Author Interviews / 22.05.2020

MedicalResearch.com Interview with: Marco Piccininni Research Associate, CONVERGE Universitätsmedizin Institute of Public Health Berlin, Germany MedicalResearch.com: What is the background for this study? Response: The Lombardy region of northern Italy was severely hit by the covid-19 pandemic. However, despite the very high number of confirmed covid-19 deaths in this region, some local investigations suggested that there was a mismatch between the confirmed covid-19 death count and the increase in all-cause deaths. In our study, we decided to further investigate this aspect in the city of Nembro (province of Bergamo), which was one of the first cities to report covid-19 cases, and one of the cities most affected by the pandemic. (more…)
Author Interviews, COVID -19 Coronavirus / 12.05.2020

MedicalResearch.com Interview with: Peter Jüni, MD, FESC Director, Applied Health Research Centre Li Ka Shing Knowledge Institute of St Michael's Hospital Department of Medicine University of Toronto, Ontario  MedicalResearch.com: What is the background for this study? Response: It is unclear whether seasonal changes, school closures or other public health interventions will result in a slowdown of the current coronavirus disease 2019 (COVID-19) pandemic. We studied 144 geopolitical areas around the world with more than 375,000 COVID-19 cases by March 27 to determine whether epidemic growth is globally associated with climate or public health interventions intended to reduce transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). (more…)
Author Interviews, COVID -19 Coronavirus, Lancet, Rheumatology / 08.05.2020

MedicalResearch.com Interview with: Dr. Giulio Cavalli MD PhD & Prof. Lorenzo Dagna MD FACP Ospedale San Raffaele and Vita-Salute San Raffaele University Milan, Italy     MedicalResearch.com: What is the background for this study? Response: Upon encountering pathogens, our immune system produces pro-inflammatory mediators, called cytokines. Cytokines activate cells from the immune system. In most people, production of cytokines is an appropriate and protective response to infection. However, some individuals develop excessive and detrimental inflammatory responses, which are even more harmful than the pathogen itself to the host organism. We hypothesized that some patients with COVID-19 might develop excessive and detrimental inflammation, and that treatment with anti-inflammatory agents might be beneficial in this population. Anakinra is an inhibitor of the pro-inflammatory molecule interleukin 1 (IL-1). It was originally marketed for the treatment of rheumatoid arthritis, but is now mostly used to treat a variety of pediatric inflammatory diseases. (more…)
Author Interviews, COVID -19 Coronavirus / 08.05.2020

MedicalResearch.com Interview with: Anirban Basu, Ph.D. Stergachis Family Endowed Director and Professor The Comparative Health Outcomes, Policy, and Economics (CHOICE) Institute University of Washington, Seattle MedicalResearch.com: What is the background for this study? What are the main findings? Response: The infection fatality ratio (IFR) of Covid19 infections is a key parameter to model the future burden of this pandemic. Case fatality rates at any point in time provide a biased estimate of IFR because of the undercounting in both the reported number of covid deaths (numerator) and the reported number of Covid19 cases (denominator). Instead, this study looked at the temporality or time trend of the CFRs within specific counties in the US (where data were deemed to be mature) to understand the underlying IFRs that these trends allude to. It estimates county-specific IFR to range from 0.5% to 3.6%, with a population average for the US at 1.3% (95% CCI: 0.6% - 2.1%).  (more…)
Author Interviews, COVID -19 Coronavirus, Weight Research / 24.04.2020

MedicalResearch.com Interview with: Univ.-Prof. Norbert Stefan, MD -Heisenberg Professorship for Clinical and Experimental Diabetology Internal Medicine IV, University of Tübingen -Head of the Department of Pathophysiology of Prediabetes at the Institute of Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich -Visiting Professor Harvard Medical School, Boston, USA  MedicalResearch.com: What is the background for this study? Response: Working in the field of obesity and cardiometabolic diseases my colleagues and I were very surprised that most of the articles reporting data about comorbid conditions, which may be associated with increased risk of severe COVID-19, did not provide data about body fat mass. Because increased fat mass, and more so higher upper-body fat mass, are known to strongly predict an increased risk of cardiometabolic disease, pneumonia and mortality, we hypothesized that they may also predict a more severe course of COVID-19. (more…)
Author Interviews, COVID -19 Coronavirus / 23.04.2020

