Finding the Right Time for Tracheotomy in COVID-19 Patients

Dr. Matthew Rochefort and Dr. Anthony Coppolino performing a bedside percutaneous tracheostomy in a COVID positive patient.Dr. Matthew Rochefort and Dr. Anthony Coppolino prepared to perform a bedside percutaneous tracheostomy in a COVID+ patient.

How does one determine when to employ tracheotomy in COVID-19 patients requiring prolonged mechanical ventilation? It’s difficult to say given what relatively little we know about the disease at this point. Stephanie L. Nitzschke, MD, an acute care surgeon, trauma surgeon and surgical intensivist, is one of the clinicians developing guidelines on tracheotomy timing at Brigham and Women’s Hospital.

Dr. Nitzschke said that in order to balance the safety of patients and health care workers, the Brigham is delaying consideration of tracheotomy until 21 days after a positive test for COVID-19. But she stressed that all protocols related to this disease are subject to change. Read More

Innovative Testing Strategy Conserves PPE During the COVID-19 Pandemic

B-PROTECTED COVID-19 Testing Booth

Personal protective equipment (PPE) constraints are creating a great challenge for hospitals and health systems across the nation as the number of COVID-19 cases continues to rise. To address this problem, a team of staff from across Brigham and Women’s Hospital came together to develop an innovative COVID-19 testing booth. The Brigham Protective Equipment for Clinical Test Environment and Diagnostics (B-PROTECTED) booth preserves PPE and keeps clinicians on the front lines protected.

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Setting the Record Straight About Hydroxychloroquine, NSAIDs and COVID-19

As the scope of the coronavirus pandemic broadens, it is only natural for people to look to the scientific and research communities for solutions. In recent weeks, however, the thirst for viable treatment options has contributed to drug shortages and misinformation for patients with rheumatic diseases.

Two cases in point involve hydroxychloroquine and ibuprofen. Laura L. Tarter, MD, and Daniel Hal Solomon, MD, MPH, of the Brigham and Women’s Hospital’s Division of Rheumatology, Inflammation and Immunity offer their perspectives on each of these issues, which carry significant implications for rheumatic care during this health crisis. Read More

Rheumatologists Worldwide Pulling Together in Face of Coronavirus Pandemic

Rheumatologists have a critical role to play in optimizing the response to COVID-19 and outcomes for our patients with rheumatic diseases. In just the past few weeks, rheumatologists at Brigham and Women’s Hospital and around the world have joined forces for this purpose.

“I’ve been very impressed by how quickly the rheumatology community has come together,” said rheumatologist Susan Y. Ritter, MD, PhD, associate medical director of the Brigham’s Arthritis Center. “I’ve seen multiple people communicating via email, Twitter and Facebook to get the word out to rheumatologists and make sure we have as much data as possible.” Read More

ACR President Ellen Gravallese, MD, on the Organization’s Response to COVID-19

Last fall, Ellen M. Gravallese, MD, was named chief of the Division of Rheumatology, Inflammation and Immunity at Brigham and Women’s Hospital and president of the American College of Rheumatology (ACR). In these roles, she is overseeing the response of the division and the ACR to the alarming spread of the novel coronavirus.

“The ACR has taken a very proactive stance to try to address COVID-19,” Dr. Gravallese said. “We understand how difficult this pandemic has been for rheumatologists in caring and making the best decisions for their patients while at the same time limiting community exposure to the SARS-CoV-2 virus as much as possible. We hope the work we are doing at the ACR will provide immediate assistance to physicians in these efforts.” Read More

COVID-19 Test Results in 24 Hours

Team clinicians and researchers in Clinical Molecular Pathology and Microbiology

Brigham and Women’s Hospital successfully validated a COVID-19 test for admitted patients, offering results within 24 hours. A team of experts from the Department of Pathology have been racing against the clock in response to the COVID-19 outbreak.

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Hepatitis C-Infected Hearts and Lungs Safely Transplanted

As the number of patients in need of heart or lung transplants continues to exceed the number of donor organs that are viable and available, many patients die while waiting for a transplant. Through the DONATE HCV Trial, a team at Brigham and Women’s Hospital is expanding the donor pool by enabling transplantation from hepatitis C-infected donors.

In a recent publication in the New England Journal of Medicine, a multidisciplinary team of experts from Brigham and Women’s Hospital reported a 100 percent success rate for transplant recipients who received lungs or a heart infected with hepatitis C (HCV).

Six months after transplantation, patients remained hepatitis C free and had functioning transplanted organs. The trial showed that a four-week antiviral treatment regimen started immediately following organ transplantation prevented HCV infection in all patients and led to excellent outcomes. Given the success of the trial, enrollment continues.

The DONATE HCV Trial is the largest clinical trial to date for HCV thoracic organ transplantation. “If even half the other centers in the United States were to adopt the Brigham protocol, we would, in fact, shorten the time to transplantation by nearly half,” says Mandeep Mehra, MD, medical director of the Heart & Vascular Center at Brigham and Women’s Hospital. The team has enrolled 69 participants to date.

In the above video, hear more from the investigators pioneering this trial, including: