Vigils for Justice, Equality, and Health Equity

Clinicians across New York City joined in a “White Coats for Black Lives” march on Saturday, June 6, from Central Park’s East Meadow down Fifth Avenue to Columbus Circle. Hundreds of health care workers and medical students—wearing the requisite face masks—were demonstrating to address a range of issues, including the murder of George Floyd in Minneapolis and structural racism that has contributed to disparities in health, both during the COVID-19 pandemic and long before.

The event was led by White Coats for Black Lives, a medical student-run organization that was born out of demonstrations in 2014 after Michael Brown in Ferguson, Missouri, and Eric Garner in Staten Island were killed by police. Since then, the group has formed chapters around the nation with this mission statement: Eliminating racism in the practice of medicine and recognizing racism as a threat to the health and well-being of people of color.

Sites across Mount Sinai have also held vigils—including powerful events on Tuesday, June 2—in which participants observe 8 minutes and 46 seconds of silence, the amount of time George Floyd was held under a police officer’s knee, suffocating to death. Demonstrations also focused on Breonna Taylor, an African-American emergency room technician who in March was killed by the police in her own home in Louisville, Kentucky.

At noon on Thursday, June 11, 1199-SEIU encouraged its members to take that pause to show solidarity for George Floyd and so many others who came before him. Many 1199 members gathered outside of Mount Sinai Beth Israel to participate. And at Mount Sinai West and Mount Sinai Morningside, vigils were led by unions including 1199 and the New York State Nurses Association. Members of hospital leadership at the sites joined in solidarity.

How a Small Force of Mount Sinai Nursing Students Played Key Support Roles at the Height of COVID-19

Nursing student volunteers, from left, Pearl Scalzo, Sylvie Jean Baptiste, and Jacky Lee stocked emergency trays for the Mount Sinai Beth Israel Pharmacy.

Twenty-two students at the Phillips School of Nursing at Mount Sinai Beth Israel have logged more than 1,000 volunteer hours since early April, taking on key support roles in pharmacy and research to help overburdened Mount Sinai Health System staff at the height of the COVID-19 pandemic. The effort was launched by two student leaders, Shayna LaSala, President of Student Government at the School of Nursing, and Frances “Frankie” Burney, chapter president of its National Student Nurse Association. They say they were inspired by the several hundred medical and graduate students and postdoctoral fellows from the Icahn School of Medicine at Mount Sinai who had been volunteering through the newly created Sinai Student Workforce.

With the help of Dean Todd F. Ambrosia, DNP, MSN, APRN, FNP-BC, FNAP, Ms. LaSala and Ms. Burney created the Nursing Student Workforce, giving nursing students the opportunity to volunteer in the pharmacy at Mount Sinai Beth Israel and at Mount Sinai Morningside, and to play vital roles in a significant COVID-19 research project at the Icahn School of Medicine.

As part of their efforts, the nursing students assembled crash carts and emergency kits, prepared medications, and performed whatever tasks were requested by pharmacy technicians. One student who was particularly skilled in phlebotomy trained registered nurses and personal care assistants on the latest venipuncture techniques. They also joined a cadre of staff and other volunteers on the Mount Sinai COVID-19 Tissue Collection Taskforce, where they helped to create a biobank of specimens from COVID-19 patients that later would be analyzed in research laboratories as part of a study by Mount Sinai scientists. The students were assigned to help assemble test tubes, deliver them to unit nurses, and then collect the full ones hours later, working in day or evening shifts.

Nursing student volunteers, from left, Dominique Falci, Rebecca Dornfeld, and Gurpawan “Gia” Kang helped to create a biobank of specimens from COVID-19 patients as part of a research study.

“Our nursing students were determined to help during this crisis,” says Dr. Ambrosia. “Their actions demonstrated that nursing truly is a calling—one that attracts those who strive to help humankind. I am extremely proud to stand with them and the nursing profession as we continue to care for our patients and one another.”

