Public Health Commons^™

Cancer Patient Perspectives During The Covid-19 Pandemic: A Thematic Analysis Of Cancer Blog Posts, Matthew A. Hintermayer, Mark Sorin, Joan M. Romero, Sarah M. Maritan, Owen J. Chen, Surabhi Rawal

Patient Experience Journal

The content of online cancer patient blogs has previously been analyzed to inform physicians about the cancer experience and patient concerns. The coronavirus disease 2019 (COVID-19) pandemic has greatly affected cancer patients due to their vulnerable health status, as well as changes in cancer testing and treatment. We sought to qualitatively describe the concerns and experiences expressed online by cancer patients, survivors, and family members in relation to COVID-19. 152 blog posts written by cancer patients, survivors, or family members, were selected using combined Boolean searches and snowball sampling. Reviewers extracted subthemes from blog posts using line-by-line text analysis until …

Congregate Care In The Time Of Covid-19: Proposed Best Practices From The Inside, Linda Bergthold, Margan Zajdowicz, Thaddeus R. Zajdowicz, Elli Hall, Kimberley A. Buckner, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Donor And Transplant Candidate Selection For Solid Organ Transplantation During The Covid-19 Pandemic, N Thao N Galvan, Nicolas F Moreno, Jay E Garza, Susan Bourgeois, Marion Hemmersbach-Miller, Bhamidipati Murthy, Katherine Timmins, Christine A O'Mahony, James Anton, Andrew Civitello, Puneet Garcha, Gabe Loor, Kenneth Liao, Alexis Shaffi, John Vierling, Rise Stribling, Abbas Rana, John A Goss

Faculty, Staff and Students Publications

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a novel coronavirus responsible for a worldwide pandemic has forced drastic changes in medical practice in an alarmingly short period of time. Caregivers must modify their strategies as well as optimize the utilization of resources to ensure public and patient safety. For organ transplantation, in particular, the loss of lifesaving organs for transplantation could lead to increased waitlist mortality. The priority is to select uninfected donors to transplant uninfected recipients while maintaining safety for health care systems in the backdrop of a virulent pandemic. We do not yet have a standard approach to evaluating …

Povidone-Iodine Solution As Sars-Cov-2 Prophylaxis For Procedures Of The Upper Aerodigestive Tract A Theoretical Framework, Syed H S Naqvi, Martin J Citardi, Davide Cattano, Luis Ostrosky-Zeichner, Mark I Knackstedt, Ron J Karni

Faculty, Staff and Student Publications

BACKGROUND: The COVID-19 pandemic has raised concerns of inadvertent SARS-CoV-2 transmission to healthcare workers during routine procedures of the aerodigestive tract in asymptomatic COVID-19 patients. Current efforts to mitigate this risk focus on Personal Protective Equipment, including high-efficiency filtration as well as other measures. Because the reservoir for SARS-CoV-2 shedding is in the nasopharynx and nasal and oral cavities, the application of viricidal agents to these surfaces may reduce virus burden. Numerous studies have confirmed that povidone-iodine inactivates many common respiratory viruses, including SARS-CoV-1. Povidone-iodine also has good profile for mucosal tolerance. Thus, we propose a prophylactic treatment protocol for …

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

College of Population Health Faculty Papers

No abstract provided.

Can Sars-Cov-2 Be Deleted In Breastmilk?, Heather Ness

Undergraduate Research Events

• The SARS-CoV-2 virus could spread from COVID-19 positive parent to infant through breast milk ingestion.

• Breast milk could have SARS-CoV-2 inhibitory properties.

The purpose of testing breast milk for SARS-CoV-2 genetic markers are to find out if breast milk from COVID-19 positive patients can be safely given to infants.

