Digital Commons Network^™

Influence Of Cigarettes And Alcohol On The Severity And Death Of Covid-19: A Multicenter Retrospective Study In Wuhan, China, Mengyuan Dai, Liyuan Tao, Zhen Chen, Zhi Tian, Xiaofang Guo, Diane S Allen-Gipson, Ruirong Tan, Rui Li, Li Chai, Fen Ai, Miao Liu

All publications

Background: The recent emergence and rapid global spread of coronavirus disease 2019 (COVID-19) is leading to public health crises worldwide. Alcohol consumption and cigarette smoking (CS) are two known risk factors in many diseases including respiratory infections.

Methods: We performed a multi-center study in the four largest hospitals designated for COVID-19 patients in Wuhan. There are totally 1547 patients diagnosed with COVID-19 enrolled in the study, alcohol consumption and CS history were evaluated among these patients. The epidemiology, laboratory findings and outcomes of patients contracted COVID-19 were further studied.

Results: Our findings indicated that COVID-19 patients with a history of …

Safety And Efficacy Of Tocilizumab In The Treatment Of Severe Acute Respiratory Syndrome Coronavirus-2 Pneumonia: A Retrospective Cohort Study, Atul Patel, Kinjal Shah, Mitkumar Dharsandiya, Ketan Patel, Tushar Patel, Mukesh Patel, Tea Reljic, Ambuj Kumar

All publications

Background: Cytokine release storm (CRS) in severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) is thought to be the cause for organ damage and death which is independent of the actual viral burden. Tocilizumab (TCZ), an interleukin-6 receptor antagonist, is approved for the treatment of CRS. We describe the efficacy and safety of TCZ in SARS CoV-2 pneumonia. Methods: This retrospective study was conducted at a tertiary care hospital from April 20 2020 to May 21 2020. The primary endpoint was the cumulative incidence of a composite of either need for admission to the intensive care unit (ICU) with invasive mechanical …

Faith In Trump, Moral Foundations, And Social Distancing Defiance During The Coronavirus Pandemic, Amanda Graham, Francis T. Cullen, Justin T. Pickett, Cheryl Lero Jonson, Murat Haner, Melissa M. Sloan

All publications

Purpose: Over the past several months, the coronavirus has infected more than six million Americans and killed nearly 200,000. Governors have issued stay-at-home orders, and prosecutors have filed criminal charges against individuals for defying those orders. And yet many Americans have still refused to keep their distance from their fellow citizens, even if they had symptoms of infection. The authors explore the underlying causes for those who intend to defy these norms.

Methods: Using national-level data from a March 2020 survey of 989 Americans, the authors explore intentions to defy social distancing norms by testing an interactionist theory of foundation-based …

Using A Rapid Assessment Methodology To Identify And Address Immediate Needs Among Low-Income Households With Children During Covid-19, Shreela V. Sharma, Amier Haidar, Jacqueline Noyola, Jacqueline Tien, Melinda Rushing, Brittni M. Naylor, Ru-Jye Chuang, Christine Markham

All publications

Objective: Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under "shelter in place" orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time ("high risk"), and to describe the response of Brighter Bites to these "high risk" families.

Methods: The rapid assessment survey was collected in April 2020 across Houston, Dallas, Washington DC, and …

Development And Validation Of A Model For Individualized Prediction Of Hospitalization Risk In 4,536 Patients With Covid-19, Lara Jehi, Xinge Ji, Alex Milinovich, Serpil Erzurum, Amy Merlino, Steve Gordon, James B. Young, Michael W. Kattan

All publications

Background: Coronavirus Disease 2019 is a pandemic that is straining healthcare resources, mainly hospital beds. Multiple risk factors of disease progression requiring hospitalization have been identified, but medical decision-making remains complex.

Objective: To characterize a large cohort of patients hospitalized with COVID-19, their outcomes, develop and validate a statistical model that allows individualized prediction of future hospitalization risk for a patient newly diagnosed with COVID-19.