“It was inspiring to be part of a team where everyone—doctors, nurses, volunteers—came together to get through this,” says Dominique Falci, a nursing student who was involved in both research and pharmacy tasks. “There were so many extremely sick patients and so much bad news, but staff and volunteers were so warm and supportive of each other. It was very uplifting, especially as a student,” she says.

The students believe they got a unique perspective that will influence how they perceive hospital relationships. “Everyone brings a different skill set into a situation,” says Ms. Burney. “This experience has, for me, highlighted the special relationship between doctors and nurses and how much they can achieve by working together closely as a team across all disciplines.”

The students volunteered between semesters, launching the project in April after completing their final exams. However, now that classes have resumed, most are unable to continue volunteering, though Ms. Falci intends to make it part of her schedule. Fortunately, as new COVID-19 admissions have been declining, there is less need for volunteers. The student volunteers, who are in the Accelerated Bachelor of Science in Nursing Program, will graduate in August.

“It really has been a privilege to ease some of the burden on front-line workers,” says Ms. LaSala. “And, seeing our student body come together and work seamlessly as an interdisciplinary team with the medical students and Mount Sinai staff during such a stressful time is a learning experience we’ll never forget.”

Nursing student volunteer Gurpawan “Gia” Kang, left, helped Nicole Simons, MA, Team Leader of the COVID-19 biobank research study, collect biospecimens at an inpatient unit in Guggenheim Pavilion.

Lessons from the Epicenter: What We Have Learned About COVID-19

Members of the Pathology Department’s autopsy study, from left: Elisabet Pujadas, MD, PhD; Zachary Grimes, DO; Kenneth Haines, MD; Clare Bryce, MBChB; Mary Fowkes, MD, PhD; and Carlos Cordon-Cardo, MD, PhD.

Since March 8, when Mount Sinai West hospitalized its first patient with COVID-19, more than 8,000 individuals with the disease have been admitted to the Mount Sinai Health System. During that time, the medical community’s knowledge of COVID-19 has evolved from seeing it as a respiratory illness to understanding its effect on the blood vessels and multiple organs.

“Mount Sinai has been the epicenter of the epicenter,” says Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System. “We’ve been attacking COVID-19 from many different perspectives and we’ve made a lot of progress in a short amount of time.”

Indeed, as Mount Sinai’s front-line doctors, nurses, and others faced a tsunami of sick patients entering their hospitals, they were able to improve patient outcomes by working closely with their colleagues in other specialties and in laboratories at the Icahn School of Medicine at Mount Sinai. Through careful observations and investigations they have come to define COVID-19 as a new disease that attacks the endothelial cells that line the body’s blood vessels. How the disease plays out in each individual depends largely on the state of their immune system and whether they have co-morbidities, such as obesity, hypertension, or heart disease, which affect blood flow within the body. Approximately 80 percent of people with COVID-19 are able to recover without hospitalization.

“This is a disease we had not seen before,” says Carlos Cordon-Cardo, MD, PhD, the Irene Heinz Given and John LaPorte Given Professor and Chair of the Lillian and Henry M. Stratton-Hans Popper Department of Pathology, Molecular and Cell-Based Medicine, who developed accurate, widespread testing throughout the Health System to help diagnose and manage COVID-19. “Initially, it was conceptualized as a viral respiratory illness. But now we know it causes endothelial damage.” This damage leads to excessive blood clots throughout the body, which can also lead to multi-organ failure. There is a strong immune component to the disease, as well, which is led by macrophages or scavenger blood cells that eat viruses and dead cells and can be very difficult to control, even with targeted immunotherapy.

A clearer understanding of the biology of the disease and the range of organ damage inflicted by COVID-19 was provided by the Department of Pathology, which “uncompromisingly performed as many autopsies as possible, and conducted over 90 in COVID-19-positive patients,” says Mary E. Fowkes, MD, PhD, Professor of Pathology, Molecular and Cell Based Medicine, and Director of Mount Sinai’s Neuropathology and Autopsy Service.

