• Neighbourhood Income and Physical Distancing During the COVID-19 Pandemic in the United States

Jay Jonathan, Bor Jacob, Nsoesie Elaine O, Lipson Sarah K, Jones David K, Galea Sandro, Raifman Julia

Abstract: Physical distancing has been the primary strategy to control COVID-19 in the United States. We used mobility data from a large, anonymized sample of smartphone users to assess the relationship between neighborhood income and physical distancing during the pandemic. We found a strong gradient between neighborhood income and physical distancing. Individuals in high-income neighborhoods increased their days at home substantially more than individuals in low-income neighborhoods did. Residents of low-income neighborhoods were more likely to work outside the home, compared to residents in higher-income neighborhoods, but were not more likely to visit locations such as supermarkets, parks, and hospitals. Read More.


  • Predictive Models of Mortality for Hospitalized COVID-19 Patients: Retrospective Cohort Study

Taiyao Wang, Aris Paschalidis, Quanying Liu, Yingxia Liu, Ye Yuan, and Ioannis Ch. Paschalidis

Background: The novel coronavirus SARS-CoV-2 and its associated disease, COVID-19, have caused the worldwide disruption, leading countries to take drastic measures to address the progression of the disease. As SARS-CoV-2 continues to spread, hospitals are struggling to allocate resources to patients who are most at risk. In this context, it has become important to develop models that can accurately predict the severity of infection of hospitalized patients to help guide triage, planning, and resource allocation. Read More.

  • Early Prediction of Level of Care Requirements in Patients with COVID-19

Boran Hao, Shahabeddin Sotudian, Taiyao Wang, Tingting Xu, Yang Hu, Apostolos Gaitanidis, Kerry Breen, George C. Velmahos, and Ioannis Ch. Paschalidis.

Abstract: This study examined records of 2566 consecutive COVID-19 patients at five Massachusetts hospitals and sought to predict level-of-care requirements based on clinical and laboratory data. Several classification methods were applied and compared against standard pneumonia severity scores. The need for hospitalization, ICU care, and mechanical ventilation were predicted with a validation accuracy of 88%, 87%, and 86%, respectively. Read More.


  • Personalized Predictive Models for Symptomatic COVID-19 Patients Using Basic Preconditions: Hospitalizations, Mortality, and the Need for an ICU or Ventilator

Salomon Wollenstein-Betech, Christos G.Cassandras, and Ioannis Ch. Paschalidis.

Background: The rapid global spread of the SARS-CoV-2 virus has provoked a spike in demand for hospital care. Hospital systems across the world have been over-extended, including in Northern Italy, Ecuador, and New York City, and many other systems face similar challenges. As a result, decisions on how to best allocate very limited medical resources and design targeted policies for vulnerable subgroups have come to the forefront. Specifically, under consideration are decisions on who to test, who to admit into hospitals, who to treat in an Intensive Care Unit (ICU), and who to support with a ventilator. Read More.

  • The DHODH Inhibitor PTC299 Arrests SARS-CoV-2 Replication and Suppresses Induction of Inflammatory Cytokines

Luban J, Sattler RA, Mühlberger E, Graci JD, Cao L, Weetall M, Trotta C, Colacino JM, Bavari S, Strambio-De-Castillia C, Suder EL, Wang Y, Soloveva V, Cintron-Lue K, Naryshkin NA, Pykett M, Welch EM, O’Keefe K, Kong R, Goodwin E, Jacobson A, Paessler S, Peltz SW.

Abstract: The coronavirus disease 2019 (COVID-19) pandemic has created an urgent need for therapeutics that inhibit the SARS-COV-2 virus and suppress the fulminant inflammation characteristic of advanced illness. Here, we describe the anti-COVID-19 potential of PTC299, an orally bioavailable compound that is a potent inhibitor of dihydroorotate dehydrogenase (DHODH), the rate-limiting enzyme of the de novo pyrimidine nucleotide biosynthesis pathway. Read More.

  • Race/Ethnicity, Underlying Medical Conditions, Homelessness, and Hospitalization Status of Adult Patients with COVID-19 at an Urban Safety-Net Medical Center – Boston, Massachusetts, 2020

Hsu Heather E, Ashe Erin M, Silverstein Michael, Hofman Melissa, Lange Samantha J, Razzaghi Hilda, Mishuris Rebecca G, Davidoff Ravin, Parker Erin M, Penman-Aguilar Ana, Clarke Kristie E N, Goldman Anna, James Thea L, Jacobson Karen, Lasser Karen E, Xuan Ziming, Peacock Georgina, Dowling Nicole F, Goodman Alyson B.

During March-May 2020, among 2,729 COVID-19 patients treated at an urban safety-net hospital serving predominantly low-income racial/ethnic minority populations, clinical severity differed by age, race/ethnicity, underlying medical conditions, and homelessness. Hospitalized patients were more likely to be Hispanic or to be experiencing homelessness; >80% of patients who died were aged ≥60 years. Read More.

  • Consistent localization of SARS-CoV-2 spike glycoprotein and ACE2 over TMPRSS2 predominance in placental villi of 15 COVID-19 positive maternal-fetal dyads

Taglauer Elizabeth, Benarroch Yoel, Rop Kevin, Barnett Elizabeth, Sabharwal Vishakha, Yarrington Christina, Wachman Elisha M.

Introduction: While the COVID-19 pandemic continues to have a significant global health impact, rates of maternal to infant vertical transmission remain low (<5%). Parenchymal changes of placentas from COVID-19 infected mothers have been reported by several groups, but the localization and relative abundance of SARS-CoV-2 viral proteins and cellular entry machinery has not been fully characterized within larger placental tissue cohorts. Read More.

