Dana-Farber Cancer Institute and Beth Israel Deaconess Cancer Collaboration

As a Governing Trustee of the Dana-Farber Cancer Institute, I am honored to share that Dana-Farber has officially announced its collaboration with the Beth Israel Deaconess Medical Center (BIDMC) to build a brand-new, cutting-edge inpatient cancer hospital. Learn more about this exciting and comprehensive venture below:

Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center Forge New Collaboration to Advance Future of Adult Cancer Care; Announce Plans to Build Region’s Only Free-Standing Cancer Hospital

Dana-Farber Beth Israel Deaconess Cancer Collaboration aims to improve access and transform patient experience as incidence of cancer increases and care models rapidly evolve.

BOSTON–(BUSINESS WIRE)–Dana-Farber Cancer Institute (Dana-Farber) and Beth Israel Deaconess Medical Center (BIDMC) today announced plans for a comprehensive new collaboration designed to advance the future of cancer care and build the region’s only independent, free-standing inpatient hospital for adult cancer patients.

The collaboration is designed to transform the future patient experience by improving access, by better integrating innovations at the bedside, and by offering high-value care. Building on both Dana-Farber’s and BIDMC’s legacies of excellence in providing compassionate, world-class patient care and innovative research, the collaboration focuses exclusively on cancer care.

While each organization will remain fully independent – including executive leadership, boards of trustees and philanthropy – the Dana-Farber Beth Israel Deaconess Cancer Collaboration leverages the expertise of both institutions. The proposed state-of-the-art inpatient cancer hospital will operate under the license of Dana-Farber and provide adult medical oncology care. Together, Dana-Farber and BIDMC, with its affiliated physician group, Harvard Medical Faculty Physicians (HMFP), will establish a coordinated clinical and organizational structure for oncology care in the Longwood Medical Area of Boston.

“Cancer care has changed dramatically. Through this collaboration, our patients and their loved ones will benefit tremendously from Dana-Farber’s leading-edge scientific discovery and exceptional patient care. We believe this will position us to provide world renowned cancer treatment in outpatient and inpatient settings well into the future,” said Laurie H. Glimcher, MD, president and CEO of Dana-Farber. “Beth Israel Deaconess Medical Center and the physicians of HMFP share our vision and are equally committed to ensuring a superior patient experience and advancing a collaborative focus on world-class cancer care and research that will benefit our region and the world.”

“Together, we are taking bold steps to transform how we care for individuals and families touched by cancer, expand equitable access to life-changing care, and harness the power of scientific discovery,” said Kevin Tabb, MD, president and CEO of Beth Israel Lahey Health. “This collaboration and a dedicated, free-standing cancer hospital will be truly unique in Massachusetts. Our community needs and deserves both.”

At a time when our population is aging, cancer incidence is rising in younger adults and severity of illness is increasing, a forward-looking model maximizes the patient benefits of advanced technologies and treatment methods by accelerating the impact of discovery and innovation.

The state-of-the-art inpatient hospital will increase adult patient capacity. It will also create flexibility to incorporate the innovations and technology in cancer care that Dana-Farber’s and BIDMC’s researchers and clinicians are developing every day. Located adjacent to existing Dana-Farber and BIDMC facilities in Longwood, the proposed new cancer hospital will support both seamless patient care and continued focus on research initiatives.

Pending regulatory approvals, it will take several years to implement the cancer collaboration and construct the new cancer hospital. Dana-Farber’s current affiliation with Brigham and Women’s Hospital for inpatient and surgical care, long-renowned for its positive outcomes and high-quality patient care, will continue through the transition. BIDMC’s nationally recognized independent oncology programs will also continue until the new collaboration is in place.

Outpatient oncology care at Dana-Farber’s existing locations in Boston, Chestnut Hill and other regional campuses will not be interrupted. Likewise, the cancer institute’s partnership for pediatric cancer care with Boston Children’s Hospital will not change. Beth Israel Lahey Health will also continue to invest in advancing cancer services at BIDMC and at its other hospitals, fulfilling their commitment to provide access to extraordinary care in community settings.

