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Cleveland Clinic Florida COVID-19 Could Inhibiting the DPP4 Enzyme

Wellness Taskforce Provides Help Treat Coronavirus?

Caregivers with Support Services Researchers and clinicians are scrambling to find ways
to combat COVID-19, including new therapeutics and
Cleveland Clinic Florida has developed Relaxation Station: The relaxation sta- eventually a vaccine. In a commentary published in the
a program to support caregivers during the tion is an area that has been designated for journal Diabetes Research and Clinical Practice, Miller
COVID-19 pandemic. The program caregivers that includes massage chairs for School of Medicine professor and endocrinologist
includes services for all caregivers and stress relief—while social distancing. All Gianluca Iacobellis, M.D., Ph.D., suggests the DPP4
some services are specific to caregivers areas are sanitized after individual use. enzyme presents an interesting target for further
working on the frontlines who are caring Meditation Classes: Caregivers can par- research, and DPP4 inhibitors could help some COVID-
for patients. Cleveland Clinic Florida lead- ticipate in meditation classes that include 19 patients.
ers believe that all caregivers play a critical chair yoga and reflexology. “We potentially have a mechanism for how the virus is
role in ensuring quality patient care and Art Therapy: Classes are available to getting into the body,” said Dr. Iacobellis. “And we poten-
want to support their mental and physical caregivers to help relieve anxiety tially have a way we can partially inhibit that mecha-
health and well-being during the pandem- Discounts for Healthcare Employees: nism. We should consider clinical trials for DPP4 for Dr. Gianluca Iacobellis
ic. Discounts to restaurants and local busi- patients who have mild or moderate COVID-19 with
The program includes a number of ben- nesses is available to all caregivers. type 2 diabetes”
efits and range from a variety of services, Gratitude Board: A portal for all work- DPP4 is found throughout the body, but its activity is only partially understood.
from discount programs, to hotel accom- ers has been setup to recognize caregivers The enzyme does play significant roles in inflammatory responses and insulin regu-
modations to self-care. In addition, who are going above and beyond and, and lation. DPP4 inhibitors increase insulin and GLP-1 secretion and are commonly pre-
Cleveland Clinic Florida has committed to to receive messages of appreciation and scribed for people suffering from type 2 diabetes.
maintaining pay and benefits for all care- encouragement. In the current crisis, type 2 diabetes patients are at much higher risk. Data from
givers and has reassigned employees to Cleveland Clinic Florida First- Wuhan and Italy have shown they have higher mortality and higher ICU admission
other areas if their role has been suspend- Responder Funds: A new philanthropic rates. Building on previous research, conducted on earlier coronaviruses, as well as a
ed as a result of COVID-19. program has been developed to benefit recent paper that demonstrates DPP4 interaction with COVID-19, Dr. Iacobellis
Caregivers across Cleveland Clinic caregivers and first responders across believes the enzyme may play a significant role in these outcomes by interfering with
Florida facilities can take advantage of the South Florida and the Treasure Coast who the immune response.
following benefits, among others: are on the front lines of the COVID-19 “The body is overreacting with this inflammatory response to the virus,” said Dr.
COVID-19 Caregivers: For caregivers pandemic. The Cleveland Clinic Regional Iacobellis. “This could be partially mediated by DPP4. The virus binds to the enzyme
who test positive, Cleveland Clinic Florida Caregiver Hardship Program, and the First and the enzymatic activity of DPP4 overexpresses inflammatory cytokines, exagger-
is committed to helping them as much as Responder Hardship Program, will pro- ating the inflammatory response. Previous studies, of SARS and MERS, showed that,
possible by delivering meals and care vide financial support to caregivers and if you blocked DPP4 activity, there was a reduction in the inflammatory response.
packages, running errands on their behalf, first responders who are experiencing a This could ameliorate the immune response to the virus.”
and providing and paying for hotel accom- temporary financial hardship due to Dr. Iacobellis notes that clinicians will need more data before embracing DPP4
modations. COVID-19 and wish to request considera- inhibitors to treat COVID-19 patients. However, he also points out that early evi-
Caregiver Support Housing: Cleveland tion for financial assistance. Both are fund- dence has shown these drugs reduce inflammation. He believes the enzyme’s poten-
Clinic Florida will offer caregivers who ed by charitable donations from generous tial role in a COVID-19 therapeutic regimen certainly deserves further study.
provide direct patient care with hotel individuals in our local communities. “Starting with diabetes patients, we should be conducting randomized studies to
options and pay for accommodations to Allocations will be distributed based on test whether treating those with mild or moderate symptoms improves outcomes,”
minimize the risk of exposure to those fund availability. said Dr. Iacobellis. “These drugs are well tolerated and may provide therapeutic ben-
caregivers’ families and loved ones The community can now also directly efit.”
Childcare Services: Childcare resources support Cleveland Clinic caregivers across
have been made available to caregivers the region by donating supplies/PPE, gift
who need these services cards, meals, and even blood through a FDA Approves Miami Cancer
COVID-19 Hotline for Caregivers: A Community Response program.
hotline has been established to provide Individuals may also support by donating
information on steps Cleveland Clinic money to the First Responders Hardship Institute to Perform New
Florida is taking, including Personal Fund program.
Protective Equipment (PPE) utilization, In-house Test for COVID-19
occupational health guidelines, and opera- Full details about donations can be found
tional updates. at give.ccf.org/covid19.
The Food & Drug Administration granted
Emergency Use Authorization (EUA) for
Dentists Donate Medical Supplies Baptist Hospital of Miami Molecular
Diagnostic Laboratory at Miami Cancer
Institute, to perform a new COVID-19 swab
for Broward Health Caregivers tests in-house. The test was developed at
Miami Cancer Institute, which is part of
Baptist Health.
Identification of COVID-19 patients is
critical in order to either self-isolate at home
or admit the patient to a specific area of the
hospital. This in-house testing allows Miami
Cancer Institute to perform a number of tests twice a day and receive results within 24
hours. The lab is able to perform 40 - 80 tests per day with capacity for more in the near
future.
“Having this test allows us to expand our in-house testing capability, allowing us to
make treatment decisions more quickly and quarantine patients appropriately,” said
Edwin Gould, M.D., chief of pathology, Miami Cancer Institute. “We were fortunate to
have all the highly sophisticated equipment and expertise needed already in-house–
making the switch possible in a short timeframe.”
As an added layer of safety, the testing process begins in a leased GermFree trailer,
which resides behind the Miami Cancer Institute facility and contains ventilated air
(l-r) Bill Diggs, President of Broward Health Foundation, welcomes the space and laminar flow hoods. The remainder of testing is performed in the building’s
laboratory. The GermFree trailer, which was used as a pharmacy during Miami Cancer
donation of personal protective equipment for front line caregivers
Institute’s construction, includes equipment like microbiology hoods that allow for
from Fort Lauderdale dentists Mark McCawley and Tom McCawley.
molecular testing of COVID-19.
South Florida Hospital News southfloridahospitalnews.com May 2020 15