Community Health and Preventive Medicine Commons^™

Characteristics And Outcomes Of Bacteremic Pneumococcal Pneumonia Of Patients With And Without Hiv Infection In Argentina, Alejandra González

The University of Louisville Journal of Respiratory Infections

Streptococcus pneumoniae is the main causative agent of pneumonia, with a 10 to 25 percent rate of isolation in blood cultures. Controversies exist regarding the prognostic impact of a history of human immunodeficiency virus (HIV) infection on community-acquired pneumonia.

The aim of our work was to analyze and compare the clinical presentation, radiological findings and progression of pneumococcal pneumonia in patients infected with and not infected with HIV. We retrospectively analyzed adult patients with positive blood cultures for Streptococcus pneumoniae and clinical and radiological findings compatible with pneumonia in the period between January 2012 and May 2017. Age, sex, comorbidities, …

Invasive Pneumococcal Serotype 3 Disease Despite Pneumococcal Polysaccharide Vaccine-23, B. Frank Parker Jr, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Pneumococcal disease has a high global morbidity and mortality. We report a case of a 63-year old female with a history of vaccination with pneumococcal polysaccharide vaccine-23 (PPSV-23) who was transferred to a tertiary care facility with fever and seizures due to an unknown etiology. The diagnosis of invasive pneumococcal disease (IPD) was based the identification of Streptococcus pneumoniae in the blood (culture; serogroup 3) and cerebrospinal fluid (antigen), and the finding of purulence under pressure at craniotomy. The pneumococcal vaccine should provide protection from IPD. The findings reported here display that IPD can overcome immunity proffered by the pneumococcal …

To Preprint Or Not To Preprint, Forest W. Arnold, Kimberley A. Buckner, Alex Glynn, Jessica Petrey, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

International Respiratory Infections Society Covid Research Conversations: Podcast 3 With Dr. Antoni Torres, Julio A. Ramirez, Antoni Torres

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–4 Introductions

5 “Spanish” influenza

6–9 Dr. Torres’ personal thoughts and experiences

10 COVID-19 hospitalizations in Barcelona

11 A threatening phone call

12–13 Origin of the CIBERESUCICOVID project

14 Baseline characteristics

15 Bloodwork at hospital admission; ICU admission vs. day 3

16 Treatments

17 Complications

18 Outcomes related to interventions

19 Viral RNA load in plasma associated with critical illness and dysregulated response

20 Follow-up with health care workers

21 Medical education

22 Conclusions

23–26 Interleukin 6

27–29 Ventilatory approach

30–33 Post-COVID syndrome

34–38 Impact on health care workers

39–41 Holidays and COVID-19 infection

42–43 New paradigm for …

A New Chapter In The Life Of The Journal, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

A Transition Of Uljri Leadership, Forest W. Arnold, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Facial Mask Use And Covid-19 Protection Measures In Jefferson County, Kentucky: Results From An Observational Survey, November 5−11, 2020, Seyed M. Karimi, Sonali S. Salunkhe, Kelsey B. White, Sahal A. Alzahrani, Bert Little, William P. Mckinney, Natalie Dupre, Riten Mitra, Yuting Chen, Martha M Popescu, Emily R. Adkins, Julia A. Barclay, Emmanuel Ezekekwu, Caleb.He X. He, Dylan M Hurst, Aravindreddy Kothagadi, Shaminul H. Shakib, Devin N. Swinney, David A. Johnson, Rebecca Hollenbach, Sarah Moyer

The University of Louisville Journal of Respiratory Infections

Introduction: The transmission of respiratory infectious diseases such as COVID-19 can significantly decrease by mask-wearing. However, accurate information about the extent and proper use of the facial mask is scarce. This study’s main objective was to observe and analyze mask-wearing behavior and the level of COVID-19 protection measures in indoor public areas (PAs) of Jefferson County, Kentucky.

Methods: For conducting the observational survey study, targets were indoor PAs, and zip codes were defined as surveying clusters. The number of selected PAs in each zip code was proportional to the population and the total number of PAs in that zip code. …

International Respiratory Infections Society Covid Research Conversations: Podcast 2 With Dr. Michael S. Niederman And Dr. Edward J. Schenck, Julio A. Ramirez, Michael S. Niederman, Edward J. Schenck

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–4 Introductions

5 COVID-19 in New York City

6–7 Telemedicine, long-term sequelae

8 Development of a multi-disciplinary ICU team

9–10 Treatment of ARDS, COVID-19 pathogenesis

11–12 Prioritizing treatment at research

13 Challenges in tracing the natural history of severe COVID-19

14–15 Experience with mechanically ventilated patients; non-pulmonary organ failure

16–17 Mapping COVID-19 trajectories by SOFA score

18–20 Findings: additive organ dysfunction, improving vs. worsening trajectory

21 ARDS therapeutic approaches

22 Clinical trials involving Cornell

23–25 Lessons learned: patient care, research, education, caring for critical care workers

26–30 2021 predictions: improved therapies and research, endemic COVID-19, vaccines

31–33 Prioritizing …

Defining Early And Late Clinical Outcomes In Patients With Sars-Cov-2 Pneumonia, Julio A. Ramirez, Jose Bordon, Rodrigo Cavallazzi, Stephen P. Furmanek, Jiapeng Huang, Timothy L. Wiemken, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

H1n1 Influenza Virus (Swine Flu): A Comprehensive Insight Into Escalating Catch-22 Scenarios, Muhammad Shahzaib, Ehsan Ul Haq

The University of Louisville Journal of Respiratory Infections

Introduction: Viruses have always been a major cause of various disastrous pandemics in mankind’s history. H1N1 became a threat when its original strain was first discovered back in the swine flu pandemic of 2009. It became highly catastrophic on a large scale because none of the therapeutic interventions and methodologies that were already present at the time were effective against the virus.

Methods: A vast amount of literature and research is available regarding H1N1 influenza from different reputable sources online. The data were gathered with the contrasting and relative situations of 1918 and 2009 pandemics in mind. The overall extracted …

International Respiratory Infections Society Covid Research Conversations: Podcast 1 With Dr. Francesco Blasi, Julio A. Ramirez Md, Francesco Blasi Md, Phd

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–2 Introductions

3 Foundations of best practice

4 COVID-19 as stimulus for innovation

5 Adapting and evolving therapeutic approach

6 Age and comorbidities as risk factors

7 Over-capacity ICU

8 Adapting the ER for COVID-19

9 Training personnel for COVID-19

10 Psychological support, healthcare heroes, and COVID fatigue

11 Increased oxygen requirement

12–13 Milan’s multi-disciplinary unit

14 Standardizing respiratory support measures

15 Nutrition, sedation, and life support

16 CPAP successes and failures

17 Prone and lateral positioning of patients on CPAP

18 Different COVID-19 phenotypes?

19 Thromboembolism risk score, age, and comorbidities

20 Cardiorespiratory considerations: hypertension, echocardiography

21 …

An Update On The Leading Covid-19 Vaccines, Ahmed A. Eladely, Javaria Anwer Mbbs, Ashwini Gotimukul Mbbs, Manish Kc Mbbs, Jessica Petrey Msls, Alex Glynn Ma, Ruth M. Carrico Phd, Dnp, Julio A. Ramirez Md

The University of Louisville Journal of Respiratory Infections

We reviewed the COVID-19 vaccines that reached phase III of clinical development. For each of the 10 vaccines identified, we described the technology used for vaccine development, the available data from phase III clinical trials, data on vaccine safety, and the role of new SARS-CoV-2 variants on vaccine efficacy.

Lack Of Association Of The Abo Blood Group With Covid-19 Risk And Severity In Hospitalized Patients In Louisville, Ky, Rafael Fernandez-Botran, Meredith Cahill, Raghava S. Ambadapoodi, Evelyn Exposito Gonzalez, Stephen P. Furmanek, Ruth Carrico, Jose Bordon, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: The potential association of the ABO blood group with the risk of COVID-19 and its severity has attracted a lot of interest since the start of the pandemic. While a number of studies have reported an increased risk associated with blood type A and a reduced risk with type O, other studies have did not found a significant effect. This study aimed to define the prevalence of different ABO blood groups in hospitalized COVID-19 patients in the Louisville, KY area and to investigate whether an association exists between the blood group and disease severity.

