Author Interviews, CDC, COVID -19 Coronavirus, Heart Disease, JAMA, UCSD / 01.07.2021
More Myocarditis Cases Than Expected in Young Men After 2nd RNA Vaccine Dose
MedicalResearch.com Interview with:
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Dr. Margaret Ryan[/caption]
Margaret Ryan MD MPH
Medical Director of Defense Health Agency Immunization
Healthcare Division
Pacific Region Office, San Diego CA
Clinical Professor at the University of California San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Military clinicians, especially those in the Defense Health Agency Immunization Healthcare Division, first became aware of a few cases of myocarditis following COVID-19 vaccination in early Feb 2021. These cases included young men who presented with chest pain a few days after 2nd dose of mRNA (Pfizer or Moderna) vaccine. As more young people became eligible for 2nd doses of vaccine, more cases were identified. By late April, the military had identified 23 cases of myocarditis, with remarkably similar presentations, after COVID-19 vaccination. This case series is described in the current issue of JAMA Cardiology.
Dr. Margaret Ryan[/caption]
Margaret Ryan MD MPH
Medical Director of Defense Health Agency Immunization
Healthcare Division
Pacific Region Office, San Diego CA
Clinical Professor at the University of California San Diego
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Military clinicians, especially those in the Defense Health Agency Immunization Healthcare Division, first became aware of a few cases of myocarditis following COVID-19 vaccination in early Feb 2021. These cases included young men who presented with chest pain a few days after 2nd dose of mRNA (Pfizer or Moderna) vaccine. As more young people became eligible for 2nd doses of vaccine, more cases were identified. By late April, the military had identified 23 cases of myocarditis, with remarkably similar presentations, after COVID-19 vaccination. This case series is described in the current issue of JAMA Cardiology.
Dr. Els Broens[/caption]
Els M. Broens DVM, PhD, Dipl. ECVM, EBVS
European Veteirnary Specialist in Veterinary Microbiology
Associate Professor / Director VMDC
Department Biomolecular Health Sciences (Clinical Infectiology)
Faculty of Veterinary Medicine | Utrecht University
MedicalResearch.com: What is the background for this study?
Response: Several events have demonstrated that SARS-CoV-2 can infect animals, felines and mustelids in particular. In companion animals these are currently considered to be incidents with a negligible risk for public health since the main force of the pandemic is transmission between humans. However, it is urgent to understand the potential risk of animal infections for public health in the later stages of the pandemic when SARS-CoV-2 transmission between humans is greatly reduced and a virus reservoir in animals could become more important.
Incidental cases have shown that COVID-19 positive owners can transmit SARS-CoV-2 to their dog or cat. The close contact between owners and their dogs and cats and the interaction between dogs and cats from different households raises questions about the risk for pets to contract the disease and also about role of these animals in the transmission of SARS-CoV-2.
Dr. Ferrara[/caption]
Michele Ferrara, PhD.
Professor of Psychobiology and Physiological Psychology
Chair of the Psychology Didactic Council
Department of Biotechnological and Applied Clinical Sciences
University of L'Aquila
MedicalResearch.com: What is the background for this study?
Response: During the current period of social distancing, the pervasive increase in the use of electronic devices (smartphones, computers, tablets and televisions) is an indisputable fact. Especially during the long lockdown period of Spring 2020, technologies played a pivotal role in coping with the unprecedented and stressful isolation phase. However, exposure to backlit screens in the hours before falling asleep can have serious repercussions on sleep health: on the one hand, by mimicking the effects of exposure to sunlight, and thus interfering with the circadian rhythm of the hormone melatonin, and on the other hand, counteracting the evening sleepiness due to the emotionally and psycho-physiologically activating contents.
In light of this assumption, we decided to test longitudinally during the third and the seventh week of lockdown a large Italian sample (2123 subjects) through a web-based survey. We assessed sleep disturbances/habits and the occurring changes of electronic device usage in the 2 hours before the sleep onset.
Dr. Navlakha[/caption]
Saket Navlakha PhD
Simons Center for Quantitative Biology
Cold Spring Harbor Laboratory
Cold Spring Harbor, NY
MedicalResearch.com: What is the background for this algorithm? How does it aide in patient care?