Pulmonary embolism in 3D.

Recently, Drs. Cordon-Cardo and Fowkes published a study of 67 individuals with the disease who were treated at Mount Sinai between March 20 and April 29, 2020. “We expected severe changes in the lungs, which we were able to confirm,” says Dr. Fowkes. “But one of our surprising findings in the lungs was that in addition to the viral infection, there was a secondary bacterial infection that made it worse.” Another surprising finding, she says, was that in a number of cases, the patients had experienced large pulmonary embolisms that traveled directly to the lungs and caused sudden death.

The pathologists also found blood clots in the small blood vessels of many major organs, as well as the central nervous system, and identified a syndrome similar to hemophagocytic lymphohistiocytosis (HLH), a rare condition in which the body makes too many activated immune cells, specifically macrophages and lymphocytes, produced in the bone marrow. HLH can overlap with Kawasaki syndrome, which has been compared to a rare reaction seen in children who seem to recover from COVID-19 but go on to experience severe symptoms that include heart inflammation, low blood pressure, and trouble breathing.

Initially, doctors were concerned that people with asthma would be at greater risk for severe symptoms due to the disease’s respiratory component. But that did not turn out to be the case, even though the disease spreads from one person to another through respiratory droplets. Another surprising finding was that in comparison with the heart, brain, lungs, and liver, the kidneys were less affected by blood clots. Researchers think that may be because the ACE2 receptor—to which the SARS-CoV-2 virus attaches in order to enter the cell—is less prevalent in the kidney’s network of blood vessels.

“In reality, it’s the patients who have heart disease who seem to be at greater risk,” for severe outcomes, says Dr. Fowkes. “Diabetes accelerates vascular disease with plaque located in blood vessels throughout the body. So that if you have pre-existing damage to blood vessels you would be at greater risk. Heart disease is similar. If you have hypertension you see damage to tissues that surround the blood vessels and to the blood vessels themselves.”

Adam Bernheim, MD, Assistant Professor of Diagnostic, Molecular and Interventional Radiology at the Icahn School of Medicine at Mount Sinai, was one of the first U.S. radiologists to review the lung CT scans of COVID-19 patients from China. Since early March, he says, doctors have begun to understand the breadth of injuries that COVID-19 inflicts on the body and its relentlessness in doing so.

“The patterns of injury to the body run the spectrum from blood clots and pulmonary embolisms to pneumonia and abdominal issues,” he says. Some patients, including those in their 20s and 30s, take months to heal and others develop permanent scarring in their lungs. With many diseases he says, the body takes a big hit and then is able to repair itself. But COVID-19 can “cause continuous injury to the lungs over weeks. It just keeps hitting and hitting.”

David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens says the last three months illustrated how well the Mount Sinai Health System functioned in ensuring that patients in each of the seven Health System hospitals treating COVID-19 patients received the life-saving care they needed. In addition, he says, “The Icahn School of Medicine, with its top scientists, was completely in lockstep with the largest health system in New York City. We were able to do things together that we never would have been able to do separately. And because of that, we were able to change the course of therapeutics for this disease, as well.”

The Mount Sinai Health System has had the largest worldwide experience with convalescent plasma therapy and was the first to demonstrate its benefit in this disease, he says.  Additionally, Mount Sinai instituted a policy to administer anticoagulant treatment, which has also been beneficial. Through its clinical trials infrastructure, Mount Sinai had early access to the antiviral drug remdesivir, the anti-inflammatory drug sarilumab, and allogeneic stem cell therapy.

During the height of the pandemic, as other health systems “were doing their best to provide some level of care while not being overwhelmed, Mount Sinai was innovating,” says Dr. Reich. “Mount Sinai was applying science and showing improved outcomes with therapeutic innovations in a way that demonstrated we are one of the best institutions in the world, especially with regard to COVID-19 care.”

Kristin Myers, MPH, Appointed Executive Vice President, Chief Information Officer, and Dean for Information Technology

Kristin Myers, MPH

Kristin Myers, MPH, Senior Vice President for Technology at the Mount Sinai Health System, will become Executive Vice President, Chief Information Officer, and Dean for Information Technology (IT). Ms. Myers will provide visionary leadership and steer IT transformation efforts to align and support Health System strategy. Her main objectives will be to drive agility in the department to support our mission of clinical care, research, and education; optimize the department’s operations; and enable the Health System for digital change.

Ms. Myers joined the Health System as a Director of IT in 2004. Her many key accomplishments include leadership of the Epic clinical and revenue cycle implementations and the organization’s transition to ICD10 coding, and establishment of the IT Program Management Office and Change Management as a discipline within IT in 2009.

Ms. Myers is a nationally acclaimed health care leader. She was recognized by IT Health Data Management as one of the “Most Powerful Women in Healthcare” in 2019 and by Becker’s Hospital Review in each of the past three years among “Women to watch in healthcare.” Under Ms. Myers’s leadership, Mount Sinai was awarded the prestigious Health Information and Management System Society (HIMSS) 2012 Enterprise Davies Award of Excellence for its electronic record implementation to improve quality of care and patient safety. Most recently, Mount Sinai Morningside and Mount Sinai West received HIMSS Stage 7, the highest level of technology adoption.

Before joining Mount Sinai, Ms. Myers worked at Cap Gemini, Ernst and Young, and the Cerner Corporation in Australia. She holds an Executive Master of Public Health from Columbia University and an Executive Chief Information Security Officer certification from Carnegie Mellon. She has been designated a Fellow of HIMSS; has received certifications in Program Management (PgMP), Project Management (PMP, Prince 2), and AIM Change Management; and is a Certified Professional in Health Information and Management Systems.

During a Pandemic, Mount Sinai’s Class of 2020 MD and PhD Graduates Receive Their Degrees

Graduating students from the Icahn School of Medicine at Mount Sinai celebrated their MD degrees during a unique commencement ceremony.

It was a most unusual commencement ceremony on Friday, May 15, for the Icahn School of Medicine at Mount Sinai, an event that was prerecorded and livestreamed to the geographically scattered members of the Class of 2020. For this commencement, graduates received their degrees not from the stage at New York City’s Lincoln Center, with all the hoopla associated with large celebratory crowds, but from the isolation of their homes.

These are the doctors and scientists who graduated in a city—and from an institution—upended by the physical and emotional disruption of the COVID-19 pandemic. This is the class that will forever be united in understanding how much healing the world requires, and the scientific discoveries that it urgently expects.

Amid the sobering speeches that were given, the oaths that were recited, and the honorary degrees that were granted, there was a special jubilance among the graduates as they made this ceremony their own. Unique to this commencement, these graduates were able to announce their own names as their degrees were conferred, which they did in short video clips, Oscars-style, with creativity and humor.

Dennis S. Charney, MD

While many graduates thanked their families, friends, and mentors for their success, others chose to give credit to their cat, or dog, allowing their pets to make cameo appearances. While several graduates wore real caps and gowns, one was “hooded” with a wreath of flowers while standing in a garden; for another, a long strip of toilet paper served as a makeshift sash. One graduate, wearing a Hawaiian shirt and shorts, was performing an athletic leg split on the beach as he announced his name. For the graduates, it was clearly time to celebrate their resilience and their future.

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, began his address to the students by saying, “I am going to speak from the heart.” He then recounted the speech he gave to the medical students at their first-year 2016 White Coat Ceremony:

“When I look back at the speech, it turns out it was pertinent for today. Back then, I said to you that being a doctor consists of people coming to you in the crisis of their lives and asking for answers. Being a doctor means living up to immense expectations of society. At any hour and any place, it is assumed that if tragedy strikes, there will be a doctor on hand to handle the case with grace and competence.” He added: “I know you have gotten to experience this.”