  • Researchers Determine How the SARS-CoV-2 Virus Hijacks and Rapidly Causes Damage to Human Lung Cells: Identify clinically approved medications that can be re-purposed for COVID-19 treatment

Raghuveera Kumar Goel, PhD; Adam Hume, PhD; Jessie Huang, PhD; Kristy Abo, BA; Rhiannon Werder, PhD and Ellen Suder, BS.

Summary: Researchers have identified host proteins and pathways in lung cells whose levels change upon infection by the SARS-CoV-2, providing insights into disease pathology and new therapeutic targets to block COVID-19. Read More.

 

  • SARS-CoV-2 Infection of Pluripotent Stem Cell-Derived Human Lung Alveolar Type 2 Cells Elicits a Rapid Epithelial-Intrinsic Inflammatory Response

Huang J, Hume AJ, Abo KM, Werder RB, Villacorta-Martin C, Alysandratos KD, Beermann ML, Simone-Roach C, Lindstrom-Vautrin J, Olejnik J, Suder EL, Bullitt E, Hinds A, Sharma A, Bosmann M, Wang R, Hawkins F, Burks EJ, Saeed M, Wilson AA, Mühlberger E, Kotton DN.

  • Decline in Stroke Alerts and Hospitalizations during the COVID-19 Pandemic

Sharma M, Lioutas VA, Madsen T, Clark J, O’Sullivan J, Elkind MSV, Willey JZ, Marshall RS, Selim MH, Greer D, Tirschwell DL, Burton T, Boehme A, Aparicio HJ.

Introduction: Patients with stroke-like symptoms may be underutilising emergency medical services and avoiding hospitalisation during the COVID-19 pandemic. We investigated a decline in admissions for stroke and transient ischaemic attack (TIA) and emergency department (ED) stroke alert activations. Read More.

  • COVID-19, Renin-Angiotensin System and Endothelial Dysfunction

Amraei R, Rahimi N.

Abstract: The newly emergent novel coronavirus disease 2019 (COVID-19) outbreak, which is caused by SARS-CoV-2 virus, has posed a serious threat to global public health and caused worldwide social and economic breakdown. Angiotensin-converting enzyme 2 (ACE2) is expressed in human vascular endothelium, respiratory epithelium, and other cell types, and is thought to be a primary mechanism of SARS-CoV-2 entry and infection. In physiological conditions, ACE2 via its carboxypeptidase activity generates angiotensin fragments (Ang 1–9 and Ang 1–7) and plays an essential role in the renin-angiotensin system (RAS), which is a critical regulator of cardiovascular homeostasis. Read More.

  • Point-of-care Lung Ultrasound Is More Sensitive than Chest Radiograph for Evaluation of COVID-19

Pare JR, Camelo I, Mayo KC, Leo MM, Dugas JN, Nelson KP, Baker WE, Shareef F, Mitchell PM, Schechter-Perkins EM.

Introduction: Current recommendations for diagnostic imaging for moderately to severely ill patients with suspected coronavirus disease 2019 (COVID-19) include chest radiograph (CXR). Our primary objective was to determine whether lung ultrasound (LUS) B-lines, when excluding patients with alternative etiologies for B-lines, are more sensitive for the associated diagnosis of COVID-19 than CXR. Read More.
  • Global Health Training in U.S. Emergency Medicine Residency Programs

Rybarczyk MM, Muck A, Kolkowitz I, Tupesis J, Jacquet G.

Objectives: Formal education in global health (GH) and short‐term experiences in GH (STEGH) are offered by many emergency medicine (EM) residency programs in the United States. In an increasingly connected world, training in GH and STEGH can provide essential knowledge and practical skills to trainees, particularly at the graduate medical education level. The current core programmatic components and the essential competencies and curricula that support ethical and effective STEGH, however, still vary widely. The authors conducted a survey of the 228 EM residency programs in the United States to describe the current state of GH training and STEGH. Read More.

  • Model and Approach for Assessing Implementation Context and Fidelity in the HEALing Communities Study

Knudsen HK, Drainoni ML, Gilbert L, Huerta TR, Oser CB, Aldrich AM, Campbell ANC, Crable EL, Garner BR, Glasgow LM, Goddard-Eckrich D, Marks KR, McAlearney AS, Oga EA, Scalise AL, Walker DM

Background: In response to the U.S. opioid epidemic, the HEALing (Helping to End Addiction Long-termSM) Communities Study (HCS) is a multisite, wait-listed, community-level cluster-randomized trial that aims to test the novel Communities That HEAL (CTH) intervention, in 67 communities. CTH will expand an integrated set of evidence-based practices (EBPs) across health care, behavioral health, justice, and other community-based settings to reduce opioid overdose deaths. We present the rationale for and adaptation of the RE-AIM/PRISM framework and methodological approach used to capture the CTH implementation context and to evaluate implementation fidelity. Read More.

  • Actionable Cytopathogenic Host Responses of Human Alveolar Type 2 Cells to SARS-CoV-2

Summary: Human transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causative pathogen of the COVID-19 pandemic, exerts a massive health and socioeconomic crisis. The virus infects alveolar epithelial type 2 cells (AT2s), leading to lung injury and impaired gas exchange, but the mechanisms driving infection and pathology are unclear. We performed a quantitative phosphoproteomic survey of induced pluripotent stem cell-derived AT2s (iAT2s) infected with SARS-CoV-2 at air-liquid interface (ALI). Time course analysis revealed rapid remodeling of diverse host systems, including signaling, RNA processing, translation, metabolism, nuclear integrity, protein trafficking, and cytoskeletal-microtubule organization, leading to cell cycle arrest, genotoxic stress, and innate immunity. Read More