Response to COVID
Response to COVID
Training During COVID-19
Despite these strange and trying times, here at MGH we are committed to providing our trainees with high quality training without forfeiting their health or safety. While the rates of COVID-19 in the state of Massachusetts are now among the lowest in the country, we are continuing to follow certain precautions for the time being.
Anatomic Pathology
In early March, as cases started peaking in Massachusetts and the hospital changed their policies to limit elective procedures, the AP services and residency program modified their operations in several ways to provide for continuity of care while preserving the safety of all department members.
- All residents’ working spaces were reassigned to provide adequate social distancing, a system that is still in place.
- Provided meals (lunch) were modified to an individually packed format and maintained for all in-house residents.
- During the peak of the surge in Massachusetts, most residents were assigned to work from home.
- A team of trainees (a senior and a junior resident, with a third one on back-up hold) were considered essential personnel and covered the frozen sections and autopsy services. Procedures in these sections were modified to ensure adequate safety precautions, guided by our hospital’s infection control team.
- All other services were covered by attendings, but residents still participated on their originally scheduled rotations by logging into remote sign out daily, via Microsoft Teams or Zoom.
- All consensus conferences and tumor boards were transitioned to a virtual format, and links were provided to all trainees. Residents and fellows were able to attend different conferences during the day, regardless of their originally scheduled rotation, to maximize learning while working from home.
- All didactic conferences were maintained and transitioned to a virtual format
- Residents were also encouraged to use other educational materials available online, which were curated in our internal page, Learn Pathology. Materials hosted in this site include our large collection of virtual slides grouped into study sets, which is accessible from anywhere.
Now that we are all back to work in the hospital, some of our measures to ensure everyone’s safety are still in place, including remote sign out and virtual conferences, as well as physically distant desk distribution. At the same time, we continue to take steps to maintain the high standard of education that we are known for at MGH. To facilitate a positive experience, each resident (and most faculty members) has been provided with their own webcam and microphone to use at their desk. By now, our residents and faculty have become well versed in using Zoom and Microsoft Teams!
Clinical Pathology
During the COVID-19 surge the CP residency program restructured its curriculum in the following ways:
- All teaching conferences and resident meetings immediately transitioned to an online format
- A rotation schedule was established for the Microbiology and Chemistry lab rotation, to minimize exposure and ensure safe distancing. This allowed time for the residents working remotely to contribute to a series of COVID-19-related research projects and community studies. Residents were actively involved in the validation and verification of various in-house COVID-19 laboratory tests.
- The Transfusion Medicine service came up with detailed guidelines to minimize exposure of residents and fellows to potential COVID-19 cases. Daily rounds and teaching conferences became virtual. Residents and fellows were able to remain on site, as safe distancing in our new resident room was secured.
- The Molecular Pathology rotation managed to come up with an entirely new, virtual curriculum in the course of few days. The residents and fellows initiated and contributed to COVID-19 research projects and community studies, in collaboration with the Microbiology residents.
- The Coagulation service became fully virtual with previewing, sign outs, and teaching all occurring remotely. Thus, despite the increase in volume of samples, service remained unaffected. Residents set up and completed their own clinical studies on COVID-19 and coagulopathies.
- Residents on research electives devoted their time to the validation of COVID-19 tests putting together a multidisciplinary team across various MGH departments and the administration of the City of Boston.
COVID-19 Research and Projects
Trainee Publications
- Strong homology between SARS-CoV-2 envelope protein and a Mycobacterium sp. antigen allows rapid diagnosis of Mycobacterial infections and may provide specific anti-SARS-CoV-2 immunity via the BCG vaccine.
Nuovo G, Tili E, Suster D, Matys E, Hupp L, Magro C.
Ann Diagn Pathol. 2020 Aug 13;48:151600. doi: 10.1016/j.anndiagpath.2020.151600. Online ahead of print.
PMID: 32805515 Free PMC article. - The Future of Pathology: What can we Learn from the COVID-19 Pandemic?
Williams BJ, Fraggetta F, Hanna MG, Huang R, Lennerz J, Salgado R, Sirintrapun SJ, Pantanowitz L, Parwani A, Zarella M, Treanor DE.