Dr. Charney continued: “And then I said to you in 2016, when an epidemic emerges, when the unspeakable occurs, it often falls upon physicians to be first responders, to explain how and why, even when it may be inexplicable.” He added, “That certainly is what we are facing right now. You are going to be part of the first responder group now that you are becoming physicians and you are entering your first years as residents.”

He continued: “I also want to point out that adversity reveals the character of an individual, and I’ve seen in you, the Class of 2020, the kind of character that has been revealed in the current pandemic and the adversity that goes along with it. So, I have great confidence in your ability to rise up and face the challenges that you are going to see over the next part of your career.”

Click here to watch a video of the commencement

In total, 139 MD degrees, and 79 PhD degrees in Biomedical Sciences and Neuroscience, were awarded to the Class of 2020. Among them were graduates who were part of dual-degree programs: MD/PhD (21); MD/MPH (5); and MD/MSCR (10). Also included in these figures were the 77 medical students who were granted permission to graduate early in April, some to join the Mount Sinai Medical Corps, a newly formed training program that gives them an opportunity to provide vitally needed support services to an overburdened staff during a time of extraordinary and unprecedented demands.

David Dominguez-Sola, MD, PhD, Assistant Professor, Oncological Sciences, and Pathology, center, and PhD graduates, recited an oath for doctoral candidates.

Kenneth L. Davis, MD, President and Chief Executive Officer, Mount Sinai Health System, greeted the graduates, remembering the words of a colleague as the pandemic surged. “He noted that this crisis has kept us apart at the very moment we need to feel closer,” said Dr. Davis. Still, “These dark days have shined a light on the reality that we are all connected,” he said. “Mount Sinai is built upon that idea, and the beauty of our community is that in difficult times, we come together. We come together to heal all those who need our care. That unity is how we rise above fear. It’s how we triumph.”

James S. Tisch, Co-Chairman, Boards of Trustees, Mount Sinai Health System, acknowledged the significant volunteer efforts of medical and graduate school students during the pandemic as members of the Sinai Student Workforce. “Even before you graduated, most of you rushed to help in this crisis,” he said. Mr. Tisch cited their coordination and sterilization of personal protective equipment, their assistance to patients as they used the telehealth platform, and their work in laboratories, administration, and operations, among other efforts. “No professor had to teach you the need for teamwork. You knew the Health System needed your help, and you stepped up to the challenge,” he said. “On behalf of all the Mount Sinai Trustees, thank you.”

Darren Walker, JD

Honorary degree recipients Darren Walker, JD, President of the Ford Foundation, and Vice Admiral Jerome M. Adams, MD, MPH, the 20th Surgeon General of the United States, each gave an address.

Mr. Walker, a social justice activist and philanthropic innovator who has worked to create sustainable social change and transform the lives of countless people in need around the world, received a Doctor of Humane Letters.

In his address, Mr. Walker invoked the essence of a remark made in 1968 by civil rights leader Martin Luther King, Jr., to actor/activist Harry Belafonte—“In a burning house, we all must become firefighters.” Mr. Walker continued on that theme. “As promising medical researchers and doctors, you are firefighters called to serve a world on fire,” he said. “Our society has always asked health care workers to fight its fires, to combat public health emergencies that are kindled and fueled by deep, structural inequality. We ask our researchers and our doctors to treat victims of America’s opioid epidemic, to care for children poisoned by lead-filled water, to tend to patients who have gone without adequate care simply because of their zip code. And, with each new crisis, you show up ready, suited up, and eager to serve, to learn, to give, to heal a broken world. You are the firefighters for justice.”

Vice Admiral Jerome M. Adams, MD, MPH

Dr. Adams received a Doctor of Science degree for dedicating his career to public health at the highest level and for having an enduring impact on the health of the American people.

As Surgeon General, Dr. Adams is considered the nation’s doctor, and he offered several challenges to the graduates. Among them was this request: “I ask that you be patient, but persistent. We’re in the midst of a once-in-a-century public health crisis, and the truth is, there is no blueprint for how we get through this,” he said. “Be persistent about demanding change you feel will improve outcomes.” He continued: “One thing is painfully clear: the status quo wasn’t adequate to deal with the novel coronavirus. So, I am calling on you to be innovators and disruptors. Never before has there been an environment so willing to embrace new ideas and to break old molds.”

Marta Filizola, PhD, Dean, Graduate School of Biomedical Sciences, and Sharon & Frederick A. Klingenstein-Nathan G. Kase, MD Professor of Pharmacological Sciences, and Neuroscience, addressed the PhD graduates. “I am in awe of how many of you have joined your colleagues in these difficult times in supporting our Mount Sinai community while completing courses, writing dissertations, and defending your theses,” she said. “The flexibility, resilience, and adaptability you have demonstrated during your training at Mount Sinai, and especially during these past months, will be an inspiration for generations of Mount Sinai students.”

During the ceremony, the medical degree candidates, in robust unison from remote locations, read the Hippocratic Oath, Modern Version. In part, they pledged to “respect the hard-earned scientific gains of those physicians in whose steps I walk,” “to prevent disease whenever I can,” and “to remember that I am a member of society, with special obligations to my fellow human beings.”

Marta Filizola, PhD

The PhD candidates recited their own oath, that pledged, in part, to “uphold the highest levels of integrity, professionalism, scholarship, and honor,” to “conduct my research and professional endeavors with honesty and objectivity,” and to “not allow financial gain or ambition to cloud my judgment.”

David Muller, MD, Dean for Medical Education, and the Marietta and Charles C. Morchand Chair of the Department of Medical Education, gave concluding remarks. “You are very dear to me,” he said to the Class of 2020. “We have been through so much together. I speak for all of us in Medical Education when I say that we are changed forever because of what you’ve given us, what you have taught us, the faith you’ve placed in us, and the opportunity we’ve had to help shape your future as physicians, scientists, advocates, and activists.”

After the event, two MD and two PhD graduates provided added perspective on the ceremony and their futures. Zina Huxley-Reicher, MD, described the experience of a virtual commencement, saying in a short video: “Graduating now is an honor. It’s hard, it’s difficult. It was so wonderful to see all of my classmates virtually today, and to see their video clips that they shared with us that really just demonstrated who they are as people and as doctors. It was inspiring as ever. My classmates have been my rock during this whole time and graduating now into the pandemic, it just really brings home the importance of being true to yourself, of fighting for equity, and fighting for patients and for our communities and hoping to take what we all have learned during this pandemic and turn this into a positive and more just health care system.”

David Muller, MD

Also providing a short video clip was Chierika “Coco” Ukogu, MD. Wearing her cap and gown, she said, “I just virtually graduated with the Class of 2020 from Mount Sinai. It definitely wasn’t Lincoln Center, but it was so incredible, even in this pandemic, to celebrate the work that we’ve done for the past four years. I cannot wait to see where my colleagues end up and how much they advance the field of medicine, and to the Class of 2020, I say a heartfelt congratulations!”

“I was glad we could mark the occasion in spite of COVID-19, though it felt a bit surreal,” said Jennie Altman, PhD, who was the PhD student commencement speaker. “It is unfortunate that it took a global pandemic to catapult science and the importance of research into the spotlight. However, it is arguably the most interesting time to enter the scientific workforce as a microbiologist, but for such a tragic reason. I hope the general public hangs onto this newfound interest and that science remains in the spotlight so we can have more favorable outcomes in the future.”

