Author Interviews, Columbia, COVID -19 Coronavirus, Pediatrics / 06.01.2022
COVID-19: Neurodevelopment Effects on Infants Exposed in Utero
MedicalResearch.com Interview with:
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Dr. Dumitriu[/caption]
Dani Dumitriu, MD, PhD
Assistant Professor of Pediatrics (in Psychiatry)
The Sackler Institute for Developmental Psychobiology
Columbia University, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A lot of research has focused on the effects of COVID-19 in various vulnerable populations, such as elderly individuals, immunocompromised patients, and individuals with severe comorbidities. However, one vulnerable population that has remained relatively understudied are the infants exposed to maternal COVID-19 disease during pregnancy.
While early on in the pandemic we and other groups showed reassuring data on low risk of vertical transmission, meaning the passing of the virus from mother-to-infant is rare, this does not necessarily mean that these infants wouldn't experience long-term consequences related to the maternal infection through other means. We know from other viral illness that maternal illness, most commonly through the activation of her immune system, can lead to a cascade of events that affect fetal development. This is why a large number of physicians and researchers at Columbia University spearheaded the COVID-19 Mother Baby Outcomes (COMBO) Initiative -- to look at potential long-term health effects on both infants and mothers.
Dr. Dumitriu[/caption]
Dani Dumitriu, MD, PhD
Assistant Professor of Pediatrics (in Psychiatry)
The Sackler Institute for Developmental Psychobiology
Columbia University, New York
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A lot of research has focused on the effects of COVID-19 in various vulnerable populations, such as elderly individuals, immunocompromised patients, and individuals with severe comorbidities. However, one vulnerable population that has remained relatively understudied are the infants exposed to maternal COVID-19 disease during pregnancy.
While early on in the pandemic we and other groups showed reassuring data on low risk of vertical transmission, meaning the passing of the virus from mother-to-infant is rare, this does not necessarily mean that these infants wouldn't experience long-term consequences related to the maternal infection through other means. We know from other viral illness that maternal illness, most commonly through the activation of her immune system, can lead to a cascade of events that affect fetal development. This is why a large number of physicians and researchers at Columbia University spearheaded the COVID-19 Mother Baby Outcomes (COMBO) Initiative -- to look at potential long-term health effects on both infants and mothers.
Sean C. Rose, MD
Child Neurology
Nationwide Children’s Hospital
The Ohio State University, Columbus
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There is conflicting evidence regarding the association between repetitive head impacts during youth contact sports and worse neurocognitive outcomes. Most research has been conducted in older adults, while the research in children is mostly limited to 1-2 sports seasons.
Dr. O'Donnell[/caption]
Julie O’Donnell, PhD MPH
Division of Overdose Prevention
National Center for Injury Prevention and Control
CDC
National Network of Public Health Institutes
New Orleans, Louisiana
MedicalResearch.com: What is the background for this study?
Response: The estimated number of drug overdose deaths in the US surpassed 100,000 over a 12-month period for the first time during May 2020-April 2021, driven by the involvement of synthetic opioids other than methadone (mainly illicitly manufactured fentanyl (IMF)), according to data from the National Vital Statistics System.
The State Unintentional Drug Overdose Reporting System (SUDORS) is a CDC-funded surveillance program that has collected detailed data on unintentional and undetermined intent drug overdose deaths since 2016 from death certificates, medical examiner and coroner reports, and full postmortem toxicology reports. SUDORS data allow for the analysis specifically of deaths involving fentanyl (rather than the larger category of synthetic opioids), and contain information about decedent demographics and other characteristics, as well as circumstances surrounding the overdose that might help inform prevention.
Dr. Eberly[/caption]
Lauren A. Eberly, MD, MPH
Clinical Fellow, Cardiovascular Medicine
Perelman School of Medicine
Cardiovascular Division, Perelman School of Medicine
Center for Cardiovascular Outcomes, Quality, and Evaluative Research,
Cardiovascular Center for Health Equity and Social Justice,
Leonard Davis Institute of Health Economics
University of Pennsylvania, Philadelphia
MedicalResearch.com: What is the background for this study?
Response: Racial inequities are pervasive in our country, and cardiovascular therapeutics with proven benefit have been shown to be underutilized among Black and Latinx patients.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), a recommended treatment option for glycemic control in patients with diabetes, have recently emerged as a cardioprotective therapy as multiple large randomized clinical trials have shown they prevent cardiovascular events among patients with Type 2 Diabetes (T2D), particularly patients with established atherosclerotic cardiovascular disease (ASCVD). Given this, they are now recommended therapy for patients with diabetes and established or high risk of ASCVD.