Methods: This was a retrospective …

A Comparative Analysis Of The Knowledge And Stigmatizing Attitude Of Ghanaians And Nigerians Towards Covid-19 Survivors, Emmanuel Lamptey, Dorcas Serwaa, Maxwell Hubert Antwi, Theckla Ikome Ms, Nkechi Odogwu

Journal of Refugee & Global Health

Introduction: In Africa, COVID-19 associated stigmatization still remains the contextual factor that poses a challenge for the mitigation and suppression of COVID-19 spread, especially among the illiterate populations. This comparative study was therefore conducted to assess the knowledge and willingness of Ghanaians and Nigerians to associate with COVID-19 survivors.

Methods: A cross-sectional study was conducted to collect information from 290 Ghanaian and 220 Nigerian nationals aged 18 years and above between 11th July-30th October 2020. An electronic-based questionnaire was developed to collect information on the public. The data were analyzed with SPSS v 22 and factors influencing knowledge and willingness …

Epidemiology And Outcomes Of Hospitalized Adults With Sars-Cov-2 Community-Acquired Pneumonia In Louisville, Kentucky, Julio A. Ramirez, T'Shura Ali, Thomas Chandler, Stephen P. Furmanek, Daniya Sheikh, Vidyulata Salunkhe, Steven Gootee, Mohammad Tahboub, William A. Mattingly, Demetra Antimisiaris, Jiapeng Huang, Jose Bordon, Rodrigo Cavallazzi, Paul Schulz, William P. Mckinney, Dawn Balcom, Mark Burns, Ruth Carrico, Forest W. Arnold, Cerid Covid-19 Study Group

The University of Louisville Journal of Respiratory Infections

Background: During the ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV-2 community-acquired pneumonia (CAP) has been the primary cause of hospitalization. The objective of this study was to evaluate the clinical characteristics and outcomes of 1,013 patients hospitalized with SARS-CoV-2 CAP from September 2020 through March 2021 in Louisville, Kentucky.

Methods: This was a retrospective observational study of 1,013 patients hospitalized with SARS-CoV-2 CAP at eight of the adult hospitals in the city of Louisville from September 2020 through March 2021. Patients with 1) a positive reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, 2) fever, cough, or …

Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve

Faculty and Staff Scholarship

Background:

Chronic immune activation and CD4⁺ T cell depletion are significant pathogenic features of HIV infection. Expression of Fas ligand (FasL), a key mediator of activation-induced cell death in T cells, is elevated in people living with HIV-1 infection (PLWH). However, the epigenetic mechanisms underlying the enhanced induction of FasL expression in CD4⁺ T lymphocytes in PLWH are not completely elucidated. Hence, the current work examined the effect of HIV infection on FasL promoter-associated histone modifications and transcriptional regulation in CD4⁺ T lymphocytes in PLWH.

Method:

Flow cytometric analysis was performed to examine the Fas-FasL expression on …

Healthcare Workers Hospitalized With Covid-19: Outcomes From The Burden Of Covid-19 Study At The University Of Louisville Center Of Excellence For Research In Infectious Diseases [Cerid], Ruth Carrico, T'Shura S. Ali, Maria Hill, Lucia B. Puga Sanchez, Catherine M. Bryan, Dawn Balcom, Stephen P. Furmanek, Amr Aboelnasr, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Introduction: On March 6, 2020, the current ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, reached the commonwealth of Kentucky. Within days, the first cases of infection and hospitalization were identified among healthcare workers (HCW) in Kentucky, other states in the U.S., and around the world. There is little information available regarding the impact of COVID-19 on the HCW population within this area. The objective of this study was to describe the baseline characteristics of hospitalized HCWs infected with COVID-19.

Methods: Data collection was performed as part of a retrospective study of patients hospitalized …

Covid-19 & Pregnancy Complication During Early Pandemic: A Narrative Review, Ahmed A. Eladely, Maria Hill, Ahmed Abdelhaleem, Zahid Imran, Ahsan M. Khan, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Background: Coronaviruses have caused three outbreaks in the past two decades. The novel one is SARS-COV-2, which causes COVID-19. Pregnant women have a somewhat altered immune state, which may make them more vulnerable to COVID-19 and its complications. Extensive research is needed to better understand the clinical course of COVID-19 in this population. This review article discusses the comparison of SARS-CoV-2 with previous coronavirus outbreaks, clinical presentations, and complications in pregnant women and newborns.

