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In The News: Asthma Emergencies, Telemedicine Effectiveness, COVID-19 Pre-op Screening, Pandemic Mapping, Food Allergy Center Distinction

Published on
Jun 19, 2020
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mccannn [at] email.chop.edu (By Nancy McCann)

In this week’s roundup of research headlines, read about the dramatic decline of asthma emergency department visits and the effectiveness of telemedicine for neurology patients during the coronavirus pandemic. Learn about the safety benefits of universal preoperative screening for COVID-19 and the forecasted impact of Memorial Day travel on the resurgence of the coronavirus. And a big air high-five goes out to the Food Allergy Center for its recognition as a Discovery Center of Distinction.

Asthma Emergency Department Visits Decline Dramatically During COVID-19 Pandemic

“Chén

Chén Kenyon, MD

Results from a Children’s Hospital of Philadelphia research study revealed a substantial drop — 76 percent — in the number of pediatric patients visiting the emergency department (ED) for asthma treatment during the first month of the coronavirus pandemic. The dramatic decline played out across all presentations of the disease, from severe to mild cases. The researchers also found the number of children admitted to the hospital decreased by 29 percent, indicating the decline was not entirely driven by patients avoiding hospital settings or delaying care due to stay-at-home orders.

“We were surprised by the magnitude and extent of the reduced utilization of emergency services for asthma during the emergence of the COVID-19 pandemic,” said Chén Kenyon, MD, MSHP, attending pediatrician at CHOP and co-author of the study published in The Journal of Allergy Clinical Immunology: In Practice. “The trend was particularly striking given that the emergence of COVID-19 in the Northeastern United States occurred during the spring, when respiratory viruses and high-pollen counts can converge and exacerbate asthma symptoms.”

Given this substantial reduction, the researchers suggest several areas for future investigation: analyzing the impact on asthma symptoms of person-to-person transmission of respiratory viruses, outdoor seasonal vs. indoor allergens, and traffic and industrial pollution.

“These results may offer new insights on where to best focus efforts to improve asthma outcomes outside of a pandemic scenario,” Dr. Kenyon said.

CHOP co-authors include: David Hill, MD, PhD; Sarah Henrickson, MD, PhD; Tyra Bryant-Stephens, MD; and Joseph Zorc, MD, MSCE.

Go to CHOP News to learn more.

Universal Preoperative COVID-19 Screening Identifies Asymptomatic Patients, Improves Safety

“Apurva

Apurva Shah, MD, MBA

Findings from research led by CHOP investigators showed that universally screening pediatric patients for COVID-19 before they undergo surgical procedures enables hospitals to improve safety by identifying all patients who test positive for the virus — half of whom have no symptoms. Published in JAMA Surgery, the study analyzed universal screening procedures at CHOP, Seattle Children’s Hospital, and Texas Children’s Hospital and found screening patients for COVID-19 allowed hospitals to ensure patients and physicians were not exposed to the virus.

Given that the study covered a time (late March to late April 2020) when all three hospitals had canceled elective surgeries, the data reflect pediatric patients who required time-sensitive surgery and thus may not represent the incidence in children undergoing elective surgery. However, the authors say the findings show the value of universal screening in protecting both patients and physicians from COVID-19 exposure in all types of surgery at times when the SARS-CoV-2 virus is actively circulating in a community.

“If a patient tests positive for COVID-19, and the procedure doesn’t need to happen immediately, providers can reschedule surgery for a time when the patient has recovered,” said Apurva Shah, MD, MBA, co-author and orthopaedic surgeon at CHOP. “But in some cases, surgery cannot wait, and in that situation, knowing a patient is positive for COVID-19 allows staff to protect themselves with appropriate personal protective equipment and prevent that patient from coming into contact with other patients and families.”

See CHOP News.

Telemedicine Proves Effective for Pediatric Neurology Network

“Brenda

Brenda Banwell, MD

A rapid conversion of outpatient clinical care — from in-person to remote telehealth services — became necessary once stay-at-home orders were issued due to the coronavirus pandemic. Researchers from CHOP’s Division of Neurology set out to discover whether newly implemented audio-video telemedicine visits are an effective way of delivering care.

