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Publications (485)
Introduction: Traumatic brain injuries (TBIs) affects approximately 1.5 million individuals annually in the U.S and 69 million globally. Acute post-concussive symptoms (PCS) are linked to delayed recovery; however, it is unclear how the severity of acute PCS relates to subjective cognitive changes (SCC) during recovery. This study examined links of...
H1 and H3 influenza A viruses (IAVs) circulating in European pigs are markedly distinct from those circulating in other global swine populations. These viruses exhibit significant genetic diversity, further expanded by periodic interspecies transmission of IAVs from humans into pigs, followed by sustained circulation. Several zoonotic IAV infection...
More than 3 million Americans visit emergency departments (EDs) annually for traumatic brain injuries (TBIs). While most recover fully, up to 30% experience persistent symptoms, with post-traumatic stress disorder (PTSD) symptoms being some of the most common. To date, research on co-occurring TBIs and PTSD has primarily focused on late diagnosis a...
Introduction
With the emergence of new SARS-CoV-2 variants has come significant variations in disease manifestation, severity, and duration in non-hospitalized infected patients. To characterize symptom patterns and risk factors associated with symptom severity and duration, COVID-19 and influenza-like illness (ILI) outpatients and their contacts w...
Background
Pelvic inflammatory Disease (PID) disproportionately impacts adolescents and young adult women. The Technology-Enhanced Community Health Nursing (TECH-N) trial demonstrated the potential benefit of a novel community health intervention for adolescents with PID. We assess the cost-effectiveness of TECH-N compared to standard care.
Method...
Objectives
Given the support for methicillin-resistant Staphylococcus aureus (MRSA) antimicrobial stewardship in the 2021 Surviving Sepsis Campaign Guidelines, we sought to measure the use of vancomycin in the emergency department (ED) in the years preceding these recommendations.
Methods
A retrospective cohort study was conducted of all patients...
Background
U.S. urban emergency departments (EDs) have identified thousands of individuals infected with hepatitis C virus (HCV) through their testing programs. However, significant challenges remain with linkage to care (LTC) rates from EDs at < 30%, representing the biggest drop-off along the HCV care continuum (HCV CC). Leventhal’s Common-Sense...
Background
Emergency departments (EDs) are directly impacted by seasonal surges in rates of respiratory viral infection and transmission with increased rates of ED visits for flu-like symptoms. It remains unclear as to why patients assigned lower acuity (level 3,4 and 5) based on standardized triage scoring systems opt to seek care within the emerg...
Background
Point-of-care ultrasound (POCUS) is a low-cost, portable imaging modality with greater sensitivity than chest x-ray to evaluate acute respiratory infections including influenza-like illness (ILI). However, clinical scale has been limited by the availability of proficient operators and unclear training requirements. We aim to assess the f...
Sepsis and septic shock are global healthcare problems associated with high mortality rates. Activation of the renin-angiotensin-aldosterone system (RAAS) is an early event in sepsis and elevated renin may be predictive of worse outcomes. In a subset of sepsis patients enrolled in the Vitamin C, Thiamine, and Steroids in Sepsis (VICTAS) trial, acti...
Progress in the management of critical care syndromes such as sepsis, Acute Respiratory Distress Syndrome (ARDS), and trauma has slowed over the last two decades, limited by the inherent heterogeneity within syndromic illnesses. Numerous immune endotypes have been proposed in sepsis and critical care, however the overlap of the endotypes is unclear...
Background/Objective: SeptiCyte RAPID is a transcriptional host response assay that discriminates between sepsis and non-infectious systemic inflammation (SIRS) with a one-hour turnaround time. The overall performance of this test in a cohort of 419 patients has recently been described [Balk et al., J Clin Med 2024, 13, 1194]. In this study, we pre...
Introduction: Sepsis and septic shock remain global healthcare issues associated with high mortality rates affecting millions every year despite best care efforts. Activation of the renin-angiotensin-system (RAS) is an early event in sepsis, and renin levels may more strongly associate with mortality than serum lactate, a widely accepted index of p...
Background
SeptiCyte RAPID is a transcriptional host response assay that discriminates between sepsis and non-infectious systemic inflammation (SIRS) with a one-hour turnaround time. The overall performance of this test in a cohort of 419 patients has recently been described [Balk et al., J Clin Med 2024, 13, 1194]. In this study we present results...