MedicalResearch.com Interview with: David B. Douglas, M.D., M.P.H. Harvard T.H. Chan School of Public Health MedicalResearch.com: What is the background for this study? Response: Health care workers are facing the major threat of catching COVID-19 through their eyes, yet currently available eye protection is inadequate. Specifically, the use of open-type eye protection allows airborne viruses to float over the top, around the sides or under the bottom of the lenses and contact the eyes. Additionally, eye protection is well known to fog up, which limits usability by making even the most basic tasks challenging. In fact, fogged goggles is a major barrier to use. (more…)
COVID -19 Coronavirus, FDA / 21.04.2020

'The U.S. Food and Drug Administration authorized the first diagnostic test with a home collection option for COVID-19. Specifically, the FDA re-issued the emergency use authorization (EUA) for the Laboratory Corporation of America (LabCorp) COVID-19 RT-PCR Test to permit testing of samples self-collected by patients at home using LabCorp’s Pixel by LabCorp COVID-19 Test home collection kit. “Throughout this pandemic we have been facilitating test development to ensure patients access to accurate diagnostics, which includes supporting the development of reliable and accurate at-home sample collection options,” said FDA Commissioner Stephen M. Hahn, M.D. “The FDA’s around-the-clock work since this outbreak began has resulted in the authorization of more than 50 diagnostic tests and engagement with over 350 test developers. Specifically, for tests that include home sample collection, we worked with LabCorp to ensure the data demonstrated from at-home patient sample collection is as safe and accurate as sample collection at a doctor’s office, hospital or other testing site. With this action, there is now a convenient and reliable option for patient sample collection from the comfort and safety of their home.” (more…)
Author Interviews, COVID -19 Coronavirus / 21.04.2020

MedicalResearch.com Interview with: Dr. med. Manuel Döhla Associate Researcher, AG "One Health" Institute for Hygiene and Public Health Medical Faculty, University of Bonn Bonn, Germany MedicalResearch.com: What is the background for this study? Response: Rapid and reliable testing of suspected cases is an important measure in the fight against the corona pandemic. In PCR diagnostics, 24 hours and sometimes more elapse between testing and notification of the test result. During this period, suspect cases must be isolated pre-emptively so that they do not cause further transmission. This is logistically and personnel-intensive and highly error-prone. The shorter the time between test and result, the more effective containment measures can be. This is why the test we have evaluated, which shows a result within 20 minutes, has aroused our interest. The manufacturer's specifications (sensitivity 70 % in early stage disease (day 4-10), 100 % in late stage disease (day 11-24), specificity 100 %) were promising. (more…)
Annals Internal Medicine, Author Interviews, COVID -19 Coronavirus / 18.04.2020

MedicalResearch.com Interview with: Nathan Stall, MD, FRCPC Geriatrics and Internal Medicine (Clinical Associate) Sinai Health System and the University Health Network Hospitals PhD Candidate, Clinical Epidemiology & Health Care Research Institute of Health Policy, Management and Evaluation Eliot Phillipson Clinician-Scientist Training Program
Vasily Giannakeas, MPH Epidemiologist/ Dedicated ICES Analyst Women's College Hospital Toronto, Ontario, Canada   MedicalResearch.com: What is the background for this study? Response: As some health care systems approach collapse, a pressing need exists for tools modeling the capacity of acute and critical care systems during the COVID-19 pandemic. We developed an online tool to estimate the maximum number of COVID-19 cases that could be managed per day within the catchment area served by a health care system, given acute and critical care resource availability. The COVID-19 Acute and Intensive Care Resource Tool (CAIC-RT) is open access and available at https://caic-rt.shinyapps.io/CAIC-RT. (more…)
Abuse and Neglect, Author Interviews, COVID -19 Coronavirus / 14.04.2020

