COVID-19 has changed the way we work and practice medicine. To mark the anniversary of when the coronavirus was first detected, Yale Cardiovascular Medicine invited a panel to speak about their experiences and the challenges ahead.
Eric J. Velazquez, MD, the Robert W. Berliner Professor of Medicine, opened the discussion. "When I think back on this year I reflect on three words that summarize what we've gained from this last year's experience and and those words are humility, resilience, and innovation." Velazquez added, "It's been bolstering for me personally to see the tremendous resilience of our faculty and our staff rise to the challenge of an uncertain future with risk to themselves. I also want to highlight the resilience of our educators and investigators who have worked through major challenges."
How to Succeed in a New Era
A common theme was the initial uncertainty about the cardiovascular complications of COVID‐19. Joyce Oen-Hsiao, MD, shared two case reports on this topic. The first, "Incidental finding of COVID-19 pulmonary infiltrates on SPECT/CT attenuation correction CT," described how a 65-year-old patient was diagnosed with COVID-19 after he received a computed tomography coronary angiography (CTCA) test. The second, "COVID‐19 complicated by ST‐segment elevation myocardial infarction in a 29‐year‐old patient," examined the case of a 29‐year‐old male with no past medical history who developed plaque in his left anterior descending artery (LAD).
Next, Alexandra Lansky, MD, presented a clinical trial led by the Yale Cardiovascular Research Group (YCRG). The COLSTAT clinical trial (Colchicine/Statin for the Prevention of COVID-19 Complications) combines colchicine with the cholesterol-lowering medication rosuvastatin to reduce complications in infected patients.
Hyung Chun, MD, summarized the role of endothelial cells in coronavirus disease-associated coagulopathy. Key manuscripts inlcuded, "A neutrophil activation signature predicts critical illness and mortality in COVID-19," and "Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study." Overtime these discoveries could help improve the management of COVID-19 patients. In collaboration with Patty J. Lee, MD, at the Duke University School of Medicine, Chun hopes to develop a greater understanding of the drivers of persistent COVID-19 symptoms.
Lastly, Erica Spatz, MD, MHS, described efforts to move towards a precision medicine-based approach to address post-COVID symptoms. A multi-center study funded by the Center for Disease Control and Prevention INSPIRE (Innovative Support for Patients with SARS COV-2 Infections Registry), aims to resolve questions about the long-term impact on the health of coronavirus survivors.
Recorded talks from Yale Cardiovascular Medicine Grand Rounds are available on YouTube.