J Pathol Inform. 2020 Jun 9;11:15. doi: 10.4103/jpi.jpi_29_20. eCollection 2020.
PMID: 32685256 Free PMC article. No abstract available. - Dynamics and significance of the antibody response to SARS-CoV-2 infection.
Iyer AS, Jones FK, Nodoushani A, Kelly M, Becker M, Slater D, Mills R, Teng E, Kamruzzaman M, Garcia-Beltran WF, Astudillo M, Yang D, Miller TE, Oliver E, Fischinger S, Atyeo C, Iafrate AJ, Calderwood SB, Lauer SA, Yu J, Li Z, Feldman J, Hauser BM, Caradonna TM, Branda JA, Turbett SE, LaRocque RC, Mellon G, Barouch DH, Schmidt AG, Azman AS, Alter G, Ryan ET, Harris JB, Charles RC.
medRxiv. 2020 Jul 20:2020.07.18.20155374. doi: 10.1101/2020.07.18.20155374. Preprint.
PMID: 32743600 Free PMC article. - Peripheral blood morphologic findings in patients with COVID-19.
Sadigh S, Massoth LR, Christensen BB, Stefely JA, Keefe J, Sohani AR.
Int J Lab Hematol. 2020 Jul 30. doi: 10.1111/ijlh.13300. Online ahead of print.
PMID: 32730694 No abstract available. - Marked factor V activity elevation in severe COVID-19 is associated with venous thromboembolism.
Stefely JA, Christensen BB, Gogakos T, Cone Sullivan JK, Montgomery GG, Barranco JP, Van Cott EM.
Am J Hematol. 2020 Aug 24. doi: 10.1002/ajh.25979. Online ahead of print.
PMID: 32833259 - Outcomes from an infectious disease physician-guided evaluation of hospitalized persons under investigation for COVID-19 at a large US academic medical center.
Dugdale CM, Turbett SE, McCluskey SM, Zachary KC, Shenoy ES, Ciaranello AL, Walensky RP, Rosenberg ES, Anahtar MN, Hooper DC, Hyle EP.
Infect Control Hosp Epidemiol. 2020 Aug 24:1-10. doi: 10.1017/ice.2020.434. Online ahead of print.
PMID: 32829726 - Comparison of RNA In Situ Hybridization and Immunohistochemistry Techniques for the Detection and Localization of SARS-CoV-2 in Human Tissues.
Massoth LR, Desai N, Szabolcs A, Harris CK, Neyaz A, Crotty R, Chebib I, Rivera MN, Sholl LM, Stone JR, Ting DT, Deshpande V.
Am J Surg Pathol. 2020 Aug 20. doi: 10.1097/PAS.0000000000001563. Online ahead of print.
PMID: 32826529 - Clinical sensitivity and interpretation of PCR and serological COVID-19 diagnostics for patients presenting to the hospital.
Miller TE, Garcia Beltran WF, Bard AZ, Gogakos T, Anahtar MN, Astudillo MG, Yang D, Thierauf J, Fisch AS, Mahowald GK, Fitzpatrick MJ, Nardi V, Feldman J, Hauser BM, Caradonna TM, Marble HD, Ritterhouse LL, Turbett SE, Batten J, Georgantas NZ, Alter G, Schmidt AG, Harris JB, Gelfand JA, Poznansky MC, Bernstein BE, Louis DN, Dighe A, Charles RC, Ryan ET, Branda JA, Pierce VM, Murali MR, Iafrate AJ, Rosenberg ES, Lennerz JK.
FASEB J. 2020 Aug 28. doi: 10.1096/fj.202001700RR. Online ahead of print.
PMID: 32856766 - Evaluation of SARS-CoV-2 serology assays reveals a range of test performance.
Whitman JD, Hiatt J, Mowery CT, Shy BR, Yu R, Yamamoto TN, Rathore U, Goldgof GM, Whitty C, Woo JM, Gallman AE, Miller TE, Levine AG, Nguyen DN, Bapat SP, Balcerek J, Bylsma SA, Lyons AM, Li S, Wong AW, Gillis-Buck EM, Steinhart ZB, Lee Y, Apathy R, Lipke MJ, Smith JA, Zheng T, Boothby IC, Isaza E, Chan J, Acenas DD 2nd, Lee J, Macrae TA, Kyaw TS, Wu D, Ng DL, Gu W, York VA, Eskandarian HA, Callaway PC, Warrier L, Moreno ME, Levan J, Torres L, Farrington LA, Loudermilk RP, Koshal K, Zorn KC, Garcia-Beltran WF, Yang D, Astudillo MG, Bernstein BE, Gelfand JA, Ryan ET, Charles RC, Iafrate AJ, Lennerz JK, Miller S, Chiu CY, Stramer SL, Wilson MR, Manglik A, Ye CJ, Krogan NJ, Anderson MS, Cyster JG, Ernst JD, Wu AHB, Lynch KL, Bern C, Hsu PD, Marson A.
Nat Biotechnol. 2020 Aug 27. doi: 10.1038/s41587-020-0659-0. Online ahead of print.
PMID: 32855547 - Hematology Laboratory Abnormalities in Patients with Coronavirus Disease 2019 (COVID-19).
Christensen B, Favaloro EJ, Lippi G, Van Cott EM.
Semin Thromb Hemost. 2020 Sep 2. doi: 10.1055/s-0040-1715458. Online ahead of print.
PMID: 32877961 - Phylogenetic analysis of SARS-CoV-2 in the Boston area highlights the role of recurrent importation and superspreading events.
Lemieux J, Siddle KJ, Shaw BM, Loreth C, Schaffner S, Gladden-Young A, Adams G, Fink T, Tomkins-Tinch CH, Krasilnikova LA, Deruff KC, Rudy M, Bauer MR, Lagerborg KA, Normandin E, Chapman SB, Reilly SK, Anahtar MN, Lin AE, Carter A, Myhrvold C, Kemball M, Chaluvadi S, Cusick C, Flowers K, Neumann A, Cerrato F, Farhat M, Slater D, Harris JB, Branda J, Hooper D, Gaeta JM, Baggett TP, O'Connell J, Gnirke A, Lieberman TD, Philippakis A, Burns M, Brown C, Luban J, Ryan ET, Turbett SE, LaRocque RC, Hanage WP, Gallagher G, Madoff LC, Smole S, Pierce VM, Rosenberg ES, Sabeti P, Park DJ, MacInnis BL.
medRxiv. 2020 Aug 25:2020.08.23.20178236. doi: 10.1101/2020.08.23.20178236. Preprint.
PMID: 32869040 Free PMC article. - High seroprevalence of anti-SARS-CoV-2 antibodies in Chelsea, Massachusetts.
Naranbhai V, Chang CC, Beltran WFG, Miller TE, Astudillo MG, Villalba JA, Yang D, Gelfand J, Bernstein BE, Feldman J, Hauser BM, Caradonna TM, Alter G, Murali MR, Jasrasaria R, Quinlan J, Xerras DC, Betancourt JR, Louis DN, Schmidt AG, Lennerz J, Poznansky MC, Iafrate AJ.
J Infect Dis. 2020 Sep 9:jiaa579. doi: 10.1093/infdis/jiaa579. Online ahead of print.
PMID: 32906151
Faculty Publications
- Case 22-2020: A 62-Year-Old Woman with Early Breast Cancer during the Covid-19 Pandemic.
Spring LM, Specht MC, Jimenez RB, Isakoff SJ, Wang GX, Ly A, Shin JA, Bardia A, Moy B.
N Engl J Med. 2020 Jul 1. doi: 10.1056/NEJMcpc2002422. [Epub ahead of print] No abstract available.
PMID: 32610007 [PubMed - as supplied by publisher] - Case 23-2020: A 76-Year-Old Woman Who Died from Covid-19.
Stone JR, Tran KM, Conklin J, Mino-Kenudson M.
N Engl J Med. 2020 Jul 8. doi: 10.1056/NEJMcpc2004974. [Epub ahead of print] No abstract available.
PMID: 32640127 [PubMed - as supplied by publisher] - The Future of Pathology: What can we Learn from the COVID-19 Pandemic?