Samuel Rose, PhD, who received his degree in Biomedical Sciences, said, “The home-theater viewing certainly can’t be matched for convenience, but the pageantry and awkwardness you would get from an in-person graduation was something I missed more than I thought I would, although the 10-second acceptance clip felt more personal than a walk and a handshake in some way. Seeing and hearing my classmates during the ceremony, and my family and friends afterwards, albeit digitally, did make it feel like a special day. The fact we couldn’t celebrate together just gives all the more reason for a reunion when things are a little more normal.”

Jonas Family Donation Supports Pediatric Research Into COVID-19

The Jonas Brothers. From left, Joe, Nick, and Kevin Jonas.

Kevin and Danielle Jonas, Joe Jonas and his wife, Sophie Turner, and Nick Jonas and his wife, Priyanka Chopra Jonas, have donated $500,000 to the Mindich Child Health and Development Institute at the Icahn School of Medicine at Mount Sinai, to support pediatric research into COVID-19 at a time when a rare syndrome is affecting children who become severely ill about four weeks after they seemed to have recovered from the disease.

Since early May, The Mount Sinai Hospital has admitted almost 20 patients between the ages of five and twenty, with multi-system inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19). It is defined as a syndrome in patients under the age of 21, with onset of fever for at least one day, laboratory evidence of inflammation, and severe illness with multi-system involvement.

George Ofori-Amanfo, MD, Chief of the Division of Pediatric Critical Care at The Mount Sinai Hospital and Mount Sinai Kravis Children’s Hospital, says Mount Sinai has developed a “strong and standardized process” for caring for these pediatric patients. This streamlined approach includes every phase of care, from the initial presentation in the pediatrician’s office or the emergency department through the entire hospitalization, discharge, and follow-up. It includes specific therapies and procedures, handoffs between the different levels of care within the hospital, and video phone calls with patients after they have been discharged and returned home.

The gift from the Jonas family will be used to support research into this inflammatory syndrome that is being conducted at the Icahn School of Medicine in areas that include genetics, bioinformatics, precision immunology, microbiology, and pediatrics.

Dusan Bogunovic, PhD, and Conor Gruber, MD/PhD candidate, Icahn School of Medicine at Mount Sinai

The effort is being spearheaded by Dusan Bogunovic, PhD, Associate Professor of Microbiology, and Pediatrics, and Director of the Center for Inborn Errors of Immunity, which is part of the Mindich Child Health and Development Institute. “We are studying two main questions,” says Dr. Bogunovic. “What causes this severe immune response that leads to MIS-C associated with COVID-19 in some children? And why do most other children seem to handle the SARS-CoV-2 virus so easily?”

This second question continues to puzzle physicians and scientists. Most children with COVID-19 appear to be asymptomatic and do not display the dry cough or trouble breathing that adults do.

Mount Sinai’s scientists will be characterizing the immune response of children at the RNA and DNA level to understand the disease pathology in cells by studying patients with the syndrome, in addition to healthy children. They will explore whether genetics plays a role in determining which children may be more susceptible to MIS-C; whether the types of antibodies these children produce influence MIS-C; and what in the immune system is driving the children’s clinical presentation. Is it the hyper-activation of their immune systems that triggers a cytokine storm or the specific cell subtype that drives pathogenesis?

“Through this work, we are striving to keep all of our children as safe as possible. The lessons we learn are sure to inform care for infections in children that go beyond COVID-19,” says Dr. Bogunovic.

Dr. Ofori-Amanfo says, “It is paramount that as we take care of our patients, we partner with our research teams and bring in their perspective in order to understand the underlying disease progression and treatment options.”

He adds that even though MIS-C is rare, if parents see their children developing abdominal pain in association with a fever or rash they should call their pediatrician immediately and not be fearful about coming to the hospital, if they need to. “The hospital is a safe place,” he says. “We are taking all of the infection prevention measures to ensure that our patients and staff are safe. We are committed to providing patients with the best care.”

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