JOHNS HOPKINS EXPERTS PUBLISH ‘GUIDEBOOK’ FOR BLOOD PLASMA THERAPY
A team of Johns Hopkins experts has created a clinical guidebook to help hospitals and medical centers rapidly increase their ability to deliver so-called convalescent plasma therapy, which leverages immune system components found in the plasma portion of blood from people who have recovered from COVID-19.
Right now there are no therapies or effective vaccines for treating COVID-10.
The U.S. Food and Drug Administration has paved the way for researchers at Johns Hopkins to proceed with clinical trials to test convalescent plasma therapy in people who are at high risk for severe COVID-19 and have been exposed to people who have tested positive for the virus that causes it. Researcher Evan M. Bloch, M.D., M.S. an associate professor of pathology at the Johns Hopkins University School of Medicine, is available to discuss details about the guidelines.
Read the full news release here.
CELL MECHANISM MAY EXPLAIN WHY OLDER ADULTS ARE AT-RISK
The coronavirus disease COVID-19 uses a protein called ACE2 — found on the surface of the cells lining the lungs — to hitchhike inside the organ, leading to infection. Researchers have theorized that the reason why people with chronic diseases are more susceptible to COVID-19 complications is that certain diabetes or blood pressure medications increase ACE2 levels, which allows more of the virus to get in. However, evidence shows that older adults naturally have declining levels of ACE2, which contradicts their higher risk of complications and death during this pandemic, as those with lower levels of ACE2 should be more protected from viral infection.
Now, Majd AlGhatrif, M.D., M.A., and his colleagues at the National Institute on Aging and Johns Hopkins Medicine, propose a new theory as to why the aging population is more at risk in a viewpoint published on April 3 in JAMA Cardiology.
ACE2 itself is anti-inflammatory in that it dampens the system that drives chronic inflammation in the body as we get older. This system is known as the renal-angiotensin system. With lower levels of anti-inflammatory ACE2 in older people, the researchers hypothesize that COVID-19 infection triggers a boost in inflammation that offsets the counteractive ACE2 reserves. The balance then tips toward chronic inflammation in the lungs, leading to severe acute respiratory syndrome (SARS), causing them to shut down and the patient needing a ventilator to breathe.
AlGhatrif’s team believes that drugs suppressing the renal-angiotensin system may be able to prevent COVID-19 infection from progressing to acute respiratory syndrome. They propose starting clinical trials to test this hypothesis using already available medications.
AlGhatrif is available for interviews about his viewpoint.
INDIRECT MEDICAL CONSEQUENCES OF COVID-19
Three and a half million Americans are diagnosed with a chronic, progressive lung disease called emphysema. Will fear of COVID-19 and the lack of national health care infrastructure to support them make these patients sicker?
Over the last decade, patients managed their emphysema symptoms with a combination of two inhalers daily, and a third for emergencies. Now, during the uncertainty of the COVID-19 pandemic, the definition of an emergency has changed. Patients now wake up with shortness of breath but concerns over exposing themselves to waiting rooms potentially full of patients with COVID-19 keep them from the emergency room. They know their chronic conditions put them in the high-risk population for developing severe complications, and they don’t want to take the risk. By the time patients get the courage to go to the emergency room, their carbon dioxide can be critically elevated and they need to be intubated. Koushik Kasanagottu, M.D., an internal medicine resident at Johns Hopkins Bayview Medical Center, can discuss the impact COVID-19 has had on such patients whose fears are heightened during this pandemic.
IT’S NOT EASY FOR EVERYONE TO STAY HOME
As COVID-19 cases in the U.S. track trends seen in other parts of the world, Italy’s radical attempt at nationwide quarantine has increasingly become part of our national consciousness. Such measures to slow the spread of infectious disease pit the social good of quarantines against individual interest. However, even with the best motivations, it is unrealistic to expect that everyone can afford to stay at home and away from their neighbors. This is particularly true for America’s waged workers who cannot suddenly stop working, especially without alteration to current sick pay policies. This situation poses the question of what happens when individual interest and a community’s health are at odds. Mary Fissell, Ph.D., professor of history of medicine at the Johns Hopkins University School of Medicine, is available to speak about what a 17th century Italian plague can teach us about who can and who cannot stay home in a time of crisis.
MEDICAL PLANNING IN TIMES OF PANDEMIC: ADVANCE HEALTH CARE PLANNING NEEDED NOW MORE THAN EVER
When it comes to making life or death decisions, it is important to have a plan. While it may be an uncomfortable thing, in a time of a pandemic, advance health care planning is critical and is needed now more than ever. April 16 is National Healthcare Decision Day. The goal is to encourage people to express their health care wishes ahead of time and for providers and facilities to respect those wishes, whatever they may be. Palliative medicine expert Danielle J. Doberman, M.D., M.P.H., assistant professor of medicine at the Johns Hopkins University School of Medicine, is available to speak about the importance of advance health care planning during COVID-19.
INSPIRING HOPE IN A TIME OF UNCERTAINTY, ISOLATION AND FEAR
During a time where there is so much uncertainty and concern due to the COVID-19 outbreak, we have all been thinking about the nonphysical ways we can touch someone’s life or make a positive impact while social and physical distancing. At Johns Hopkins, there are teams trying to do just that for their patients.
One group of Johns Hopkins nurses heeded a call to comfort and encourage patients affected by coronavirus by asking local families in the Johns Hopkins community to make greeting cards with messages of encouragement. That simple gesture brought a moment of hope to each patient who received a card and provided a much needed morale boost to the staff on those units.
A group of medical students located offsite from the hospital are working to connect patients who have coronavirus with their loved ones by offering resources such as arranging video calls, calls from social work and chaplain services, and helping them prepare for the daily call from the health care team. Electronic tablets at the bedside of all patients have been loaded with a video conferencing app, and these devices will be used to keep patients and loved ones connected as well as provide links to volunteers for a chat, a book reading, or to hear live music from the Peabody Institute. Chief Patient Experience Officer Lisa Allen, Ph.D., Senior Vice President of the Department of Nursing Deborah Baker,D.N.P, C.R.N.P., and Department of Surgery Nurse Educator Nancy Beck are available to discuss how Johns Hopkins employees and the community are taking initiative to care for patients, family members and their co-workers while leading with a spirit of hope.
For more information about coronavirus disease (COVID-19) from Johns Hopkins Medicine, visit hopkinsmedicine.org/coronavirus. For information on coronavirus disease (COVID-19) from around the Johns Hopkins enterprise, including from the Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University, visit coronavirus.jhu.edu.
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