For more information (including video/audio content), visit:

Review the press release here: https://www.businesswire.com/news/home/20230914978433/en/Dana-Farber-Cancer-Institute-and-Beth-Israel-Deaconess-Medical-Center-Forge-New-Collaboration-to-Advance-Future-of-Adult-Cancer-Care-Announce-Plans-to-Build-Region%E2%80%99s-Only-Free-Standing-Cancer-Hospital

The Acceleration of Cancer Treatment

It should come as no surprise that cancer has a major impact on the lives of individuals and communities within the United States and across the world. According to the National Institute of Health (NIH), 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States in 2023 alone. Due to the overwhelming number of anticipated cases, in addition to the millions of patients already diagnosed with cancer, research and treatment development remain a top priority. 

With May being National Cancer Research Month, let’s take a closer look at the U.S. National Cancer Plan, as well as what contributing factors have been instrumental in our progress toward eradicating cancer.

The National Cancer Plan

The U.S. Department of Health and Human Services (HHS) released the National Cancer Plan in April of 2023. The plan was developed in collaboration with the NIH’s National Cancer Institute (NCI), the President’s reignited initiative Cancer Moonshot℠, HHS, and other representatives from the cancer community. 

The plan provides a detailed framework guiding governmental, private sector, academic, philanthropic, and patient advocacy partner actions toward the ultimate goal of ending cancer. In fact, it was designed to support the efforts of the Cancer Moonshot℠ initiative, which aims to reduce the cancer death rate by 50% within 25 years. To achieve this measurable goal, changes in the way advances in cancer diagnosis and treatment are translated into patient care will need to be updated.

An Overview of the National Cancer Plan 

The National Cancer Plan outlines three key elements:

  1. A call-to-action that “every organization and individual—do their part to help end cancer as we know it” 
  2. Eight fundamental goals
  3. Strategies that are aligned with each of those goals

The strategies involve a concentrated effort to unite U.S. cancer research and care communities in the fight against cancer. Note that the National Cancer Plan is a living document that evolves to accommodate expanding research and knowledge. As of the time of publication of this article, the eight key goals laid out within the National Cancer Plan are as follows:

The National Cancer Plan Goals

Goal  Description 
Deliver Optimal Care Healthcare systems to provide patient-centered and evidence-based care that focuses on cancer prevention, and enhances the lives of survivors and those actively fighting cancer. 
Detect Cancers Early Early detection of cancer and early treatment implementation to support more successful outcomes and lower cancer mortality rates. 
Develop Effective Treatments Offer patients effective treatment, with minimal side effects regardless of cancer severity or rarity of their particular cancer. 
Eliminate Inequities Provide equal access to prevention, screening, treatment, and care to all patients, helping to eliminate disparities in cancer risk factors. 
Engage Every Person Remove barriers to patient involvement and maximize opportunities to participate in clinical research, adding to our pool of knowledge. 
Maximize Data Utility Researchers share and utilize available information to make more efficient and rapid progress in the fight against cancer.
Optimize the Workforce Vary the cancer care and research workforce to help represent all communities and meet the needs of all cancer patients. 
Prevent Cancer  Support the adoption of proven preventative measures to help reduce the risk of cancer for all individuals. 

In order to achieve these goals, we must work together as individuals and as organizations to further our progress in the fight against cancer.

The New Director of the Cancer Institute Monica Bertagnolli

Leading the charge in our continued “war on cancer” is the new director of the National Cancer Institute, Monica Bertagnolli, M.D. After President Biden’s announcement to renew the Cancer Moonshot℠ initiative in 2022, Dr. Bertagnolli, and her team at the NCI committed to developing the National Cancer Plan to help guide the cancer research and treatment workforce towards success. (Note that Dr. Bertagnolli was recently nominated by the President to become Director of the National Institutes of Health, which may impact on the implementation of the National Cancer Plan.)

In addition to the National Cancer Plan, Dr. Bertagnolli has been instrumental in several of the NCI’s recent developments, including the:

  • Major trials to evaluate multi-cancer detection tests
  • Cancer Moonshot Scholars program 
  • NCI Telehealth Research Center of Excellence (TRACE) program

The Dana-Farber Cancer Institute alumna, joined the NCI in October of 2022. Dr. Bertagnolli previously served as the Richard E. Wilson Professor of Surgery at Harvard Medical School, was a cancer surgeon at Brigham and Women’s Hospital, and was a member of the Gastrointestinal Cancer Treatment and Sarcoma Centers at Dana-Farber Cancer Institute. Bertagnolli also trained in surgery at Brigham and Women’s Hospital and was a research fellow in tumor immunology at the Dana-Farber Cancer Institute.

