  (more…)
Author Interviews, COVID -19 Coronavirus, Diabetes, Race/Ethnic Diversity / 16.01.2021

MedicalResearch.com Interview with: Anath Shalev, M.D. Professor of Medicine Nancy R. and Eugene C. Gwaltney Family Endowed Chair in Juvenile Diabetes Research Director, Comprehensive Diabetes Center University of Alabama at Birmingham Birmingham, AL  MedicalResearch.com: What is the background for this study?  What is metformin normally prescribed for? Response: Diabetes has been recognized as one of the major comorbidities associated with higher mortality in the context of the spreading COVID-19 pandemic, but ways to improve outcome in this at-risk population are lacking. Metformin is the most common medication used for type 2 diabetes. In addition, it is sometimes prescribed to people with prediabetes or to women with polycystic ovary syndrome (PCOS). (more…)
Author Interviews, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, Pulmonary Disease / 15.01.2021

MedicalResearch.com Interview with: Dr Andrew Conway Morris Wellcome Trust Clinical Research Career Development Fellow University of Cambridge Hon Consultant in Intensive Care Medicine Addenbrookes Hospital, Cambridge MedicalResearch.com: What is the background for this study? Response: Patients with COVID-19 frequently need to come to the intensive care unit (ICU), where we use mechanical ventilation to support their lungs as they get over the intense inflammation caused by the virus.  During the first wave of the virus we noted that a lot of our patients appeared to be developing secondary infections (infections they didn’t have when they came into the ICU). We therefore rolled out a rapid diagnostic test for these secondary bacterial infections that we had developed previously, and this study reports the use of this diagnostic and also describes the types of bacteria seen.  To see if the increase in secondary infections was due to COVID specifically, we compared them to patients who were managed in the same ICU but who did not have COVID. (more…)
Author Interviews, COVID -19 Coronavirus, Mental Health Research, Race/Ethnic Diversity, Social Issues, UCSF / 15.01.2021

MedicalResearch.com Interview with: Jason Nagata, MD, MSc Assistant Professor of Pediatrics University of California, San Francisco San Francisco, California MedicalResearch.com: What is the background for this study? Response: Food insecurity is the inability to afford or access nutritionally adequate and safe foods for an active, healthy lifestyle. Rates of food insecurity were projected to rise during the COVID-19 pandemic; however, prior studies had not examined the association between food insufficiency, the most extreme form of food insecurity, and mental health. MedicalResearch.com: What are the main findings? Response: Using a large national sample of nearly 64,000 adults, we found that food insufficiency rose from 8.1% to 10.0% during the pandemic. People of color and younger adults had higher risk of food insufficiency. People living in poverty or experiencing recent job loss were at higher risk of food insufficiency. Food insufficiency was associated with symptoms of anxiety, worrying, and depression. Hunger, exhaustion, and worrying about not getting enough food to eat may worsen depression and anxiety symptoms. Receiving food assistance alleviated the relationship between food insufficiency and poor mental health.   (more…)
Author Interviews, COVID -19 Coronavirus, Pulmonary Disease / 12.01.2021

MedicalResearch.com Interview with: Dr. Liam Townsend, PhD Department of Infectious Diseases St. James's Hospital and Department of Clinical Medicine Trinity Translational Medicine Institute Trinity College, Dublin, Ireland  MedicalResearch.com: What is the background for this study? Response: Much is known about the clinical characteristics and pathological features of acute SARS-CoV-2 infection, but there is relatively little known about post-COVID recovery. This has come under increasing scrutiny in light of reports that patients suffer persistent symptoms beyond resolution of initial infection, known as long COVID. We set out to assess patients in our post-COVID clinic for ongoing ill-health, with particular focus on fatigue and breathlessness. Given that COVID-19 primarily affects the respiratory system, we also evaluated respiratory recovery. Patients underwent chest radiography and six-minute-walk testing, as well as routine blood tests including inflammatory markers and D-dimers. We included both patients who were admitted during their acute infection as well as those managed in the community in order to capture the full spectrum of disease. (more…)
Aging, Author Interviews, COVID -19 Coronavirus, Pulmonary Disease / 12.01.2021

MedicalResearch.com Interview with: Dr. Maria A. Blasco, PhD Director of the Spanish National Cancer Research Centre Head of the Telomeres and Telomerase Group – CNIO  MedicalResearch.com: What is the background for this study? Response: In my group we have previously described that telomere dysfunction in alveolar type II (ATII) cells in the lung is sufficient to induce pulmonary fibrosis in mice, thus demonstrating that these cells, which have a role in lung regeneration, are at the origin of the disease (Povedano et al., Cell Reports, 2015). Indeed, we further demonstrated that telomere elongation in these cells by using a gene therapy strategy based on telomerase activation, was sufficient to stop the progression of pulmonary fibrosis induced by short telomeres in mice (Povedano, eLife, 2018). (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Heart Disease, JACC / 11.01.2021

MedicalResearch.com Interview with: Rishi K. Wadhera, MD, MPP, MPhil Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center Associate Program Director, Cardiovascular Medicine Fellowship Assistant Professor of Medicine, Harvard Medical School  MedicalResearch.com: What is the background for this study? Response: The direct toll of the novel coronavirus disease 2019 (COVID-19) in the U.S. has been substantial, but concerns have also arisen about the indirect effects of the pandemic on higher-risk patients with chronic medical conditions, such as cardiovascular disease. Hospitalizations for acute cardiovascular conditions, including myocardial infarction, heart failure, and stroke precipitously declined during the early phase of the pandemic. These patterns have raised concern that patients may be avoiding hospitals due to fear of contracting SARS-CoV-2, and that some have died from cardiovascular conditions without seeking medical care. In addition, there has been growing concern about the the effects of health-care system strain and the deferral of semi-elective procedures on patients with cardiovascular conditions. (more…)
Author Interviews, CDC, COVID -19 Coronavirus, JAMA / 08.01.2021

MedicalResearch.com Interview with: Jay C. Butler, MD, FAAP, MACP, FIDSA Deputy Director for Infectious Diseases Centers for Disease Control and Prevention Atlanta, GA  30333 MedicalResearch.com: What is the background for this study? Response: There are still disagreements about the significance of transmission of SARS-CoV-2 from asymptomatic persons.  It has been known since at least March 2020 that, unlike the closely related coronavirus that causes SARS, transmission of COVID-19 from asymptomatic and presymptomatic persons occurs and that at least 30% of infected persons do not develop symptoms.  Estimating the proportion of transmissions from persons without symptoms informs the decision analysis for prioritization of community mitigations opportunities:  wearing of masks, social distancing, and hand hygiene. If only a low proportion of transmission occurs from people without symptoms, these interventions would be less likely to control transmission when broadly applied in the community.  On the other hand, if a significant proportion of spread is from infected persons without symptoms, the value of these measures is enhanced. Additionally, obtaining strategic and systematic screening tests for SARS-CoV-2 to identify and isolate persons without symptoms in selected settings, such as congregational housing settings, will have greater potential impact if spread from persons without symptoms is common.  (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Race/Ethnic Diversity, Social Issues, Technology, University of Pennsylvania / 30.12.2020

MedicalResearch.com Interview with: Srinath Adusumalli, MD, MSc, FACC Assistant Professor of Clinical Medicine Division of Cardiovascular Medicine| Penn Medicine Lauren A. Eberly, MD, MPH Division of Cardiovascular Medicine, Department of Medicine Hospital of the University of Pennsylvania, Philadelphia MedicalResearch.com: What is the background for this study?   Response: The coronavirus disease 2019 (COVID-19) pandemic has uprooted conventional health care delivery for routine ambulatory care, requiring health systems to rapidly adopt telemedicine capabilities. At Penn Medicine, we wanted to ensure that as we developed a new system of telemedical care, we were reaching all of the patients we serve and access to care was maintained. As such, we undertook this study to examine utilization of care as we continued to iterate on and develop our telemedical system of care. (more…)
Author Interviews, COVID -19 Coronavirus / 30.12.2020

MedicalResearch.com Interview with: Anita M. McGahan PhD, MBA University Professor Professor of Strategic Management Professor, Munk School of Global Affairs & Public Policy George E. Connell Chair in Organizations & Society Rotman School of Management University of Toronto MedicalResearch.com: What is the background for this study? What are the main findings? Response:    The article by Phebo Wibbens, Wesley Wu-Yi Koo, and me that came out today in PLOS ONE at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244177 investigates how effective different policies are in accomplishing COVID control across 40 different countries and U.S. states.   The policies that we consider are standardized in the Oxford COVID policy database, and include, for example, school closings, workplace closings, international travel controls, restrictions on gatherings, etc.  Each of these policies can be implemented at different levels of intensity.   The analysis looks at the marginal impact of each of these policies in the presence of the others.  We find that, in 90% of jurisdictions, compliance is not high enough to make a core group of socially tolerable policies sufficient to drive COVID growth below zero.   In these places, one or more tougher-to-tolerate policies must be implemented on top of the core group to get COVID growth to stop. (more…)
Author Interviews, Clots - Coagulation, COVID -19 Coronavirus, Heart Disease, JAMA / 30.12.2020

MedicalResearch.com Interview with: Ana Blasco, MD, PhD Cardiology Department, Hospital Universitario Puerta de Hierro–Majadahonda Madrid, Spain MedicalResearch.com: What is the background for this study? Response: Our group has been investigating issues related to coronary thrombosis in patients with acute myocardial infarction for years. Recently, we developed a standardized technique for the detection and quantification of extracellular neutrophil networks (NETs) in coronary thrombi. During the first wave of the COVID-19 pandemic in Madrid, Spain, we had some cases of myocardial infarctions with ST elevation and a large thrombotic component among patients with severe SARS-CoV-2 infection. Given the important participation of NETs in severe COVID-19 disease, causing occlusion of microvessels as shown in pulmonary samples, we decided to analyze their role in coronary thrombi. Thanks to similar previous analyzes in patients without COVID-19, we have been able to compare our results with a historical series. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, JAMA, Social Issues / 23.12.2020

MedicalResearch.com Interview with: Kenneth Freedberg, MD Director, Medical Practice Evaluation Center Massachusetts General Hospital Professor of Medicine at Harvard Medical School Study senior author Jessie Gaeta, MD Chief Medical Officer Boston Health Care for the Homeless Program Assistant Professor of Medicine Boston University School of Medicine Travis P. Baggett, MD, MPH Faculty clinician-investigator MGH Division of General Internal Medicine Assistant Professor of Medicine Harvard Medical School MedicalResearch.com: What are the main findings?  Dr. Baggett: We found that two strategies are crucial for addressing COVID-19 among people staying in homeless shelters: 1) Proactively identifying and testing people with symptoms, and 2) Providing a dedicated, medically supervised, non-hospital space for isolation and management of people with mild to moderate COVID. Together these two strategies would reduce infections, hospitalizations, and health care costs compared to not doing them. During a pandemic surge, like we are seeing now, it makes sense to add periodic universal testing of all shelter residents, even those without symptoms. (more…)
Annals Internal Medicine, Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Education / 23.12.2020

MedicalResearch.com Interview with: Elena Losina, PhD Robert W. Lovett Professor of Orthopedic Surgery Harvard Medical School Director, Policy and Innovation eValuations in Orthopedic Treatments (PIVOT) Center Co-Director, Orthopedic and Arthritis Center for Outcomes Research Department of Orthopedic Surgery Brigham and Women’s HospitalBoston, MA, 02115 MedicalResearch.com: What is the background for this study? Response: Since the pandemic began, there have been over 320,000 COVID-19 cases and 80 deaths at over 1,700 colleges, highlighting the consequences of different mitigation strategies, and as colleges are closing the fall semester and preparing for the spring semester, figuring out what worked what did not, in term of COVID-19 mitigation, is critical to minimize the impact of COVID-19 on college campuses during the spring semeste.  (more…)
Abuse and Neglect, Author Interviews, COVID -19 Coronavirus, Emergency Care, Heart Disease / 21.12.2020

MedicalResearch.com Interview with: Michalis Katsoulis PhD Immediate PostDoctoral BHF fellow Institute of Health Informatics Senior Research Fellow, UCL MedicalResearch.com: What is the background for this study? Response: In the early stage of the pandemic, we observed a decline in patient visits to Emergency Departments (ED), including those for cardiac diseases. This decline may have been due to fear of coronavirus infection when attending hospital, public reluctance to overload National Health Service facilities, or difficulty accessing care. In our study, we tried to estimate the impact of reduced ED visits on cardiac mortality in England. We used data from ED visits from the Public Health England Emergency Department Syndromic Surveillance System (EDSSS). For cardiovascular disease outcomes, we obtained mortality counts for cardiac disease from the Office of National Statistics (ONS) for England. (more…)