Mount Sinai Researchers Streamline Patient Data to Find Patterns in COVID-19 Patients

Girish Nadkarni, MD

With the influx of patient data resulting from the SARS-CoV-2 pandemic, the Mount Sinai COVID Informatics Center is collaborating with London-based software company Clinithink to uncover key findings that can enable better treatment methods for COVID-19 patients.

Clinithink’s artificial intelligence platform, CLiX, processes large volumes of data from physician notes and documents within electronic health records, allowing providers to save time and effectively determine key information on patient conditions.

“We are currently using the platform to mine clinical documents in order to extract information to further our understanding of COVID-19 and its complexities, so we can determine the best course of action for individual patients,” said Girish Nadkarni, MD, Assistant Professor, Department of Medicine (Nephrology), Clinical Director of the Hasso Plattner Institute for Digital Health, and Co-Director of the Mount Sinai COVID Informatics Center.

Through the use of Clinithink’s platform “CLiXTM unlock,” the COVID Informatics Center is creating risk scores for COVID-19 patient symptoms, sifting through data that has been stripped of any personal information to find patterns that can ultimately lead to new discoveries in COVID-19 treatment.

“Clinithink is enabling us to identify and distinguish the symptoms in hospitalized COVID-19 patients during admission, in order to determine if and when new symptoms are appearing during their hospitalization,” Dr. Nadkarni said.

The Icahn School of Medicine at Mount Sinai was the first academic institution in the nation to partner with Clinithink in 2016, its original use to accelerate the prescreening process to identify eligible candidates for clinical trials.

“The collaboration between Clinithink and Mount Sinai represents how novel research can be translated into clinical practice,” Chris Tackaberry, CEO of Clinithink, said. “We are delighted to see Mount Sinai extend the use of our platform as they continue to make breakthrough discoveries in COVID-19.”

The collaboration was facilitated by Mount Sinai Innovation Partners (MSIP), the technology commercialization engine at Mount Sinai.

“Collaborating with Clinithink improves the way we understand and serve our patients,” said Erik Lium, PhD, President of MSIP and Executive Vice President and Chief Commercial Innovation Officer at the Mount Sinai Health System. “We look forward to seeing how Dr. Nadkarni’s team leverages Clinithink to extend our knowledge about COVID-19, and potentially improve treatment and patient outcomes.”

Inspirational White Coat Ceremony Captures the Gravity of Becoming a Physician at a Pivotal Moment in History

Simran Malhotra and her fellow classmates participated in Mount Sinai’s first virtual White Coat Ceremony.

The Icahn School of Medicine at Mount Sinai’s Class of 2024 donned their white coats for the first time in October, in a symbolic and inspirational ceremony that has become an annual tradition marking the start of medical school and a life-long journey in the field of medicine. This year’s event was held virtually. It displayed the proud and hopeful faces of 140 incoming students, their voices giving way to a cacophony over Zoom, as they recited an oath they had written collectively—one that recognized the “gravity of the moment,” of become physicians during the most challenging time in a century.

David Muller, MD, Dean for Medical Education, and the Marietta and Charles C. Morchand Chair in Medical Education, kicked off the White Coat Ceremony with introductory remarks. He characterized this moment in history by saying there are “many intersecting threads of uncertainty: a global pandemic of COVID-19, a national pandemic of racism, a political landscape that has the potential to tear this country apart. Your class is ushering in a new dawn in medicine. Nothing will ever be the same again.”

This year’s two “virtual” keynote speakers were recent Icahn School of Medicine at Mount Sinai medical school graduates who have continued their training at Mount Sinai: Mary Nwosuocha, MD, a second-year resident in Psychiatry; and Katleen Lozada, MD, a first-year resident in Emergency Medicine. Each talked about their experiences last spring, when COVID-19 hit New York City and, according to Dr. Nwosuocha, “it was all hands on deck.”