Background
Despite many studies evaluating lung ultrasound (LUS) for coronavirus disease 2019 (COVID-19) prognostication, the generalizability and utility across clinical settings are uncertain.
Methods
Adults (≥18 years of age) with COVID-19 were enrolled at 2 military hospitals, an emergency department, home visits, and a homeless shelter in the...
Introduction
Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. In a predominately young adult female population of healthcare workers, we sought to determine the intersection of biological sex an...
Background
Syphilis diagnosis in the emergency department (ED) setting is often missed due to the lack of ED-specific testing strategies. We characterized ED patients with high-titer syphilis infections (HTSIs) with the goal of defining a screening strategy that most parsimoniously identifies undiagnosed, untreated syphilis infections.
Methods
Unl...
Background
Point-of-care (POC) tests for sexually transmitted infections (STIs) permit delivery of results during the patient’s emergency department (ED) encounter. We evaluated performance, patient acceptability, and feasibility of a new duplex POC test, Chembio DPP® HIV-Syphilis Assay in an urban ED setting.
Methods
Convenience sampling approach...
Objectives
To determine the diagnostic accuracy of a rapid host‐protein test for differentiating bacterial from viral infections in patients who presented to the emergency department (ED) or urgent care center (UCC).
Methods
This was a prospective multicenter, blinded study. MeMed BV (MMBV), a test based on tumor necrosis factor‐related apoptosis‐...
Background
COVID-19 stay-at-home orders and research restrictions halted recruitment and follow-up of clinical research patients. While clinical research has resumed, it is an open question whether research participation has returned to levels similar to those before COVID-19.
Methods
We utilized data from the TECH-PN (NCT# NCT03828994) study, a s...
Background
During the 2017–18 influenza season in the USA, there was a high incidence of influenza illness and mortality. However, no apparent antigenic change was identified in the dominant H3N2 viruses, and the severity of the season could not be solely attributed to a vaccine mismatch. We aimed to investigate whether the altered virus properties...
(1) Background: SeptiCyte RAPID is a molecular test for discriminating sepsis from non-infectious systemic inflammation, and for estimating sepsis probabilities. The objective of this study was the clinical validation of SeptiCyte RAPID, based on testing retrospectively banked and prospectively collected patient samples. (2) Methods: The cartridge-...
Introduction: Active and passive surveillance studies have found that a greater proportion of females report adverse events (AE) following receipt of either the COVID-19 or seasonal influenza vaccine compared to males. We sought to determine the intersection of biological sex and sociocultural gender differences in prospective active reporting of v...
Potentially septic patients have a huge clinical and economic impact on hospitals and often present to the emergency department (ED) with undifferentiated symptoms. The triage of these patients is complex and has historically relied heavily upon provider judgment. This study aims to evaluate the consistency of provider judgment and the potential of...
Background
The Emergency Department (ED) is a safety net for vulnerable patients, and where almost 50% of patients with Mpox initially presented for care. We hypothesized that insufficient healthcare provider knowledge and expertise with Orthopoxvirus outbreaks, compounded by the social stigma experienced by patients at risk of acquiring Mpox, may...
Background
Use of Point of Care Testing (POCT) in Emergency Departments (EDs) may afford the opportunity to improve key ED operational metrics. We evaluated the impact of COVID-19 POCT on time to delivery of test results, rates of patients who left the ED with or without a COVID-19 diagnosis, and the amount of time COVID-19-negative patients spent...
Background
Millions of Americans are infected by influenza each year. Most experience mild and self-limited illness but a minority progress to severe disease and death. Emergency departments (ED) serve as a frontline for the US health system and must distinguish those at risk for clinical deterioration from those who can be safely discharged to the...
Background
The circulation and the genomic evolution of influenza A(H3N2) viruses during the 2021/2022 and 2022/2023 seasons were studied and associated with infection outcomes.
Methods
Remnant influenza A–positive samples following standard-of-care testing from patients across the Johns Hopkins Health System (JHHS) were used for the study. Sample...
Objective
Sepsis is a leading cause of mortality. Predicting outcomes is challenging and few biomarkers perform well. Defects in the renin–angiotensin system (RAS) can predict clinical outcomes in sepsis and may outperform traditional biomarkers. We postulated that RAS dysfunction (elevated active renin, angiotensin 1-7 [Ang-(1-7)], and angiotensin...
