Researchers in NYU Langone’s Division of Pulmonary, Critical Care, and Sleep Medicine are conducting research to better understand 2019 coronavirus disease (COVID-19), its impact on patients, and potential therapies.

Potential Medications for Treating COVID-19

Daniel H. Sterman, MD, serves as principal investigator at NYU Langone for a multicenter study on the safety of the anti–IL-6 receptor monoclonal antibody sarilumab in patients with COVID-19 to assess whether it can decrease the duration of disease symptoms. He is also studying the effects of tocilizumab, another anti–IL-6 receptor monoclonal antibody, for the treatment of acute hypoxic respiratory failure in people with the illness. As part of a multicenter trial, Dr. Sterman is evaluating intravenous aviptadil, a vasoactive intestinal polypeptide, for patients with COVID-19 and respiratory failure.

Another study, led by Jan Bakker, MD, PhD, is investigating the effects of CytoSorb, a blood purification therapy that may help manage the cytokine storm associated with COVID-19 severity in patients admitted to the intensive care unit (ICU). David A. Kaufman, MD, is studying the effects of inhaled corticosteroids and long acting beta agonists in patients admitted with pneumonia, including those with COVID-19.

Sam Parnia, MD, PhD, is investigating immune modulators, including stem cell therapies, to help minimize the overactive immune response to SARS-CoV-2 in hospitalized patients through Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) 1, coordinated by the Foundation of National Institutes of Health (NIH). In ACTIV 3, he is testing multiple therapies, starting with monoclonal antibodies, in hospitalized adults with COVID-19.

As part of an international team of researchers, Dr. Parnia is conducting an adaptive clinical trial, a Randomized, Multifactorial, Embedded, Adaptive Platform Trial for Community-Acquired Pneumonia (REMAP-CAP) to evaluate multiple treatments for COVID-19. He is also investigating the safety and efficacy of remestemcel-L, or mesenchymal stromal cell treatment, versus placebo in patients with COVID-19 and moderate to severe acute respiratory distress syndrome.

Registry Information

Current clinical trials in this area of research include the following:

• Clinical Trials: Registry S20-00351, NCT04311697, NCT04422626, NCT04193878, NCT02735707

Ventilation and Respiratory Support

Anthony S. Lubinsky, MD and Dr. Kaufman are evaluating the interaction between dead space ventilation and biomarkers of abnormal coagulation and positive signals of clotting.

Dr. Kaufman is also studying bedside physiologic testing to optimize individualized ventilator settings in acute respiratory distress syndrome. Dr. Lubinsky is studying respiratory support with high flow nasal cannula and noninvasive ventilation in patients with COVID-19.

Diastolic Shock Index and Blood Volume

Dr. Bakker and Dr. Kaufman are assessing the relationship between diastolic shock index and mortality in patients with a confirmed SARS-CoV-2 infection who present in the emergency department of NYU Langone’s Tisch Hospital and are then admitted to the ICU.

The researchers are also studying the use of specialized software to calculate blood volume, volume of blood components, and capillary leak during the early phase of hospitalization of patients with SARS-CoV-2 infection.

Factors Influencing Morbidity and Mortality

Other topics Dr. Kaufman is investigating include the association between ferritin levels and the development of acute kidney injury resulting in the need for renal replacement therapy in ICU patients with COVID-19; the association of lactate levels >2 mmol/L with co-morbidities, pressor requirements, in-hospital mortality and disposition; and the immediate cause of and the events leading to the death in patients with COVID-19 infections, including co-morbidities, inflammatory markers, signs of end organ dysfunction, and interventions.

Dr. Kaufman is also helping to build a multicenter registry of patients hospitalized with COVID-19 that assesses patient factors, medical care factors, and medical interventions associated with better or worse outcomes. Innovative Bayesian analysis is allowing researchers to continually test and adjust hypotheses.

Selected Divisional COVID-19 Publications

Brosnahan SB, Jonkman AH, Kugler MC, Munger JS, Kaufman DA. COVID-19 and Respiratory System Disorders: Current Knowledge, Future Clinical and Translational Research Questions. Arterioscler Thromb Vasc Biol. 2020 Nov;40(11):2586-2597. 120.314515. Epub 2020 Sep 22. PMID: 32960072; PMCID: PMC7571846. DOI.

Brosnahan SB, Smilowitz NR, Amoroso NE, Barfield M, Berger JS, Goldenberg R, Ishida K, Talmor N, Torres J, Yaghi S, Yuriditsky E, Maldonado TS. Thrombosis at hospital presentation in patients with and without coronavirus disease 2019. J Vasc Surg Venous Lymphat Disord. 2020 Nov 10:S2213-333X(20)30625-9. Epub ahead of print. PMID: 33186750; PMCID: PMC7655032. DOI.

Yuriditsky E, Mitchell OJL, Brosnahan SB, Smilowitz NR, Drus KW, Gonzales AM, Xia Y, Parnia S, Horowitz JM. Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19. Resusc Plus. 2020 Dec; 4:100054. Epub 2020 Nov 21. PMID: 33403368; PMCID: PMC7680084. DOI.

