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Anchor lead: How can we tell if an existing drug might be used to treat COVID-19? Elizabeth Tracey reports

Hydroxychloroquine, a malaria drug, and azithromycin, an antibiotic, are two existing drugs now in clinical trials to treat COVID-19. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says an existing Johns Hopkins database can help in the search for additional potential therapies.

Nelson: You then look at the target and say is there any drug that’s out there, perhaps not as its primary effect, but has some effect that hits the target in the same way that you’d want to make a drug? Can we just get a sense of whether there’s any beneficial action of this drug, in this context where we know what the target is? Here, Jun Liu built one of the great libraries of drugs that are approved for any use anywhere, and also drugs that were taken into phase two clinical trials, so there’s a safety data behind them, built this library so it could be used by anybody to screen for particular targets.  :34

The Johns Hopkins Drug Library can be accessed by anyone using those terms to search. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: There are strategies to alleviate the shortage of ventilators for people with COVID-19, Elizabeth Tracey reports

Ventilators, machines that help people with severe COVID-19 breath, are in short supply. Enid Neptune, a lung expert and critical care medicine physician at Johns Hopkins, says one strategy that’s being discussed is using machines used for sleep apnea known as CPAP or BIPAP machines, of which there are many.

Neptune: The risk of disseminating droplets would definitely be higher than they would be with a closed system like a ventilator system. But what we’re recognizing is that in this situation where we’re worried about not having enough ventilators we should consider some of these noninvasive modes in which you are able to ventilate a patient.  We can change them in a way that they can be much more protective than we think they are now.  :27

Neptune says other advantages of CPAP or BIPAP would be not having to sedate the person as well as greater ease in managing their therapy. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What does a doctor do to quell panic in the face of COVID-19? Elizabeth Tracey reports

Are you feeling more and more frightened in the barrage of information about the COVID-19 pandemic? On the front lines of treating patients with the infection, Enid Neptune, a lung expert at Johns Hopkins, offers one of her coping strategies.

Neptune: It’s very useful to pick a few sources of information that are reliable. And not try to venture beyond that, because that is the setting where you’re getting multiple incoming informational fire, that it can generate a panic mode. Or a sense of I don’t know what’s actually true. And there are objective truths in this pandemic. Select very carefully the places where you are going to get your information. And what I would suggest are conventional news sites.  :32

Neptune says adding others like the CDC and NIH sites is okay, and she says limiting yourself to checking in at most twice a day will keep you informed but out of panic mode. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Observations that the heart may be damaged by COVID-19 infection have important clinical implications, Elizabeth Tracey reports

 Twenty percent of patients with COVID-19 infection in Wuhan had evidence of acute heart damage, a study in JAMA Cardiology shows. Erin Michos, a cardiologist at Johns Hopkins, says what is not known is why, and that’s a question that needs to be answered.

Michos: The mechanism of why is there heart damage is important because this may guide strategies of how we treat these patients. If they have underlying heart disease we would focus treatments on their underlying heart disease and improving oxygenation, if the cardiac troponin elevation was due to direct injury of the heart from the virus then treatments that are antiviral may be beneficial, or if this was due to the immune response then there are therapies that are directed at the immune system.  :32

Michos says that studies are underway to understand COVID-19 heart damage, and for now, she’s telling all of her patients to strictly observe public health recommendations. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Damage to the heart may be one of the most serious of COVID-19 consequences, Elizabeth Tracey reports

Analysis of data from patients hospitalized with COVID-19 in Wuhan has detected evidence of heart damage in one in five, a study in JAMA Cardiology reports. Erin Michos, a cardiologist at Johns Hopkins, explains.

Michos: They evaluated hospitalized patients for COVID-19. The presence of cardiac injury that was detected by a blood test, cardiac troponin. Up to 20% of their patients had elevated levels of troponin and even after you took into account underlying disease, age, pre-existing coronary disease, diabetes, kidney disease, cancer, patients with this evidence of cardiac injury were four-fold more likely to die, this was a marker for more likely to die versus survive.  :30

Michos says this observation could have a range of clinical implications that may ultimately guide treatment, but for now what needs to be determined is why heart damage is taking place so strategic intervention is possible. At Johns Hopkins, I’m Elizabeth Tracey.

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In this next podcast, we bring back our guest from the Center for the Practice of Collaborative Leadership, Carolyn Cumpsty-Fowler, Ph.D., MPH. First, Carolyn provides an overview of what is meant by strengths spotting. We review why strengths spotting is important in the healthcare setting. Next, we tackle why it can be difficult to actually implement strengths spotting in practice... and give you tools to get started! Finally, Carolyn shares ways to enhance our ability to spot strengths in our practice environments that will ultimately impact inquiry work.
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Anchor lead: There are measures you can take to relieve your own stress during the pandemic, Elizabeth Tracey reports

Stress is rampant as concerns about COVID-19 accelerate. Karen Swartz, a psychiatrist at Johns Hopkins, reminds everyone to pay attention to what public health authorities are telling us to do, and then to do it.

Swartz: One of the most important things we can all do is to go into a one day at a time philosophy. I think one of the critical things is to make sure that we’re reducing our stress and maybe the most important thing is that we’re getting enough sleep. :12

Swartz says many providers are capable of remote visits to help.

Swartz: Just make sure that you’re paying attention to your own level of stress. And if you have resources, meaning a therapist, a doctor, someone you trust, or close friend or family member, talk about that.  :12

Swartz notes using that technologies most of us have at our fingertips to reach out to others will go a long way toward interrupting endless cycles of anxiety and worry. At Johns Hopkins, I’m Elizabeth Tracey.