Pulmonary, Critical Care and Sleep Medicine

A Buffalo News story reporting that there will likely be several more weeks of rising COVID-19 cases includes interviews with Thomas A. Russo, MD, SUNY Distinguished Professor of medicine and chief of the Division of Infectious Diseases, and Manoj J. Mammen, MD, associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine. On a recent day, 70 people were hospitalized with COVID in Western New York. A year earlier to the day, that number was only 29. “At that time, the county was in lockdown in terms of commercial and scholastic and other activities. People, behavior-wise, were just not interacting with each other at all,” Mammen said. “Now we have almost normal business and scholastic and personal interactions. I think that’s the difference.” Added Russo: “For the most part, if you’re fully vaccinated, your concern should be less, but not zero. It doesn’t mean your behavior should be reckless.”

Prevention Magazine interviewed Manoj J. Mammen, MD, associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine, about two arthritis drugs — tocilizumab and sarilumab — that are being recommended by the World Health Organization for use on critically ill COVID-19 patients. The drugs have worked well on severe cases, but are not as effective on mild COVID cases. “There is less evidence that there is an abundance of interleukin-6 activity with less severe cases of COVID-19, and so it seems less likely it would be helpful,” as the initial inflammatory response would not be as high,” said Mammen. The article was also published in other media outlets.

An article in Clinical Trials Arena has interviewed Sanjay Sethi, MD, professor of medicine and chief of the Division of Pulmonary, Critical Care and Sleep Medicine. The article discusses the fact that ongoing COVID-19 trials are adopting different strategies to sequence patient samples to identify the impact of emerging SARS-CoV-2 variants on the efficacy of monoclonal antibody cocktails. The trial setting — treatment or prevention — is driving the sequencing strategy. While trials are collecting participant samples to ascertain the impact of emerging variants of concern, the immediate focus remains mainly on clinical outcome measures, with sequencing data expected to be available later. 

A story reporting on why rising COVID-19 vaccinations are not cutting down on the number of positive cases and hospitalizations in Western New York quotes Manoj J. Mammen, MD, associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine, who addressed vaccine hesitancy. “There’s a lot of skepticism, anxiety, mistrust,” Mammen said. “Our goal as health care professionals is to educate everyone.”

A story reporting on why even vaccinated individuals should still wear face masks in public quotes Manoj J. Mammen, MD, associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine, who said: “One of the reasons why we want people to wear masks, is we don’t want to spread the infection around when you don’t have symptoms, even if you’re fully vaccinated.” The story also quoted Timothy F. Murphy, MD, SUNY Distinguished Professor of medicine in the Division of Infectious Diseases. “Particularly, with the high level of circulating virus right now, the new variants are going to be forming and so we don’t know what new variants are coming, and it’s possible that the new ones are less susceptible to prevention by the vaccines,” Murphy said.

WBFO reported on the UB connection for global guidelines for treating seriously ill COVID-19 patients, recognizing Manoj J. Mammen, MD, associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine, who said these guidelines were updated using the knowledge acquired over the past several months. “Going forward, we would have to look at using the best available evidence and data and marshal all our resources to reduce any further deaths, and to prevent any more spread of the pandemic,” Mammen said. “I think there’s definitely political will for it. We just have to be more vigilant in the next several months.”

Should we feel optimistic about the coming months of the COVID-19 pandemic because positive tests and hospitalizations are declining and more people are getting the vaccine every day? Or should we be pessimistic because dangerous, easily transmissible variants of the virus are spreading around the globe and into New York? “I think I am a glass-half-full person,” says Manoj J. Mammen, MD, associate professor of medicine. Still, he adds: “We haven’t won the war yet. We’ll still have to struggle in the coming months.” Peter Winkelstein, MD, clinical professor of pediatrics and executive director of UB’s Institute for Healthcare Informatics, leads a team that models COVID-19 hospitalizations in Erie County. If vaccinations can reach 5,000 or more doses delivered per day, the number of hospital patients could fall to almost zero within two months, assuming variants do not take hold. “We don't have to wait for everybody to be immunized before we see an effect from the vaccine,” Winkelstein says.