Response: The machine learning algorithm helps to predict if and when a patient will develop severe COVID symptoms, based on information on how the patient presents on the day of infection. This could lead to improved patient outcomes, by getting a “heads up” on what may happen in the near future.
Dr. Peruvemba[/caption]
Ramani “Ram” Peruvemba, MD, FASA
Co-founder and CMO of HSR.health
MedicalResearch.com: Would you tell us about your background?
Response: I am a dual-board certified Anesthesiologist and Pain Management physician, currently serving as the co-founder and CMO of 
Prof. Papageorghiou[/caption]
Aris Papageorghiou MBChB, MRCOG
Professor of Fetal Medicine and the Clinical Research Director
Oxford Maternal and Perinatal Health Institute
University of Oxford
MedicalResearch.com: What is the background for this study?
Response: Our study was really guided by a key question: does Covid-19 in pregnancy increase the risk of adverse maternal and neonatal outcomes as compared with pregnant women who do not have the infection?
The question is highly relevant because of the known deleterious effects of other coronavirus infections in pregnancy, e.g. SARS (severe acute respiratory syndrome) and MERS-CoV (Middle East respiratory syndrome coronavirus).
In order to answer this question we undertook this multinational cohort study.
Dr. Hosie[/caption]
Margaret J. Hosie BVM&S, MRCVS, BSc. PhD.
Professor of Comparative Virology
MRC-University of Glasgow Centre for Virus Research
United Kingdom
MedicalResearch.com: What is the background for this study?
Response: SARS-CoV-2 is a new coronavirus of animal origin that recently jumped to humans and has spread rapidly across the world. It is likely that SARS-CoV-2 will establish as an endemic virus of humans, which has the potential to be transmitted to animals that live in close proximity to humans. There have been sporadic reports of infections in pet cats in households with COVID-19 patients, which demonstrates that cats are susceptible to SARS-CoV-2 infection and could act as virus reservoirs.
Dr. Blankson[/caption]
Joel N. Blankson, MD, PhD
Department of Infectious Diseases
Associate Professor
Cellular and Molecular Medicine Program
Johns Hopkins
MedicalResearch.com: What is the background for this study? Which vaccines did you evaluate?
Response: Prior studies from several groups including our own have found T cell cross-recognition of peptides from SARS-CoV-2 and the common cold coronaviruses.
We asked whether as a result of this cross-reactivity, immunization with the SARS-CoV-2 vaccine would also enhance T cell responses to the common cold coronaviruses.
Prior studies also suggested that antibodies elicited from the mRNA vaccines had a reduced ability to neutralize the emerging variants of concern.
Most of the study participants had received the Pfizer vaccine, but a few had received the Moderna vaccine. 
Dr. Lashaki[/caption]
Masoud Jahandar Lashaki, Ph.D.
Assistant Professor
Department of Civil, Environmental and Geomatics Engineering
Florida Atlantic University
MedicalResearch.com: What is the background for this study?
Response: Toilet flushing can generate large quantities of microbe-containing aerosols depending on the design and water pressure or flushing energy of the toilet. Based on previous reports, a variety of different pathogens which are found in stagnant water or in waste products (e.g., urine, feces, and vomit) can get dispersed widely via such aerosolization, including the legionella bacterium responsible for causing Legionnaire’s disease, the Ebola virus, the norovirus which causes severe gastroenteritis (food poisoning), and the Middle East Respiratory Syndrome coronavirus (MERS-CoV).
Based on previous reports, such airborne dispersion is suspected to have played a key role in the outbreak of viral gastroenteritis aboard a cruise ship, where infection was twice as prevalent among passengers who used shared toilets compared to those who had private bathrooms. Similarly, transmission of norovirus via aerosolized droplets was linked to the occurrence of vomiting or diarrhea within an aircraft restroom, as passengers and crew who got infected subsequently were more likely to have visited restrooms than those that were not infected. The participants in the study reported that all of the restroom surfaces appeared to be clean, which indicates that infection is likely to have occurred via bioaerosols suspended within the restroom.
Although many of these studies blamed flush-generated aerosols for disease outbreak, a limited number of them quantified the presence of such aerosols. Consequently, we decided to conduct this study to demonstrate the spike in aerosol concentrations following flushing. 