Potential Scenarios And Hazards In The Work Of The Future: A Systematic Review Of The Peer-Reviewed And Gray Literatures, Paul A Schulte, Jessica M K Streit, Fatima Sheriff, George Delclos, Sarah A Felknor, Sara L Tamers, Sherry Fendinger, James Grosch, Robert Sala

Faculty, Staff and Student Publications

It would be useful for researchers, practitioners, and decision-makers to anticipate the hazards that workers will face in the future. The focus of this study is a systematic review of published information to identify and characterize scenarios and hazards in the future of work. Eleven bibliographic databases were systematically searched for papers and reports published from 1999 to 2019 that described future of work scenarios or identified future work-related hazards. to compile a comprehensive collection of views of the future, supplemental and ad hoc searches were also performed. After screening all search records against a set of predetermined criteria, the …

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

College of Population Health Faculty Papers

No abstract provided.

The Hypercoagulable State In Covid-19: Incidence, Pathophysiology, And Management, Mouhamed Yazan Abou-Ismail, Akiva Diamond, Yasmin Arafah, Lalitha Nayak

Faculty Scholarship

The 2019 coronavirus disease (COVID-19) presents with a large variety of clinical manifestations ranging from asymptomatic carrier state to severe respiratory distress, multiple organ dysfunction and death. While it was initially considered primarily a respiratory illness, rapidly accumulating data suggests that COVID-19 results in a unique, profoundly prothrombotic milieu leading to both arterial and venous thrombosis. Consistently, elevated D-dimer level has emerged as an independent risk factor for poor outcomes, including death. Several other laboratory markers and blood counts have also been associated with poor prognosis, possibly due to their connection to thrombosis. At present, the pathophysiology underlying the hypercoagulable …

Social Determinants Of Health-Related Needs During Covid-19 Among Low-Income Households With Children, Shreela V Sharma, Ru-Jye Chuang, Melinda Rushing, Brittni Naylor, Nalini Ranjit, Mike Pomeroy, Christine Markham

Faculty, Staff and Student Publications

INTRODUCTION: Little is known about the social needs of low-income households with children during the coronavirus-2019 (COVID-19) pandemic. Our objective was to conduct a cross-sectional quantitative and qualitative descriptive analysis of a rapid-response survey among low-income households with children on social needs, COVID-19-related concerns, and diet-related behaviors.

METHODS: We distributed an electronic survey in April 2020 to 16,435 families in 4 geographic areas, and 1,048 responded. The survey asked families enrolled in a coordinated school-based nutrition program about their social needs, COVID-19-related concerns, food insecurity, and diet-related behaviors during the pandemic. An open-ended question asked about their greatest concern. We …

Canakinumab To Reduce Deterioration Of Cardiac And Respiratory Function In Sars-Cov-2 Associated Myocardial Injury With Heightened Inflammation (Canakinumab In Covid-19 Cardiac Injury: The Three C Study), Calvin C Sheng, Debasis Sahoo, Siddharth Dugar, Robier Aguillon Prada, Tom Kai Ming Wang, Ossama K Abou Hassan, Danielle Brennan, Daniel A Culver, Prabalini Rajendram, Abhijit Duggal, A Michael Lincoff, Steven E Nissen, Venu Menon, Paul C Cremer

Faculty, Staff and Student Publications

BACKGROUND: In patients with Covid-19, myocardial injury and increased inflammation are associated with morbidity and mortality. We designed a proof-of-concept randomized controlled trial to evaluate whether treatment with canakinumab prevents progressive respiratory failure and worsening cardiac dysfunction in patients with SARS-CoV2 infection, myocardial injury, and high levels of inflammation.

HYPOTHESIS: The primary hypothesis is that canakiumab will shorten time to recovery.

METHODS: The three C study (canakinumab in Covid-19 Cardiac Injury, NCT04365153) is a double-blind, randomized controlled trial comparing canakinumab 300 mg IV, 600 mg IV, or placebo in a 1:1:1 ratio in hospitalized Covid-19 patients with elevations in troponin …

A Review Of Quarantine Period In Relation To Incubation Period Of Sars-Cov-2, Satya Rashmit Durugu, Hammad Tanzeem, Divya Menghani, Zahid Imran, Priya Krishnan

The University of Louisville Journal of Respiratory Infections

Introduction: The period from exposure to a potential pathogen to the manifestation of symptoms, i.e.  the incubation period, is time the virus spends replicating in the host. An estimation of this period and subsequent quarantine of the host can limit potential spread, particularly in asymptomatic carriers. Effective contact tracing, length of self-quarantine, repeat testing, and understanding of disease transmission are all contingent on a true estimation of this incubation period.