Williams BJ, Fraggetta F, Hanna MG, Huang R, Lennerz J, Salgado R, Sirintrapun SJ, Pantanowitz L, Parwani A, Zarella M, Treanor DE.
J Pathol Inform. 2020 Jun 9;11:15. doi: 10.4103/jpi.jpi_29_20. eCollection 2020.
PMID: 32685256 Free PMC article. No abstract available. - Presymptomatic Transmission of SARS-CoV-2 Amongst Residents and Staff at a Skilled Nursing Facility: Results of Real-Time PCR and Serologic Testing.
Goldberg SA, Lennerz J, Klompas M, Mark E, Pierce VM, Thompson RW, Pu CT, Ritterhouse LL, Dighe A, Rosenberg ES, Grabowski DC.
Clin Infect Dis. 2020 Jul 15:ciaa991. doi: 10.1093/cid/ciaa991. Online ahead of print.
PMID: 32667967 - Coagulation Status and Venous Thromboembolism Risk in African Americans: A Potential Risk Factor in COVID-19.
Frydman GH, Boyer EW, Nazarian RM, Van Cott EM, Piazza G.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620943671. doi: 10.1177/1076029620943671.
PMID: 32702995 - Dynamics and significance of the antibody response to SARS-CoV-2 infection.
Iyer AS, Jones FK, Nodoushani A, Kelly M, Becker M, Slater D, Mills R, Teng E, Kamruzzaman M, Garcia-Beltran WF, Astudillo M, Yang D, Miller TE, Oliver E, Fischinger S, Atyeo C, Iafrate AJ, Calderwood SB, Lauer SA, Yu J, Li Z, Feldman J, Hauser BM, Caradonna TM, Branda JA, Turbett SE, LaRocque RC, Mellon G, Barouch DH, Schmidt AG, Azman AS, Alter G, Ryan ET, Harris JB, Charles RC.
medRxiv. 2020 Jul 20:2020.07.18.20155374. doi: 10.1101/2020.07.18.20155374. Preprint.
PMID: 32743600 Free PMC article. - Cerebral Microvascular Injury in Severe COVID-19.
Conklin J, Frosch MP, Mukerji S, Rapalino O, Maher M, Schaefer PW, Lev MH, Gonzalez RG, Das S, Champion SN, Magdamo C, Sen P, Harrold GK, Alabsi H, Normandin E, Shaw B, Lemieux J, Sabeti P, Branda JA, Brown EN, Westover MB, Huang SY, Edlow BL.
medRxiv. 2020 Jul 24:2020.07.21.20159376. doi: 10.1101/2020.07.21.20159376. Preprint.
PMID: 32743599 Free PMC article. - SARS-CoV-2 can infect the placenta and is not associated with specific placental histopathology: a series of 19 placentas from COVID-19-positive mothers.
Hecht JL, Quade B, Deshpande V, Mino-Kenudson M, Ting DT, Desai N, Dygulska B, Heyman T, Salafia C, Shen D, Bates SV, Roberts DJ.
Mod Pathol. 2020 Aug 2:1-12. doi: 10.1038/s41379-020-0639-4. Online ahead of print.
PMID: 32741970 Free PMC article. - Peripheral blood morphologic findings in patients with COVID-19.
Sadigh S, Massoth LR, Christensen BB, Stefely JA, Keefe J, Sohani AR.
Int J Lab Hematol. 2020 Jul 30. doi: 10.1111/ijlh.13300. Online ahead of print.
PMID: 32730694 No abstract available. - Temporal and Spatial Heterogeneity of Host Response to SARS-CoV-2 Pulmonary Infection.
Desai N, Neyaz A, Szabolcs A, Shih AR, Chen JH, Thapar V, Nieman LT, Solovyov A, Mehta A, Lieb DJ, Kulkarni AS, Jaicks C, Pinto CJ, Juric D, Chebib I, Colvin RB, Kim AY, Monroe R, Warren SE, Danaher P, Reeves JW, Gong J, Rueckert EH, Greenbaum BD, Hacohen N, Lagana SM, Rivera MN, Sholl LM, Stone JR, Ting DT, Deshpande V.
medRxiv. 2020 Aug 2:2020.07.30.20165241. doi: 10.1101/2020.07.30.20165241. Preprint.