Mary Nwosuocha, MD

Dr. Nwosuocha told the audience, “There was a time back in March when I asked myself, ‘Would I still accept my medical school admission offer if I knew that in my first year as a physician I would be facing the worst pandemic in 100 years? Would I still want to be a doctor knowing that my job would require risking my life every day and seeing my colleagues who became good friends fight for their own lives?’ ”

Instead of completing her scheduled rotation in Neurology last spring, Dr. Nwosuocha became part of a small COVID-19 unit that was set up for psychiatrically ill patients with the disease. She said, “I had to figure out how an agitated patient who produces a lot of respiratory droplets wouldn’t infect me or my colleagues, and to help a disorganized patient understand the concept of social distancing while they struggled with something as basic as their own hygiene. Having to wear a gown, a mask, and a face shield made establishing rapport with already paranoid patients even more difficult.”

During those dark days, Dr. Nwosuocha said, it was her experience with a COVID-19 patient with schizophrenia, whose mother was also sick with COVID-19 and not able to visit him, that led her to answer her own initial question with a resounding “yes.” She said, “I believe I am here to help other people at their most vulnerable; to use my skills and responsibilities to serve my patients. And I would say you are all remarkable in your position because you have already answered yes.”

Katleen Lozada, MD

In April, Dr. Lozada graduated medical school early to support front-line health care workers under New York State Governor Andrew Cuomo’s emergency executive order. Within weeks, she said, her classmates were also organizing to help the community. “Mount Sinai’s medical students implemented teams to carry out telehealth visits, assist hospital pharmacies, distribute personal protective equipment to our staff and communities, and much more. I and many of my extraordinary classmates woke up each morning with an important job to do.” She told the incoming students, “Being a medical student is powerful. It’s honorable. It’s invaluable. You are now in a position to use your incredible intelligence, empathy, diversity, cultural competence, and your mighty will to make a real difference in our community. Your white coat will give you an admission ticket to the most incredible and complex field in the world.”

In several ways, Mount Sinai’s 23rd White Coat Ceremony was a marked departure from years past. Traditionally, the event is held on the medical school campus in Stern Auditorium. But this year, the students themselves have been attending classes remotely. The White Coat Ceremony included videos of each student putting on their white coat for the first time, in their living rooms surrounded by family, or in backyards or local parks near their homes. The event also included video clips of the students explaining what the white coat means to them.

Richard Friedman, Co-Chairman of the Mount Sinai Health System Boards of Trustees, welcomed the students and told them, “Now is an auspicious moment to be at Mount Sinai, not only because of our COVID-19 response but also because of the pace of discovery in our laboratories.” He said, “Society has new appreciation for the hard work required to become a doctor and the dedication to care for people at the worst moments of their lives. Mount Sinai front-line workers bravely treated a constant flow of COVID-19 patients. They saved thousands of lives. This is what medicine is all about. This is why you’ve chosen to be here; to make a difference in the world.”

Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System, said, “This has been a year unlike any other. A year of suffering and survival, a year that has seen some of the worst days and some of the best days of humanity. You could not be joining us at a more important time. Our profession needs you. Our patients need you. Our country needs you.” Mount Sinai’s mission, he said, “is to maximize your potential, to give you the space to find your passion and support you from the moment you put on your white coat and throughout your career. What will you do with that opportunity? It’s all in your hands.”

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs, Mount Sinai Health System, said, “Today, as you don your white coat, this seemingly simple act carries enormous symbolism. Participating in today’s White Coat Ceremony is a testament to your determination to literally change the world of medicine and scientific discovery. While our clinicians battled COVID-19 on the front lines, our scientists tirelessly studied the virus and worked closely with our clinicians to find better ways of fighting this deadly virus. They made fundamental discoveries that improved outcomes and saved lives, such as developing the world’s best antibody assay and identifying anticoagulation therapies, convalescent plasma, and by monitoring the immune response. Our people worked through their exhaustion and their fear, and they did not stand down. They are heroes in every sense of the word. These same amazing people will be your teachers, your mentors, and your role models. This is your Mount Sinai.”

