COVID-19 Commons^™

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 …

Covid-19 Risk And Outcomes In Patients With Substance Use Disorders, Quangqiu Wang, David C. Kaelber, Rong Xu

Faculty Scholarship

The global pandemic of COVID-19 is colliding with the epidemic of opioid use disorders (OUD) and other substance use disorders (SUD) in the United States (US). Currently, there is limited data on risks, disparity, and outcomes for COVID-19 in individuals suffering from SUD. This is a retrospective case-control study of electronic health records (EHRs) data of 73,099,850 unique patients, of whom 12,030 had a diagnosis of COVID-19. Patients with a recent diagnosis of SUD (within past year) were at significantly increased risk for COVID-19 (adjusted odds ratio or AOR=8.699 [8.411–8.997], P<10−30), an effect that was strongest for individuals with OUD (AOR=10.244 [9.107–11.524], P<10−30), followed by individuals with tobacco use disorder (TUD) (AOR=8.222 ([7.925–8.530], P<10−30). Compared to patients without SUD, patients with SUD had significantly higher prevalence of chronic kidney, liver, lung diseases, cardiovascular diseases, type 2 diabetes, obesity and cancer. Among patients with recent diagnosis of SUD, African Americans had significantly higher risk of COVID-19 than Caucasians (AOR=2.173 [2.01–2.349], P<10−30), with strongest effect for OUD (AOR=4.162 [3.13–5.533], P<10−25). COVID-19 patients with SUD had significantly worse outcomes (death: 9.6%, hospitalization: 41.0%) than general COVID-19 patients (death: 6.6%, hospitalization: 30.1%) and African Americans with COVID-19 and SUD had worse outcomes (death: 13.0%, hospitalization: 50.7%) than Caucasians (death: 8.6%, hospitalization: 35.2%). These findings identify individuals with SUD, especially individuals with OUD and African Americans, as having increased risk for COVID-19 and its adverse outcomes, highlighting the need to screen and treat individuals with SUD as part of the strategy to control the pandemic while ensuring no disparities in access to healthcare support.

Can Lessons From The Covid-19 Pandemic Help Define A Strategy For Global Pediatric Radiology Education?, Jennifer Lynn Nicholas

Faculty Scholarship

No abstract provided.

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 …

Quantifying The Decrease In Emergency Department Imaging Utilization During The Covid-19 Pandemic At A Multicenter Healthcare System In Ohio, Keval D. Parikh, Nikhil H. Ramaiya, Elias G. Kikano, Sree Harsha Tirumani, Jonathan Pierce, Carl Butcher, Jeffrey L. Sunshine, Donna M. Plecha

Faculty Scholarship

PURPOSE: To illustrate the change in emergency department (ED) imaging utilization at a multicenter health system in the state of Ohio during the COVID-19 pandemic. METHODS: A retrospective observational study was conducted assessing ED imaging volumes between March 1, 2020, and May 11, 2020, during the COVID-19 crisis. A rolling 7-day total value was used for volume tracking and comparison. Total imaging utilization in the ED was compared with new COVID-19 cases in our region. Utilization was first categorized by modality and then by plain films and computed tomography (CT) scans grouped by body part. CT imaging of the chest …

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 …

G-Csf And Gm-Csf Are Different. Which One Is Better For Covid-19?, Hillard M. Lazarus

Faculty Scholarship

No abstract provided.

Covid-19 Wku Staff Reference Guide, Wku Staff Senate

Staff Council

Document prepared by WKU Staff Senate Executive Committee along with campus leadership to answer questions that staff have regarding COVID-19.

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.

Cbt-Informed Interventions For Essential Workers During The Covid-19 Pandemic, Kathy Benhamou, Alexandra Piedra

Student Scholarship

Essential workers during the COVID-19 pandemic face heightened levels of anxiety and depression due to increased work demands, lack of adequate personal protective equipment, fear of contracting the virus, and fear of spreading it to loved ones. This is a time of urgent need for mental health support for workers affected by the pandemic crisis. Clinicians may employ empirically supported interventions derived from cognitive behavioral therapy (CBT) and related therapies. Psychological First Aid, an evidence-based crisis intervention, may be utilized to emphasize basic needs and support, but is intended as an acute disaster intervention. Given that a pandemic is an …

Acute Effusive Pericarditis: A Late Complication Of Covid-19., Kelli Fox, Jessica A Prokup, Kyle Butson, Kim Jordan

Heart and Vascular Articles

As the COVID-19 pandemic evolves, the medical community continues to discover novel clinical manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Often, extrapulmonary manifestations occur simultaneously with pulmonary disease. However, there is a paucity of literature describing the cardiac manifestations of COVID-19 in the absence of pulmonary findings. We report a rare case of acute pericarditis presenting with pericardial effusion and cardiac tamponade in a 43-year-old man diagnosed with COVID-19. This case emphasizes the importance of continued investigation regarding diagnosis and treatment of COVID-19 and its related symptoms.