Design: Retrospective cohort study of patients with COVID-19 applying a least absolute shrinkage and selection operator (LASSO) logistic regression algorithm to retain the most predictive features for hospitalization risk, followed by validation in a temporally …

Modeling The Role Of Asymptomatics In Infection Spread With Application To Sars-Cov-2, Hana M. Dobrovolny

All publications

SARS-CoV-2 started causing infections in humans in late 2019 and has spread rapidly around the world. While the number of symptomatically infected and severely ill people is high and has overwhelmed the medical systems of many countries, there is mounting evidence that some of the rapid spread of this virus has been driven by asymptomatic infections. In this study, we use a compartmental mathematical model of a viral epidemic that includes asymptomatic infection to examine the role of asymptomatic individuals in the spread of the infection. We apply the model to epidemics in California, Florida, New York, and Texas, finding …

Implementation Of A Medical Student-Run Telemedicine Program For Medications For Opioid Use Disorder During The Covid-19 Pandemic, Marcus Castillo, Brianna Conte, Sam Hinkes, Megan Mathew, C J Na, Ainhoa Norindr, David P. Serota, David W. Forrest, Amar R. Deshpande, Tyler S. Bartholomew, Hansel E. Tookes

All publications

Objectives: The COVID-19 pandemic led to the closure of the IDEA syringe services program medical student-run free clinic in Miami, Florida. In an effort to continue to serve the community of people who inject drugs and practice compassionate and non-judgmental care, the students transitioned the clinic to a model of TeleMOUD (medications for opioid use disorder). We describe development and implementation of a medical student-run telemedicine clinic through an academic medical center-operated syringe services program.

Methods: Students advertised TeleMOUD services at the syringe service program on social media and created an online sign-up form. They coordinated appointments and interviewed patients …

Guidelines For Tms/Tes Clinical Services And Research Through The Covid-19 Pandemic, Marom Bikson, Colleen A. Hanlon, Adam J. Woods, Bernadette T. Gillick, Leigh Charvet

All publications

The COVID-19 pandemic has broadly disrupted biomedical treatment and research including non-invasive brain stimulation (NIBS). Moreover, the rapid onset of societal disruption and evolving regulatory restrictions may not have allowed for systematic planning of how clinical and research work may continue throughout the pandemic or be restarted as restrictions are abated. The urgency to provide and develop NIBS as an intervention for diverse neurological and mental health indications, and as a catalyst of fundamental brain research, is not dampened by the parallel efforts to address the most life-threatening aspects of COVID-19; rather in many cases the need for NIBS is …

Pharmacist-Led Chronic Care Management For Medically Underserved Rural Populations In Florida During The Covid-19 Pandemic, Madison Como, Chenita White Carter, Margareth Larose-Pierre, Kellie O'Dare, Cynthia R Hall, Jason Mobley, Gervin Robertson, Jason Leonard, Lindsey Tew

All publications

Medically underserved patients in rural areas are more vulnerable to poor health outcomes, including the risks associated with coronavirus disease 2019 (COVID-19). Pharmacists, student pharmacists, and other health care professionals are working together to implement new, innovative ways to deliver the same standard of care during the COVID-19 pandemic to these vulnerable patients. These services include telehealth with virtual and telephone medication therapy management sessions led by ambulatory care pharmacists and student pharmacists. Pharmacists, student pharmacists, and other health care professionals should continue to adapt to these new technologies to improve health outcomes for their patients during the pandemic.

Statewide Implementation Of Virtual Perinatal Home Visiting During Covid-19, Jennifer Marshall, Laura Kihlström, Acadia Buro, Vidya Chandran, Concha Prieto, Rafaella Stein-Elger, Keryden Koeut-Futch, Allison Parish, Katie Hood

All publications

Purpose: This evaluation describes efforts taken by MIECHV administrators and staff during the pandemic using data collected from 60 MIECHV staff surveys and nine statewide weekly focus groups.

Description: The Florida Maternal, Infant and Early Childhood Home Visiting (MIECHV) Initiative funds perinatal home visiting for pregnant women and families with infants throughout the state. Florida MIECHV has shown resilience to disasters and times of crises in the past, while generating a culture of adaptation and continuous quality improvement among local implementing agencies. Florida MIECHV responded to the COVID-19 pandemic crisis within the first few days of the first reported case …

The Impact Of Covid-19 On Hiv Treatment And Research: A Call To Action., Tiffany Chenneville, Kemesha Gabbidon, Patricia Hanson, Cashea Holyfield

All publications

The impact of the COVID-19 pandemic is far reaching, with devastating effects on individuals, communities, and societies across the world. People with chronic health conditions may be at greater risk of contracting or experiencing complications from COVID-19. In addition to illness or death for those who contract the virus, the physical distancing required to flatten the curve of new cases is having a negative impact on the economy, the effects of which intersect with mental health and other existing health concerns, thus affecting marginalized communities. Given that HIV also has a disproportionate impact on marginalized communities, COVID-19 is affecting people …

A Possible Path Towards Rapid Development Of Live-Attenuated Sars-Cov-2 Vaccines: Plunging Into The Natural Pool, German Todorov, Vladimir N. Uversky