Methods: We conducted a literature search for case series and case reports about pregnancy outcomes in pregnant women with COVID-19 during the early phase of pandemic. …

The Case Of A Pregnant Woman With Ards Due To Covid-19 Treated With Hydroxychloroquine, Azithromycin, And Remdesivir And Delivery Of A Healthy Baby During Mechanical Ventilation Through Cesarean Section, Adria Madera-Acosta, Martin Gnoni, Bassman Tappuni, Monika Sadlak, Ravleen Grewal, Angel Mena, Yousef Ali-Ahwel

The University of Louisville Journal of Respiratory Infections

We are in the midst of a pandemic due to SARS-CoV-2. Pregnancy was identified among the risk factors for worse clinical outcomes in multiple studies. The optimal therapy in this group of patients remains to be defined. Here, we present the case of a 39-year-old Caucasian pregnant female at 31 weeks of gestation, who was treated successfully with hydroxychloroquine, azithromycin, remdesivir, prone therapy, and cesarean delivery of a healthy baby while on mechanical ventilation. She remained SARS-CoV-2-positive until the 39th day of hospitalization. We discuss the pathophysiology of the increased risk of infections during pregnancy and particularly the high risk …

Characteristics And Outcomes Of Adults Hospitalized With Sars-Cov-2 Community-Acquired Pneumonia In Louisville, Kentucky, Julio A. Ramirez, Jose Bordon, Rodrigo Cavallazzi, Stephen P. Furmanek, Amr Aboelnasr, Mahder A. Tella, William A. Mattingly, Ashley M. Wilde, Daisy Sangroula, Demetra Antimisiaris, Donghoon Chung, Guillermo Cabral, Gabino R Fernandez-Botran, Jiapeng Huang, Martin Gnoni, Ozan Akca, Paul Schulz, Phillip F. Bressoud, Priya Krishnan, Sally Suliman, Sathya Krishnasamy, Stephen S. Hanson, William P. Mckinney, Harpal Sandhu, Leslie A Wolf, Mark Burns, Ruth Carrico, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Background: Patients infected with the novel coronavirus SARS-CoV-2 are frequently hospitalized with community-acquired pneumonia (CAP). The objective of this study was to define the clinical characteristics and outcomes of hospitalized patients with SARS-CoV-2 CAP in the city of Louisville, KY.

Methods: This was a retrospective observational study of 700 patients with SARS-CoV-2 infection hospitalized at eight of the adult hospitals in the city of Louisville. Patients with 1) a positive RT-PCR for SARS-CoV-2, 2) fever, cough, or shortness of breath, and 3) an infiltrate on chest imaging were defined as having SARS-CoV-2 CAP. Demographic characteristics of the study population were …

Implementation Of The University Of Louisville Covid-19 Biorepository: Experiences From The Center Of Excellence In Infectious Diseases (Cerid), Dawn Balcom, Leslie A Wolf, Subathra Marimuthu, William Johnson, Danial Malik, Chet Dhakal, Pavani Nathala, Mohammed Abbas, Sahaj Hardeep Singh, Basel Haddad, Rafik Elbeblawy, Fnu Deepti, Ahmed Ali, Evelyn Exposito Gonzalez, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

The limited availability of biological samples from patients testing positive for SARS-CoV-2 for future research was quickly identified at the onset of the COVID-19 pandemic. In response to this need, a COVID-19 biobank was initiated by the University of Louisville Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID). The COVID-19 biobank contains waste samples obtained from patients hospitalized with COVID-19 in any of the nine Louisville, Kentucky, area hospitals during the timeframe of April 13 to September 20, 2020. The COVID-19 biobank stores approximately 1,623 waste samples with 2,127 aliquots for distribution. All samples are …

Age, Comorbidities, And Mortality Correlation In Covid-19 Patients: A Review, Vidyulata Salunkhe, Amr Aboelnasr, Parul Pahal, Nida Qadir, Simra Kiran, Balaji Sekaran, Omar Fahmy, Farah Daas, Syed Shah

The University of Louisville Journal of Respiratory Infections

Background: The risk of death due to COVID-19 among hospitalized patients is known to be higher in older adults and those with underlying health conditions. Understanding the proportion of patients who are at increased risk of death due to COVID-19 and how this varies between age groups will inform the healthcare community as to how to evaluate the risk of COVID-19 and better design healthcare and economic policies.