Manoj J. Mammen, MD, associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine, is a co-author on both the previous and current guidelines on treating patients severely ill with COVID-19.  Authored by 43 clinicians from 14 countries, the guidelines concern patients hospitalized with severe and critical disease in intensive care units. “The new guidelines demonstrate what we have learned about treating patients with severe COVID-19, while underscoring how much still needs to be determined,” Mammen said.

Several Jacobs School of Medicine and Biomedical Sciences research projects are profiled in a story that looks at medical research projects conducted during the global COVID-19 pandemic. Among the faculty members mentioned are Teresa Quattrin, MD, UB Distinguished Professor of pediatrics; M. Jeffery Mador, PhD, associate professor of medicine in the Division of Pulmonary, Critical Care and Sleep Medicine; Robert A. Fenstermaker, MD, director of neurosurgical oncology in the Department of Neurosurgery; and Nikhil Satchidanand, PhD, assistant professor of medicine.

The head of the U.S. effort to produce a coronavirus vaccine recently said the first immunizations could happen in early December. Health officials acknowledge there may be hesitancy among some members of the public to take a vaccine — something that usually takes several years to develop. “The FDA is not going to do a hack job on this … the FDA is not going to approve anything if it has concerns,” says Sanjay Sethi, MD, professor of medicine and chief of the Division of Pulmonary, Critical Care and Sleep Medicine. “I’ll be first in line to get it when they tell me I can,” Sethi says.

Researchers — including Sanjay Sethi, MD, professor of medicine and chief of the Division of Pulmonary, Critical Care and Sleep Medicine — are recruiting household members of individuals who have tested positive for COVID-19 to enroll in a study of Regeneron’s national clinical trial of the investigational antibody cocktail REGN-COV2. The monoclonal antibody treatment is believed to reduce the severity of symptoms in individuals exposed to COVID-19 or possibly even prevent symptoms entirely.

News reports said UB’s Clinical Research Office is leading the regional effort of a national Regeneron Pharmaceuticals clinical trial to help measure the effectiveness of the antibody drug REGN-COV2. “At a time when our region is unfortunately experiencing an uptick in cases, we are pleased that we are able to provide Western New Yorkers with the opportunity to enroll in a study of this very promising potential COVID-19 treatment,” said principal investigator Sanjay Sethi, MD, professor of medicine and chief of the Division of Pulmonary, Critical Care and Sleep Medicine.

Sanjay Sethi, MD, professor of medicine and chief of the Division of Pulmonary, Critical Care and Sleep Medicine, was quoted in an article on new research that identified the sleep aid melatonin as a potential treatment for COVID-19. Sethi, who is conducting similar research, said, “Ultimately, the proof is in the pudding, and it has to show benefit in properly conducted trials before it is added to our treatment arsenal for COVID. It would be a welcome addition if it turns out to be safe and effective because it is inexpensive and widely available.”

Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, and Sanjay Sethi, MD, professor of medicine and chief of the Division of Pulmonary, Critical Care and Sleep Medicine​, were quoted in a story on how preventing hospital systems from becoming overburdened is important in minimizing mortality rates. If hospitals become overwhelmed, “the level of care unquestionably will decrease and as a result, mortality and bad outcomes certainly will increase,” Russo said. Sethi said, “It’s not just the system. It’s the people in the hospital. Exhaustion sets in.”

Thomas A. Russo, MD, professor of medicine and chief of the Division of Infectious Diseases, and Sanjay Sethi, MD, professor of medicine and chief of the Division of Pulmonary, Critical Care and Sleep Medicine​, were quoted in a story on how increasing knowledge has led to improved treatment of COVID-19. "We understand it better. We understand the course better. We understand the intervention and how to time them," Sethi said.