Medicine and Health Sciences Commons^™

Igg3 Subclass Antibodies Recognize Antigenically Drifted Influenza Viruses And Sars-Cov-2 Variants Through Efficient Bivalent Binding, Marcus J. Bolton, Jefferson J.S. Santos, Claudia P. Arevalo, Trevor Griesman, Megan Watson, Shuk Hang Li, Paul Bates, Holly Ramage, Patrick C. Wilson, Scott E. Hensley

Department of Microbiology and Immunology Faculty Papers

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The constant domains of antibodies are important for effector functions, but less is known about how they can affect binding and neutralization of viruses. Here, we evaluated a panel of human influenza virus monoclonal antibodies (mAbs) expressed as IgG1, IgG2, or IgG3. We found that many influenza virus-specific mAbs have altered binding and neutralization capacity depending on the IgG subclass encoded and that these differences result from unique bivalency capacities of the subclasses. Importantly, subclass differences in antibody binding and neutralization were greatest when the affinity for the target antigen was reduced through antigenic mismatch. We found that antibodies expressed …

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Sars-Cov-2 Covid-19 Infection During Pregnancy And Differential Dna Methylation In Human Cord Blood Cells From Term Neonates, Pedro Urday, Suhita Gayen Nee' Betal, Rochelle Sequeira Gomes, Huda B. Al-Kouatly, Kolawole Solarin, Joanna S.Y. Chan, Dongmei Li, Irfan Rahman, Sankar Addya, Rupsa C. Boelig, Zubair H. Aghai

Department of Obstetrics and Gynecology Faculty Papers

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Background:

The global pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). About 18.4% of total Covid-19 cases were reported in children. Even though vertical transmission from mother to infant is likely to occur at a low rate, exposure to COVID-19 during fetal life may alter DNA methylation patterns with potential long-term effects.

Objective:

To determine if COVID-19 infection during pregnancy alters the DNA methylation patterns in umbilical cord blood cells from term infants and to identify potential pathways and genes affected by exposure to COVID-19 infection.

Methods:

Umbilical cord blood was collected …

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Physical And Stressful Psychological Impacts Of Prolonged Personal Protective Equipment Use During The Covid-19 Pandemic: A Cross-Sectional Survey Study, Giuseppe Candido, Costanza Tortù, Chiara Seghieri, Riccardo Tartaglia, Chiara Baglioni, Paolo Citti, Ida Marina Raciti, Micaela La Regina, Silvia Simonini, Moira Urbani, Chiara Parretti, Paul Barach

College of Population Health Faculty Papers

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BACKGROUND: Healthcare workers (HCWs) caring for COVID-19 infected patients are exposed to stressful and traumatic events with potential for severe and sustained adverse mental and physical health consequences. Our aim was to assess the magnitude of physical and mental health outcomes of HCWs due to the prolonged use of personal protective equipment (PPE) treating COVID-19 patients.

METHODS: This cross-sectional study assessed the symptoms of stress, anxiety, insomnia, and psychological resilience using the Stress and Anxiety to Viral Epidemics (SAVE) scale, Insomnia Severity Index (ISI), and Resilience Scale (RS), respectively, in Italy between 1st February and 31st March 2022. The physical …

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Presence Of Symptoms 6 Weeks After Covid-19 Among Vaccinated And Unvaccinated Us Healthcare Personnel: A Prospective Cohort Study, Nicholas M. Mohr, Ian D. Plumb, Kari K. Harland, Tamara Pilishvili, Katherine E. Fleming-Dutra, Anusha Krishnadasan, Karin F. Hoth, Sharon H. Saydah, Zachary Mankoff, John P. Haran, Melissa Briggs-Hagen, Eliezer Santos León, David A. Talan

Department of Emergency Medicine Faculty Papers

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OBJECTIVES: Although COVID-19 vaccines offer protection against infection and severe disease, there is limited information on the effect of vaccination on prolonged symptoms following COVID-19. Our objective was to determine differences in prevalence of prolonged symptoms 6 weeks after onset of COVID-19 among healthcare personnel (HCP) by vaccination status, and to assess differences in timing of return to work.

DESIGN: Cohort analysis of HCP with COVID-19 enrolled in a multicentre vaccine effectiveness study. HCP with COVID-19 between December 2020 and August 2021 were followed up 6 weeks after illness onset.

SETTING: Health systems in 12 US states.

PARTICIPANTS: HCP participating …

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Efficacy And Safety Of Pacritinib Vs Placebo For Patients With Severe Covid-19: A Phase 2 Randomized Clinical Trial, John Cafardi, Carole Miller, Howard Terebelo, Chad Tewell, Sadia Benzaquen, David Park, Pamela Egan, Daniel Lebovic, Kristen Pettit, Eric Whitman, Douglas Tremblay, Jonathan Feld, Sarah Buckley, Karisse Roman-Torres, Jennifer Smith, Adam Craig, John Mascarenhas

Einstein Health Papers

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IMPORTANCE: The morbidity and mortality associated with COVID-19 remain high despite advances in standard of care therapy, and the role of anti-inflammatory agents that inhibit the interleukin 6/JAK2 pathway is still being elucidated.

OBJECTIVE: To evaluate the efficacy and safety of the oral JAK2/IRAK1 inhibitor pacritinib vs placebo in the treatment of adults with severe COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This phase 2, double-blind, placebo-controlled, randomized clinical trial enrolled hospitalized adult patients with severe COVID-19 at 21 centers across the US between June 2020 and February 2021, with approximately 1.5 months of safety follow-up per patient. Data analysis was performed …

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Conducting A Supportive Oncology Clinical Trial During The Covid-19 Pandemic: Challenges And Strategies, Jie Deng, John N. Lukens, Joy C. Cohn, Erin Mcmenamin, Barbara Murphy, Bryan A. Spinelli, Niya Murphy, Alicia K. Steinmetz, Megan A. Landriau, Alexander Lin

Department of Physical Therapy Faculty Papers

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The coronavirus disease 2019 (COVID-19) pandemic resulted in severe interruptions to clinical research worldwide. This global public health crisis required investigators and researchers to rapidly develop and implement new strategies and solutions to mitigate its negative impact on the progress of clinical trials. In this paper, we describe the challenges, strategies, and lessons learned regarding the continuation of a supportive oncology clinical trial during the pandemic. We hope to provide insight into the implementation of clinical trials during a public health emergency to be better prepared for future instances.

Trial registration: ClinicalTrials.gov, a service of the US National Institute of …

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Resilience And Protection Of Health Care And Research Laboratory Workers During The Sars-Cov-2 Pandemic: Analysis And Case Study From An Austrian High Security Laboratory, Martina Loibner, Paul Barach, Stella Wolfgruber, Christine Langner, Verena Stangl, Julia Rieger, Esther Föderl-Höbenreich, Melina Hardt, Eva Kicker, Silvia Groiss, Martin Zacharias, Philipp Wurm, Gregor Gorkiewicz, Peter Regitnig, Kurt Zatloukal

College of Population Health Faculty Papers

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The SARS-CoV-2 pandemic has highlighted the interdependency of healthcare systems and research organizations on manufacturers and suppliers of personnel protective equipment (PPE) and the need for well-trained personnel who can react quickly to changing working conditions. Reports on challenges faced by research laboratory workers (RLWs) are rare in contrast to the lived experience of hospital health care workers. We report on experiences gained by RLWs (e.g., molecular scientists, pathologists, autopsy assistants) who significantly contributed to combating the pandemic under particularly challenging conditions due to increased workload, sickness and interrupted PPE supply chains. RLWs perform a broad spectrum of work with …

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Hyperdynamic Left Ventricular Ejection Fraction Is Associated With Higher Mortality In Covid-19 Patients, Annas Rahman, Max Ruge, Md, Alex Hlepas, Batha Nair, Joanne Gomez, Jeanne Du Fey De Lavallaz, Setri Fugar, Nusrat Jahan, Annabelle Santos Volgman, Kim A. Williams, Anupama Rao, Karolina Marinescu, Tisha Suboc

Division of Internal Medicine Faculty Papers & Presentations

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Study objective: To compare the characteristics and outcomes of COVID-19 patients with a hyperdynamic LVEF (HDLVEF) to those with a normal or reduced LVEF.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: Of the 1682 adult patients hospitalized with COVID-19, 419 had a transthoracic echocardiogram (TTE) during admission and met study inclusion criteria. Interventions: Participants were divided into reduced (LVEF < 50%), normal (≥50% and <70%), and hyper- dynamic (≥70%) LVEF groups.

Main outcome measures: LVEF was assessed as a predictor of 60-day mortality. Logistic regression was used to adjust for age and BMI.