Understanding Influenza B virus infections is of critical importance in our efforts to control severe influenza and influenza-related diseases. Until 2020, two genetic lineages of influenza B virus-Yamagata and Victoria-circulated in the population. These lineages are antigenically distinct, but the differences in virus replication or the induction...
Background
Integration of a sensitive point-of-care (POC) HIV viral load (VL) test into screening algorithms may help detect acute HIV infection earlier, identify people with HIV (PWH) who are not virally suppressed, and facilitate earlier referral to antiretroviral therapy (ART), or evaluation for pre-exposure prophylaxis (PrEP). This report descr...
Understanding Influenza B virus infections is of critical importance in our efforts to control severe influenza and influenza-related disease. Until 2020, two genetic lineages of influenza B virus, Yamagata and Victoria, circulated in the population. These lineages are antigenically distinct but differences in virus replication or the induction of...
Objectives:
Limited data on respiratory infections are available from sub-Saharan Africa during the COVID-19 pandemic. The objective of this study was to evaluate the burden of respiratory viruses in rural Zambia from 2019-2021.
Methods:
Surveillance was initiated at Macha Hospital in Zambia in December 2018. Each week, patients with respiratory...
Objectives:
Recent research has helped define the complex pathways in sepsis, affording new opportunities for advancing diagnostics tests. Given significant advances in the field, a group of academic investigators from emergency medicine, intensive care, pathology, and pharmacology assembled to develop consensus around key gaps and potential futur...
Background
Hepatitis C (HCV) poses a major public health problem in the USA. While early identification is a critical priority, subsequent linkage to a treatment specialist is a crucial step that bridges diagnosed patients to treatment, cure, and prevention of ongoing transmission. Emergency departments (EDs) serve as an important clinical setting...
Background
While point-of-care ultrasound (POCUS) has been used to track disease resolution, temporal trends in lung ultrasound (LUS) findings among hospitalized patients with COVID-19 is not well-characterized.
Methods
We studied 413 LUS scans in 244 participants ≥ 18 years of age hospitalized for COVID-19 pneumonia within 28 days of symptom onse...
Background
BV is a score for differentiating between bacterial and viral etiologies. Recently FDA cleared, it is based on computational integration of the blood levels of three host-proteins (TRAIL, IP-10, CRP). Here we report a multi-cohort analysis validating its diagnostic performance in comparison to a microbiology confirmed reference standard...
Background
Given the steady increase of emergency department (ED) visits related to opioid overdoses, this study aims to determine the design and usability of an ED-centered mHealth patient-to-peer referral prototype tool that allows patients to refer peers to comprehensive HIV/HCV and opioid misuse prevention services.
Methods
Two iterative focus...
Abstract Monocyte distribution width (MDW) is a novel marker of monocyte activation, which is known to occur in the immune response to viral pathogens. Our objective was to determine the performance of MDW and other leukocyte parameters as screening tests for SARS-CoV-2 and influenza infection. This was a prospective cohort analysis of adult patien...
Vaccines are effective tools to prevent COVID-19-related morbidity. However, coverage is low throughout sub-Saharan Africa. Uptake of public health measures, perceptions of COVID-19 illness and vaccines, and intention to vaccinate were evaluated in 2021–2022 in rural Zambia. Adherence to public health measures, perceptions of COVID-19 risk and seve...
There is a significant number of Emergency Department (ED) patients with known chronic hepatitis C virus (HCV) infection who have not been treated with directly acting antivirals. We implemented a pilot ED‐based linkage‐to‐care program to address this need and evaluated the impact of the program using the HCV Care Continuum metrics. Between March 2...
Severe COVID-19 is characterized by a prothrombotic state associated with thrombocytopenia, with microvascular thrombosis being almost invariably present in the lung and other organs at postmortem examination. We evaluated the presence of antibodies to platelet factor 4 (PF4)-polyanion complexes using a clinically validated immunoassay in 100 hospi...
The first pandemic of the 21st century was caused by an H1N1 influenza A virus (IAV) introduced from pigs into humans, highlighting the importance of swine as reservoirs for pandemic viruses. Two major lineages of swine H1 circulate in North America: the 1A classical swine lineage (including that of the 2009 H1N1 pandemic) and the 1B human seasonal...
