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When the United States implemented nationwide "stay-at-home" orders last year amid a worsening pandemic, so did research laboratories around the world. Projects came to a grinding halt, and many researchers had to remain at home. But Karola Jering, M.D., a cardiovascular medicine research fellow at Brigham and Women’s Hospital in Boston, got called back to the hospital: Jering studies advanced heart failure in a critical care setting. So she ended up not only caring for people with severe heart disease in the intensive care unit, but treating COVID-19 patients as well.
At the time, research related to COVID-19 only involved a small group of patients. And doctors made treatment decisions in the hospital with very little data. “We had to care for really sick patients, and there were moments where I thought, ‘What am I going to do with them?’” Jering recalled “It was so early in the pandemic and we just didn’t know. People were grasping at straws.”
That paucity of information, she said, motivated her to do her own research – and with a large, diverse group of patients. Using a database that captured nearly 20 percent of all hospitalizations in the U.S., she and her colleagues looked first at 3,222 young adults, age 28 on average, and found that they experienced significant adverse outcomes. Among young adults hospitalized with COVID-19, 677 required intensive care, 323 needed mechanical ventilation, and 97 died. Over half were Black and/or Hispanic. Morbid obesity, hypertension, and diabetes were also common among this group and were associated with worse outcomes. This finding, Jering said, was consistent with others that have shown disproportionate illness severity among these populations.
Jering then thought about how little data was available about two other groups hospitalized with COVID-19: pregnant women and people with heart failure. Using the same database, she found that 1 in 4 patients with chronic heart failure died when hospitalized with COVID-19. And among pregnant women giving birth, the risk of death and adverse pregnancy events – such as needing a higher level of medical care during pregnancy, labor, and delivery – was also higher among the more than 6,000 women with COVID-19 than among women without COVID-19. Health disparities seemed to affect pregnant women’s risk of dying from COVID-19 as well.
“It’s been a difficult, but amazing experience to not only contribute to the care of COVID-19 patients, but to support fellow doctors,” Jering said. “I wish I could do more, but I’m hopeful that my research will contribute to how doctors will care for COVID-19 patients moving forward.”
Jering plans to share her data with the World Health Organization in an effort to provide evidence for healthcare decision making in real time. Her next research endeavors include assessing clinical outcomes of COVID-19 among other patient groups.
Learn more about Karola Jering, M.D.
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