Methods: Articles in English published since December 1st, 2019, on Google scholar, PubMed, and Research Gate, along with bulletins from the World Health Organization and the Centers for Disease Control …

Call To Action: Sars-Cov-2 And Cerebrovascular Disorders (Cascade), Shahram Abootalebi, Benjamin M. Aertker, Mohammad Sobhan Andalibi, Negar Asdaghi, Ozlem Aykac, M. Reza Azarpazhooh, M. Cecilia Bahit, Kristian Barlinn, Hamidon Basri, Reza Bavarsad Shahripour, Anna Bersano, Jose Biller, Afshin Borhani-Haghighi, Robert D. Brown, Bruce Cv Campbell, Salvador Cruz-Flores, Deidre Anne De Silva, Mario Di Napoli, Afshin A. Divani, Randall C. Edgell, Johanna T. Fifi, Abdoreza Ghoreishi, Teruyuki Hirano, Keun Sik Hong, Chung Y. Hsu, Josephine F. Huang, Manabu Inoue, Amanda L. Jagolino, Moira Kapral, Hoo Fan Kee, Zafer Keser, Rakesh Khatri

Epidemiology and Biostatistics Publications

Background and purpose: The novel severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), now named coronavirus disease 2019 (COVID-19), may change the risk of stroke through an enhanced systemic inflammatory response, hypercoagulable state, and endothelial damage in the cerebrovascular system. Moreover, due to the current pandemic, some countries have prioritized health resources towards COVID-19 management, making it more challenging to appropriately care for other potentially disabling and fatal diseases such as stroke. The aim of this study is to identify and describe changes in stroke epidemiological trends before, during, and after the COVID-19 pandemic. Methods: This is an international, multicenter, hospital-based …

Comparison Of Sars-Cov-2 Detection From Nasopharyngeal Swab Samples By The Roche Cobas 6800 Sars-Cov-2 Test And A Laboratory-Developed Real-Time Rt-Pcr Test, Elisabet Pujadas, Nnaemeka Ibeh, Matthew M Hernandez, Aneta Waluszko, Tatyana Sidorenko, Vanessa Flores, Biana Shiffrin, Numthip Chiu, Alicia Young-Francois, Michael D Nowak, Alberto E Paniz-Mondolfi, Emilia M Sordillo, Carlos Cordon-Cardo, Jane Houldsworth, Melissa R Gitman

Faculty, Staff and Student Publications

The urgent need to implement and rapidly expand testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has led to the development of multiple assays. How these tests perform relative to one another is poorly understood. We evaluated the concordance between the Roche Diagnostics cobas 6800 SARS-CoV-2 test and a laboratory-developed test (LDT) real-time reverse transcription-polymerase chain reaction based on a modified Centers for Disease Control and Prevention protocol, for the detection of SARS-CoV-2 in samples submitted to the Clinical Laboratories of the Mount Sinai Health System. A total of 1006 nasopharyngeal swabs in universal transport medium from persons under …