“This is the largest telemedicine study that has ever been done in pediatric neurology and was made possible based on the growth of our network, the adaptability of our clinical team in order to provide the best patient care under these circumstances, and our excellent relationship with our patients and caregivers, without whom this transition could not have come together as quickly as it did,” said study co-author Brenda Banwell, MD, chief of the Division of Neurology at CHOP. “Safe and effective care is always at the top of our minds every single day, and this study has shown, that going forward, telemedicine may have a sustained role in making sure every patient receives the attention they deserve.”

Study findings appeared this month in Neurology. See CHOP News for more information.

One-stop Resource for Genetics of Mitochondrial Disease

“Marni

Marni Falk, MD

Thanks to the talented team of the Mitochondrial Medicine Frontier Program at CHOP, the first-ever, readable encyclopedia for physicians and scientists describing all of the genes in which pathogenic variants have been shown to cause mitochondrial disease, “Mitochondrial Disease Genes Compendium: From Genes to Clinical Manifestations,” is now available. It provides expert-curated knowledge of 256 genes that are understood to directly impact mitochondria and contribute to a wide range of human diseases.

“Mitochondrial disease manifests itself with a wide variety of clinical symptoms, and in so many cases, identifying the precise underlying genetic cause plays a critical role in how the disease presents and should be treated in a given patient,” said book editor Marni Falk, MD, executive director of the Mitochondrial Medicine Frontier Program. “This Compendium provides an invaluable resource to those on the frontlines of patient care and research, making decades of learnings readily available to help facilitate improved understanding of mitochondrial disease.”

Go to the CHOP press release for more information.

PolicyLab Model Forecasts Show Memorial Day Travel has Minimal Impact on COVID-19 Cases

“David

David Rubin, MD, MSCE

CHOP’s PolicyLab released updated model data that show many U.S. counties — even those home to vacation destinations — are not projected to see a resurgence in COVID-19 cases through mid-July following increased travel and activity around Memorial Day weekend. However, the four-week forecasts of the model “COVID-LAB: Mapping COVID-19 in Your Community,” show concern for several areas of the country, such as Texas and the greater Southwest, which already had significant disease burden or elevated risk going into the holiday weekend.

“Since we first launched our models, we have predicted that if communities took a more cautious approach to reopening — relaxing social distancing policies more slowly, maintaining limited gathering sizes, and practicing vigilance in masking in crowded indoor locations — they could avoid a second wave of coronavirus cases. That is what we see realized in today’s updated, but mixed, forecasts,” said David Rubin, MD, MSCE, director of the PolicyLab. “While some areas appear headed for a relatively normal summer, we are concerned by the new epicenters that have formed over Texas and the greater Southwest — particularly in light of reports that ICU bed capacity is worsening in large cities like Houston and Phoenix. As well as growing risk in smaller cities like Greenville and Columbia, South Carolina, and Charlotte and Winston Salem, North Carolina. It’s these types of indicators that tell us which areas may be headed for a second wave of coronavirus cases and crisis.”

For model update information, see this PolicyLab press release. To learn more about the PolicyLab model, read this Cornerstone story.

Food Allergy Center Named Discovery Center of Distinction

“Jonathan

Jonathan Spergel, MD, PhD

Congratulations go out to the team in CHOP’s Food Allergy Center Frontier Program, as it was recently recognized as a Discover Center of Distinction from Food Allergy Research & Education (FARE), the world’s leading food allergy research organization. CHOP is now one of 44 institutions across the United States working together to find new treatments for food allergies and improvements to care.

“This is a very exciting day for us,” said Jonathan Spergel, MD, PhD, chief of CHOP’s Allergy Program. “CHOP has always been determined to find new treatments, and hopefully one day a cure, for food allergies. This partnership with other FARE centers across the country brings us one step closer in reaching that goal.”

See CHOP News for more information.

ICYMI

Catch up on our headlines from our June 5 In the News:

  • CHOP Researchers Publish Case Series of Patients With MIS-C
  • JAMA Live Features Paul Offit, MD, in COVID-19 Vaccine Discussion
  • Research Shows Increase in At-home Fractures During COVID-19 Pandemic
  • Review Highlights Sex Differences in Psychiatric Disorders

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