Given the known inequitable utilization of other therapies, along with the known higher burden of diabetes and cardiovascular disease among Black patients, the aim of this study was to evaluate the uptake of GLP-1 RA as well as for inequities in utilization.
Dr. Deshmukh[/caption]
Ashish A. Deshmukh, PhD, MPH
Associate Professor, Management, Policy & Community Health
Associate Director, Center for Health Services Research
Co-director, Clinical Analytics and Decision Science Lab
UTHealth School of Public Health
Houston, TX 77030
MedicalResearch.com: What is the background for this study?
Response: Oropharyngeal cancer is the most common cancer caused by human papillomavirus (HPV) in the United States (US). We know from previous studies that oropharyngeal cancer to be one of the fastest rising cancers in the US. However, trends (i.e., extent of change) in incidence rates among men and women in all 50 US states and trends according to tumor diagnostic characteristics (i.e., stage, size) have not been comprehensively studied. In addition, no prior study evaluated contemporary trends in oropharyngeal cancer mortality (death) rates in the US. Our study provides a comprehensive picture of oropharyngeal cancer incidence and mortality (according to age, stage, tumor size, and state of residence) in all 50 states and DC.
Jiawen Liu[/caption]
Jiawen Liu, PhD student
Department of Civil & Environmental Engineering
University of Washington
MedicalResearch.com: What is the background for this study?
Response: As previous literature has documented, racial/ethnic minority populations and lower-income populations in the US often experience higher-than-average burdens of air pollution and its associated health impacts.
The disparities vary by pollutant, location, and time. In 2014, Clark et al. found higher average NO2 exposure for nonwhites than for whites and for below-poverty-level than for above-poverty-level. Clark et al. (2017) expanded research for NO2 exposure by race-ethnicity and socioeconomic status to 2000 and 2010 and found that absolute racial-ethnic disparities decreased over time while relative racial-ethnic disparities persisted.
Dr. Ooi Eng Eong[/caption]
Professor Ooi Eng Eong
Programme in Emerging Infectious Diseases
Duke-NUS Medical School
Professor, Saw Swee Hock School of Public Health
National University of Singapore
Co-director, Viral Research And Experimental Medicine Centre
MedicalResearch.com: What is the background for this study?
Response: The emergence of Zika virus as a cause of fetal developmental disorder, or congenital Zika syndrome (CZS), mirrors the impact of congenital rubella syndrome on public health. Congenital rubella syndrome was controlled through the development of a live attenuated rubella virus vaccine that, when given to young children, elicited long-lasting immunity that protected against rubella well into adulthood.
Indeed, live viral vaccines cause subclinical infection to elicit immunity that approaches those that develop following wild-type viral infection. However, the boundary between attenuated and virulent Zika virus has not been clearly defined, making development of any live attenuated Zika virus vaccine risky.
Shuchi Anand, MD MS (she/her)
Assistant Professor in Medicine
Director, Center for Tubulointerstitial Kidney Disease
Stanford University School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: A majority of people on dialysis who completed vaccination as of September 2021 have had a decline in antibody response to levels that would render them vulnerable to infection. Antibody response immediately after vaccination and circulating antibody response is strongly associated with risk for breakthrough after the initial vaccination series.
Dr. Mapara[/caption]
Markus Y Mapara, MD
Professor of Medicine
Director of the Blood and Marrow Transplantation
Columbia University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Sickle cell disease is caused by a point mutation in the beta-globin gene of hemoglobin resulting in the production of abnormal hemoglobin which leads to formation of sickle-shaped RBC under conditions of low oxygen. Sickle cell disease affects about 100,000 patients in the US which are predominantly African American. The only curative approach is to perform an allogeneic bone marrow transplant which is however fraught with significant treatment-related risks if a matched sibling donor is not available.
The current study describes the successful application of a novel gene therapy to treat patients with sickle cell disease. The strategy is based on a gene-addition approach to introduce the genetic information for a Hemoglobin F-like molecule termed HgAT87Q into hematopoietic stem cells. The expression of this novel hemoglobin prevents polymerization of HgbS and has now been demonstrated to prevent the occurrence of vaso-occlusive pain crises in sickle cell disease patients.
Dr. Thakrar[/caption]
Ashish Thakrar, MD
Internal Medicine & Addiction Medicine
National Clinician Scholars Program
University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: About 1.8 million Americans are currently incarcerated, more than any other country in the world per capita. Of those 1.8 million, about 1 in 7 suffers from opioid addiction, putting them at high risk of overdose and death, particularly in the weeks following release.
Opioid use disorder is a treatable condition, particularly with the medications buprenorphine or methadone, but historically, prisons and jails have not offered treatment. Over the past five years, a few states and municipalities have enacted policies to provide access for OUD treatment. We examined whether these policies were actually improving access to treatment.
Dr. van Dalen[/caption]
Jan Willem van Dalen, PhD
Department of Neurology
Donders Institute for Brain, Behaviour and Cognition
Radboud University Medical Centre Nijmegen
Department of Neurology
The Netherlands3Department of Public and Occupational Health
Amsterdam UMC, University of Amsterdam, Amsterdam
MedicalResearch.com: What is the background for this study?
Response: Although high systolic blood pressure in midlife has consistently been reported as a condition that increases the risk of developing dementia in old age, reports regarding this relationship in older people have been inconsistent. One potential reason for this, is that the relationship between systolic blood pressure and dementia in later life may be U-shaped, meaning that both individuals with low and with high systolic blood pressure are at increased incident dementia risk.
This study combined data from several longitudinal cohort studies specifically designed to study incident dementia in older people, to investigate whether these U-shaped relationships exist, and in which age ranges they appear. We included more than 16,500 people aged 60 and older, with over 2,700 incident dementia cases.
Also, we aimed to investigate whether these observational associations might be caused by confounding, differences in mortality, or result from opposite relationships between certain subgroups of individuals.
Dr. Lee[/caption]
Cecilia S. Lee, MD, MS
Associate Professor,Director, Clinical Research
Department of Ophthalmology
Harborview Medical Center
University of Washington Seattle, WA
MedicalResearch.com: What is the background for this study?
Response: Cataract is a natural aging process of the eye and affects the majority of older adults who are at risk for dementia. Sensory loss, including vision and hearing, is of interest to the research community as a possible risk factor for dementia, and also as a potential point of intervention. Because cataract surgery improves visual function, we hypothesized that older people who undergo cataract surgery may have a decreased risk of developing Alzheimer disease and dementia.
We used the longitudinal data from an ongoing, prospective, community based cohort, Adult Changes in Thought (ACT) study. The ACT study includes over 5000 participants to date who are dementia free at recruitment and followed until they develop Alzheimer disease or dementia. We had access to their extensive medical history including comprehensive ophthalmology visit data. We investigated whether cataract surgery was associated with a decreased risk of developing Alzheimer disease and dementia.
Dr. Dalton[/caption]
Kristine Dalton PhD FAAO, FBCLA
School of Optometry & Vision Science
University of Waterloo
Waterloo, Canada
MedicalResearch.com: What is the background for this study?
Response: Dynamic visual acuity refers to the ability to detect and perceive small details in objects that are moving relative to an observer. Dynamic visual acuity is a complex visual function, that involves a number of different aspects of vision, including detecting the target, moving the eyes appropriately to observe the target, and processing the visual information from the target in the brain to interpret what we are seeing. What makes dynamic visual acuity so interesting to study, is that as a visual function, it appears to play an important role in a number of real-world situations, including playing sports, driving, and piloting, and it may provide us more information about how the visual system is functioning compared to the more traditional, static vision tests alone.
Previous research has demonstrated that consumption of caffeine has been shown to benefit physiological, psychomotor, and cognitive performance. More recently there has been an increased interest in studying the impacts of caffeine on the vision system, however the impact of caffeine on dynamic visual acuity has not been studied. This study was designed to address this limitation in the literature, particularly because dynamic visual acuity appears to be such an important visual function for real-world activities.
Dr. Dickerman[/caption]
Dr. Barbra Dickerman, PhD
CAUSALab investigator and instructor
Department of Epidemiology
Harvard T.H. Chan School of Public Health
MedicalResearch.com: What is the background for this study?
Response: Early randomized trials showed that the BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) vaccines were both remarkably effective at preventing symptomatic disease, when comparing each vaccine with no vaccine. However, head-to-head comparisons of these vaccines have been lacking, leaving open the question of which vaccine is more effective.
In this study, we analyzed the VA’s high-quality databases in a way that emulated the design of the hypothetical trial that would have answered this question. Specifically, we used the findings from the original trials to benchmark our methods and then extended them to provide novel evidence for the comparative effectiveness of these two vaccines in a real-world setting and across diverse subgroups and different time periods.
Dr. Woodruff[/caption]
Carina M. Woodruff, MD
Department of Dermatolog
University of California, San Francisco
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Rigorous hand hygiene has been an important component of the CDC's COVID-19 guidelines. With millions of Americans now using hand sanitizers regularly, we are seeing many more cases of hand dermatitis. Our study evaluated the key product features and most common allergens in the top-reviewed, commercial hand sanitizers sold by major US retailers.
We found that the most common potential allergens were tocopherol, fragrance, propylene glycol and phenoxyethanol. Our study also showed that nearly 1 in 5 marketing claims on these products was misleading. For example, 70% of sanitizers with the marketing claim "hypoallergenic" included at least one common allergen in its formulation.