Objective
A recent academic-government partnership demonstrated the feasibility of utilizing Emergency Departments (ED) as a primary site for subject enrollment in clinical trials and achieved high rates of recruitment in two U.S. EDs. Given the ongoing need to test new therapeutics for influenza and other emerging infections, we sought to describe...
The clinical utility of point-of-care lung ultrasound (LUS) among hospitalized patients with COVID-19 is unclear.
Design:
Prospective cohort study.
Setting:
A large tertiary care center in Maryland, between April 2020 and September 2021.
Patients:
Hospitalized adults (≥ 18 yr old) with positive severe acute respiratory syndrome coronavirus 2...
Rationale
SeptiCyte RAPID, a molecular test distinguishing sepsis from non-infectious systemic inflammation, has potential clinical utility.
Objectives
Clinical validation of SeptiCyte RAPID, based on testing retrospective (banked) and prospectively collected patient samples.
Methods
Testing retrospective (banked) and prospective samples from adu...
Background
The intersecting epidemics of opioid misuse, injection drug use, and HIV/HCV have resulted in record overdose deaths and sustained high levels of HIV/HCV transmissions. Literature on social networks suggests opportunities to connect people who use drugs (PWUD) and their peers to HIV/HCV and opioid overdose prevention services. However, l...
Objectives
With the emergence of the COVID‐19 pandemic, restrictions were implemented globally to control the virus. Data on respiratory pathogens in sub‐Saharan Africa during the COVID‐19 pandemic are scarce. This analysis was conducted to evaluate patterns of respiratory pathogens in rural Zambia before and during the first year of the pandemic....
Background
Sepsis is a life-threatening organ dysfunction syndrome caused by the body's response to infection. Timely and appropriate sepsis management, including appropriate treatment of bacterial infection, improves outcomes. MeMed BV (BV), a test for differentiating between bacterial and viral infection, is based on computational integration of...
Background
Early identification of HCV is a critical health priority, especially now that treatment options are available to limit further transmission and provide cure before long-term sequelae develop. Emergency departments (EDs) are important clinical settings for HCV screening given that EDs serve many at-risk patients who do not access other f...
Background:
COVID-19 is a global pandemic caused by the novel coronavirus SARS-CoV-2. Some clinical features of severe COVID-19 represent blood vessel damage induced by activation of host immune responses, initiated by the virus. We hypothesized that autoantibodies against angiotensin converting enzyme-2 (ACE2), the SARS-CoV-2 receptor expressed o...
Early in the COVID-19 pandemic (March–July 2020 in Baltimore), emergency department (ED) healthcare workers (HCWs) were considered to be at greater risk of contracting SARS-CoV-2. Limited data existed, however, on the prevalence of SARS-CoV-2 infection and its impact in this workforce population. We enrolled 191 ED HCWs from a tertiary academic cen...
Background: Emergency Departments (EDs) can serve as surveillance sites for infectious diseases. The objective of this study was to determine the burden of SARS-CoV-2 infection and to monitor the prevalence of vaccination against COVID-19 among patients attending an urban ED in Baltimore City. Methods: Using 1,914 samples of known exposure status,...
Background
Emergency Departments (EDs) serve as a window for detecting and tracking emerging infectious disease epidemics. We sought to determine the prevalence, socio-demographic and clinical correlates of acute and convalescent SARS-CoV-2, HCV, and HIV infections among ED patients in Baltimore.
Methods
Remnant blood samples from 7450 unique ED p...
Background
Monocyte distribution width (MDW) is a novel marker of monocyte activation, which is known to occur in the immune response to viral pathogens. Our objective was to determine the diagnostic performance of MDW and other leukocyte parameters for SARS-CoV-2 and influenza infection.
Methods
This was a prospective cohort analysis of adult pat...
Study objective:
Enhancement of a routine complete blood count (CBC) for detection of sepsis in the emergency department (ED) has pragmatic utility for early management. This study evaluated the performance of monocyte distribution width (MDW) alone and in combination with other routine CBC parameters as a screen for sepsis and septic shock in ED...
Human-to-swine transmission of influenza A virus (IAV) repeatedly occurs, leading to sustained transmission and increased diversity in swine; human seasonal H3N2 introductions occurred in the 1990s and 2010s and were maintained in North American swine. Swine H3N2 were subsequently associated with zoonotic infections, highlighting the need to unders...
Importance:
Emergency departments (EDs) are increasingly initiating treatment for patients with untreated opioid use disorder (OUD) and linking them to ongoing addiction care. To our knowledge, patient perspectives related to their ED visit have not been characterized and may influence their access to and interest in OUD treatment.
Objective:
To...
Objective: The clinical utility of point-of-care lung ultrasound (LUS) for disease severity triage of hospitalized patients with COVID-19 is unclear.
Design: Prospective cohort study
Setting: A large tertiary care center in Maryland, USA between April 2020 to September 2021.
Patients: Hospitalized adults (18 years of age or greater) with positive S...
Background
As the COVID-19 pandemic continues, growing attention has been placed on whether patients previously infected with SARS-CoV-2 have an increased risk of developing and/or exacerbating medical complications. Our study aimed to determine whether individuals with previous evidence of SARS-CoV-2 infection prior to their current emergency depa...
Background
Emergency departments (EDs) serve as sentinel settings for diagnosing sexually transmitted infections (STIs), including HIV and syphilis. We aimed to assess performance and patient acceptability of a point-of-care (POC) test, the Chembio Dual Path Platform (DPP®) HIV-Syphilis Assay, in an urban ED in Baltimore.
Methods
170 patients were...
Background
Identifying infectious etiology is essential for appropriate patient management, including antibiotic use. A host-protein signature for differentiating bacterial from viral infection has exhibited robust performance (AUC of 0.9, 95% CI 0.86-0.95) in prior studies. Performance data was lacking for a broad pediatric population recruited in...
Background:
The signal-to-cutoff (S/CO) ratio of the HIV antigen/antibody test may help immediately to differentiate true-positive results from false-positive results, which may be particularly useful in time-sensitive circumstances, such as when providing emergency department (ED) care.
Setting:
Seven US EDs with HIV screening programs using HI...
Objectives: To assess emergency department (ED) clinicians' perceptions of a novel real-time influenza surveillance system using a pre- and post-implementation structured survey.
Methods: We created and implemented a laboratory-based real-time influenza surveillance system at two EDs at the beginning of the 2013-2014 influenza season. Patients with...
Background
Emergency Departments (EDs) have served as critical surveillance sites for infectious diseases. We sought to determine the prevalence and temporal trends of acute (by PCR) and convalescent (by antibody [Ab]) SARS-CoV-2 infection during the earliest phase of the pandemic among patients in an urban ED in Baltimore City.
Methods
We tested...
Background
While southern Africa experiences among the highest mortality rates from respiratory infections, the burden of influenza and respiratory syncytial virus (RSV) in rural areas is poorly understood.
Methods
We implemented facility-based surveillance in Macha, Zambia. Outpatients and inpatients presenting with influenza-like illness (ILI) u...
Background
Influenza B accounts for approximately one fourth of the seasonal influenza burden. However, research on the importance of influenza B has received less attention compared to influenza A. We sought to describe the association of both coinfections and comorbidities with disease severity among adults presenting to emergency departments (ED...
What is already known about this topic? Two 2-dose mRNA COVID-19 vaccines (from Pfizer-BioNTech and Moderna) and a 1-dose viral vector vaccine (from Janssen [Johnson & Johnson]) are currently used in the United States. What is added by this report? Among U.S. adults without immunocompromising conditions, vaccine effectiveness against COVID-19 hospi...
Real-world evaluations have demonstrated high effectiveness of vaccines against COVID-19-associated hospitalizations (1-4) measured shortly after vaccination; longer follow-up is needed to assess durability of protection. In an evaluation at 21 hospitals in 18 states, the duration of mRNA vaccine (Pfizer-BioNTech or Moderna) effectiveness (VE) agai...
New approaches to pelvic inflammatory disease (PID) care among adolescents and young adults (AYAs) that optimize self-care and personalize treatment are warranted to address age and racial-ethnic PID-related health disparities. Here we describe the 13-month preliminary feasibility and acceptability outcomes of recruitment, retention, and interventi...
Background: Our understanding of pathogens and disease transmission has improved dramatically over the past 100 years, but coinfection, how different pathogens interact with each other, remains a challenge. Cross-sectional serological studies including multiple pathogens offer a crucial insight into this problem.
Methods: We use data from three cro...
All academic medical specialties have the obligation to continuously create new knowledge that will improve patient care and outcomes. Emergency medicine (EM) is no exception. Since its origins over 50 year ago, EM has struggled to fulfill its research mission. EM ranks last among clinical specialties in the percent of medical school faculty who ar...
Importance
The National HIV Strategic Plan for the US recommends HIV screening in emergency departments (EDs). The most effective approach to ED-based HIV screening remains unknown.
Objective
To compare strategies for HIV screening when integrated into usual ED practice.
Design, Setting, and Participants
This randomized clinical trial included pa...
The burden of nosocomial respiratory infections in rural southern Africa is poorly understood. We established a surveillance program at a rural Zambian hospital to detect influenza-like illness (ILI) and respiratory infections among hospitalized patients and a cohort of healthcare workers (HCWs). Nasopharyngeal specimens from symptomatic patients a...
Emergency departments (EDs) have played a major role in the science and practice of HIV population screening. After decades of experience, EDs have demonstrated the capacity to provide testing and linkage to care to large volumes of patients, particularly those who do not otherwise engage the healthcare system. Efforts to expand ED HIV screening in...
Background: We assessed the performance of CoronaCHEK lateral flow assay on samples from Uganda and Baltimore to determine the impact of geographic origin on assay performance.
Methods: Plasma samples from SARS-CoV-2 PCR+ individuals (Uganda: 78 samples from 78 individuals and Baltimore: 266 samples from 38 individuals) and from pre-pandemic indivi...
Background
Several inflammatory cytokines are upregulated in severe COVID-19. We compared cytokines in COVID-19 versus influenza in order to define differentiating features of the inflammatory response to these pathogens and their association with severe disease. Because elevated body mass index (BMI) is a known risk factor for severe COVID-19, we...
While COVID-19 vaccines have been shown to significantly decrease morbidity and mortality, there is still much debate about optimal strategies of vaccine rollout. We tested identity-unlinked stored remnant blood specimens of patients at least 18 years presenting to the Johns Hopkins Hospital emergency department (ED) between May to November 2020 fo...
Objectives:
Delays in sepsis diagnosis can increase morbidity and mortality. Previously, we performed a Symptom-Disease Pair Analysis of Diagnostic Error (SPADE) "look-back" analysis to identify symptoms at risk for delayed sepsis diagnosis. We found treat-and-release emergency department (ED) encounters for fluid and electrolyte disorders (FED) a...
Cautious optimism suggests the COVID‐19 pandemic in the United States (U.S.) has reached a turning point. Cases have declined precipitously from their heights in the early winter months and vaccine distribution and administration has moved ahead at an accelerated pace. As of late‐March, more than 140 million doses of COVID‐19 vaccine had been admin...
Objectives
Emergency department (ED) patients with serious skin and soft tissue infections (SSTI) are often hospitalized to receive intravenous (IV) antibiotics. Appropriate patients may avoid admission following a single‐dose, long‐acting IV antibiotic.
Methods
We conducted a pre‐ vs. post‐intervention design trial at 11 US EDs comparing hospital...
Importance
Sepsis is a common syndrome with substantial morbidity and mortality. A combination of vitamin C, thiamine, and corticosteroids has been proposed as a potential treatment for patients with sepsis.
Objective
To determine whether a combination of vitamin C, thiamine, and hydrocortisone every 6 hours increases ventilator- and vasopressor-f...
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the virus responsible for COVID‐19 has infected more than 25 million Americans, leading to over 420,000 deaths.¹ The Centers for Disease Control and Prevention (CDC) reports over 378,000 cases of COVID‐19 in US health care personnel (HCP) with 1,286 deaths.² By summer 2020, an estimated...
There is an urgent and unprecedented need for sensitive and high-throughput molecular diagnostic tests to combat the SARS-CoV-2 pandemic. Here we present a generalized version of the RNA-mediated oligonucleotide Annealing Selection and Ligation with next generation DNA sequencing (RASL-seq) assay, called “capture RASL-seq” (cRASL-seq), which enable...
BACKGROUND Little is known regarding the sociodemographic and clinical characteristics of emergency department (ED) patients with untreated opioid use disorder (OUD) and the relationship of those characteristics with whether they were seeking a referral to substance use treatment at the time of their ED visit. METHODS Using data collected from 2/20...
Background: Several inflammatory cytokines are upregulated in severe COVID-19. We compared cytokines in COVID-19 versus influenza in order to define differentiating features of the inflammatory response to these pathogens and their association with severe disease. Because elevated body mass index (BMI) is a known risk factor for severe COVID-19, we...