MedicalResearch.com Interview with: Dr. Naveen Vankadari PhD Research Fellow Monash University, Australia MedicalResearch.com: What is the background for this study? What are the main findings? Response: The recent outbreak of pneumonia-causing COVID-19 pandemic is an urgent global public health issue. It is critical to understand and unravel the key difference of COVID-19 or SARS-CoV-2 with the previous coronavirus (SARS and MERS) infections. Specifically, structural and molecular dynamics which underline the mechanism of viral infection. The study first addresses the structure of COVID-19 spike glycoprotein in both closed (ligand-free) and open (ligand-bound) conformation, which open the arena in understating the viral attachment to the host cell. The study also provides the first and complete sequence alignment of spike glycol protein from COVID19 and SARA-1, showing novel insertions and deletions that highlights the uniqueness of COVID19 and underlies the differential interaction mode. The study also unravels how this new coronavirus camouflages in humans through its unique glycosylation of spike glycoprotein, which makes the most of neutralizing antibodies useless. Furthermore, In addition to known ACE2 receptor in human, the study discovers the human CD26 as another potential receptor of COVID-19 for host adhesion and hijacking.  (more…)
Author Interviews, COVID -19 Coronavirus / 12.04.2020

MedicalResearch.com Interview with: Bart van Straten, Tim Horeman and John van den Dobbelsteen Research team TU Delft, Delft University of Technology, Dpt. of BioMechanical Engineering The Netherlands  MedicalResearch.com: What is the background for this study? Response: The background for this study was the urgent shortages of mouth masks in several hospitals. Franciscus Hospital, Rotterdam, The Netherland requested on 17 March if face masks could be sterilized since they were facing these shortages. The COVID-19 pandemic and its rapid spread has led to imminent shortages of these masks. (more…)
Author Interviews, COVID -19 Coronavirus, Pharmaceutical Companies / 02.04.2020

MedicalResearch.com Interview with: Dr. Larry Schlesinger MD Professor, President and CEO Texas Biomed MedicalResearch.com: What is the background and mission of Texas Biomed? Response: Texas Biomedical Research Institute (Texas Biomed) is a not-for-profit, independent research institute with a strong history of pioneering, biomedical breakthroughs that have contributed to the world of science and human health for nearly 80 years. The Texas Biomed mission is to pioneer and share scientific breakthroughs that protect you, your families and our global community from the threat of infectious diseases. Texas Biomed is capitalizing on its strengths – outstanding collaborative scientists and unique assets and resources. Texas Biomed is home to the nation’s only privately-owned BSL4 facility, five fully outfitted BSL3 facilities with the latest technologies and the Southwest National Primate Research Center (SNPRC). The Institute focuses on a core understanding of the basic biology of infectious diseases, animal model development, and studies to move therapies and vaccines to human clinical trials. The Institute’s independent, nonprofit business model moves science from the bench to clinical trials faster and with less bureaucracy. (more…)
Author Interviews, Columbia, COVID -19 Coronavirus, NYU, Technology / 02.04.2020

MedicalResearch.com Interview with: Professor Anasse Bari PhD Courant Institute of Mathematical Sciences, Computer Science Department, New York University, New York, and Megan Coffee MD PhD Division of Infectious Diseases and Immunology, Department of Medicine New York University, Department of Population and Family Health Mailman School of Public Health Columbia University, New York MedicalResearch.com: What is the background for this study? Coffee and Bari:  This work is led by NYU Grossman School of Medicine and NYU’s Courant Institute of Mathematical Sciences, in partnership with Wenzhou Central Hospital and Cangnan People's Hospital, both in Wenzhou, China. This is a multi-disciplinary team with backgrounds in clinical infectious disease as well as artificial intelligence (AI) and computer science. There is a critical need to better understand COVID-19. Doctors learn from collective and individual clinical experiences. Here, no clinician has years of experience. All are learning as they go, having to make important decisions about clinical management with stretched resources. The goal here is to augment clinical learning with machine learning. In particular, the goal is to allow clinicians to identify early who from the many infected will need close medical attention. Most patients will first develop mild symptoms, yet some 5-8 days later will develop critical illness. It is hard to know who these people are who will need to be admitted and may need to be intubated until they become ill. Knowing this earlier would allow more attention and resources to be spent on those patients with worse prognoses. If there were ever treatments in the future that could be used early in the course of illness, it would be important to identify who would most benefit We present in this study a first step in building an artificial intelligence (AI) framework, with predictive analytics (PA) capabilities applied to real patient data, to provide rapid clinical decision-making support. It is at this point a proof of concept that it could be possible to identify future severity based on initial presentation in COVID-19. (more…)
Author Interviews, COVID -19 Coronavirus / 02.04.2020

MedicalResearch.com Interview with: Hongcui Cao, M.D. State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases National Clinical Research Center for Infectious Diseases The First Affiliated Hospital College of Medicine, Zhejiang University Hangzhou, China MedicalResearch.com: What is the background for this study? Response: The proportion of severe novel coronavirus disease (COVID-19) cases has dropped significantly. Specifically, this number has decreased from 32.4% on January 28 to 21.6% in Wuhan and to 7.2% in other provinces of China on February. Measures such as strengthened medical support and centralized isolation greatly contributed to the improved circumstances, and laid a solid foundation for further enhancing the cure rate and reducing the mortality rate. However, there are still hundreds of severe patients dying every day. It is extremely important to make timely and efficient diagnosis and initiate treatment for severe patients. (more…)
Author Interviews, COVID -19 Coronavirus / 31.03.2020

MedicalResearch.com Interview with: Professor Carl Coleman, JD Professor of Law Seton Hall Law School MedicalResearch.com: Do health care workers have an ethical and/or legal obligation to provide treatment during an infectious disease outbreak? Are there exceptions such as pregnancy, if the health care worker is her/himself immunocompromised or have young children at home?   Response: As a legal matter, health care workers can generally be required to fulfill pre-existing employment or contractual obligations during an infectious disease outbreak.  For example, an emergency room nurse who refuses to come to work during a pandemic can be disciplined or fired; a physician who breaches a contractual obligation to provide on-call services during an outbreak can be held liable for damages.  In addition to loss of employment and contractual damages, other potential consequences for failing to honor pre-existing commitments during a pandemic could include professional discipline for patient abandonment and, for physicians with on-call responsibilities in hospital emergency departments, civil fines under the federal Emergency Medical Treatment and Active Labor Act. This does not mean that health care workers are obligated to show up for work during a pandemic regardless of the circumstances.  For example, under the Americans with Disabilities Act, health care workers who are immunocompromised can ask for a "reasonable accommodation," such as the right to work remotely (if possible) or to take leave.  Under the Family and Medical Leave Act, employers with more than 50 employees must give workers up to 12 weeks of unpaid time off to care for a seriously ill immediate family member.  In addition, federal labor laws allow employees to refuse to work under "abnormally dangerous conditions," which might apply in situations where an employer fails to provide necessary protective equipment.  However, assuming protective equipment is available, it is not clear that an outbreak itself would be considered "abnormally dangerous," particularly in fields like emergency medicine, where exposure to contagious disease is always a foreseeable risk. In most states, health care workers without pre-existing employment or contractual obligations cannot be compelled to treat patients during a pandemic.  However, a few states have laws that authorize public health authorities to require health care professionals to work during public health emergencies.  I am not aware of any state that has invoked this authority so far. As for ethical obligations, in 2004, the American Medical Association (AMA) declared that "individual physicians have an obligation to provide urgent medical care during disasters," and that "this ethical obligation holds even in the face of greater than usual risks to their own safety, health or life."  Some academic ethicists have expressed similar views.  Common justifications for this position are that physicians "assumed the risk" of exposure to infectious diseases when they voluntarily committed themselves to the healing professions; that a "social contract" requires physicians to assume risks in exchange for their social status and privileges; and that individuals who are uniquely capable of providing life-saving care have an obligation to do so. However, I am not persuaded that all physicians -- let alone health care workers more generally -- have an ethical obligation to provide treatment when doing so involves significant risk.  A willingness to accept risk is not a condition of obtaining a medical license, nor is it part of the oaths that students commonly take at medical school graduation.  While I agree that physicians have ethical obligations to contribute to society, there are many ways they can fulfill these obligations without assuming personal health risks.  And even assuming that individuals who are in a unique position to provide life-saving care should normally do so, we generally do not expect people to rescue others from danger at significant risk to themselves.  (more…)
Author Interviews, Cost of Health Care, Infections / 07.03.2020

MedicalResearch.com Interview with: Dr. Steve Miller MD MBA Chief Clinical Officer Cigna MedicalResearch.com: What is the background for this study? Response: With diagnoses of coronavirus increasing, Cigna is committed to helping contain the virus, removing barriers to testing and treatment, and giving peace of mind to its clients and customers. (more…)