Featured Publications
Reduced fixed dose tocilizumab 400 mg IV compared to weight-based dosing in critically ill patients with COVID-19: A before-after cohort study
Stukas S, Goshua G, Kinkade A, Grey R, Mah G, Biggs CM, Jamal S, Thiara S, Lau TTY, Piszczek J, Partovi N, Sweet DD, Lee AYY, Wellington CL, Sekhon MS, Chen LYC. Reduced fixed dose tocilizumab 400 mg IV compared to weight-based dosing in critically ill patients with COVID-19: A before-after cohort study. The Lancet Regional Health - Americas 2022, 11: 100228. PMID: 35345649, PMCID: PMC8941850, DOI: 10.1016/j.lana.2022.100228.Peer-Reviewed Original ResearchDoses of tocilizumabCohort studyClinical outcomesIll patientsIll COVID-19 patientsCOVID-19Interleukin-6 inhibitorsSevere COVID-19Weight-based dosingCOVID-19 patientsDrug shortagesNet monetary benefitMedian CRPControl cohortTocilizumabPatientsAssumed willingnessDexamethasoneComparable reductionMortalityPhysiological responsesSignificant differencesOnly groupDoseDoses
2022
Thrombosis questions from the inpatient wards
Goshua G, Bendapudi P, Lee A. Thrombosis questions from the inpatient wards. Hematology 2022, 2022: 481-490. PMID: 36485139, PMCID: PMC9819989, DOI: 10.1182/hematology.2022000384.Peer-Reviewed Original ResearchConceptsCancer-associated thrombosisInpatient wardsPurpura fulminansIntermediate-dose anticoagulationEtiology of thrombocytopeniaMajor clinical trialsCases of thrombosisCoronavirus disease 2019Recent prospective dataCOVID-19Antithrombin replacementAnticoagulation therapyAntiplatelet therapyAntithrombotic therapyAnticoagulation managementMicrovascular thrombosisPlasma transfusionHospitalized patientsAntiplatelet agentsThromboembolic diseasePlatelet countConsensus guidelinesProspective dataClinical trialsDisease 2019
2021
Increased complement activation is a distinctive feature of severe SARS-CoV-2 infection
Ma L, Sahu S, Cano M, Kuppuswamy V, Bajwa J, McPhatter J, Pine A, Meizlish M, Goshua G, Chang C, Zhang H, Price C, Bahel P, Rinder H, Lei T, Day A, Reynolds D, Wu X, Schriefer R, Rauseo A, Goss C, O’Halloran J, Presti R, Kim A, Gelman A, Dela Cruz C, Lee A, Mudd P, Chun H, Atkinson J, Kulkarni H. Increased complement activation is a distinctive feature of severe SARS-CoV-2 infection. Science Immunology 2021, 6: eabh2259. PMID: 34446527, PMCID: PMC8158979, DOI: 10.1126/sciimmunol.abh2259.Peer-Reviewed Original ResearchConceptsSevere SARS-CoV-2 infectionSARS-CoV-2 infectionIntensive care unitComplement activationRespiratory failureEndothelial injuryCOVID-19Non-COVID cohortPersonalized clinical trialsAcute respiratory failureInvasive mechanical ventilationSevere COVID-19Tertiary care centerAlternative complement pathwayICU admissionCritical illnessCare unitMechanical ventilationRisk prognosticationWashington University SchoolWorse outcomesCare centerClinical trialsHigh riskPatientsA neutrophil activation signature predicts critical illness and mortality in COVID-19
Meizlish ML, Pine AB, Bishai JD, Goshua G, Nadelmann ER, Simonov M, Chang CH, Zhang H, Shallow M, Bahel P, Owusu K, Yamamoto Y, Arora T, Atri DS, Patel A, Gbyli R, Kwan J, Won CH, Dela Cruz C, Price C, Koff J, King BA, Rinder HM, Wilson FP, Hwa J, Halene S, Damsky W, van Dijk D, Lee AI, Chun HJ. A neutrophil activation signature predicts critical illness and mortality in COVID-19. Blood Advances 2021, 5: 1164-1177. PMID: 33635335, PMCID: PMC7908851, DOI: 10.1182/bloodadvances.2020003568.Peer-Reviewed Original ResearchConceptsCritical illnessHealth system databaseNeutrophil activationCOVID-19Neutrophil activation signatureSevere COVID-19Intensive care unitGranulocyte colony-stimulating factorHigh mortality rateColony-stimulating factorSystem databaseHepatocyte growth factorClinical decompensationNeutrophil countImmune hyperactivationCare unitEarly elevationLipocalin-2Interleukin-8Longitudinal cohortClinical dataMortality ratePatientsIllnessActivation signatureIntermediate‐dose anticoagulation, aspirin, and in‐hospital mortality in COVID‐19: A propensity score‐matched analysis