Covid-19 Pathways For Brain And Heart Injury In Comorbidity Patients: A Role Of Medical Imaging And Artificial Intelligence-Based Covid Severity Classification: A Review., Jasjit S Suri, Anudeep Puvvula, Mainak Biswas, Misha Majhail, Luca Saba, Gavino Faa, Inder M Singh, Ronald Oberleitner, Monika Turk, Paramjit S Chadha, Amer M Johri, J Miguel Sanches, Narendra N Khanna, Klaudija Viskovic, Sophie Mavrogeni, John R Laird, Gyan Pareek, Martin Miner, David W Sobel, Antonella Balestrieri, Petros P Sfikakis, George Tsoulfas, Athanasios Protogerou, Durga Prasanna Misra, Vikas Agarwal, George D Kitas, Puneet Ahluwalia, Raghu Kolluri, Jagjit Teji, Mustafa Al Maini, Ann Agbakoba, Surinder K Dhanjil, Meyypan Sockalingam, Ajit Saxena, Andrew Nicolaides, Aditya Sharma, Vijay Rathore, Janet N A Ajuluchukwu, Mostafa Fatemi, Azra Alizad, Vijay Viswanathan, Pudukode R Krishnan, Subbaram Naidu

Trauma and Acute Care Articles

Artificial intelligence (AI) has penetrated the field of medicine, particularly the field of radiology. Since its emergence, the highly virulent coronavirus disease 2019 (COVID-19) has infected over 10 million people, leading to over 500,000 deaths as of July 1st, 2020. Since the outbreak began, almost 28,000 articles about COVID-19 have been published (https://pubmed.ncbi.nlm.nih.gov); however, few have explored the role of imaging and artificial intelligence in COVID-19 patients-specifically, those with comorbidities. This paper begins by presenting the four pathways that can lead to heart and brain injuries following a COVID-19 infection. Our survey also offers insights into the role that imaging …

Part I. Sars-Cov-2 Triggered 'Panic' Attack In Severe Covid-19, Elliot M. Frohman, Nicole R. Villemarette-Pittman, Esther Melamed, Roberto A. Cruz, Reid Longmuir, Thomas C. Varkey, Lawrence Steinman, Scott S. Zamvil, Teresa C. Frohman

School of Medicine Publications

The coronavirus disease 2019 (COVID-19) pandemic has produced a world-wide collapse of social and economic infrastructure, as well as constrained our freedom of movement. This respiratory tract infection is nefarious in how it targets the most distal and highly vulnerable aspect of the human bronchopulmonary tree, specifically, the delicate yet irreplaceable alveoli that are responsible for the loading of oxygen upon red cell hemoglobin for use by all of the body's tissues.

In most symptomatic individuals, the disease is a mild immune-mediated syndrome, with limited damage to the lung tissues. About 20% of those affected experience a disease course characterized …

Part Ii. High-Dose Methotrexate With Leucovorin Rescue For Severe Covid-19: An Immune Stabilization Strategy For Sars-Cov-2 Induced 'Panic' Attack, Elliot M. Frohman, Nicole R. Villemarette-Pittman, Roberto A. Cruz, Reid Longmuir, Vernon Rowe, Elizabeth S. Rowe, Thomas C. Varkey, Lawrence Steinman, Scott S. Zamvil, Teresa C. Frohman

School of Medicine Publications

Here, in Part II of a duology on the characterization and potential treatment for COVID-19, we characterize the application of an innovative treatment regimen for the prevention of the transition from mild to severe COVID-19, as well as detail an intensive immunotherapy intervention hypothesis. We propose as a putative randomized controlled trial that high-dose methotrexate with leucovorin (HDMTX-LR) rescue can abolish 'PANIC', thereby 'left-shifting' severe COVID-19 patients to the group majority of those infected with SARS-CoV-2, who are designated as having mild, even asymptomatic, disease. HDMTX-LR is endowed with broadly pleiotropic properties and is a repurposed, generic, inexpensive, and widely …

Understanding Covid-19: From Origin To Potential Therapeutics, Muhammad Moazzam, Muhammad Imran Sajid, Hamza Shahid, Jahanzaib Butt, Irfan Bashir, Muhammad Jamshaid, Amir Nasrolahi Shirazi, Rakesh Kumar Tiwari