Dr. Bertagnolli has stood at the forefront of clinical oncology throughout her career, specifically aiming to advance our current understanding of the roles that gene mutation and inflammation play in the development of certain types of cancer. She has led initiatives such as the NCI’s National Clinical Trials Network, as well as initiatives to transform the data infrastructure for clinical research. In addition, she has served on the board of the Alliance for Clinical Trials in Oncology (a national clinical trials network member organization).

The Development of Cancer Medications

Over the last several decades, researchers have worked hard to understand how cancer (in its various forms) develops, changes, and evolves. Cancer is complex by nature and is an extremely adaptive disease, making it one of the most difficult to treat. Because no two cancers are completely the same, the course of treatment will vary in most cases. 

That said, with advancements in technology and an increased understanding of the biology of cancer, we have made significant strides in our goals to prevent, treat, and even cure many different forms of cancer. Utilizing precision medicine, targeted therapies, and advancements in genomics, immunology, and screening, the development of cancer medicines has accelerated beyond what many thought to be possible. Let’s take a look at how these innovations have helped accelerate the development of cancer medications.

Precision Medicine and Targeted Therapies 

Thanks to precision medicine and targeted therapies, treatments for certain types of cancer can be personalized based on an individual’s particular cancer, genes, proteins, and other substances found within the body. Utilizing these methods, researchers can use information from certain lab tests to pinpoint specific genomic abnormalities and markers within a tumor (that help it to survive and grow), and develop personalized, targeted therapies that have the ability to attack malignant cells, while avoiding healthy ones. It can even be used in combination with other cancer treatments, such as chemotherapy and immunotherapy.

Although not all types of cancers can be treated this way, precision medicine and targeted therapies have revolutionized the world of cancer treatment. This field of research and treatment is rapidly growing, creating a plethora of options we never thought possible.

Technological Advancements 

Advancements in technology such as the development of artificial intelligence, CRISPR gene editing, high-throughput screening methods, cellular and patient imaging techniques, genotyping, next-generation sequencing, robotic surgery, and telehealth have had massive impacts on the development of cancer medications and treatments. These types of tools have led to life-saving breakthroughs in the ways that researchers are able to find, see, and treat cancer. 

Other advancements in technology that have aided in the development of cancer treatment are big data and computational biology tools such as Cryo-EM and XFEL techniques, multiscale modeling, and single-cell sequencing. These types of tools have also enabled researchers and data analysts to review large sets of data, recognize specific patterns, and make information-based decisions when looking at how medications affect the body and in turn, how they affect cancer.

Developments in Immunotherapy

Another extraordinary contributor to the improvement of cancer treatment has been the development of immunotherapy. Although the immune system is one of the most powerful mechanisms in the human body, cancer has a way of tricking the immune system into thinking that it is not actually a threat. 

In recent years, researchers have discovered ways to support the immune system (immunotherapy) when fighting certain types of cancers, teaching it to recognize which cells are harmful and which are acceptable. This type of treatment has been transformational in the fight against cancer, especially considering that it can be used in conjunction with other cancer treatments, increasing the chances of success. Immune checkpoint monoclonal antibodies that block the proteins CTLA-4, PD-1 and PD-L1 are the most widely used form of immunotherapy. This new class of therapy is based on the pioneering work of immunologists, Drs. James Allison of MD Anderson Cancer Institute, Tasuko Honjo of Kyoto University and Gordon Freeman of Dana-Farber Cancer Institute.

Collaborative Research 

As previously mentioned, the National Cancer Plan actively calls for a collaborative effort in the “war on cancer.” This call to action is founded on the already proven idea that we can make infinite progress in the fight against cancer by working together on both an organizational and individual level. By sharing our data, resources, and expertise, our collaborative efforts have already helped to facilitate massive information sharing, large-scale clinical trials, fast-tracked translations of research, and more.


Unsurprisingly, funding is essential to the improvement of cancer care and treatment. This means that fundraising and awareness campaigns will continue to be a high priority across both public and private cancer research and treatment programs. Thanks to the funding previously invested by government programs, private organizations, and various philanthropic operations, researchers have been provided with the opportunity to develop new and innovative ideas, generate new therapeutic medications, and dive into comprehensive studies – propelling us forward in our goals. 

