STEMI Rare in Patients Hospitalized With COVID-19, but Prognosis Is Poor

Close up of white graph paper from electrocardiogram showing ST-elevation

Researchers at Brigham and Women’s Hospital recently completed the first large multicenter study of the incidence of ST-segment–elevation myocardial infarction (STEMI) as a complication of COVID-19. STEMI was rare in 0.35% of patients but was associated with poor in-hospital outcomes and high mortality.

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Galectin-mediated Immunity Is Dysregulated in Protozoan–Viral–Bacterial Female Genital Tract Infections

3D Rendering Galectin-3

Raina N. Fichorova, MD, PhD, and Hidemi S. Yamamoto, BA, of the Laboratory of Genital Tract Biology in the Department of Obstetrics and Gynecology at the Brigham, and colleagues have discovered concurrent exposure to Trichomonas vaginalis and bacterial vaginosis dysregulates the expression of galectins.

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Interest in COVID-19 Vaccination High Among Patients With Systemic Rheumatic Disease

Doctor administers COVID-19 vaccine to patient

Daniel H. Solomon, MD, MPH, Sara K. Tedeschi, MD, MPH, and colleagues surveyed patients with systemic rheumatic disease (SRD) about their attitudes toward COVID-19 vaccination. They report high interest and a high trust in physician recommendations about vaccination.

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Brigham Clinicians Help Develop COVID-19 Clinical Guidance

“Who knew that rheumatology patients would be right in the middle of the COVID-19 crisis?”

This question was posed by rheumatologist Karen H. Costenbader, MD, MPH, director of the Brigham and Women’s Hospital Lupus Program and chair of the Medical and Scientific Advisory Council for the Lupus Foundation of America. In these roles, she has found herself at the center of the controversy around the use of hydroxychloroquine (HCQ) and other rheumatology medications in COVID-19. Read More

COVID-19 Driving Evolution in Rheumatology Teaching

In the span of just a few months, the COVID-19 pandemic has transformed the practice of rheumatology and the entire field of clinical medicine. Traditional ways of doing things, from seeing patients to leading teaching rounds, have been temporarily or permanently abandoned.

Nevertheless, teaching hospitals must stay true to their mission of educating the next generation of clinicians. And so, many are striving to adapt to this strange new reality. Read More

Creating a Roadmap to Negotiating Cytokine Storm in COVID-19

Cytokine storm syndromes are associated with autoimmune diseases such as systemic juvenile idiopathic arthritis (sJIA), adult onset Still’s disease and systemic lupus erythematosus. Speculation is mounting that they may also play a role in severe cases of COVID-19.

“We don’t know for sure yet if there’s cytokine storm in COVID-19, but it certainly looks that way in some patients,” said Peter A. Nigrovic, MD, director of the Brigham and Women’s Hospital Center for Adults with Pediatric Rheumatic Illness and the principal investigator of a basic science laboratory focused on mechanisms of inflammation. “Based on some of the findings in the blood of the sickest individuals, it may well be that the immune system mediates damage rather than serving to protect the host. We want to be able to recognize those cases where immunosuppression could optimize patient outcomes.” Read More

Rheumatologists as Patient Advocates in the COVID-19 Era

As of early May 2020, the United States had 1.19 million confirmed coronavirus cases and nearly 70,000 deaths due to COVID-19. In the urgent quest for therapeutic solutions, some have looked to antimalarial medications such as hydroxychloroquine (HCQ).

A recent paper in Annals of the Rheumatic Diseases argues that rheumatologists as well as “researchers and patient partners must advocate for the appropriate distribution and use of HCQ, as millions of people with rheumatic diseases worldwide depend on HCQ to control disease activity and maintain quality of life.” Read More

Rapid Innovation in the Fight Against COVID-19

With expertise that spans basic, translational and clinical research, Brigham and Women’s Hospital clinicians and investigators are working tirelessly to address the most urgent needs related to the COVID-19 pandemic.

To help reduce the spread of COVID-19, the Brigham has shut down most of its physical research labs. But many labs are still performing COVID-19 research remotely to better understand SARS-CoV-2 and COVID-19 in order to develop treatment strategies against them. Read More

Proning Awake COVID-19 Patients in Early Stages of ARDS

Prone ventilation is well-established as an essential treatment for mechanically ventilated patients with moderate to severe acute respiratory distress syndrome (ARDS). Since the start of the COVID-19 pandemic, clinicians at Brigham and Women’s Hospital have been investigating the impact of proning awake individuals with ARDS before intubation.

Anthony Francis Massaro, MD, director of the Brigham’s Medical Intensive Care Unit, said that early initiation of prone ventilation in mechanically ventilated ARDS patients enhances oxygenation via several mechanisms. Read More

Enhancing Safety of Clinicians Intubating COVID-19 Patients

Emergency medicine doctors and anesthesiologists at Brigham and Women’s Hospital have worked together to create lightweight hoods that provide a physical barrier between COVID-19 patients and clinicians during intubation. These homemade devices, each constructed with less than $20 worth of materials, offer an additional, urgently needed layer of protection when treating COVID-19 patients. Read More