Pharmacy Faculty Articles and Research

Currently, a global pandemic era of public health concerns is going on with the Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first case of COVID-19 was reported from Wuhan’s Huanan seafood market in China late December 2019. Bats, pangolins, and snakes have been nominated as salient carriers of the virus. Thanks to its high pathogenicity, it can cause severe respiratory infections. Fever, dry cough, sore throat, pneumonia, septic shock, and ground-glass opacities are the foremost clinical manifestations of COVID-19. Immunocompromised patients are at high risk for COVID-19 infection and may lead to …

Molecular Mechanisms And Epidemiology Of Covid-19 From An Allergist’S Perspective, Koa Hosoki, Abhijit Chakraborty, Sanjiv Sur

Faculty, Staff and Students Publications

The global pandemic caused by the newly described severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused worldwide suffering and death of unimaginable magnitude from coronavirus disease 2019 (COVID-19). The virus is transmitted through aerosol droplets, and causes severe acute respiratory syndrome. SARS-CoV-2 uses the receptor-binding domain of its spike protein S1 to attach to the host angiotensin-converting enzyme 2 receptor in lung and airway cells. Binding requires the help of another host protein, transmembrane protease serine S1 member 2. Several factors likely contribute to the efficient transmission of SARS-CoV-2. The receptor-binding domain of SARS-CoV-2 has a 10- to 20-fold …

Evaluation Of The Humoral Immune Response As A Potential Indicator Of Disease Severity For Patients Hospitalized With Covid-19, Spencer Sterling

Capstone Experience: Master of Public Health

Members of the family Coronaviridae, including the severe acute respiratory syndrome coronaviruses (SARS-CoV-1 and SARS-CoV-2), Middle East respiratory syndrome coronavirus (MERS-CoV) and seasonal human coronaviruses (HCoV-HKU1and HCoV-OC43), are highly communicable respiratory viruses; SARS-CoV-1, SARS-CoV-2, and MERS can cause severe disease, while seasonal human coronaviruses present with mild to moderate illness. Coronavirus envelope spike (S) glycoproteins are involved in receptor binding and cell fusion, and are the primary target for a neutralizing humoral response. The S protein is comprised of the S₁ and S₂ subunits; the S₁ subunit contains the receptor-binding domain (RBD), while the S_{2 …}

Anesthesia Services In The Time Of Covid, James Chen, Daisy Sangroula, Katelyn Williams, Sydney Pham, Ozan Akca, Jiapeng Huang, Sean Clifford

The University of Louisville Journal of Respiratory Infections

Our hospital is a 400-bed, Level-1 trauma center with 78 intensive care unit (ICU) beds serving the greater Louisville metropolitan area. The COVID-19 pandemic forced our hospital to re-evaluate our core business operations and to develop a coherent response to a fluid situation. Between March 15 and May 15, 2020, the University of Louisville Hospital admitted more than 100 COVID-19 inpatients; approximately 30 were admitted to the ICU, and most required endotracheal intubation. The following review describes our Department of Anesthesiology \& Perioperative Medicine foci, actions, and rationale during the COVID-19 pandemic. While we hope not to experience another pandemic …

Prospects For Rnai Therapy Of Covid-19, Hasan Uludağ, Kylie Parent, Hamidreza Montazeri Aliabadi, Azita Haddadi

Pharmacy Faculty Articles and Research

COVID-19 caused by the SARS-CoV-2 virus is a fast emerging disease with deadly consequences. The pulmonary system and lungs in particular are most prone to damage caused by the SARS-CoV-2 infection, which leaves a destructive footprint in the lung tissue, making it incapable of conducting its respiratory functions and resulting in severe acute respiratory disease and loss of life. There were no drug treatments or vaccines approved for SARS-CoV-2 at the onset of pandemic, necessitating an urgent need to develop effective therapeutics. To this end, the innate RNA interference (RNAi) mechanism can be employed to develop front line therapies against …

Is Sars-Cov-2 A Neurotropic Virus And A Potential Facilitator Of Cns Infection For Other Pathogens?, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Comparison Of Abbott Id Now, Diasorin Simplexa, And Cdc Fda Emergency Use Authorization Methods For The Detection Of Sars-Cov-2 From Nasopharyngeal And Nasal Swabs From Individuals Diagnosed With Covid-19, Daniel D. Rhoads, Sree S. Cherian, Lisa M. Stempak, Christine L. Schmotzer, Navid Sadri

Faculty Scholarship

No abstract provided.