Covid-19 Pandemic Impact On Decreased Imaging Utilization: A Single Institutional Experience, Keval D. Parikh, Nikhil H. Ramaiya, Elias G. Kikano, Sree Harsha Tirumani, Himanshu Pandya, Bart Stovicek, Jeffrey L. Sunshine, Donna M. Plecha

Faculty Scholarship

RATIONALE AND OBJECTIVES: Predictive models and anecdotal articles suggest radiology practices were losing 50-70% of their normal imaging volume during the COVID-19 pandemic. Using actual institutional data, we investigated the change in imaging utilization and revenue during this public health crisis. MATERIALS AND METHODS: Imaging performed within the 8-week span between March 8-April 30, 2020 was categorized into the COVID-19 healthcare crisis timeframe. The first week of this date range and the 10 weeks prior were used to derive the normal practice expected volume. A rolling seven-day total value was used for volume tracking and comparison. Total imaging utilization was …

Respiratory Viral Panels And Pediatric Airway Evaluation: The Role Of Testing For Upper Respiratory Infections To Stratify Perioperative Risk., Weston L Niermeyer, Jessica Ball, Noah Worobetz, Tran Bourgeois, Amanda Onwuka, Candice Burrier, Tendy Chiang

Ambulatory and Primary Care Articles

OBJECTIVES: Children admitted with stridor and respiratory distress comprise a complex patient group that requires the otolaryngologist to decide when to assess and intervene with direct laryngoscopy and bronchoscopy (DLB). Historically, the diagnosis of viral upper respiratory tract infection (URTI) can lead to postponement of surgery due to concerns of perioperative complications related to acute illness. Respiratory viral panels (RVP) are often used to confirm the presence of recent or active viral infection and can affect the differential diagnosis of upper airway obstruction. This study examined whether positive RVP testing is associated with perioperative complications and operative findings in pediatric …

Should Asymptomatic And Low-Risk Individuals Be Tested For Sars-Cov-2?, Ashwini R. Sehgal

Faculty Scholarship

Because people with asymptomatic SARS-CoV-2 infections are an important source of transmission, widespread testing has the potential to identify and isolate such individuals, quarantine their contacts, and prevent further spread. However, testing for a condition in a group with low disease prevalence may lead to numerous false positive results. This study quantifies the tradeoff between reducing transmission by true positives and unnecessary isolation and quarantine due to false positives.

Class A G Protein-Coupled Receptor Antagonist Famotidine As A Therapeutic Alternative Against Sars-Cov2: An In Silico Analysis, Joseph Thomas Ortega, Beata Jastrzebska

Faculty Scholarship

The pandemic associated with Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV2) and its disease named COVID-19 challenged the scientific community to discover effective therapeutic solutions in a short period. Repurposing existing drugs is one viable approach that emphasizes speed during these urgent times. Famotidine, a class A G protein-coupled receptor antagonist used for the treatment of gastroesophageal reflux was recently identified in an in silico screening. Additionally, a recent retrospective clinical report showed that the treatment with famotidine provided a good outcome in patients infected with SARS-CoV2. A clinical trial testing effectiveness of famotidine in combination with hydroxychloroquine is …

Ua3/10 Big Red Restart, Wku President's Office - Caboni

WKU Administration Documents

Report regarding reopening procedures for WKU after COVID-19 shutdown.

Covid-19: Launching Neurosurgery Into The Era Of Telehealth In The United States, Christina Huang Wright, James Wright, Berje Shammassian

Faculty Scholarship

The authors discuss the implications of the COVID-19 pandemic on the use of telehealth in the United States.

Antibody Testing For Covid-19: Can It Be Used As A Screening Tool In Areas With Low Prevalence?, Sweta Mathur

Faculty Scholarship

No abstract provided.

Steam Treatment For Rapid Decontamination Of N95 Respirators And Medical Face Masks, Sarah N. Redmond, Lucas D. Jones, Curtis J. Donskey

Faculty Scholarship

No abstract provided.

Management Of Patients With Cerebellar Ataxia During The Covid-19 Pandemic, Aasef G. Shaikh

Faculty Scholarship

The current worldwide severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic that causes coronavirus disease 2019 (COVID-19) has brought some medical systems to the brink of collapse. This crisis is also negatively impacting the care of patients with non-COVID-19 conditions, including those with cerebellar ataxia (CA). Older patients with CA and those with immune-mediated ataxias on immunosuppressive medication are potentially at high risk of developing serious complications of the infection, although it is also possible that immunosuppressive agents may provide a defense against cytokine storm. This has implications for even greater attention to preventing contracting the disease through physical distancing …

Flattening The Curve In Covid-19 Using Personalised Protective Equipment: Lessons From Air Pollution, Sanjay Rajagopalan

Faculty Scholarship

No abstract provided.

