Page 11 - SOUTH FLORIDA HOSPITAL NEWS & HEALTHCARE REPORT JUNE 2022

Miller School Researchers on the Trail to Unraveling Long COVID-19

Long COVID-19 syndrome, in which begins with virus-induced lung inflamma-
symptoms last a year or longer beyond tion and defective cholesterol homeosta-
infection, impacts about 30 percent of sis, and ultimately leads to endothelial
survivors of the coronavirus. It is a mul- dysfunction.
tifaceted systemic condition character- The team is investigating evidence that
ized by fatigue, “cognitive fog,” and often there is an overzealous inflammatory
heart, lung and neurological complica- response from the mating of protein
tions. spikes on the SARS-CoV-2 virus with
Lina Shehadeh, Ph.D., professor of low-density lipoprotein receptors (LDLr)
medicine in the Interdisciplinary Stem on the infected cells. Central to this
Cell Institute and Division of Cardiology response is the formation of neutrophil
at the University of Miami Miller School extracellular traps (NETs), which are
of Medicine, received a $1 million grant net-like structures composed of DNA-
from the American Heart Association to histone complexes and proteins. These
study long COVID. Recognizing the sub- form as the immune system activates an
stantial public health impact and burden overabundance of neutrophils in the
of this syndrome, the American Heart lungs.
Association awarded three-year grants to While they form as an overreaction to
10 research programs in the nation with real pathogens like the SARS-CoV-2
proposals for unraveling long COVID’s virus, they are also complicit in a num-
etiology and molecular mechanisms. ber of autoimmune diseases, coagulation
“When you have an impact that is sys- disorders and thrombus, diabetes, ather-
temic — not confined to certain organs osclerosis, vasculitis, sepsis and cancer. (l-r) Dr. Leo Tamariz, Dr. Shathiyah Kulandavelu, Dr. Lina Shehadeh, and Dr. Jose Condor
— you think about the circulatory sys- “In COVID-19, when these neu- Dr. Shehadeh is working with Jeffrey ble vessel anomalies.
tem, since its function affects everything trophils are overwhelmed or defeated by Goldberger, M.D., M.B.A., professor of “This ties in with work we have done
else,” Dr. Shehadeh said. “We have the virus, they burst in the lungs, releas- medicine and chief of the Cardiovascular for years in studying battle fatigue in vet-
observed signs that the endothelial func- ing their DNA material [netosis],” Dr. Division, and Leonardo J. Tamariz, M.D., erans, which can persist long after they
tion of the blood vessels is abnormal in Shehadeh explained. “From there we an internist in the COVID-19 Long- return from the field,” Dr. Tamariz said.
preclinical models of long COVID. Now, think the NETs are carried through the haulers Clinic at the Miami Veterans Other key team members are
we are working to connect the dots and systemic circulation and become stuck Affairs Healthcare System. Dr. Tamariz is Shathiyah Kulandavelu, Ph.D., a junior
explain this cascade.” and then embedded in the vessel walls in obtaining blood samples and heart and faculty member at the Interdisciplinary
As part of her research, Dr. Shehadeh is the limbs and in the organs. This would lung MRI images of 150 or so patients Stem Cell Institute whose expertise is in
using a mouse model and human blood explain the loss of normal homeostasis in from the clinic to sample the neutrophils endothelial function, and Jose Manuel
samples to interrogate a chain of events the vascular walls and the tendency and check for markers of netosis, while Condor Capcha, Ph.D, a postdoctoral
that may account for symptoms seen in toward thrombus we see so often in Dr. Goldberger is examining the MRIs associate who is spearheading the lab
people with long COVID. This chain COVID long-haulers.” and other cardiac readouts to assess visi- work.

Cover Story: Severity of Jury Verdicts Should Concern Florida Physicians

Continued from page 1 seek payment for mental pain and suffer- carriers, we now discuss ways to prepare ly suggest that they consider a separate
ing,” explained Danna. “This new law ourselves to work with the millennial policy for the corporation and put the
despite the fact that Florida is already
one of the highest in the nation for med- allows parents of adult children who mentality versus a jury of our peers. You allies under that. Doctors need a pure
ical malpractice insurance costs.” have no spouse or children to seek pay- have to consider how that age group policy for themselves, where they are not
Danna notes that while plaintiffs’ attor- ment of those non-economic damages as thinks when sitting on a jury panel, and sharing their limits.”
neys used to pursue more lawsuits, caus- well. how to go to court with the younger gen- Danna advises physicians to carry a
ing a frequency problem, courts are now “This is going to cause even more eration making decisions.” $500,000 per claim/$1.5 million aggre-
facing a severity problem, with attorneys opportunity for lawsuits; attorneys going While many Florida doctors have cho- gate per year limit to meet the national
going for fewer cases that will result in after this money are going to cause chaos sen to carry low policy limits of threshold. “We are seeing a lot of surgical
much higher awards. in Florida,” she added. $250,000/$750,000, believing that attor- groups going for $1million/$3 million,”
An added concern for physicians is Court cases are also being influenced neys wouldn’t pursue them if there she added.
House Bill 6011, which will allow par- by changing jury demographics, which wasn’t as much of a reward, with out-of-
ents of adult children to recover damages now include younger millennials. court claims settling at an average of
for mental pain and suffering in a med- “Back in the day we had a jury of our $400,000, this still leaves them at risk. For more information on policy limits,
ical negligence suit. The bill will take peers, but now these younger millenni- “A lot of doctors share their $250,000 contact Julie Danna at
effect on July 1, 2022. als, who are very compassionate, tend to limits with their corporations and allied julie@dannagracey.com, call
“Before when a child died due to loss, be more willing to award plaintiffs professionals, which leaves them even (850) 530-3924 or visit
the immediate family was allowed to money,” said Danna. “At meetings with more vulnerable,” said Danna. “I strong- www.dannagracey.com.

e
N
t
x
W ha s ’ t N t ?
w w b . w d o c . o m h / l a e t l hca e r

o

o

o c un t n i o

. ed.

South Florida Hospital News southfloridahospitalnews.com June 2022 11