PMID: 32766600 Free PMC article. - Strong homology between SARS-CoV-2 envelope protein and a Mycobacterium sp. antigen allows rapid diagnosis of Mycobacterial infections and may provide specific anti-SARS-CoV-2 immunity via the BCG vaccine.
Nuovo G, Tili E, Suster D, Matys E, Hupp L, Magro C.
Ann Diagn Pathol. 2020 Aug 13;48:151600. doi: 10.1016/j.anndiagpath.2020.151600. Online ahead of print.
PMID: 32805515 Free PMC article. - AKI and Collapsing Glomerulopathy Associated with COVID-19 and APOL 1 High-Risk Genotype.
Wu H, Larsen CP, Hernandez-Arroyo CF, Mohamed MMB, Caza T, Sharshir M, Chughtai A, Xie L, Gimenez JM, Sandow TA, Lusco MA, Yang H, Acheampong E, Rosales IA, Colvin RB, Fogo AB, Velez JCQ.
J Am Soc Nephrol. 2020 Aug;31(8):1688-1695. doi: 10.1681/ASN.2020050558. Epub 2020 Jun 19.
PMID: 32561682 - Marked factor V activity elevation in severe COVID-19 is associated with venous thromboembolism.
Stefely JA, Christensen BB, Gogakos T, Cone Sullivan JK, Montgomery GG, Barranco JP, Van Cott EM.
Am J Hematol. 2020 Aug 24. doi: 10.1002/ajh.25979. Online ahead of print.
PMID: 32833259 - Outcomes from an infectious disease physician-guided evaluation of hospitalized persons under investigation for COVID-19 at a large US academic medical center.
Dugdale CM, Turbett SE, McCluskey SM, Zachary KC, Shenoy ES, Ciaranello AL, Walensky RP, Rosenberg ES, Anahtar MN, Hooper DC, Hyle EP.
Infect Control Hosp Epidemiol. 2020 Aug 24:1-10. doi: 10.1017/ice.2020.434. Online ahead of print.
PMID: 32829726 - Discovery of ACE2 receptors for SARS-CoV-2 (COVID-19) on peripheral small-fiber sensory neurons of uncertain clinical significance.
Oaklander AL.
Pain. 2020 Aug 18. doi: 10.1097/j.pain.0000000000002050. Online ahead of print.
PMID: 32826753 No abstract available. - Comparison of RNA In Situ Hybridization and Immunohistochemistry Techniques for the Detection and Localization of SARS-CoV-2 in Human Tissues.
Massoth LR, Desai N, Szabolcs A, Harris CK, Neyaz A, Crotty R, Chebib I, Rivera MN, Sholl LM, Stone JR, Ting DT, Deshpande V.
Am J Surg Pathol. 2020 Aug 20. doi: 10.1097/PAS.0000000000001563. Online ahead of print.
PMID: 32826529 - Clinical sensitivity and interpretation of PCR and serological COVID-19 diagnostics for patients presenting to the hospital.
Miller TE, Garcia Beltran WF, Bard AZ, Gogakos T, Anahtar MN, Astudillo MG, Yang D, Thierauf J, Fisch AS, Mahowald GK, Fitzpatrick MJ, Nardi V, Feldman J, Hauser BM, Caradonna TM, Marble HD, Ritterhouse LL, Turbett SE, Batten J, Georgantas NZ, Alter G, Schmidt AG, Harris JB, Gelfand JA, Poznansky MC, Bernstein BE, Louis DN, Dighe A, Charles RC, Ryan ET, Branda JA, Pierce VM, Murali MR, Iafrate AJ, Rosenberg ES, Lennerz JK.
FASEB J. 2020 Aug 28. doi: 10.1096/fj.202001700RR. Online ahead of print.
PMID: 32856766 - Evaluation of SARS-CoV-2 serology assays reveals a range of test performance.
