Story Tips From Johns Hopkins Experts on Covid-19

COVID-19 Story Tip: Front-Line Worker Story: Katherine Fenstermacher, Ph.D. — We’re Here for You

Media Contact: Waun’Shae Blount, [email protected]

Video: Katherine Fenstermacher- Frontlines of COVID-19 Care

It seems as though there will never be enough “thank-you’s” for the incredible doctors, nurses, technicians and support staff who are working around the clock to help patients with this dangerous coronavirus disease. It’s their dedication, determination and spirit that enable Johns Hopkins to deliver the promise of medicine.

Because of the pandemic, Katherine Fenstermacher, an emergency medicine virologist and clinical research program manager, maintains a dual role as program manager in the biocontainment inpatient unit, where patients who are COVID-19 positive and those on clinical trials are treated and cared for. Fenstermacher now manages the hospital-wide clinical characterization protocol used to determine which risk factors contribute to a patient being asymptomatic with COVID-19, and what causes the disease to be fatal for others. Fenstermacher and other researchers aim to understand what features are associated with severe disease and poor clinical outcomes, which they hope will help identify patients in need of early intervention and contribute to the development of future clinical treatments.

Fenstermacher collaborates with a team including research coordinators, doctors, nurses and scientists and says, “We’re all working incredibly hard while gathering as much information as possible about this serious disease. Every second is critical to helping our current and future patients. We want to be there for patients during their worst and as they recover from such a horrible illness as COVID-19.”

Fenstermacher is available for interviews.

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Artificial Intelligence Can Improve How Chest Images Are Used in Care of COVID-19 Patients

Media Contact: Waun’Shae Blount, [email protected]

According to a recent report by Johns Hopkins Medicine researchers, artificial intelligence (AI) should be used to expand the role of chest X-ray imaging — using computed tomography, or CT — in diagnosing and assessing coronavirus infection so that it can be more than just a means of screening for signs of COVID-19 in a patient’s lungs.

Within the study, published in the May 6 issue of Radiology: Artificial Intelligence, the researchers say that “AI’s power to generate models from large volumes of information — fusing molecular, clinical, epidemiological and imaging data — may accelerate solutions to detect, contain and treat COVID-19.”

Although CT chest imaging is not currently a routine method for diagnosing COVID-19 in patients, it has been helpful in excluding other possible causes for COVID-like symptoms, confirming a diagnosis made by another means or providing critical data for monitoring a patient’s progress in severe cases of the disease. The Johns Hopkins Medicine researchers believe this isn’t enough, making the case that there is “an untapped potential” for AI-enhanced imaging to improve. They suggest the technology can be used for:

• Risk stratification, the process of categorizing patients for the type of care they receive based on the predicted course of their COVID-19 infection.
• Treatment monitoring to define the effectiveness of agents used to combat the disease.
• Modeling how COVID-19 behaves, so that novel, customized therapies can be developed, tested and deployed.

For example, the researchers propose that “AI may help identify the immunological markers most associated with poor clinical course, which may yield new targets” for drugs that will direct the immune system against the SARS-CoV-2 virus that causes COVID-19.

Shinjini Kundu, M.D., Ph.D., a radiology resident at the Johns Hopkins University School of Medicine, is available to discuss the use of AI to make chest imaging a more beneficial tool in the care of COVID-19 patients.

 

Innovation Amid Pandemic: Using Tech to Help Patients Recover

Media Contact: Waun’Shae Blount, [email protected]

Video: Physical therapy patient using the FDA-approved therapeutic gaming platform.

As patients recover from COVID-19 and other complex conditions, their care teams have to consider the best rehab approach while a patient is hospitalized and especially once they return home. This is vitally important since the COVID-19 pandemic, quarantine and social distancing have significantly reduced access to neurological and rehabilitation services, and preplanning is important. Equally important are the tools clinicians use to help patients recover. 

For patients recovering from COVID-19, strokes and heart attacks, neurorehabilitation is an often required aspect of rehabilitative care. A pandemic can make that challenging. So an interdisciplinary team of physicians, occupational therapists and physical therapists brainstormed the best way to bring needed rehabilitation care to the patient. They landed on an FDA cleared therapeutic video game-like tool that enables clinicians to provide telerehabilitation therapy to patients and COVID-19 survivors in the hospital and at home.

The technology, containing 26 games, tracks the patient’s movements using a newly developed mobile technology platform and interface. The games are assigned by the providers based on the patient’s therapy needs. With assistive devices such as a walker or the help of a caregiver, patients can use the games while building their strength, endurance and balance. As the patient plays the games, the therapist has the ability to monitor the patient as well as adjust the duration, level of difficulty and function of the games through synchronized telemedicine.

Some patients are using the device, which was developed by neuroscientist, as soon as one week from stroke recovery or coming off a ventilator after being in an intensive care environment due to COVID-19. The computer device is equipped with a camera and cloud-based software applications that are fine-tuned to meet a patient’s physical and occupational rehab needs.

The Johns Hopkins Hospital is believed to be the first institution in the United States to adopt the use of this technology in all levels of patient care. This project was made possible by a $150,000 philanthropic donation. 

Experts Preeti Raghavan, M.B.B.S., associate professor of physical medicine and rehabilitation and director of the Center of Excellence in Stroke Treatment, Recovery and Rehabilitation at the Sheikh Khalifa Stroke Institute; Steven Zeiler, M.D., Ph.D., associate professor of neurology and director of the vascular neurology fellowship program; Ken Johnson, P.T., director of rehab therapy services outreach; and Harrison Segall, P.T., D.P.T., senior outpatient physical therapist, are available for comment on the use of the computer device for neurorehabilitation.

 

The Next Surge? Potential Skyrocketing Rates of Unemployment Among COVID-19 Survivors

Media Contact: Waun’Shae Blount, [email protected]

For many patients recovering from COVID-19, discharge from the intensive care unit is just the beginning of a long road to recovery. Patients recovering after critical illness may face cognitive and physical changes, including a decline in bodily strength and thinking abilities, requiring comprehensive rehab.

But one of the most critical and seldom discussed issues that may face many of these COVID-19 survivors is the likelihood of unemployment after discharge due to an extended recovery process.

A five-year study, published online Sept. 16, 2017, in the journal Thorax, examined return to work in patients recovering from acute respiratory distress syndrome (ARDS) — a condition common in patients with COVID-19 that causes inflammation in the lungs with fluid buildup in the tiny breathing sacs due to extended ventilation. The study revealed that about 3 in 4 survivors lost earnings, with an average loss of $180,000 over five years.

“Over the five-year follow-up, about one-third of these patients never returned to work. The financial consequences are profound. A couple of weeks in the ICU can be life-altering for patients and their families,” says Dale Needham, M.D., Ph.D., study lead and medical director of the Johns Hopkins Critical Care Physical Medicine and Rehabilitation Program at the Johns Hopkins University School of Medicine.

Results from a one-year, multicenter national study showed that 44% of patients recovering from ARDS did not return to work within one year after their critical illness. The findings of the study showed that among these unemployed patients, 14% lost private health insurance and 16% needed government-funded coverage. Needham, who also co-led this study, notes that those who returned to work subsequently lost their jobs, or could not return to their normal type of work or work hours, compared with before their critical illness. Needham says this is why it is important to implement job-based rehab interventions for patients recovering from ARDS. Such interventions may help patients return to work sooner and even stay employed.

Needham warns that this silent aspect of the pandemic needs more attention before it becomes an unmanageable, yet potentially avoidable problem.

Needham is available for comment on unemployment related to recovery from COVID-19.

For information from Johns Hopkins Medicine about the coronavirus pandemic, visit hopkinsmedicine.org/coronavirus. For information on the coronavirus from throughout the Johns Hopkins enterprise, including the Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University, visit coronavirus.jhu.edu.

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