2020 Jacobi Medallion Award Ceremony and Gold-Headed Cane Presentation

Michael L. Marin, MD

Accomplished physicians and researchers received the 2020 Jacobi Medallion, one of Mount Sinai’s highest awards, in a virtual ceremony on Tuesday, October 6, that also included the presentation of the Gold-Headed Cane—an honor only rarely bestowed.

The recipients of these awards have made exceptional contributions to the Icahn School of Medicine at Mount Sinai, the Mount Sinai Health System, The Mount Sinai Alumni Association, or the fields of medicine or biomedicine. The presentation of the Gold-Headed Cane is the pinnacle to which a Mount Sinai physician may aspire. This award is rarely presented, and only then to the physician who best represents the traditions of Mount Sinai: devotion to patient care, scholarship, science, and teaching,

The event can be viewed here; and the digital program can be accessed here.

These are the recipients of the 2020 Jacobi Medallion and the Gold-Headed Cane:

2020 JACOBI MEDALLION RECIPIENTS:

 

Joshua B. Bederson, MD

Leonard I. Malis, MD/Corinne and Joseph Graber Professor of Neurosurgery

System Chair and Professor, Department of Neurosurgery

Icahn School of Medicine at Mount Sinai

Nina Bhardwaj, MD, PhD

Ward-Coleman Chair in Cancer Research 

Director, Cancer Immunotherapy Program, The Tisch Cancer Institute

Professor, Department of Medicine, Division of Hematology and Medical Oncology 

Professor, The Milton and Carroll Petrie Department of Urology

Icahn School of Medicine at Mount Sinai

Douglas T. Dieterich, MD

Director, Institute for Liver Medicine

Professor, Department of Medicine, Division of Liver Diseases 

Icahn School of Medicine at Mount Sinai

Carol R. Horowitz, MD, MPH

Dean for Gender Equity in Science and Medicine

Professor, Department of Population Health Science and Policy

Professor, Department of Medicine, Division of General Internal Medicine

Director, Institute for Health Equity Research

Icahn School of Medicine at Mount Sinai

Yasmin S. Meah, MD, MSH ’01

Program Director, East Harlem Health Outreach Partnership

Associate Professor, Department of Medicine, Division of General Internal Medicine

Associate Professor, Department of Medical Education

Associate Professor, Brookdale Department of Geriatrics and Palliative Medicine 

Icahn School of Medicine at Mount Sinai 

Miriam Merad, MD, PhD

Mount Sinai Professor in Cancer Immunology

Director, Precision Immunology Institute

Co-Director, Cancer Immunology Program, The Tisch Cancer Institute

Professor, Department of Oncological Sciences 

Icahn School of Medicine at Mount Sinai

Michael Minikes

Vice-Chairman, J.P. Morgan Prime Finance

Member, Boards of Trustees, Mount Sinai Health System

David G. Nichols, MD, MBA, MSSM ’77

President and Chief Executive Officer, American Board of Pediatrics

President, American Board of Pediatrics Foundation

Professor of Anesthesiology/Critical Care Medicine and Pediatrics

The Johns Hopkins University School of Medicine

Samuel Waxman, MD, MSH ’64

Distinguished Service Professor, Oncologic Sciences, The Tisch Cancer Institute

Distinguished Service Professor, Department of Medicine, Division of Hematology and Medical Oncology

Icahn School of Medicine at Mount Sinai

Founder and CEO, Samuel Waxman Cancer Research Foundation

Honorary Professor, Shanghai Jiao Tong University

 

GOLD-HEADED CANE RECIPIENT:

Michael L. Marin, MD, MSSM ’84

Dr. Julius H. Jacobson II Chair in Vascular Surgery

System Chair and Professor, The Ruth J. & Maxwell Hauser and Harriet & Arthur H. Aufses, Jr., MD 

Department of Surgery, Icahn School of Medicine at Mount Sinai

Surgeon-in-Chief, Mount Sinai Health System

Major League Baseball Recognizes Mount Sinai Front Line Workers

As part of an effort to honor front-line workers and others throughout the nation, Major League Baseball is featuring images of Mount Sinai employees during the baseball postseason games.

The images of employees are attached to “cutouts” placed in the stands during the Division Series games held in stadiums where fans are not allowed to attend due to the COVID-19 pandemic. The images are displayed in specific “Community” sections. Click on the two slideshows to view the Mount Sinai employees.

“We thought this would bring joy to all of the staff who have been working so hard,” said Arycelis Segura, a Trainer at Mount Sinai-Union Square who helped to organize employees to get their photos taken, along with Paul Zucker, Vice President, Ambulatory Operations, and Ellie Park, Senior Director of Operations, Mount Sinai-Union Square. “They deserve to be on national television.”

Other photos on display at the baseball games include health care workers, military service members, cancer survivors and cancer research scientists, COVID-19 essential workers, and youths with Boys & Girls Clubs of America.

 

The images of Mount Sinai employees were displayed during the following games:

Monday, October 5: Astros/Athletics (Dodger Stadium Los Angeles) and Yankees/Rays (Petco Park San Diego)

Tuesday, October 6: Marlins/Braves (Minute Maid Park Houston); Astros/Athletics (Dodger Stadium Los Angeles); Yankees/Rays (Petco Park San Diego) and Padres/Dodgers (Globe Life Field Arlington, Texas)

Wednesday, October 7: Marlins/Braves (Minute Maid Park Houston); Athletics/Astros (Dodger Stadium Los Angeles); Rays/Yankees (Petco Park San Diego) amd Padres/Dodgers (Globe Life Field Arlington, Texas)

Thursday, October 8: Braves/Marlins (Minute Maid Park Houston) and Dodgers/Padres (Globe Life Field Arlington, Texas)

Mount Sinai Gets $2.5 Million NIH Grant to Open New Avenues for Diabetes Treatment

Principal investigator Andrew F. Stewart, MD, Director of the Diabetes Obesity and Metabolism Institute and Irene and Dr. Arthur M. Fishberg Professor of Medicine, right, and Adolfo García-Ocaña, PhD, Professor of Medicine (Endocrinology, Diabetes and Bone Disease).

About 420 million people in the world have Type 1 or Type 2 diabetes, including 30 million in the United States, and all suffer from reduced numbers of beta cells, says Andrew F. Stewart, MD, Director of the Diabetes Obesity and Metabolism Institute and Irene and Dr. Arthur M. Fishberg Professor of Medicine at the Icahn School of Medicine at Mount Sinai. “There are 30 to 40 drugs on the market for diabetes, and none of them make beta cells regenerate,” he says. “Developing such a drug, and a precise way to deliver it, is our aim.”

A project led by Dr. Stewart recently received a $2.5 million, four-year grant from the National Institute of Diabetes Digestive and Kidney Disease, to support Mount Sinai researchers’ innovative efforts to regenerate insulin-producing beta cells that could lead to novel drugs for patients with diabetes.

Dr. Stewart’s team in 2015 identified the first potent human beta cell regenerative drug, harmine, which is in a class of drugs called DYRK1A inhibitors. They identified additional drugs that enhance the regenerative capabilities of harmine—TGF beta inhibitors in 2019, and GLP-1 receptor agonists in 2020. The new grant will support new efforts to develop a means to deliver these drugs precisely.

Robert J. DeVita, PhD, Research Professor of Pharmacological Sciences, and Director of the Medicinal Chemistry Core of the Drug Discovery Institute, and Chalada Suebsuwong, PhD.

“These drugs clearly are effective but also have the potential to cause unwanted effects outside the beta cell, so we now need a way to target the beta cell regenerative drugs to the beta cell,” says Dr. Stewart, principal investigator of the grant. “In lay terms, we have a UPS package to make your beta cells better, but we do not yet know the address to deliver the package.” There are potential strategies for delivering these “packages” by attaching them to a GLP-1 receptor agonist or a monoclonal antibody, each a widely used type of drug.

The current project is a collaboration among Dr. Stewart; Adolfo García-Ocaña, PhD, Professor of Medicine (Endocrinology, Diabetes and Bone Disease); Robert J. DeVita, PhD, Research Professor of Pharmacological Sciences, and Director of the Medicinal Chemistry Core of the Drug Discovery Institute;  and Thomas Moran, PhD, Professor of Microbiology, and Director of the Center for Therapeutic Antibody Development.

The research has four aims: First, Dr. DeVita and his team are making TGF beta inhibitors that can be linked to other molecules targeting beta cells. Second, Dr. Moran is focused on making one such molecule, a monoclonal antibody, which can deliver the drugs to beta cells. Third, Dr. Stewart and Dr. DeVita will “conjugate” the drugs with the delivery methods to investigate which combinations work the best.  And fourth, Dr. García-Ocaña will test the therapies on human beta cells in mice.

Thomas Moran, PhD, Professor of Microbiology, and Director of the Center for Therapeutic Antibody Development.

“We are excited about these collaborative and translational studies that link basic laboratory research with ultimate goal of treating patients.  For the first time, we have a series of new molecules that could be effective for both major forms of diabetes,” Dr. DeVita says. “If successful, a new targeted molecule could be scaled up in the future for further drug development, with the potential to treat millions of people around the world.”

Dr. Stewart is the site principal investigator for another grant for the study of diabetes, obesity, and other metabolic disorders, which was recently renewed by the National Institutes of Health. That five-year, $9.5 million grant was awarded to support the Einstein-Mount Sinai Diabetes Research Center, a regional collaborative led by Jeffrey Pessin, PhD, the Judy R. and Alfred A. Rosenberg Professorial Chair in Diabetes Research at the Albert Einstein College of Medicine and principal investigator on the grant.

The Center was founded in 1976 and has long focused its efforts on minority and other underserved populations in the region. Five years ago, it expanded into a regional collaborative, partnering with Mount Sinai to increase its capacity to support research studies and services. “The idea of these center grants is to have a series of cores that allow us to help people who are doing research, to do it faster, better, and more cost-efficiently,” Dr. Stewart says. For example, at Mount Sinai a core providing expertise in immune technology is led by Dirk Homann, MD, Professor of Medicine (Endocrinology, Diabetes and Bone Disease); and a human islet adenovirus core is led by Dr. García-Ocaña.

“The Center has provided a major boost to basic science and clinical diabetes and obesity research and training efforts at both Mount Sinai, Albert Einstein College of Medicine, and multiple other medical schools in the greater New York region,” Dr. Stewart says. “The Einstein team has been an extraordinary scientific partner.”

 

Mount Sinai Actively Recruits Volunteers From Hardest Hit Communities for COVID-19 Vaccine Trial

WillieBenjamin Loadholt, right, undergoes a checkup from Kiwan Stewart, RN, at The Mount Sinai Hospital prior to receiving his second injection as a participant in the phase 3 clinical trial for Pfizer’s COVID-19 vaccine.

Participating in the Mount Sinai Health System’s clinical trial for the Pfizer COVID-19 vaccine has been deeply personal for New York City educator WillieBenjamin Loadholt. He says it has provided him with the opportunity to be proactive, to contribute to a potential solution that could put an end to the COVID-19 pandemic, which has been “devastating to the African American community.”

For months, Mr. Loadholt says, “Every time I would go on a friend’s Facebook page I would see, ‘We regret to announce the passing or the transition of this person or that person.’ A friend of mine owns a funeral home and they were doing so many funerals. This one’s mom passed away, or this one’s father or sister passed away. It was heartbreaking.”