Whitman JD, Hiatt J, Mowery CT, Shy BR, Yu R, Yamamoto TN, Rathore U, Goldgof GM, Whitty C, Woo JM, Gallman AE, Miller TE, Levine AG, Nguyen DN, Bapat SP, Balcerek J, Bylsma SA, Lyons AM, Li S, Wong AW, Gillis-Buck EM, Steinhart ZB, Lee Y, Apathy R, Lipke MJ, Smith JA, Zheng T, Boothby IC, Isaza E, Chan J, Acenas DD 2nd, Lee J, Macrae TA, Kyaw TS, Wu D, Ng DL, Gu W, York VA, Eskandarian HA, Callaway PC, Warrier L, Moreno ME, Levan J, Torres L, Farrington LA, Loudermilk RP, Koshal K, Zorn KC, Garcia-Beltran WF, Yang D, Astudillo MG, Bernstein BE, Gelfand JA, Ryan ET, Charles RC, Iafrate AJ, Lennerz JK, Miller S, Chiu CY, Stramer SL, Wilson MR, Manglik A, Ye CJ, Krogan NJ, Anderson MS, Cyster JG, Ernst JD, Wu AHB, Lynch KL, Bern C, Hsu PD, Marson A.
Nat Biotechnol. 2020 Aug 27. doi: 10.1038/s41587-020-0659-0. Online ahead of print.
PMID: 32855547 - Hematology Laboratory Abnormalities in Patients with Coronavirus Disease 2019 (COVID-19).
Christensen B, Favaloro EJ, Lippi G, Van Cott EM.
Semin Thromb Hemost. 2020 Sep 2. doi: 10.1055/s-0040-1715458. Online ahead of print.
PMID: 32877961 - Phylogenetic analysis of SARS-CoV-2 in the Boston area highlights the role of recurrent importation and superspreading events.
Lemieux J, Siddle KJ, Shaw BM, Loreth C, Schaffner S, Gladden-Young A, Adams G, Fink T, Tomkins-Tinch CH, Krasilnikova LA, Deruff KC, Rudy M, Bauer MR, Lagerborg KA, Normandin E, Chapman SB, Reilly SK, Anahtar MN, Lin AE, Carter A, Myhrvold C, Kemball M, Chaluvadi S, Cusick C, Flowers K, Neumann A, Cerrato F, Farhat M, Slater D, Harris JB, Branda J, Hooper D, Gaeta JM, Baggett TP, O'Connell J, Gnirke A, Lieberman TD, Philippakis A, Burns M, Brown C, Luban J, Ryan ET, Turbett SE, LaRocque RC, Hanage WP, Gallagher G, Madoff LC, Smole S, Pierce VM, Rosenberg ES, Sabeti P, Park DJ, MacInnis BL.
medRxiv. 2020 Aug 25:2020.08.23.20178236. doi: 10.1101/2020.08.23.20178236. Preprint.
PMID: 32869040 Free PMC article. - A Possible Case of Vertical Transmission of SARS-CoV-2 in a Newborn with Positive Placental In Situ Hybridization of SARS-CoV-2 RNA.
Alamar I, Abu-Arja MH, Heyman T, Roberts DJ, Desai N, Narula P, Dygulska B.
J Pediatric Infect Dis Soc. 2020 Sep 5:piaa109. doi: 10.1093/jpids/piaa109. Online ahead of print.
PMID: 32888013 No abstract available. - High seroprevalence of anti-SARS-CoV-2 antibodies in Chelsea, Massachusetts.
Naranbhai V, Chang CC, Beltran WFG, Miller TE, Astudillo MG, Villalba JA, Yang D, Gelfand J, Bernstein BE, Feldman J, Hauser BM, Caradonna TM, Alter G, Murali MR, Jasrasaria R, Quinlan J, Xerras DC, Betancourt JR, Louis DN, Schmidt AG, Lennerz J, Poznansky MC, Iafrate AJ.
J Infect Dis. 2020 Sep 9:jiaa579. doi: 10.1093/infdis/jiaa579. Online ahead of print.
PMID: 32906151 - Going remote: Maintaining normalcy in our pathology laboratories during the COVID‐19 pandemic
Emilio Madrigal DO
First published: 07 April 2020 https://doi.org/10.1002/cncy.22276