Covid-19 Surveillance Testing Of Healthcare Personnel Drives Universal Masking Practice, Paul S. Schulz, Ashley M. Wilde, Steve T. Hester, Jim Frazier, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Health care professionals (HCP) are at increased risk of COVID-19 infection due to the unpredictable clinical presentation of COVID-19 disease, limited SARS-CoV-2 testing, personal protective equipment (PPE) shortages, and the inherent inability to distance from patients. Infected HCP may infect others, including coworkers, leading to a simultaneous increase in the number of infections and decrease in the availability of HCP in a community. Due to PPE shortages, many healthcare systems have faced difficult decisions regarding utilization of PPE to protect HCP, patients, and the communities they serve. We describe Norton Healthcare’s success utilizing surveillance COVID-19 testing of HCP to inform …

Why Every Hospital Needs A Covid-19 Clinical Case Review Team, Ashley M. Wilde, Paul Schulz, Brian C. Bohn, Sarah E. Moore, Matthew Song, Clayton J. Patross, Bryan Denham, Jim Frazier, Steve T. Hester, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A hospital’s response to a global pandemic requires a coordinated effort to provide consistent guidance as information rapidly changes. In the early months of the COVID-19 pandemic, diagnosis and subsequent containment was challenging due to unfamiliarity with disease presentation, unknown reverse transcription-polymerase chain reaction sensitivity, and inconsistent access to testing supplies. A centralized COVID-19 clinical case review team can provide guidance on test interpretation, isolation, resource coordination and more.

The Nurse Practitioner In The Time Of Covid, Julie Marfell, Lynn Kelso

The University of Louisville Journal of Respiratory Infections

No abstract provided.

An Overview Of Current Clinical Trials Of Agents For The Treatment And Prevention Of Covid-19 In The United States, Kenneth Schot Hannan, William P. Mckinney

The University of Louisville Journal of Respiratory Infections

Introduction: Given the rapid worldwide spread of SARS-CoV-2 and the attendant risks for severe complications and mortality, numerous clinical trials for its treatment and prevention have been generated in a short period. This report focuses on the categories of the wide spectrum of agents being studied in the United States and the intensity of effort involved with each so that clinicians may consider whether suggesting enrollment may be appropriate for their patients.

Methods: A search was completed of the ClinicalTrials.gov database on May 28, 2020, for all such trials underway as of that date in the US. A total 190 …

Rna-Gps Predicts Sars-Cov-2 Rna Residency To Host Mitochondria And Nucleolus, Kevin E Wu, Furqan M Fazal, Kevin R Parker, James Zou, Howard Y Chang

Faculty, Staff and Students Publications

SARS-CoV-2 genomic and subgenomic RNA (sgRNA) transcripts hijack the host cell's machinery. Subcellular localization of its viral RNA could, thus, play important roles in viral replication and host antiviral immune response. We perform computational modeling of SARS-CoV-2 viral RNA subcellular residency across eight subcellular neighborhoods. We compare hundreds of SARS-CoV-2 genomes with the human transcriptome and other coronaviruses. We predict the SARS-CoV-2 RNA genome and sgRNAs to be enriched toward the host mitochondrial matrix and nucleolus, and that the 5' and 3' viral untranslated regions contain the strongest, most distinct localization signals. We interpret the mitochondrial residency signal as an …

Covid-19: In The Absence Of Vaccination – ‘Mask-The-Nation’, Roy D. Sleator, Steven Darby, Alan Giltinan, Niall Smith

Department of Biological Sciences Publications

“In the absence of a vaccine, or effective antiviral, one of our only remaining strategies for controlling COVID-19 is to physically block the spread of SARS-CoV-2 in the community”