As far as we have come, there is still much progress to be made. Learn more about the National Cancer Plan and how you can contribute towards the fight against cancer, here. For more information about the development of cancer research and treatment, consider my most recent article: The Importance of Cancer Research. 

The Importance of Cancer Research

According to the National Cancer Institute (the U.S. government’s agency for cancer research of the National Institutes of Health)  roughly 2 million people will be diagnosed with some form of cancer in the United States in the year 2023. It is also estimated that over 300,000 people (the vast majority of which being women) will be diagnosed specifically with breast cancer, and prostate cancer diagnoses are expected to climb to over 288,000 cases this year. In addition to this, it is estimated that nearly 610,000 people will succumb to this disease this year alone.

With these statistics, it should come as no surprise that cancer research is of the utmost importance. Thanks to advances in the medical sciences and dedicated research efforts we have already witnessed significant progress in the field; despite this, we still have far to go. Research and development is imperative to furthering the improvement of prevention, detection and treatment of this life-threatening disease.

Cancer’s Complexity 

Over the past several decades, researchers, and scientists have worked hard to understand how different types of cancers can change and evolve. It goes without saying that cancer, in its many iterations, is a vastly complex, adaptive disease. 

With each individual case of cancer, comes its own differentiation. The body is made up of trillions of different cells, all growing, dividing, and dying each day. The body works diligently to keep those cells under control, but unfortunately, some cells will deviate from their original path; when this happens, they become malignant. 

Where some cancers manifest themselves in the form of a solid mass (often referred to as a tumor), others may present in the blood or show up in the form of skin changes (such as discoloration, sores, changes in moles, etc).

What’s more, cells within an individual tumor can vary from other tumors of the same cancer type. It’s also important to recognize that cancer is not stagnant; it moves and grows over time. This can happen incredibly quickly, even during the course of treatment. This complexity means that cancer can be very difficult to treat, making cancer research all the more critical.

What Does Cancer Research Consist Of? 

Simply put, cancer research is the study and testing of cancer, how it evolves, how we can treat it and ultimately how we can cure it. Research progress in any field is often cyclical and ongoing, this is especially true of cancer research. The more we understand about cancer, the more progress we’ll make towards eradicating it completely. 

A few key components of cancer research are:

  • Clinical Research
  • Laboratory Cancer Research
  • Prevention and Early Detection
  • Precision Medicine and Personalized Treatments
  • Population Research
  • Targeted Therapies and Immunotherapies 

Let’s take a closer look at these areas of research and how they are critical parts in eradicating cancer.

Laboratory Cancer Research

Laboratory research (sometimes referred to as “basic cancer research”) focuses on the understanding of how healthy cells function and how cancer grows and changes. Researchers can accomplish this by studying the cellular, molecular, genetic, biochemical, and immunological mechanisms that affect the progression of cancer. 

In most cases, laboratory cancer research will start with the study of cells or tissues (rather than whole organism) before a promising idea is found, and testing ultimately moves on to animal models. Successful tools and treatments move slowly and carefully from animal trials into human trials. This type of research is an essential starting point that helps to inform the development of new treatments and diagnostic tools, especially personalized/precision medicine. 

Clinical Cancer Research

Clinical trials have been a massive contributor in the fight against cancer. Clinical cancer research is the comprehensive study of cancer treatments and tools in patients to ensure their safety and effectiveness. Utilizing clinical trials, doctors and researchers are able to fine tune treatments helping to improve the quality of life and care of patients. Often associated with the testing of new medications, clinical research can be used to test any prevention, detection, treatment and management method. 

One of the key challenges in modern cancer clinical research is to ensure inclusion and diversity in these trials. Historically, trials tended to focus primarily on adult male Caucasian patients. It’s clear that clinical trials must incorporate more women, patients of color, representatives of the LGBTQ+ community, and other under-represented groups. 

There are 4 phases of clinical trials. These phases are designed to ensure that new treatment methods and tools are safe for use, as well as to see how it may compare to the current standard of care. 