Results: There was no difference in 60-day mortality between patients in the reduced LVEF and normal LVEF …

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Overcrowded Housing Increases Risk For Covid-19 Mortality: An Ecological Study, Karan Varshney, Talia Glodjo, Jenna R Adalbert

College of Population Health Faculty Papers

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Objectives: Overcrowded housing is a sociodemographic variable associated with increased infection and mortality rates from communicable diseases. It is not well understood if this association exists for COVID-19. Our objective was hence to determine the association between household overcrowding and risk of mortality from COVID-19, and this was done by performing bivariable and multivariable analyses using COVID-19 data from cities in Los Angeles County.

Results: Bivariate regression revealed that overcrowded households were positively associated with COVID-19 deaths (standardized β = 0.863, p < 0.001). COVID-19 case totals, people aged 60+, and the number of overcrowded households met conditions for inclusion in the backwards stepwise linear regression model. Analysis revealed all independent variables were positively associated with mortality rates, primarily for individuals 60 + (standardized β1 = 0.375, p = 0.001), followed by overcrowded households (standardized β2 = 0.346, p = 0.014), and total COVID-19 cases (standardized β3 = 0.311, p < 0.001). Our findings highlight that residing in overcrowded households may be an important risk factor for COVID-19 mortality. Public health entities should consider this population when allocating resources for prevention and control of COVID-19 mortality and future disease outbreaks.

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Overcrowded Housing Increases Risk For Covid-19 Mortality: An Ecological Study., Karan Varshney, Talia Glodjo, Jenna Adalbert

College of Population Health Faculty Papers

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OBJECTIVES: Overcrowded housing is a sociodemographic variable associated with increased infection and mortality rates from communicable diseases. It is not well understood if this association exists for COVID-19. Our objective was hence to determine the association between household overcrowding and risk of mortality from COVID-19, and this was done by performing bivariable and multivariable analyses using COVID-19 data from cities in Los Angeles County.

RESULTS: Bivariate regression revealed that overcrowded households were positively associated with COVID-19 deaths (standardized β = 0.863, p < 0.001). COVID-19 case totals, people aged 60+, and the number of overcrowded households met conditions for inclusion in the backwards stepwise linear regression model. Analysis revealed all independent variables were positively associated with mortality rates, primarily for individuals 60 + (standardized β

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Prognostic Value Of H2fpef Score In Covid-19, Priya Patel, Max Ruge, Joanne Michelle D. Gomez, Jeanne Du Fay De Lavallaz, Anupama Rao, Kim A. Williams, Annabelle Santos Volgman, Maria Rosa R. Costanzo, Tisha Suboc, Karolina Marinescu

Division of Internal Medicine Faculty Papers & Presentations

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Study objective: This study sought to assess the predictive value of H2FPEF score in patients with COVID-19.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: A total of 1682 patients had an echocardiogram in the year preceding their COVID-19 admission with a preserved ejection fraction (≥50%). A total of 156 patients met inclusion criteria. Interventions: Patients were divided into H2FPEF into low (0–2), intermediate (3–5), and high (6–9) score H2FPEF groups and outcomes were compared.

Main outcome measures: Adjusted multivariable logistic regression models evaluated the association between H2FPEF score group and a composite outcome for severe COVID-19 infection consisting …

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Rehabilitation Care At The Time Of Coronavirus Disease-19 (Covid-19) Pandemic: A Scoping Review Of Health System Recommendations, Ahmed M Negm, Adrian Salopek, Mashal Zaide, Victoria J Meng, Carlos Prada, Yaping Chang, Preeti Zanwar, Flavia H Santos, Elena Philippou, Emily R Rosario, Julie Faieta, Jason R Falvey, Amit Kumar, Timothy A Reistetter, Vanina Dal Bello-Haas, Jonathan F Bean, Mohit Bhandari, Patricia C Heyn

College of Population Health Faculty Papers

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Purpose: The coronavirus disease-19 (COVID-19) was declared a pandemic by the World Health Organization in March 2020. COVID-19, caused by SARS-CoV-2 has imposed a significant burden on health care systems, economies, and social systems in many countries around the world. The provision of rehabilitation services for persons with active COVID-19 infection poses challenges to maintaining a safe environment for patients and treating providers. Materials and Methods: Established frameworks were used to guide the scoping review methodology. Medline, Embase, Pubmed, CINAHL databases from inception to August 1, 2020, and prominent rehabilitation organizations' websites were searched. Study Selection: We included articles and …

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Evaluation Of Pediatric Rheumatology Telehealth Satisfaction During The Covid-19 Pandemic, Lindsay N Waqar-Cowles, John Chuo, Pamela F Weiss, Sabrina Gmuca, Marianna Lanoue, Jon M Burnham

College of Population Health Faculty Papers

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Background: During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients.