Meizlish ML, Goshua G, Liu Y, Fine R, Amin K, Chang E, DeFilippo N, Keating C, Liu Y, Mankbadi M, McManus D, Wang SY, Price C, Bona RD, Chaar C, Chun HJ, Pine AB, Rinder HM, Siner JM, Neuberg DS, Owusu KA, Lee AI. Intermediate‐dose anticoagulation, aspirin, and in‐hospital mortality in COVID‐19: A propensity score‐matched analysis. American Journal Of Hematology 2021, 96: 471-479. PMID: 33476420, PMCID: PMC8013588, DOI: 10.1002/ajh.26102.Peer-Reviewed Original ResearchConceptsProphylactic-dose anticoagulationAntiplatelet therapyHospital deathCumulative incidenceMultivariable regression modelsHospital mortalityHospitalized adult COVID-19 patientsAdult COVID-19 patientsPropensity score-matched patientsPropensity score-matched analysisCOVID-19Intensive antithrombotic therapyIntermediate-dose anticoagulationCohort of patientsCOVID-19 patientsPatient-specific covariatesAnticoagulation cohortAspirin cohortDose anticoagulationAntithrombotic therapyThrombotic complicationsHospitalized patientsPrimary outcomeIllness severityRegression models
2020
Admission Rothman Index, Aspirin, and Intermediate Dose Anticoagulation Effects on Outcomes in COVID-19: A Multi-Site Propensity Matched Analysis
Goshua G, Liu Y, Meizlish M, Fine R, Amin K, Chang E, Liu Y, McManus D, Petrosan A, Chaar C, Chun H, Defilippo N, Neuberg D, Owusu K, Lee A. Admission Rothman Index, Aspirin, and Intermediate Dose Anticoagulation Effects on Outcomes in COVID-19: A Multi-Site Propensity Matched Analysis. Blood 2020, 136: 23-24. PMCID: PMC8330288, DOI: 10.1182/blood-2020-143349.Peer-Reviewed Original ResearchIntermediate-dose anticoagulationAnti-platelet therapyAnticoagulation cohortOverall cohortMultivariable regression modelingRothman IndexDose anticoagulationHospital deathD-dimerPropensity scoreHospitalized patientsMechanical ventilationClinical trialsCOVID-19Prophylactic-dose anticoagulationRisk-stratified algorithmUse of aspirinChronic kidney diseasePropensity-Matched AnalysisEfficacy of aspirinSeverity of illnessAnti-platelet agentsMulti-site cohortImpact of aspirinSmall vessel thrombosisEndotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study
Goshua G, Pine AB, Meizlish ML, Chang CH, Zhang H, Bahel P, Baluha A, Bar N, Bona RD, Burns AJ, Dela Cruz CS, Dumont A, Halene S, Hwa J, Koff J, Menninger H, Neparidze N, Price C, Siner JM, Tormey C, Rinder HM, Chun HJ, Lee AI. Endotheliopathy in COVID-19-associated coagulopathy: evidence from a single-centre, cross-sectional study. The Lancet Haematology 2020, 7: e575-e582. PMID: 32619411, PMCID: PMC7326446, DOI: 10.1016/s2352-3026(20)30216-7.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBetacoronavirusBiomarkersBlood Coagulation DisordersCoronavirus InfectionsCOVID-19Critical IllnessCross-Sectional StudiesEndothelium, VascularFemaleFollow-Up StudiesHumansIntensive Care UnitsMaleMiddle AgedPandemicsPneumonia, ViralPrognosisSARS-CoV-2Vascular DiseasesYoung AdultConceptsCOVID-19-associated coagulopathyNon-ICU patientsIntensive care unitKaplan-Meier analysisSoluble P-selectinCross-sectional studyPlatelet activationHospital dischargeICU patientsSoluble thrombomodulinEndothelial cellsVWF antigenCOVID-19P-selectinSingle-center cross-sectional studyLaboratory-confirmed COVID-19Medical intensive care unitSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogenesisVon Willebrand factor antigenSoluble thrombomodulin concentrationsVWF antigen concentrationEndothelial cell injurySoluble CD40 ligandMicrovascular complicationsAdult patients