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COVID-19 pandemic impact on telehealth use and perceptions for atopic and respiratory disease: Survey results

Bukstein, Don A; Eghrari-Sabet, Jacqueline; Hart, Mary; Hill, Tanisha; Parikh, Purvi; Winders, Tonya A
PMID: 35524354
ISSN: 1539-6304
CID: 5213702

Insights from American College of Allergy, Asthma, and Immunology COVID-19 Vaccine Task Force: Allergic Reactions to mRNA SARS-CoV-2 Vaccines

Murphy, Kevin R; Patel, Niraj C; Ein, Daniel; Hudelson, Mary; Kodoth, Sangeetha; Marshall, Gailen D; Parikh, Purvi; Blaiss, Michael S
PMCID:7825848
PMID: 33493641
ISSN: 1534-4436
CID: 4792992

Immune-Based Prediction of COVID-19 Severity and Chronicity Decoded Using Machine Learning

Patterson, Bruce K; Guevara-Coto, Jose; Yogendra, Ram; Francisco, Edgar B; Long, Emily; Pise, Amruta; Rodrigues, Hallison; Parikh, Purvi; Mora, Javier; Mora-Rodríguez, Rodrigo A
Expression of CCR5 and its cognate ligands have been implicated in COVID-19 pathogenesis, consequently therapeutics directed against CCR5 are being investigated. Here, we explored the role of CCR5 and its ligands across the immunologic spectrum of COVID-19. We used a bioinformatics approach to predict and model the immunologic phases of COVID so that effective treatment strategies can be devised and monitored. We investigated 224 individuals including healthy controls and patients spanning the COVID-19 disease continuum. We assessed the plasma and isolated peripheral blood mononuclear cells (PBMCs) from 29 healthy controls, 26 Mild-Moderate COVID-19 individuals, 48 Severe COVID-19 individuals, and 121 individuals with post-acute sequelae of COVID-19 (PASC) symptoms. Immune subset profiling and a 14-plex cytokine panel were run on all patients from each group. B-cells were significantly elevated compared to healthy control individuals (P<0.001) as was the CD14+, CD16+, CCR5+ monocytic subset (P<0.001). CD4 and CD8 positive T-cells expressing PD-1 as well as T-regulatory cells were significantly lower than healthy controls (P<0.001 and P=0.01 respectively). CCL5/RANTES, IL-2, IL-4, CCL3, IL-6, IL-10, IFN-γ, and VEGF were all significantly elevated compared to healthy controls (all P<0.001). Conversely GM-CSF and CCL4 were in significantly lower levels than healthy controls (P=0.01). Data were further analyzed and the classes were balanced using SMOTE. With a balanced working dataset, we constructed 3 random forest classifiers: a multi-class predictor, a Severe disease group binary classifier and a PASC binary classifier. Models were also analyzed for feature importance to identify relevant cytokines to generate a disease score. Multi-class models generated a score specific for the PASC patients and defined as S1 = (IFN-γ + IL-2)/CCL4-MIP-1β. Second, a score for the Severe COVID-19 patients was defined as S2 = (IL-6+sCD40L/1000 + VEGF/10 + 10*IL-10)/(IL-2 + IL-8). Severe COVID-19 patients are characterized by excessive inflammation and dysregulated T cell activation, recruitment, and counteracting activities. While PASC patients are characterized by a profile able to induce the activation of effector T cells with pro-inflammatory properties and the capacity of generating an effective immune response to eliminate the virus but without the proper recruitment signals to attract activated T cells.
PMCID:8273732
PMID: 34262570
ISSN: 1664-3224
CID: 4965322

Persistence of SARS CoV-2 S1 Protein in CD16+ Monocytes in Post-Acute Sequelae of COVID-19 (PASC) up to 15 Months Post-Infection

Patterson, Bruce K; Francisco, Edgar B; Yogendra, Ram; Long, Emily; Pise, Amruta; Rodrigues, Hallison; Hall, Eric; Herrera, Monica; Parikh, Purvi; Guevara-Coto, Jose; Triche, Timothy J; Scott, Paul; Hekmati, Saboor; Maglinte, Dennis; Chang, Xaiolan; Mora-Rodríguez, Rodrigo A; Mora, Javier
The recent COVID-19 pandemic is a treatment challenge in the acute infection stage but the recognition of chronic COVID-19 symptoms termed post-acute sequelae SARS-CoV-2 infection (PASC) may affect up to 30% of all infected individuals. The underlying mechanism and source of this distinct immunologic condition three months or more after initial infection remains elusive. Here, we investigated the presence of SARS-CoV-2 S1 protein in 46 individuals. We analyzed T-cell, B-cell, and monocytic subsets in both severe COVID-19 patients and in patients with post-acute sequelae of COVID-19 (PASC). The levels of both intermediate (CD14+, CD16+) and non-classical monocyte (CD14Lo, CD16+) were significantly elevated in PASC patients up to 15 months post-acute infection compared to healthy controls (P=0.002 and P=0.01, respectively). A statistically significant number of non-classical monocytes contained SARS-CoV-2 S1 protein in both severe (P=0.004) and PASC patients (P=0.02) out to 15 months post-infection. Non-classical monocytes were sorted from PASC patients using flow cytometric sorting and the SARS-CoV-2 S1 protein was confirmed by mass spectrometry. Cells from 4 out of 11 severe COVID-19 patients and 1 out of 26 PASC patients contained ddPCR+ peripheral blood mononuclear cells, however, only fragmented SARS-CoV-2 RNA was found in PASC patients. No full length sequences were identified, and no sequences that could account for the observed S1 protein were identified in any patient. That non-classical monocytes may be a source of inflammation in PASC warrants further study.
PMCID:8784688
PMID: 35082777
ISSN: 1664-3224
CID: 5147542

The economic implications of penicillin allergy

Parikh, Purvi; Patel, Niraj C; Trogen, Brit; Feldman, Eleanor; Meadows, J Allen
PMID: 32768634
ISSN: 1534-4436
CID: 4603202

Intraoperative Anaphylaxis to Chlorhexidine During LVAD and Transplant Surgery

Zhou, Eric; Parikh, Purvi S; Kanchuger, Marc S; Balsam, Leora B
PMID: 29859756
ISSN: 1532-8422
CID: 3144242

Disseminated HSV-2 presenting with relapsing encephalomyelitis

Hainline, Clotilde; Rosales, Dominique; Parikh, Purvi; Louie, Eddie; Howard, Jonathan; Kim, Nina; Galetta, Steven L
PMCID:5964824
PMID: 29849208
ISSN: 2163-0402
CID: 3136322

Racial Disparities in Esophageal Cancer Cost and Mortality [Meeting Abstract]

Tzimas, Demetrios; Bucobo, Juan Carlos; Buscaglia, Jonathan M.; Parikh, Purvi; Sasson, Aaron; Nelson, Rebecca; Talamini, Mark A.; Kim, Joseph
ISI:000392524900181
ISSN: 0016-5107
CID: 2956782

Highlighting the variability in presenting symptoms of chronic granulomatous disease

Bottomley, Claire; Davenport, Patricia; Lala, Shailee; Thomas, Kristen; Parikh, Purvi
PMID: 27017560
ISSN: 1534-4436
CID: 2059002

KevinMD.com, 2014

The importance of recognizing immunodeficiency

Parikh, Purvi
(Website)
CID: 1707092