All publications

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19) pandemic spreading around the world, causing massive distress to the world’s economy and affecting healthcare systems worldwide. Although some exposed individuals have no symptoms and most symptomatic infections are not severe, COVID-19 cases span a wide spectrum, ranging from mild to critical and sometimes resulting in life-threatening complications, such as pneumonia, severe respiratory distress and cardiac problems. Currently, there is no curative drug for COVID-19 and vaccines are still under development. We are presenting here a strategy for the fast development of natural …

Untreated Stroke As Collateral Damage Of Covid-19: “Time Is Brain” Versus “Stay At Home”:, David Z. Rose, W. Scott Burgin, Swetha Renati

All publications

For decades, neurologists have been advocating that anyone with acute focal deficits report immediately to the closest hospital’s emergency room. Major advancements in the hyperacute diagnosis and treatment of stroke have justified our call-to-action slogan of “Time is Brain”—faster therapy leads to superior outcomes. However, this mantra has been recently usurped by the catchphrase “Stay at Home” during the coronavirus disease 2019 (COVID-19) pandemic. Fewer patients are presenting to hospitals with acute stroke; our census is down. Presumably the etiology of this phenomenon is either strict “social distancing” that some people may misperceive to exclude even emergent situations, or fears …

Consumerism And Covid - 19 : A Neoliberal Analysis, Taylor M. Roy

Communication Senior Capstones

This paper attempts to draw a line between consumer culture and COVID -19, while finding how it has been influenced by social media and targeted advertisements. Through exploring Foucault's understanding of neoliberalism and the homoeconomicus, articles and media news, this paper will have assessed the changes of consumer culture due to the “shelter in place” orders. Additionally, it will attempt to redefine Foucaults homoeconomicus to fit this new model as well as observe how electronic surveillance through social media platforms and their targeted ads will or have changed the landscape of neoliberalism. In summarizing the notable differences in the use …

Covid-19 And Public Accommodations Under The Americans With Disabilities Act: Getting Americans Safely Back To Restaurants, Theaters, Gyms, And “Normal”, Frank Griffin M.D., J.D.

SLU Law Journal Online

THIS IS A PRELIMINARY EXPEDITED VERSION OF THE OFFICIAL ARTICLE TO BE ORIGINALLY PUBLISHED IN SAINT LOUIS UNIVERSITY LAW JOURNAL VOLUME 65 NUMBER 2

COVID-19 permanently changed the way places of public accommodation like restaurants, theaters, medical facilities, arenas, gyms, and many other proprietors of mainstream American activities must operate in order to accommodate people with newly-defined, COVID-19-related disabilities under Title III of the Americans with Disabilities Act (ADA). The required modifications will affect all patrons and employees of these establishments. Under the ADA, places of public accommodation are barred from discriminating against people with disabilities in the full and …

Supporting Student Mental Health During And After Covid-19, David Bryant Naff, Shenita Williams, Jenna Furman, Melissa Lee

MERC Publications

This report by the Metropolitan Educational Research Consortium (MERC) in the VCU School of Education offers a rapid review of research about supporting student mental health as they return to school during COVID-19. It pulls from literature on natural disasters like hurricane Katrina, the psychological impacts of quarantine, and emergent research on the mental health impacts of the Coronavirus. The report is structured to answer three overarching questions: 1) Why is it important to address the mental health needs of students in schools? 2) How can we expect COVID-19 to impact the mental health of students? 3) What are some …

A Covid-19 Induced Shift: From Introducing High School Females To Computing Careers To An Assessment Of Technological Readiness Among Stem Teachers, Jareau Almeyda

CCAC Theses and Dissertations

Prior to the global COVID-19 pandemic, this study aimed to explore how exposure to information systems (IS) project management impacts perceptions of computing careers among high school female participants. Given the demand for computing professionals continues to grow, enrollment in some computing disciplines across institutions of higher education have experienced declining enrollments. Studies have shown that one of the reasons high school students do not enroll in computing disciplines is because they perceive computing as difficult, boring, and irrelevant.