So, in August, when a friend told him about the Pfizer COVID-19 vaccine trial at Mount Sinai, Mr. Loadholt was eager to sign up. “We want to know what’s going on,” he says. “People perish from a lack of knowledge. How can we avoid this? How can we get solutions for this?” Participating in the search for answers to the COVID-19 pandemic is “worthwhile because I am able to help myself as well as my community. We can’t get this if we don’t help each other.”

Mount Sinai is actively recruiting volunteer participants in communities of color. “We want to make sure the trial is representative of the people who were hardest hit by COVID-19,” says Debbie Lucy, Program Manager for the Mount Sinai Health System’s COVID Clinical Trials Unit. Based on a legacy of mistreatment and longstanding inequities in access to health care, Black Americans, in particular, are more hesitant than other groups to embrace the use of experimental vaccines and therapies.

Debbie Lucy

In August, Ms. Lucy and her team began handing out information about the vaccine in the communities around The Mount Sinai Hospital, between 96th and 105th Streets, east of Park Avenue. In fact, Mr. Loadholt found out about the clinical trial from a friend who lives in the area and received a knock on his door from Mount Sinai.

“We have teams of people who are out in different areas trying to educate people and get them involved. We are talking to people, handing out flyers, and making as many connections as we can,” says Ms. Lucy. “We’re going to different grocery stores, hair salons, nail salons, laundromats, restaurants—any place where we think people of color are either working or going to.”

When Ms. Lucy met a man who told her that his family did not have any masks, she says she called up a team member who immediately brought several masks to the corner of East 103rd Street where they were standing. “He was in awe that we went the extra mile to do that for him,” Ms. Lucy says. “For him it was more than the masks we gave him; it was the fact that we connected with him and met his need immediately. We stood out there and talked with him and gave him additional information about participating in the trial.”

Mount Sinai has also held community forums that educate people of color about the Pfizer vaccine trial. In September, Mr. Loadholt discussed his experience at one of these forums. Ms. Lucy says, “We believe it’s easier for people who look like you to talk with you about participating in a trial because we recognize that there’s a lot of mistrust around research among people of color. Our ultimate goal is to find a vaccine that’s going to help prevent COVID-19, but with any trial we also want to test for safety to make sure it’s not causing any negative side effects in people, and that it’s well tolerated.”

Of the more than 180 COVID-19 vaccines under development, Pfizer’s RNA vaccine is one of the furthest along in the phase 3 clinical trials taking place at Mount Sinai and other locations throughout the United States. The vaccine is based on new technology and can be produced completely in vitro, or in a laboratory.

“I am grateful to individuals like Mr. Loadholt who are participating in this vaccine study and helping us to inform others,” says Judith A. Aberg, MD, the Dr. George Baehr Professor of Clinical Medicine, and Chief of Infectious Diseases for the Mount Sinai Health System. “Involvement with communities should not be overlooked due to false assumptions that people of color are unwilling to enroll in clinical trials. Such false assumptions result in harmful health disparities. We must provide everyone with the opportunity to participate in clinical trials and receive linkage to care. Only through engagement and education can people protect themselves and their loved ones.”

After receiving his second of two injections in September, Mr. Loadholt says he feels fine. He does not know whether he received the real vaccine or a placebo, which is how the placebo-controlled, randomized, observer-blinded vaccine trial is designed. He will be able to find this out in two years. “If I did receive a placebo, at least I can help another person of color receive the real one,” he says.

Mount Sinai has provided Mr. Loadholt and other trial participants with either an iPhone app or their own separate device to communicate any symptoms. “The staff at Mount Sinai has been wonderful,” Mr. Loadholt adds. “I would like Mount Sinai to do what they’re doing and be a beacon in the community.”

To potential volunteers, he says, “Don’t be afraid. Try it.”

If you are interested in volunteering for a COVID-19 vaccine clinical trial, please call 212-824-7714 or email: COVIDTRIALSINFO@MOUNTSINAI.ORG. Mount Sinai offers $119 in compensation for all visits related to the clinical trial. Watch the following video to learn more

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