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…)
Author Interviews, COVID -19 Coronavirus, Genetic Research, NYU / 19.12.2020

MedicalResearch.com Interview with: John T. Poirier, PhD Assistant Professor of Medicine, NYU Grossman School of Medicine Director, Preclinical Therapeutics Program Perlmutter Cancer Center An NCI-designated Comprehensive Cancer Center NYU Langone Health Smilow Research Center New York, NY 10016  MedicalResearch.com: What is the background for this study? Response: The goal of this study was to identify in as much detail as possible the genes that SARS-CoV-2, the virus that causes COVID-19, needs to successfully infect a human host cell. CRISPR technology played a key role in this research; it was used to disrupt every gene in the human genome in parallel and study which ones were required for infection. (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, University of Pennsylvania, Vaccine Studies / 18.12.2020

MedicalResearch.com Interview with: Emily Largent, PhD, JD, RN Senior Fellow Leonard Davis Institute of Health Economics Assistant Professor, Medical Ethics and Health Policy Perelman School of Medicine  MedicalResearch.com: What is the background for this study? Response: Ending the COVID-19 pandemic through vaccination will require sufficient vaccine uptake.  Various means are being considered to promote uptake, including mandatory vaccination.  For instance, COVID-19 vaccination might be mandated by states (e.g., as a condition for children to attend public school) or by employers.  Given the opposition we’ve seen to masks, to choose just one example, our team wanted to gauge the acceptability of COVID-19 vaccine mandates. (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, Lung Cancer / 17.12.2020

MedicalResearch.com Interview with: Robert Van Haren, MD, MSPH College of Medicine University of Cincinnati  MedicalResearch.com: What is the background for this study? Response: The COVID-19 pandemic has impacted all areas of society including the field of oncology. This study evaluated the impact of COVID-19 on lung cancer screening.  Screening with low-dose computed tomography (LDCT) scans are important because they reduce lung cancer mortality by at least 20%.  Our lung cancer screening program was closed in March 2020 due to COVID 19 and reopened again in June 2020.  We cancelled over 800 LDCTs during that time period.  (more…)
Author Interviews, COVID -19 Coronavirus / 17.12.2020

MedicalResearch.com Interview with: Xiaolei Yang  The State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics School of Engineering Sciences University of Chinese Academy of Sciences Beijing, China hallway-air-flow.jpegMedicalResearch.com: What is the background for this study? What are the main findings? Response: The most important finding of this study is that the transmission of COVID-19 is highly influenced by the airflow and that a slight difference in the airflow can significantly alter the virus spreading pattern in the air. In this study, the change of airflow is caused by a minor difference in the corridor width and the walking speed. However, such a change can also come from other factors, such as the indoor architectural structure, the temperature, the humidity, etc. In many of these cases, the common guideline of 6-feet may not be enough when the influence of airflow is taken into account. Due to this complexity, there is still a gap of knowledge to fill before a safety guideline for different indoor environments can be provided to the public, many research efforts are needed from the fluid mechanics’ aspect. (more…)
Author Interviews, Brigham & Women's - Harvard, COVID -19 Coronavirus, Critical Care - Intensive Care - ICUs, End of Life Care / 14.12.2020

MedicalResearch.com Interview with: Isaac Chua, MD, MPH Division of General Internal Medicine and Primary Care Brigham and Women's Hospital MedicalResearch.com: What is the background for this study? Response: Patient surveys have shown that most people prefer to die at home at the end-of-life. However, during the initial wave of the COVID-19 pandemic, anecdotal evidence from our colleagues and findings from a prior study published in the Journal of the American Geriatrics Society suggested that majority of COVID-19 decedents died in a medical facility. However, less is known about care intensity at the end-of-life according to place of death among patients who died of COVID-19. Therefore, we characterized end-of-life care by place of death among COVID-19 decedents at Mass General Brigham (MGB), the largest health system in Massachusetts.  (more…)
Author Interviews, COVID -19 Coronavirus, OBGYNE / 13.12.2020

MedicalResearch.com Interview with: Sheela Maru, MD, MPH Department of Health System Design and Global Health and Arnhold Institute for Global Health and Department of Obstetrics, Gynecology and Reproductive Science Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? Response: Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic. (more…)
Author Interviews, COVID -19 Coronavirus, CT Scanning, Johns Hopkins, Nature / 12.12.2020