Methods: Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total …

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Clinical Outcomes In Patients Co-Infected With Covid-19 And Staphylococcus Aureus: A Scoping Review, Jenna Adalbert, Karan Varshney, Rachel Tobin, Rafael Pajaro

College of Population Health Faculty Papers

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BACKGROUND: Endemic to the hospital environment, Staphylococcus aureus (S. aureus) is a leading bacterial pathogen that causes deadly infections such as bacteremia and endocarditis. In past viral pandemics, it has been the principal cause of secondary bacterial infections, significantly increasing patient mortality rates. Our world now combats the rapid spread of COVID-19, leading to a pandemic with a death toll greatly surpassing those of many past pandemics. However, the impact of co-infection with S. aureus remains unclear. Therefore, we aimed to perform a high-quality scoping review of the literature to synthesize the existing evidence on the clinical outcomes of COVID-19 …

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Digital Literacy At An Urban Cancer Center: Implications For Technology Use And Vulnerable Patients, Amy Leader, Lisa M. Capparella, L. Waldman, Ba, Rebecca Cammy, Alison Petok, Rebecca Dean, Ayako Shimada, Liana Yocavitch, Kristin L. Rising, Gregory Garber, Brooke Worster, Adam Dicker

Kimmel Cancer Center Faculty Papers

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PURPOSE: eHealth literacy, or the ability to seek, find, understand, and appraise health information from electronic sources, has become increasingly relevant in the era of COVID-19, when so many aspects of patient care became dependent on technology. We aimed to understand eHealth literacy among a diverse sample of patients with cancer and discuss ways for health systems and cancer centers to ensure that all patients have access to high-quality care.

METHODS: A cross-sectional survey of patients with cancer and caregivers was conducted at an NCI-designated cancer center to assess access to the Internet, smartphone ownership, use of mobile apps, willingness …

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Will The Covid-19 Pandemic Finally Fuel Drug Repurposing Efforts?, Anna Chen, Shivangi Patel, Matthew Alcusky, Vittorio Maio

College of Population Health Faculty Papers

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No abstract provided.

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The Quest For Conquering Covid-19: Updates From The Laboratory, David B. Nash

College of Population Health Faculty Papers

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No abstract provided.

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Disparities In Sars-Cov-2 Positivity Rates: Associations With Race And Ethnicity, Harvey W Kaufman, Justin K Niles, David B. Nash

College of Population Health Faculty Papers

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Numerous reports indicate that African Americans and Latinos are being affected disproportionately by coronavirus disease 2019 (COVID-19). Positivity rates have not been analyzed on scale because only 4 states report race/ethnicity as part of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Previous studies also have had little ability to control for many known risk factors to better identify the effects of COVID-19 on racial and ethnic communities. Using test results from a large national reference laboratory database that included patients from all 50 states and the District of Columbia, this study compared positivity rates for SARS-CoV-2 nucleic acid amplification …

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New Normal For Medical Practice Post Covid-19?, David B. Nash

College of Population Health Faculty Papers

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No abstract provided.

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Population Health And The Pandemic: Emerging Stronger Next Time., David B. Nash

College of Population Health Faculty Papers

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No abstract provided.

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Virtual Community Health Workers: Outreach Calls During Covid-19, Geoffrey Hayden, Md, Paula Ostroff, Rn, Ms, Emily Romano, Bs, Imani Gray-Taylor, Carl Johnson, Bs, Angelique Miller, Sharla Thomas, Ba, Gina Mccoy, Bs, Deborah Ziring, Md

House Staff Quality Improvement and Patient Safety Conference (2020-)

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The “Clinical Experience” program at the Sidney Kimmel Medical College, established in 2017, provides pre-clerkship students with an opportunity to identify and address patients’ needs for social determinants of health (SDoH). The COVID-19 pandemic led to a suspension of the student program in the clinical environment, but the CHWs continued to address patients’ social needs from a remote setting. In the absence of established best practices regarding patient outreach calls from a remote setting, we sought to develop an effective workflow that would mask the CHWs’ personal cell phones while leading to fewer “unable to reach” scenarios and improved case …

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