MICHIGAN MEDICINE
Division of Pulmonary & Critical Care Medicine
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Dear Alumni and Friends,
We hope you are healthy and doing well given the circumstances. COVID-19 remains a significant challenge, not only for our medical center and division, but for our community, the state of Michigan, and our country.
I am humbled by the work of our faculty, fellows, and advanced practice providers who work the front lines caring for critically ill patients as well as our researchers at the bench to address gaps in COVID-19 knowledge and care.
The more than doubling of our intensive care unit capacity during the surge was undoubtedly a team effort, but could not have happened without the leadership provided by many in our division:
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Jose De Cardenas, MD performed the majority of tracheostomies for COVID patients requiring long-term mechanical ventilation.
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Robert Hyzy, MD played a central role in optimizing care for critically ill patients as well as assisted in the triage of patients requiring intensive care from outside institutions.
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Dennis Lyu, MD was instrumental in converting a moderate care unit into a fully functioning medical intensive care unit.
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Jakob McSparron, MD served as the Associate Director of Michigan Medicine's Regional Infection Containment Unit (RICU), where nearly 200 patients were cared for.
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Helena Schotland, MD operationalized the rapid mobilization of pulmonary and critical care faculty to areas of clinical need.
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Jane Deng, MD, MS and Dru Claar, MD led the effort of providing care at the Veterans Affairs Hospital in Ann Arbor. For the first time in its history, the VA hospital opened it's doors to humanitarian patients transferred from overwhelmed healthcare systems in Southeast Michigan.
This newsletter shares our progress as we continually work to understand the clinical course, management, and treatment of this devastating disease.
Sincerely,
Chief, Division of Pulmonary and Critical Care Medicine
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COVID-19
RESEARCH
Faster Than COVID-19: A Computer Model That Predicts the Disease’s Next Move
Michael Sjoding, MD explains the significance of M-CURES, a predictive model in development at the University of Michigan, that could help care providers stay safe and anticipate patient needs. Read more.
Study Shows Variation in Hospital Visitor & ICU Communication Policies Due to COVID-19
Thomas Valley, MD, MSc discusses his study that looked at changes to visitation policies and communication practices in Michigan intensive care units as a result of COVID-19. Read more.
Treatment of Cytokine Storm and Endothelial Dysfunction
Meilan Han, MD, MS was the international principal investigator for a Phase 3 randomized, double blind, placebo controlled trial of ruxolitinib to treat COVID-19. Ruxolitinib is a is a JAK1/2 inhibitor which is being tested to help reverse the cytokine storm that can lead to lung damage.
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COVID-19
PATIENT CARE
Months After Infection, Patients Report Breathing Difficulty, Excessive Fatigue
Meilan Han, MD, MS has been quoted by CNN; "For the patients I have followed, many continue to complain of cough, breathing issues and severe fatigue long after their first infection." Read more.
Recovery After Severe COVID Infection Poses Unique Challenges
Hallie Prescott, MD, MSc and Jake McSparron, MD discuss the multiple issues that patients with COVID-19 may face after being discharged from the hospital. Read more.
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Black Microbiologists Push for Visibility Amid a Pandemic
Ariangela Kozik, PhD, a postdoctoral fellow in Dr. Yvonne Huang’s lab, was featured in the New York Times highlighting Black scientists. Dr. Kozik is a talented microbiologist and immunologist who has particular expertise in the airway microbiome in asthma. Read more.
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Rapid Cytokine Detection
Benjamin Singer, MD, PhD and team leveraged an existing collaboration focused on biomarker detection in critical illness to provide rapid assays that detect cytokine storm in critically ill patients with COVID-19. This effort, supported by a Rapid COVID-19 Response grant, involved refining and automating assay technology, with the goal of providing low-cost, robust, and rapid measurements of cytokines for future trials of precision medicine in critical care.
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COVID-19 Data and Biorepositories
Michael Sjoding, MD; Andrew Admon, MD, MPH, MSc; and Robert Dickson, MD established a data repository of hospitalized patients with COVID-19, which equipped Michigan Medicine investigators to compare the pathophysiology and outcomes of COVID-19 lung injury with that of other causes of severe lung injury. Using this repository, they established that the respiratory physiology and intensive care unit outcomes of patients with severe COVID-19 lung injury are comparable to that of patients with non-COVID-19 causes of acute respiratory distress syndrome.
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New Therapy for ARDS
Vibha Lama, MD, MS is leading an investigator-initiated trial of Defibrotide therapy for SARS-CoV2 acute respiratory distress syndrome funded by Jazz pharmaceutical. Defibrotide is an endothelial stabilizer with inhibitory effect on thrombo-inflammatory pathways. Read more.
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Oxygen Therapy Harms Lung Microbiome in Mice
A team led by Robert Dickson, MD found that COVID-19 patients who are administered oxygen, a universal therapy, may have unintended consequences on the microbiome. Read more.
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State and Nationwide
COVID-19 Registries
Hallie Prescott, MD, MSc and colleagues helped launched the MI-COVID-19 registry, which is a statewide registry of hospitalizations for COVID-19, sponsored by Blue Cross/Blue Shield of Michigan. They have presented data to participating hospitals regarding the presentation, treatments, and outcomes for patients hospitalized with COVID-19 in Michigan, and the variation across hospitals. Dr. Prescott also measured readmissions and post-discharge mortality in the nearly 2000 patients who survived hospitalization for COVID-19 in the nationwide Veterans Affairs system. Read more.
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Developing an Early Warning System for Use in COVID-19
Michael Sjoding, MD and Andrew Admon, MD worked to develop PICTURE, a clinical prediction system that detects early signs of deterioration among inpatients with COVID-19. Early prototypes were able to detect impending respiratory failure and cardiac arrest sooner than other available clinical prediction systems. During a subsequent surge, PICTURE will help physicians better allocate ICU beds and other clinical resources while enabling them to intervene more quickly to stem complications of COVID-19. Read more.
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Development of Large, Multicenter Cohort Studies
Jack Iwashyna, MD, PhD; Robert Hyzy, MD and colleagues have led our division's representation in the design, analysis, and interpretation of several large, national cohort studies. These include the PETAL Network’s RED CORAL study and the STOP-COVID study. In addition, we have been an active enroller in several randomized, controlled PETAL COVID therapeutic trials, including the use of hydroxychloroquine in severe acute respiratory distress syndrome.
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Mobile CT Scanner
Michael Sjoding, MD; Meilan Han, MD, MS and Richard Dickson, MD partnered with a local company (Xoran) to adapt their mobile head CT scanner for thoracic imaging. This bedside CT scanner will enable providers to obtain cross-sectional chest imaging in critically ill patients without leaving the intensive care unit and will be valuable for surge deployment in future outbreaks.
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Collaborative Effort Catalogs and Stores COVID-19 Blood Samples, COVID-19 Vaccine Trial and Q&A
Njira Lugogo, MD has been a key participant in a collaborative effort involving the Michigan Clinical Research Unit and the Central biorepository to collect, process and archive serum and plasma samples from patients with COVID-19 treated at Michigan Medicine. This includes both residual clinical samples and prospectively collected samples and have cataloged and stored over 20,000 samples thus far.
Dr. Lugogo is also the site principal investigator for the AstraZeneca Oxford vaccine trial, which will enroll 500 patients at Michigan Medicine and 30,000 subjects in the United States and South America. It is anticipated that two additional vaccine trials will come on board at Michigan Medicine over the next several months.
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Dr. Philip Choi Interviewed by USA Today About Miracle Recovery of COVID-19 Patient
Philip Choi, MD, MA was interviewed by USA Today regarding his care of a 67 year old patient, Deanna Hair, who spent 196 days in the hospital fighting COVID-19 complications. "While hospitalized, she had infections in her chest and belly, pneumonia in her lungs, and became septic when her kidneys started to fail," Choi said. Read more.
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Research Partnership with the Veterans Affairs Hospital
Single-Cell RNA Sequencing of White Blood Cells From COVID-19 Patients
Jane Deng, MD, MS; Michal Olszewski, DVM, PhD; and Jintao Xu, PhD are leveraging novel single-cell RNA sequencing technology to help understand how different immune pathways are activated in patients with mild versus severe lung injury from COVID-19. The results may help us pinpoint new immune targets to "neutralize" to decrease the severity of lung injury, while preserving the immune system's ability to fight off the viral infection.
Neutrophils and Lung Injury During COVID-19 Infection
Jane Deng, MD, MS and Christine Freeman, PhD are leading a team to understand how neutrophils lead to severe lung injury, which is the major cause of death from COVID-19 infections. In addition, they will test whether novel peptides designed by their collaborator Gerard Wong, PhD, Professor of Engineering at UCLA, can block SARS-CoV-2 viral infection of lung cells and neutrophil products that cause lung epithelial cell death. These peptides potentially can be used therapeutically to combat severe COVID-19 and other viral infections.
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U.S. News & World Report Rating Best Hospital 2020 Rating
U.S. News and World Report ranked our Division #8 on their 2020-2021 Best Hospitals list. This up from #10 last year. Read more.
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Michigan Medicine Department of Internal Medicine 2020 Awards
Robert Dickson, MD - Jerome Conn Award for Excellence in Research
Jakob McSparron, MD - H. Marvin Pollard for Outstanding Teaching of House Officers, Chairs Award for Impact
Richard Simon, MD - Chair’s Award for Outstanding Service to the Department
Theodore Standiford, MD - Chairs Award for Impact
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Vibha Lama, MD, MS was named the new Michigan Medicine Department of Internal Medicine Vice Chair for Basic and Translational Research. Read more.
Bethany Moore, PhD was the recipient of the inaugural Michigan Medicine Nancy Williams Walls Professor of Microbiology and Immunology. Read more.
Thomas Sisson, MD was selected for membership in the Michigan Chapter of the Gold Humanism Honor Society by the faculty, house officers, and student members of the Michigan Chapter.
Rachel Zemans, MD was highlighted in a recent press release by the American Thoracic Society. Read more.
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Kevin Chan, MD, graduate of Wayne State University (WSU) School of Medicine, received WSU's 2020 Distinguished Alumni Award. The award is presented annually to individuals who have received their MD degree from WSU School of Medicine, that have made outstanding contributions to humanitarian causes, and whose contributions to the health field in the broader sense is outstanding. Read more.
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Muhammad Sajawal Ali, MBBS, MS joined our faculty as Clinical Assistant Professor in August. Dr. Ali earned his MBBS from Aga Khan University in 2010 then completed an internship at Jinnah Hospital in Lahore in 2012. Subsequently, he completed his residency in internal medicine at Cook County in Chicago. He then earned his MS in Clinical Research from Rush University in 2016. Dr. Ali completed his fellowship in PCCM at the Medical College of Wisconsin and interventional pulmonary fellowship at Harvard University this past year. Dr. Ali is joining our interventional pulmonology group, and brings specific expertise in pleural disease and therapeutic and diagnostic bronchoscopy.
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Mina Pirzadeh, MD joined our faculty as a Clinical Assistant Professor in July. Dr. Pirzadeh received her BS in Neuroscience from the University of Michigan in 2010 and her MD from Wayne State University in 2014. She performed her residency in internal medicine at Boston Medical Center and completed her fellowship in PCCM at the University of Michigan in June 2020. Dr. Pirzadeh has clinical interests in smoking-related lung disease and her clinical activities will be focused primarily at the Ann Arbor VAMC. Mina will also serve as co-lead of the outpatient pulmonary service at the VAAAHS and as virtual care champion for the PCCM Division.
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The Joseph P. Lynch III Endowed Fellowship Fund
The Joseph P. Lynch III Endowed Fellowship fund provides support for fellowship activities, including support for travel and participation in scientific meetings and other educational activities. The ultimate goal is for the fund to reach $500,000 to ensure that the program continues to provide the best to our fellows. Please consider supporting to help reach our goal! The division continues to match contributions up to $100,000. To give, please click here.
The Karen Rappleye Fund
The Karen Rappleye Fund has been established to honor the life of Karen Rappleye, who passed away on September 16, 2020. The purpose of this fund is to support initiatives to improve the quality of care for patients with chronic lung disease. To give, please click here.
If you have questions regarding these funds or how to contribute, please contact our development partner, Andrea LaFave at (734) 763-6173 or ajlafave@umich.edu.
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Michigan Medicine
Division of Pulmonary and Critical
Care Medicine
6220 MSRB III, SPC 5642
1150 West Medical Center Drive
Ann Arbor, MI 48109
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