MedicalResearch.com Interview with: Nilanjan Chatterjee, PhD Bloomberg Distinguished Professor Departments of Biostatistics and Epidemiology Johns Hopkins Bloomberg School of Public Health  MedicalResearch.com: What is the background for this study? Response: Calculation of risks or severe COVID-19 disease and mortality for individuals in the general population can help to prioritize prevention efforts, such as early vaccination. We developed a model to estimate risks for COVID-19 mortality for currently uninflected individuals based on sociodemographic factors, pre-existing conditions and local pandemic intensity.  The model captures factors associated with both risk of infection and complications after infection. The model was developed using information from a large UK based cohort study called OpenSAFELY, and was adapted to the US population based on information on mortality rate associated with age and race/ethnicity available through CDC.  The model also utilizes information on state level projected death rates from pandemic forecasting models.  (more…)
Author Interviews, COVID -19 Coronavirus, Environmental Risks, Science / 11.12.2020

MedicalResearch.com Interview with: Asimanshu Das, Ph.D. student Brown University School of Engineering MedicalResearch.com: What is the background for this study? What are the main findings? Response: Driving in a car with  ride-share or car-pool is a widely prevalent social interaction. The study aimed to address the airflows inside cars in various window open/closed configurations using computer simulations, and also looking into the possibility of movement of aerosol-type of particles from one occupant to other. The main findings are that opening windows provides a likely benefit to reduce the potentially pathogenic aerosols inside the cabin. Generally, more windows the better, but at the least it would be advisable to have one rear side window and one frontside window open. (more…)
Author Interviews, Breast Cancer, Cancer Research, COVID -19 Coronavirus / 10.12.2020

MedicalResearch.com Interview with: Joanne L. Blum, MD, PhD, FACP Texas Oncology and Director Hereditary Cancer Risk Program Baylor University Medical Center MedicalResearch.com: What is the background for this study? Would you briefly describe the POLARIS study? Response: POLARIS is an ongoing prospective, real-world, non-interventional study in patients with HR+/HER2-ABC receiving palboiclib plus endocrine therapy with a targeted enrollment of 1500 patients at 110 sites in the United States and Canada.  MedicalResearch.com: What are the main findings?
  • Because of the COVID-19 pandemic, approximately one third of the study sites experienced an impact on their responsiveness to correspondence, timely data entry, and subject management.
  • The geographic location or type (e.g., academic or community) of study site appears associated with whether the site was impacted by COVID-19.
  • Other study site characteristics were generally similar between sites that reported an impact of COVID-19 and those that were not impacted.
  • Because of inherent limitations of survey studies, these findings must be interpreted with caution.
(more…)
Author Interviews, Infections / 09.12.2020

MedicalResearch.com Interview with: Ed Breitschwerdt, DVM, DACVIM The Melanie S. Steele Distinguished Professorship in Medicine Professor, Internal Medicine NC State College of Veterinary Medicine MedicalResearch.com: What is the background for this study? Response: Bartonella species represent a medically underappreciated group of vector-transmitted bacteria that are increasingly implicated in a spectrum of animal and human diseases. Most recently, our research group has focused on the potential role of these bacteria as a cause or co-factor in patients with neuropsychiatric symptoms. This focus is based upon prior case reports and case series generated by our research group and others. (more…)
Alcohol, Author Interviews, COVID -19 Coronavirus / 07.12.2020

MedicalResearch.com Interview with: Sitara Weerakoon, MPH (she/her) PhD Candidate | Epidemiology & Biostatistics Graduate Research Assistant Center for Pediatric Population Health UTHealth MedicalResearch.com: What is the background for this study? What are the main findings? Response: Measures to control the spread of COVID-19 included stay-at-home mandates and business lockdown policies which resulted in many facing a loss of income or employment and more time spent isolated at home. Life stressors (like job loss and social isolation) have been shown to be associated with increased drinking at unhealthy levels. Those with a history of mental health problems may be even more at risk. We aimed to see if binge drinking (5 or more drinks [male] or 4 or more drinks [female] in one session) and levels of alcohol consumption among binge drinkers were impacted by these pandemic-related factors. We found that increased time spent at home (in weeks) was associated with a 19% increase in the odds of binge drinking and binge drinkers with a previous diagnosis of depression and current depression symptoms (during the early months of the pandemic) had a 237% greater odds of drinking more alcohol (vs drinking the same amount) compared to those with no history and current symptoms of depression. (more…)
Author Interviews, COVID -19 Coronavirus / 07.12.2020