There are four phases of clinical trials, Phase 1 through 4. In Phase 1 trials, initial impressions of the safety and potential activity of the experimental treatment are obtained; this can be studied in normal volunteers or advanced cancer patients that have very limited options available to them. Multiple dose levels are interrogated. In Phase 2 trials, a few dose levels are tested in larger numbers of patients, and efficacy endpoints are included; this may involve initial estimates of progression-free survival (PFS) or surrogates of efficacy, such as biomarkers, genetic changes, blood tests, etc. In the evaluation of some cancers, larger (or extended) Phase 2 trials may be sufficient for accelerated approval, subject to further confirmation after approval. Phase 3 trials are designed to test the efficacy of new treatments. In most Phase 3 clinical trials (and some Phase 2 trials), participants are assigned to either a “control group” (where a placebo or standard of care is given) or an “experimental group” (where the treatment is given). During these randomized clinical trials, participants are not allowed to know which group they’ve been placed in. However, they are informed that being given a placebo is a possibility. Phase 4 trials are generally post-approval and are used to expand our knowledge of real-world data on the treatment in larger numbers of patients – aimed at better defining the uses and limitations of new treatments. 

Because testing is designed to answer specific questions (about the treatment, disease, tool, etc), participants must meet certain entry requirements. For example, volunteers may be required to be at a certain stage in the progress of their disease while also at a certain age in their lives. This can lead trial populations to become limited compared to that of the world. To combat this, some institutions have begun designing testing specifically for underserved populations and communities. In addition to helping close the gap in medical research for minority groups, this also helps create more reliable options for the general population. 

Prevention and Early Detection Cancer Research

Prevention and early detection cancer research is about understanding the causes of cancer, finding cancer (as well as precancerous changes) in the body, and mitigating against its risks. Learning how to spot the disease when it’s still treatable, and learning to stop it before it ever starts is a critical piece of eradicating cancer. New cancer blood tests based on genomic and proteomic information (genes and proteins) are becoming extremely valuable and are likely to dramatically impact the early diagnosis of cancer.

Unfortunately, there are millions of people across the world who currently are and will be suffering with preventable cancer diagnoses simply due to economic challenges within underserved communities. Because of this, it is imperative that we continue to support and fund this type of research; so that answers, treatment methods and accessibility will continue to spread and expand. 

Precision Medicine and Personalized Cancer Treatments

When it comes to medicine, it’s almost never a “one-size-fits-all”situation. This is especially true of cancer treatment. Precision medicine and personalized treatments are medical care options designed to optimize the efficiency and benefits for individual patients, that take into consideration that person’s individual genes, life-style and environment. 

As previously mentioned, no two cancers are identical. Depending on the person, cancer develops and evolves in unique ways. This type of medicine often uses a person’s specific genetic information to help prevent, diagnose and treat cancer. Developing personalized treatments, prediction, and detection methods leads to fewer side effects, less internal cell damage and more efficient options overall. 

The more information we have about how genetic changes correlate to cancer, the better we will be at preventing and curing the disease. Although the term may be relatively new, the concept of personalized medicine has been around for many years. For example, if a person needed to receive a blood transfusion, the donor’s blood would need to be matched to the receiver’s blood type in order to reduce the risk of complications. Utilizing this concept, doctors and researchers can look for specific patterns in a person’s gene markers, habits, and locations and more to create personalized care options. 

Targeted Cancer Therapies and Immunotherapies

Targeted cancer therapy “targets” specific proteins within the cells that help regulate the growth and development of cancer. This type of cancer treatment is often referred to as the foundation of precision medicine. Most often administered in the form of a pill (small-molecule medications) or through a shot (monoclonal antibody treatments) targeted cancer therapy works by: 

  • Delivering compounds that kill cancer-cells specifically
  • Helping the immune system fight and destroy cancer cells 
  • Starving cancer of the hormones it needs to develop  
  • Modifying the patient’s immune response to cancer to augment the body’s ability to fight the cancer

Population Cancer Research

Population research refers to the study of how specific groups of people are more susceptible to certain diseases and illnesses. It also focuses on studying the overall long-term health of special populations. Characteristics and lifestyle factors that can influence health outcomes include (but are not limited to): 

  • Age
  • Access to healthcare
  • Culture
  • Education 
  • Experience 
  • Gender 
  • Genetics 
  • Geographic location 
  • Income 
  • Health conditions 
  • Lifestyle choices (such as diet, activity level, social habits, etc…) 
  • Race 

Studies generally include large numbers of people over significant amounts of time in order to learn about health or disease in a certain population. These observations allow researchers to improve cancer screening, prevention techniques and treatments.

Supporting Cancer Research 

With each passing day, we climb closer and closer to curing cancer. Progress in cancer research is made possible by dedicated doctors and researchers around the world, as well as the support of generous donors. If you are looking to support cancer research, consider donating to one of the nation’s leading cancer research centers, the Dana-Farber Cancer Institute. Learn more about donating here

If you enjoyed this article, you may also be interested in: Dana-Farber/Boston Children’s Cancer and Blood Disorders Center Named the Nation’s #1 Pediatric Cancer Program:

Disclosure: I am currently a Governing Trustee of the Dana-Farber Cancer Institute, a member of the Board’s Executive Committee and Chair of the Board’s Science Committee.  I am not a paid employee or consultant of the DFCI. I previously was the Founder, Chairman and CEO of ARIAD Pharmaceuticals, Inc.,a cancer therapeutics company focused on targeted cancer therapies for patients with difficult-to-treat cancers, such as non-small lung cancer and Ph+ leukemias. ARIAD now is a subsidiary of Takeda Oncology, Cambridge, MA.

Approved and Effective COVID-19 Medications

In early 2020, the life-threatening, quickly evolving, and easily transmissible disease COVID-19 (caused by the SARS-CoV-2 virus) had taken the world by storm. Without the proper tools and protocols in place, much of the world was left unequipped to handle a viral outbreak of this magnitude. Because obtaining full U.S. Food and Drug Administration (FDA) approval is a lengthy process, doctors and researchers first turned to medications that already had FDA approval, in hopes to find an overlap in effective treatment strategies. As time went on, new (and more effective) medications were created and granted emergency use approval (EUA) by the FDA. Similar processes for emergency access are in place in the EU, UK and many countries around the world.

Full FDA Approval vs. Emergency Use Approval

Under EUA, the FDA authorizes use of certain medical products when evidence presented at the time of emergency shows reasonable belief the product will be effective. Essentially, EUA is a tool that can expedite the availability of medical products like medications and vaccines during a major health crisis. Although there is no difference in the scientific rigor of trials for full FDA approval compared to EUA, there are a few differences in the process. 

The main two differences are that for EUAs, the FDA requires monitoring of at least half of the clinical trial participants for a minimum of two months after vaccination. However, full FDA approval of COVID-19 vaccines and treatments requires at least six months of monitoring. In addition, full FDA approval requires extensive data about the product maker’s processes and facilities. For more information about the difference between full FDA approval and emergency use approval, review this article from Yale Medicine

Approved Treatments for COVID-19

Since the pandemic began, scientists and researchers around the world have been working hard to create safe and effective medications to treat COVID-19 patients. Thankfully, there has been success in this pursuit, and there are now several medications available for use. As of 3/16/2023, there are two primary types of medications approved for use by the FDA that are effective in treating COVID-19; oral antivirals and IV antivirals. 

Antivirals: What Are They and How Do They Work? 

Antivirals are medications created to stop viruses from multiplying in the body. They do this by:

  • Blocking receptors so viruses are unable to bind to and enter healthy cells 
  • Boosting the immune system, helping it to fight a viral infection 
  • Lowering the overall viral load within the body

Receiving antiviral treatment early on in an infection can lessen symptom severity and lower the chances of hospitalization. Antivirals can be prescribed in two forms: oral or IV. Oral antivirals are typically taken in the form of a pill, whereas IV antivirals are administered directly into a patient’s bloodstream over the course of several days.

Less Effective Treatments 

Although there are several medications available for use in the treatment of COVID-19, many of those treatments are less effective than originally hoped. Unfortunately, drugs like LAGEVRIO™ (an oral antiviral also known as Molnupiravir), Veklury® (an IV antiviral also known as Remdesivir) and immune modulators like Olumiant (Baricitinib) and Actemra (Tocilizumab) and Dexamethasone have shown to be less effective than the prevailing treatment PAXLOVID™.