Aga Institute Rapid Review Of The Gi And Liver Manifestations Of Covid-19, Meta-Analysis Of International Data, And Recommendations For The Consultative Management Of Patients With Covid-19, Perica Davitkov, Yngve Falck-Ytter

Faculty Scholarship

Background & aims: Multiple gastrointestinal (GI) symptoms, including diarrhea, nausea/vomiting, and abdominal pain, as well as liver enzyme abnormalities, have been variably reported in patients with coronavirus disease 2019 (COVID-19). This document provides best practice statements and recommendations for consultative management based on a systematic review and meta-analysis of international data on GI and liver manifestations of COVID-19. Methods: We performed a systematic literature search to identify published and unpublished studies using OVID Medline and preprint servers (medRxiv, LitCovid, and SSRN) up until April 5, 2020; major journal sites were monitored for US publications until April 19, 2020. We pooled …

Adapting To Uncertainty: Nursing Responsiveness To Covid-19, Scott Emory Moore

Faculty Scholarship

No abstract provided.

Changes In Gastroenterology And Endoscopy Practices In Response To The Covid-19 Pandemic: Results From A North American Survey, Zachary L. Smith

Faculty Scholarship

Digestive manifestations appear to be common in patients with coronavirus disease 2019 (COVID19). Gastroenterologists will invariably come into contact with infected patients, and the risk of intraprocedural exposure is well established. Recommendations have been issued to guide personal protective equipment (PPE) use and the triage of procedural urgency, among other operational considerations. In response, institutions providing gastroenterology and endoscopy services have taken urgent action to protect patients and staff, but the uptake and extent of these practice changes in North America is unknown. We conducted a survey of gastroenterology and endoscopy practices to assess the response to the COVID-19 pandemic …

Effectiveness Of Ultraviolet-C Light And A High-Level Disinfection Cabinet For Decontamination Of N95 Respirators, Curtis J. Donskey

Faculty Scholarship

Background: Shortages of personal protective equipment (PPE) including N95 respirators are an urgent concern in the setting of the global COVID-19 pandemic. Decontamination of PPE could be useful to maintain adequate supplies, but there is uncertainty regarding the efficacy of decontamination technologies. Methods: A modification of the American Society for Testing and Materials standard quantitative carrier disk test method (ASTM E-2197-11) was used to examine the effectiveness of 3 methods, including ultraviolet-C (UV-C) light, a high-level disinfection cabinet that generates aerosolized peracetic acid and hydrogen peroxide, and dry heat at 70°C for 30 minutes. We assessed the decontamination of 3 …

Head And Neck Survivorship Care In The Times Of The Sars-Cov-2 Pandemic, Victoria Huang

Faculty Scholarship

With the arrival of the coronavirus disease (SARS-CoV-2) in the United States, care practice paradigms have drastically changed. Data from China suggest that the new virus poses additional risks as case fatality of patients with cancer was higher at 5.6% compared to 2.3% of the general population. There are three proposed major strategies to address care for patients with cancer in this SARS-CoV-2 pandemic with postponing treatment for those with stable cancer, increasing personal protection provisions for patients with cancer, and increasing monitoring if a patient becomes infected with SARS-CoV-2. In this present commentary, we discuss the unique mental health …

How Big Data And Artificial Intelligence Can Help Better Manage The Covid-19 Pandemic, Giovanni Damiani

Faculty Scholarship

SARS-CoV2 is a novel coronavirus, responsible for the COVID-19 pandemic declared by the World Health Organization. Thanks to the latest advancements in the field of molecular and computational techniques and information and communication technologies (ICTs), artificial intelligence (AI) and Big Data can help in handling the huge, unprecedented amount of data derived from public health surveillance, real-time epidemic outbreaks monitoring, trend now-casting/forecasting, regular situation briefing and updating from governmental institutions and organisms, and health facility utilization information. The present review is aimed at overviewing the potential applications of AI and Big Data in the global effort to manage the pandemic. …

Physical Distancing With Social Connectedness, Kurt C. Stange

Faculty Scholarship

In light of concerns over the potential detrimental effects of declining care continuity, and the need for connection between patients and health care providers, our multidisciplinary group considered the possible ways that relationships might be developed in different kinds of health care encounters.We were surprised to discover many avenues to invest in relationships, even in non-continuity consultations, and how meaningful human connections might be developed even in telehealth visits. Opportunities range from the quality of attention or the structure of the time during the visit, to supporting relationship development in how care is organized at the local or system level …