MedicalResearch.com Interview with: Prof. Martin Scholz Heinrich-Heine-University Düsseldorf, Germany MedicalResearch.com: What is the background for this study? Response: Primary care physicians should have options available to effectively treat newly diagnosed COVID-19 patients in the outpatient setting to avoid severe COVID-19 progression, hospitalizations, and mortality. Already since the beginning of the pandemic different early treatment options were evaluated. My co-authors, Dr. Zelenko, Dr. Derwand, and myself were keen to confirm retrospectively the observed evidence for beneficial early treatment effects of an already applied  triple therapy in combination with a risk stratification approach. The defined risk stratification allowed to differentiate between patients at low and high risk for disease progression and guided treatment decisions. (more…)
Author Interviews, Cancer Research, COVID -19 Coronavirus, Leukemia / 06.12.2020

MedicalResearch.com Interview with: William Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of MedicineWilliam Wood, MD Associate Professor of Medicine, Division of Hematology UNC School of Medicine MedicalResearch.com: What is the background for this study? What are the main findings? Response: In the earliest days of the COVID-19 pandemic, there were concerns that individuals with cancer, and especially those with hematologic malignancies, could be at higher risk for adverse outcomes following COVID-19 infection than the general population. For this reason the ASH Research Collaborative developed a voluntary data collection registry in which providers or sites caring for patients with hematologic malignancies and COVID-19 infection provided de-identified data via an online data collection platform. We believe that our findings – that 20% of patients with blood cancers who had COVID-19 infection died, including 33% of those who required hospital or ICU level-care – indicate that patients with blood cancers are a medically vulnerable group when it comes to COVID-19. The risk of dying was highest in patients who were older, had more severe infection, opted to forego more intensive treatment, and/or had poorer prognosis before their COVID-19 infection, as determined by their treating clinicians (more…)
Author Interviews, COVID -19 Coronavirus, Infections, JAMA, NYU, Race/Ethnic Diversity / 04.12.2020

MedicalResearch.com Interview with: Gbenga Ogedegbe, MD, MPH Dr. Adolph & Margaret Berger Professor of Population Health Director, Division of Health & Behavior Director Center for Healthful Behavior Change Department of Population Health NYU Langone Health NYU School of Medicine MedicalResearch.com: What is the background for this study? Response: The background for the study is the disproportionately higher rates of COVID-19 hospitalizations and deaths in Blacks and Hispanics compared to Whites in major cities across the country. We asked two questions: 1) are there racial/ethnic differences in COVID-19 outcomes (likelihood of testing positive, hospitalizations, severe illness, and deaths) among patients who receive care at NYU Langone Health? If there are differences, are they explained by comorbidity and neighborhood characteristics (poverty, educational status, employment, housing, proportion of Blacks and Hispanics in communities)? (more…)
Author Interviews, COVID -19 Coronavirus, Hematology / 04.12.2020

MedicalResearch.com Interview with: George Sakoulas, MD Sharp Memorial Hospital and Sharp Rees-Stealy Medical Group Associate Adjunct Professor UC San Diego School of Medicine San Diego MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by IVIG?   Response: IVIG stands for intravenous immunoglobulin. It is a preparation from pooled blood donors isolating antibodies in their blood and highly concentrated for use. It's uses are to either replace immunoglobulins in patients who do not produce enough of them because of some underlying immunodeficiency or, as in the case of COVID, they take advantage of the immune signaling properties of the non-variable part of the antibodies. Many immune cells have receptors that bind the non-variable (also called the Fc-gamma region), and when bound, the activity of these activated immune cells is modulated. IVIG is used in many immunologic complications of infections like Guillan-Barre, Kawasaki's disease, immune mediated encephalitis from mycoplasma, just to name a few. We decided to study IVIG because:
  1. Our anecdotal yet successful use of IVIG in treating ARDS due to influenza and other viruses.
  2. Our very definitive successful use of IVIG in a very sick patient with COVID early in the pandemic.
  3. The weak yet positive retrospective data from China of IVIG in COVID.
  4. The mechanism of IVIG inhibiting neutrophil extracellular trap (or NETS) thought to play an important role in COVID severe disease.
  5. IVIG has been around to 4 decades and many physicians have a level of prescribing comfort.
It is worth clarifying that the benefit here is NOT from neutralizing antibodies against SARS-CoV-2 virus but rather the immunomodulatory effect. It will be very interesting to see if the effect/benefit changes over time as pooled blood donors feeding the IVIG supply do develop more antibodies against SARS-CoV-2, but this is not yet known.  (more…)
Author Interviews, COVID -19 Coronavirus, JAMA, Pediatrics, Smoking, Stanford, Tobacco, Tobacco Research / 03.12.2020