Kwok B, Brosnahan SB, Amoroso NE, Goldenberg RM, Heyman B, Horowitz JM, Jamin C, Sista AK, Smith DE, Yuriditsky E, Maldonado TS. Pulmonary Embolism Response Team activation during the COVID-19 pandemic in a New York City Academic Hospital: a retrospective cohort analysis. J Thromb Thrombolysis. 2021 Feb;51(2):330-338. PMID: 32910409; PMCID: PMC7482370. DOI.

Yuriditsky E, Horowitz JM, Merchan C, Ahuja T, Brosnahan SB, McVoy L, Berger JS. Thromboelastography Profiles of Critically Ill Patients With Coronavirus Disease 2019. Crit Care Med. 2020 Sep;48(9):1319-1326. PMID: 32618696; PMCID: PMC7314320. DOI.

Brosnahan SB, Bhatt A, Berger JS, Yuriditsky E, Iturrate E, Amoroso NE. COVID-19 Pneumonia Hospitalizations Followed by Re-Presentation for Presumed Thrombotic Event. Chest. 2020 Oct;158(4):1665-1668. Epub 2020 Jun 23. PMID: 32589950; PMCID: PMC7309731. DOI.

Moores LK, Tritschler T, Brosnahan S, Carrier M, Collen JF, Doerschug K, Holley AB, Jimenez D, Le Gal G, Rali P, Wells P. Prevention, Diagnosis, and Treatment of VTE in Patients With Coronavirus Disease 2019: CHEST Guideline and Expert Panel Report. Chest. 2020 Sep;158(3):1143-1163. Epub 2020 Jun 2. PMID: 32502594; PMCID: PMC7265858. DOI.

Sulaiman I, Chung M, Angel L, Tsay JJ, Wu BG, Yeung ST, Krolikowski K, Li Y, Duerr R, Schluger R, Thannickal SA, Koide A, Rafeq S, Barnett C, Postelnicu R, Wang C, Banakis S, Perez-Perez L, Jour G, Shen G, Meyn P, Carpenito J, Liu X, Ji K, Collazo D, Labarbiera A, Amoroso N, Brosnahan S, Mukherjee V, Kaufman D, Bakker J, Lubinsky A, Pradhan D, Sterman DH, Weiden M, Hegu A, Evans L, Uyeki TM, Clemente JC, De Wit E, Schmidt AM, Shopsin B, Desvignes L, Wang C, Li H, Zhang B, Forst CV, Koide S, Stapleford KA, Khanna KM, Ghedin E, Segal LN. Microbial signatures in the lower airways of mechanically ventilated COVID19 patients associated with poor clinical outcome. medRxiv [Preprint]. 2021 Feb 26:2021.02.23.21252221. PMID: 33655261; PMCID: PMC7924286. DOI.

Charytan DM, Parnia S, Khatri M, Petrilli CM, Jones S, Benstein J, Horwitz LI. Decreasing Incidence of AKI in Patients with COVID-19 critical illness in New York City. Kidney Int Rep. 2021 Feb 4. Epub ahead of print. PMID: 33558853; PMCID: PMC7857986. DOI.

Berger JS, Kunichoff D, Adhikari S, Ahuja T, Amoroso N, Aphinyanaphongs Y, Cao M, Goldenberg R, Hindenburg A, Horowitz J, Parnia S, Petrilli C, Reynolds H, Simon E, Slater J, Yaghi S, Yuriditsky E, Hochman J, Horwitz LI. Prevalence and Outcomes of D-Dimer Elevation in Hospitalized Patients With COVID-19. Arterioscler Thromb Vasc Biol. 2020 Oct;40(10):2539-2547.120.314872. Epub 2020 Aug 25. PMID: 32840379; PMCID: PMC7505147. DOI.

Lewis TC, Adhikari S, Tatapudi V, Holub M, Kunichoff D, Troxel AB, Montgomery RA, Sterman DH. A Propensity-Matched Cohort Study of Tocilizumab in Patients With Coronavirus Disease 2019. Crit Care Explor. 2020 Nov 16;2(11):e0283. PMID: 33225307; PMCID: PMC7671881. DOI.

Mukherjee V, Toth AT, Fenianos M, Martell S, Karpel HC, Postelnicu R, Bhatt A, Deshwal H, Kreiger-Benson E, Brill K, Goldlust S, Nair S, Walsh BC, Ellenberg D, Magda G, Pradhan D, Uppal A, Hena K, Chitkara N, Alviar CL, Basavaraj A, Luoma K, Link N, Bails D, Addrizzo-Harris D, Sterman DH. Clinical Outcomes in Critically Ill Coronavirus Disease 2019 Patients: A Unique New York City Public Hospital Experience. Crit Care Explor. 2020 Aug 19;2(8):e0188. PMID: 32885172; PMCID: PMC7437795. DOI.

Boudourakis L, Uppal A. Decreased COVID-19 Mortality-A Cause for Optimism. JAMA Intern Med. 2020 Dec 22. Epub ahead of print. PMID: 33351074. DOI.