As a computing discipline, information systems is focused on developing professionals who are able to integrate technologies into systems that run …

Sars-Cov-2 Viral Rna Shedding For More Than 87 Days In An Individual With An Impaired Cd8+ T Cell Response, Jackson S Turner, Aaron Day, Wafaa B Alsoussi, Zhuoming Liu, Jane A O'Halloran, Rachel M Presti, Bruce K Patterson, Sean P J Whelan, Ali H Ellebedy, Philip A Mudd

Open Access Publications

Prolonged shedding of viral RNA occurs in some individuals following SARS-CoV-2 infection. We perform comprehensive immunologic evaluation of one individual with prolonged shedding. The case subject recovered from severe COVID-19 and tested positive for SARS-CoV-2 viral RNA repeatedly as many as 87 days after the first positive test, 97 days after symptom onset. The subject did not have any associated rise in anti-Spike protein antibody titers or plasma neutralization activity, arguing against re-infection. This index subject exhibited a profoundly diminished circulating CD8+ T cell population and correspondingly low SARS-CoV-2-specific CD8+ T cell responses when compared with a cohort of other …

A Teenager With Fever, Chest Pain, And Respiratory Distress During The Coronavirus Disease 2019 Pandemic: A Lesson On Anchoring Bias, Michele N. Karn, Nicholas P. Johnson, Susan K. Yaeger, Kimberly L. Fugok

Internal Medicine Faculty Publications

Symptoms of coronavirus disease 2019 overlap with other important illnesses affecting young adults. We report a case of a 17-year old male presenting to the emergency department in the midst of a pandemic with symptoms of coronavirus disease 2019. He had fever, dyspnea, chest pain, and myalgias, with bilateral infiltrates on chest radiograph, and developed septic shock secondary to infectious thromboembolic events. However, his blood cultures grew group G streptococcus secondary to his oropharyngeal infection, and he experienced an infectious thrombus in the internal jugular vein, consistent with the rare but well-described Lemierre's syndrome. This case report calls attention to …

An Evaluation Of Florida’S Zika Response Using The Who Health Systems Framework: Can We Apply These Lessons To Covid-19?, Jennifer Marshall, Blake Scott, Jennifer Delva, Cedrick Ade, Santiago Hernandez, Jaladhikumar Patel, Mantero Moreno-Cheek, Dogeli Rojas, Jean-Paul Tanner, Russell S. Kirby

All publications

Objectives: From 2016 to 2018 Florida documented 1471 cases of Zika virus, 299 of which were pregnant women (Florida Department of Health, https://www.floridahealth.gov/diseases-and-conditions/mosquito-bornediseases/surveillance.html , 2019a). Florida's response required unprecedented rapid and continuous cross-sector communication, adaptation, and coordination. Zika tested public health systems in new ways, particularly for maternal child health populations. The systems are now being challenged again, as the Coronavirus COVID-19 pandemic spreads throughout Florida. This qualitative journey mapping evaluation of Florida's response focused on care for pregnant women and families with infants exposed to Zika virus.

Methods: Fifteen focus groups and interviews were conducted with 33 public health …

Examining Spatial Accessibility To Covid-19 Testing Sites In Florida, Ran Tao, Joni Downs, Theresa M. Beckie, Yuzhou Chen, Warren Mcnelley

All publications

Massive and rapid testing is crucial for containing the spread of COVID-19. Health and policy planners must ensure that access to and uptake of SARS-CoV-2 testing is adequate and equitable. This study measures the spatial accessibility to testing sites in Florida at the census tract level at the end of May 2020, using the 2-step floating catchment area method that integrates both driving and walking modes. Accessibility scores were found to be heterogeneous across geographic regions and among different groups of people. In particular, many rural areas were in a testing desert. While people in larger cities tended to have …

Us-County Level Variation In Intersecting Individual, Household And Community Characteristics Relevant To Covid-19 And Planning An Equitable Response: A Cross-Sectional Analysis, Taylor Chin, Rebecca Kahn, Ruoran Li, Jarvis T. Chen, Nancy Krieger, Caroline O. Buckee, Satchit Balsari, Mathew V. Kiang

All publications

Objectives: To illustrate the intersections of, and intercounty variation in, individual, household and community factors that influence the impact of COVID-19 on US counties and their ability to respond.

Design: We identified key individual, household and community characteristics influencing COVID-19 risks of infection and survival, guided by international experiences and consideration of epidemiological parameters of importance. Using publicly available data, we developed an open-access online tool that allows county-specific querying and mapping of risk factors. As an illustrative example, we assess the pairwise intersections of age (individual level), poverty (household level) and prevalence of group homes (community-level) in US counties. …

Literature-Guided Recommendations For Otolaryngologists During The Covid-19 Pandemic: A Contemporary Review, Mausumi Syamal

Otolaryngology Head & Neck Surgery Faculty Publications

Objective: The objective of this study was to review the current literature and guidelines on management of the novel coronavirus 2019 (COVID-19 or 2019nCoV) with respect to the field of Otolaryngology.

Design: Contemporary literature review.

Methods: Systematic literature review of global medical literature databases and communications were queried to find all available literature recommendations, research, and guidelines applicable to otolaryngologists in the COVID-19 pandemic.