MedicalResearch.com Interview with: Bonnie Halpern-Felsher, PhD, FSAHM (pronouns: she/her) Professor of Pediatrics Taube Endowed Research Faculty Scholar Professor (by courtesy), Epidemiology and Population Health Professor (by courtesy), Psychiatry and Behavioral Sciences Director of Fellows’ Scholarship, Department of Pediatrics Director of Research, Division of Adolescent Medicine Co-leader, Scholarly Concentrations, Pediatrics Residency Program MedicalResearch.com: What is the background for this study? What are the main findings? Response: To examine adolescent and young adult e-cigarette use during the COVID-19 pandemic. There were 4 main findings:
  • About 2/3 of adolescent and young adult ever-e-cigarette users reported either quitting or cutting back on e-cigarette use since COVID-19 began.
  • Users least likely to quit or cut back e-cigarette use were those showing higher levels of nicotine dependence and those who had used e- cigarettes a large number of times.
  • Adolescent and young adult e-cigarette users found it harder to access e-cigarettes, but unlike studies before COVID-19, the dominant source of purchasing e-cigs was online instead of brick-and-mortar during COVID-19 pandemic.
  • Youth below 21 years were able to purchase e-cigarettes without any age verification, and those whose age was verified were asked to physically show ID or provided an email, which are less effective means to prevent underage youth use.
(more…)
Addiction, Author Interviews, COVID -19 Coronavirus, JAMA, Opiods, UCLA / 03.12.2020

MedicalResearch.com Interview with: Joseph Friedman, MD/PhD student David Geffen School of Medicine UCLA MedicalResearch.com: What is the background for this study? Response: Numerous researchers, clinicians, officials, harm reduction agencies, and people who use drugs have sounded the alarm that the COVID-19 pandemic is exacerbating the United States overdose crisis. However, data sources typically used to track overdoses in the US often have long lags that impede timely monitoring and response. For example, the CDC released preliminary overdose figures for 2019 in July 2020, and even these numbers may change. As they are available in near real-time, emergency medical services (EMS) data have increasingly been used as a source of up-to-date information to monitor epidemiological shifts during the COVID-19 pandemic. In this study, we used data from the National EMS Information System (NEMSIS), a large registry of over 10,000 EMS agencies in 47 states that represented over 80% of all EMS activations nationally in 2020. We used the data to track shifts in overdose-related cardiac arrests observed by EMS.   (more…)
Author Interviews, COVID -19 Coronavirus, Inflammation, JAMA, Pediatrics, Race/Ethnic Diversity / 30.11.2020

MedicalResearch.com Interview with: Ellen H. Lee, MD Incident Command System Surveillance and Epidemiology Section New York City Department of Health and Mental Hygiene Long Island City, New York  MedicalResearch.com: What is the background for this study? Response: Published reports of the COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) have described higher proportions of cases among Black and Hispanic children. However, case series are limited by the lack of population-level data, which could help provide context for the racial/ethnic distribution of cases described in these reports. The New York City (NYC) Department of Health and Mental Hygiene required reporting of all possible cases of MIS-C among NYC residents, and for cases meeting MIS-C criteria, applied population denominators to calculate MIS-C incidence rates stratified by race/ethnicity. To help characterize the burden of severe COVID-19 disease in NYC, we also calculated COVID-19 hospitalization rates stratified by race/ethnicity. (more…)