Methods: We conducted a literature search for studies published between December 2019 and May 16, 2020 in PubMed, Embase, and Cochrane (CENTRAL). Descriptive statistics were performed.

Results: We reviewed 14 studies, of …

A Community Academic Partnership Approach To Addressing Health Needs Of The Local Refugees: Participants’ Perspectives And Recommendations For Developing New Partnerships, Melissa D. Warne-Griggs, Nicolin Thaler, Kristin Koehn, Kristin Sohl

Journal of Refugee & Global Health

Community-academic partnerships have demonstrated how collaboration can provide academic healthcare workers and non-medical community providers such as educators and social services with a comprehensive view of issues affecting refugee populations. The ICIH (Interagency Council on Immigrant Health) is a physician-community partnership consisting of healthcare professionals, non-medical educators, social workers, early childhood services and other community agencies. It was formed to address the well-being of a local immigrant population, strengthen bonds between the community and healthcare system, and educate and empower pediatricians to provide culturally aware services. The collaboration has been very successful as demonstrated by the production of multiple collaborative …

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.

Covid-19 Contact Tracing Apps: How They Notify Users Of Potential Exposure, William A. Mattingly

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Considerations For A Covid-19 Research Data Warehouse In The Time Of Covid, William A. Mattingly

The University of Louisville Journal of Respiratory Infections

No abstract provided.

The Role Of Rapid Diagnostic Point Of Care Igg/Igm Antibody Tests In The Diagnosis Of Sars-Cov-2 Infection, Nishita Tripathi, Daniya Sheikh, Dawn Balcom

The University of Louisville Journal of Respiratory Infections

Background: Current testing of symptomatic patients for SARS-CoV-2 involves the use of nucleic acid amplification tests, also known as genetic, RNA, or polymerase chain reaction (PCR), to detect viral RNA. The initial use of point of care (POC) antibody tests, also known as serological tests, in the management of SARS-CoV-2 infection was limited. In this review, we determine the significance of POC antibody serological tests and explore their possible role in the diagnosis and management of patients infected with the SARS-CoV-2 virus.

Methods: A literature search was conducted in Google Scholar, PubMed, and Embase, supplemented by searching the Centers for …

Gastrointestinal Symptoms In Patients With Covid-19, Mohammed Abbas, Rafik Elbeblawy, Islam Gadelmoula, Suvarna Rekha, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: Though coronavirus disease 2019 (COVID-19) is predominantly a respiratory illness, a growing number of studies reported gastrointestinal (GI) symptoms among these patients. We examined the incidence of GI symptoms in patients with COVID-19 and GI symptoms as the initial presentation of the disease.

Methods: We examined peer-reviewed studies in English of patients with COVID-19 that reported GI symptoms. We searched PubMed and Google Scholar for articles published up to June 30, 2020, by using the keywords ``COVID-19,'' ``Coronavirus,'' ``severe acute respiratory syndrome coronavirus 2,'', ``SARS-CoV-2,'' ``gastrointestinal tract,'' ``gastrointestinal diseases,'' and ``gastrointestinal symptoms and signs.'' Studies with fewer than 30 …

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 …

Covid-19 Is Associated With Increased Severity In Pregnant Women, Zahid Imran, Vidyulata Salunkhe, Ahmed A. Eladely, Ahmed Abdelhaleem, Satya Durugu, Daisy Sangroula

The University of Louisville Journal of Respiratory Infections

Introduction: The COVID-19 pandemic originated in China in late 2019; the number of cases is increasing with 2,104,346 cases and 116,140 deaths in the United States as of June 16, 2020. Pregnant women are a vulnerable population in epidemics or pandemics. This review is designed to look in detail at the severity of COVID-19 in pregnant women compared to non-pregnant women of reproductive age.

Methods: Literature searches on PubMed, Google Scholar, the Lancet, and Web of Science were conducted.

Results: We found evidence of increased risk for severe disease and distinctive symptoms among pregnant women diagnosed with COVID-19 compared …