Results: Guidance on personal protective equipment, office visits, and surgical scheduling, as well as recommendations for safe airway management and tracheotomy performance during the COVID-19 pandemic were compiled and interpreted.

Conclusion: Little guidance exists for otolaryngologists …

Meat Processing Workers And The Covid-19 Pandemic: The Subrogation Of People, Public Health, And Ethics To Profits And A Path Forward, Kelly K. Dineen

Saint Louis University Journal of Health Law & Policy

The COVID-19 pandemic has highlighted and exacerbated existing health injustices. People who are Latino/Latinx, Black, Indigenous or members of other minority groups have disproportionately paid with their very lives. The pandemic has also exposed the complex interdependence of worker health and well-being, community health, and economic security. Industries like meat processing facilities—with congregate and high-density workplaces staffed by workers who are already disadvantaged by structural discrimination—must reckon with decades of subrogation and exploitation of workers. During this pandemic, the industry has pushed that exploitation to a point of no return. Policies to protect workers need a reset to an orientation …

Hsp90 Inhibitors For Ipf/Covid-19, Ruben Manuel Luciano Colunga Biancatelli, Pavel A. Solopov, John Catravas

Bioelectrics Publications

Heat shock protein 90 (HSP90) is an important chaperone that assists the late stage folding of several proteins involved in cell survival in response to environmental stressors. The inhibition of HSP90 is followed by a complex modulation of the proteome and the kinome, that has proved beneficial in cancer and various neurodegenerative diseases. Additionally, accumulating literature suggests that HSP90 may be a key target during the development of pulmonary fibrosis and that its inhibition could serve as a new and exciting therapeutic approach. We have summarized the current evidence about HSP90’s role in Idiopathic Pulmonary Fibrosis (IPF), the results from …

The Federal Law Clerk Hiring Pilot And The Coronavirus Pandemic, Carl W. Tobias

Law Faculty Publications

Just when law students attained a comfort level with the arcane intricacies of the federal law clerk employment process, as increasingly exacerbated by the second year of an experimental hiring pilot plan, the coronavirus attacked the country and has been ravaging it ever since. To date, the virus has inflicted the most profound harm on the jurisdictions that comprise all of the “coastal elite circuits” that span the District of Columbia north to Maine, as well as the United States Courts of Appeals for the Seventh and Ninth Circuits, which apply the pilot. This piece examines impacts that the coronavirus’ …

Decarcerating New York City: Lessons From A Pandemic, Nicole Smith Futrell

Faculty Scholarship

Over the last decade, long before the sweeping impact of COVID-19, the criminal legal system in New York City has been on a halting path toward decarceration. Set against the national backdrop of declining crime rates and a reckoning with the economic, social, and racial costs of mass criminalization and incarceration, elected officials in New York City and State have acknowledged that a shift toward reducing the number of people held in New York City jails is long overdue. Particular attention has been focused on Rikers Island, the notoriously violent, sprawling jail complex, which has been regarded as one of …

Executive Overreach And Underreach In The Pandemic, Kim Lane Scheppele, David E. Pozen

Faculty Scholarship

The pandemic that convulsed the globe in 2020 was long foretold but still surprising to many. Within a few months of its appearance, COVID-19 became one of the leading causes of death worldwide. Governments struggled at first to comprehend what was happening – and then reacted in very different ways. Most political leaders followed the advice of epidemiologists. Many declared states of emergency. A few pursued autocratic agendas. And some did almost nothing.

During emergencies, constitutional scholars normally worry about executive aggrandizement at the expense of human rights and democratic values. Emergencies often require national executives to act quickly and …

Dispute Resolution In Pandemic Circumstances, George A. Bermann

Faculty Scholarship

The peaceful resolution of disputes is among the most important earmarks of a regime attached to the rule of law. Even in countries in which, for one reason or another, courts do not work especially well, civil peace is of paramount importance. The absence of effective institutions for the administration of justice between and among private parties would spell a high degree of social disorder.

Even in the absence of a crisis such as we are experiencing, justice systems face a number of challenges in this day and age. Does a jurisdiction have a sufficient number of persons qualified to …

Executive Underreach, In Pandemics And Otherwise, David E. Pozen, Kim Lane Scheppele

Faculty Scholarship

Legal scholars are familiar with the problem of executive overreach, especially in emergencies. But sometimes, instead of being too audacious or extreme, a national executive's attempts to address a true threat prove far too limited and insubstantial. In this Essay, we seek to define and clarify the phenomenon of executive underreach, with special reference to the COVID-19 crisis; to outline ways in which such underreach may compromise constitutional governance and the international legal order; and to suggest a partial remedy.