Dr. Bullard[/caption]
Jared Bullard MD FRCPC
Associate Professor, Departments of Pediatrics & Child Health and Medical Microbiology & Infectious Diseases
Max Rady College of Medicine
Rady Faculty of Health Sciences
Cadham Provincial Laboratory
Children’s Hospital Research Institute of Manitoba
MedicalResearch.com: What is the background for this study?
Response: Children are well known to transmit epidemic/endemic respiratory viruses like influenza. Initial public health policy was based on that children were likely to transmit SARS-CoV-2 effectively within a community and subsequently in-person school and extracurricular activities were suspended.
Initial research did not show a clear association with children driving transmission. The purpose of our study was to take respiratory samples from both children and adults with COVID-19 (all had SARS-CoV-2 detected by RT-PCR) and compare those samples by their ability to grow in cell culture and amount of virus in samples.
We took 175 samples from children (97 younger than 10 years of age and 78 between 11-17 years) and compared them to 130 adult samples from the same communities in Manitoba experiencing outbreaks of COVID-19. 
Dr. Sickbert-Bennett[/caption]
Emily Sickbert-Bennett PhD, MS, CIC, FSHEA
Director, Infection Prevention, UNC Hospitals
Administrative Director, Carolina Antimicrobial Stewardship Program, UNC Hospitals
Associate Professor of Medicine-Infectious Diseases, UNC School of Medicine
Associate Professor of Epidemiology, UNC Gillings School of Global Public Health
MedicalResearch.com: What is the background for this study?
Response: Recently public health officials have recommended doubling masks, although the 
Dr. Dashti[/caption]
Hesam Dashti, PhD
Brigham and Women's Hospital, Harvard Medical School
Senior Computational Scientist
The Broad Institute of MIT and Harvard
MedicalResearch.com: What is the background for this study? What parameters does the SARS2 score take into consideration?
Response: While complex models have been developed for predicting the severity of COVID-19 from the medical history, laboratory, and imaging results of patients, simplified models with similar accuracy would be more practical for individualizing the decision making, especially when detailed medical history of patients is not readily available. In this study, we developed the SARS2 risk equations for estimating risk of hospitalization of patients with COVID-19 and also the risk of mortality among hospitalized patients. The “SARS2” risk equations are named for their input variables: Sex, Age, Race, Socioeconomic and Smoking status.
To develop and validate the models, we used the electronic records from 12,347 patients who tested positive for COVID-19 at the Mass General Brigham medical centers in Massachusetts between 02/26/2020 and 07/14/2020 to construct derivation and validation cohorts for estimating 1) risk of hospitalization within 30 days of COVID-19 positive PCR test, and 2) for the hospitalized patients, risk of mortality within approximately 3 months.
Dr. Sinha[/caption]
Pranay Sinha, MD
Section of Infectious Diseases
Boston University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: We hypothesized that mitigation measures such as physical distancing and mask wearing instituted in Boston would reduce transmission of common respiratory viruses such as influenza, Rhinovirus, and Parainfluenzavirus. We compared the rate of detection of such viruses at Boston Medical Center on comprehensive respiratory panels in the ambulatory, emergency room, and hospital settings in 2020 to rates in the previous five years.
Dr. Meyer, J.D.[/caption]
Michelle N. Meyer, PhD, JD
Assistant Professor & Associate Director, Research Ethics, Center for Translational Bioethics & Health Care Policy
Faculty Co-Director, Behavioral Insights Team, Steele Institute for Health Innovation
Assistant Professor of Bioethics
Geisinger Commonwealth School of Medicine
Geisinger, PA
MedicalResearch.com: What is the background for this study?
Response: Earlier research had found people are less likely to say they'll receive a COVID-19 vaccine offered to them under an Emergency Use Authorization (EUA) than one offered to them following full FDA approval. Earlier surveys had also found that only around 30% of health care workers intended to receive a COVID-19 vaccine. Because the public often looks to local health care workers for health advice, and in most prioritization schemes they were slated to be offered vaccines first, this was quite concerning for the prospect of achieving population immunity. Commenters had warned that if the FDA chose to make COVID-19 vaccines available under EUAs, that substantial efforts would need to be made to ensure trust. On Dec. 4, 2020, an announcement about anticipated vaccine availability was emailed to all 23,784 Geisinger employees, who were asked to indicate their intention to receive a vaccine when one was available to them and the reasons for any hesitation they might have.