  • LAGEVRIO™ is an oral antiviral (also known as Molnupiravir) authorized for emergency use on December 23, 2021 to provide an additional treatment option for those 18 and older who were at risk of developing severe symptoms (including hospitalization and/or death). In its first clinical trial, results showed that out of the 709 people who received molnupiravir, 6.8% were either hospitalized or died within a 29-day follow-up period compared to the 9.7% of 699 people who received a placebo. That said, when new COVID-19 variants developed and molnupiravir underwent a second round of trials, researchers found no difference in results for those who were treated with the medication versus those treated with a placebo, indicating molnupiravir may be less effective against newer virus variants.


  • Veklury® is an IV antiviral (also known as Remdesivir) originally created in 2009 to help treat hepatitis C and respiratory syncytial virus (RSV). Veklury acts as a nucleotide prodrug that binds to the viral RNA-dependent RNA polymerase and inhibits viral replication by terminating RNA transcription, attempting to stop the viral replication in the body. Due to its long-standing history and prior FDA approval for treating other illnesses, Veklury was the first drug to receive full FDA approval for the treatment of COVID-19. When compared to other treatment options across all other time periods [pre-Delta (35%), Delta (21%), and Omicron (16%)], the prompt administration of Veklury (within two days of hospital admission) was linked with an overall 25% lower risk, according to mortality results at Day 28.


  • Immune modulators such as Olumiant (Baricitinib), Actemra (Tocilizumab), and Dexamethasone, all fall under another type of medication that was repurposed for the treatment of COVID-19. Immune modulators are a type of medication that either stimulates or suppresses the immune system, helping restore normal immune function after damage from an infection. The idea to repurpose these already FDA-approved medications came from the fact that COVID-19 attacks the immune system as well as other systems within the body. These medications are typically used to supplement an antiviral COVID-19 treatment.


Pfizer’s PAXLOVID was approved for emergency use on December 22, 2021 and is now the leading treatment for COVID-19. 

PAXLOVID has been approved for use in persons 12 years and older (who weigh more than 88 lbs) with an active diagnosis of mild-to-moderate COVID-19 and who are likely to progress to severe COVID-19 (including hospitalization or death). Generally speaking, risk factors for progression to severe COVID-19 include but are not limited to: 

  • Age 50+
  • Being Overweight or Obese 
  • Being a smoker
  • Having health conditions such as heart disease or diabetes
  • Having mental health conditions 
  • Having other physical, mental, or developmental disabilities

How PAXLOVID™ was Created 

Although PAXLOVID wasn’t necessarily created from scratch, it was created with the sole intention of treating COVID-19, unlike previously mentioned medications. According to Pfizer’s Chief Scientific Officer Mikael Dolsten, company scientists had begun searching for ways to combat coronavirus during the SARS outbreak of 2003. They were specifically looking at proteins’ crucial role in virus replication. Researchers believed if they could find a compound that would disrupt the process of replication, they could bring the virus to a halt. The knowledge gained during that study was critical to the creation of PAXLOVID. 

Prior to its authorization, a clinical trial including over 2,200 participants from around the world was conducted on PAXLOVID to compare how well the medication reduced the risk of developing severe COVID-19 symptoms against a placebo. The results of this trial reported that only 9 out of 1,039 people who started treatment with PAXLOVID within five days of their first COVID-19 symptoms, were hospitalized but none had died. In comparison, 66 out of the 1,046 people who were given a placebo were hospitalized and did pass away (from any cause). 

How to Take PAXLOVID™ 

According to Penn Medicine, PAXLOVID can reduce the risk of hospitalization and death by up to 88% when taken within the first five days of symptoms. For best results, medications should be taken within the first day of showing mild-to-moderate symptoms of COVID-19.

Generally speaking, there are five blister cards with morning and evening doses within each package of PAXLOVID. Each dose contains two types of medicine: nirmatrelvir tablets (pink) and a ritonavir tablet (white to off-white).

Begin taking your first dose in the morning or night (depending on when you get access to the medication). It’s important to take each dose either simultaneously or consecutively and not space them out over time. Note these pills should not be broken, chewed, or crushed, and they are safe to take with or without food. Repeat this process at the same time each day (morning and night) until the course of treatment has been completed. 

If you are experiencing side effects, it’s important to discuss these issues with your doctor and continue taking PAXLOVID unless you have been instructed not to. If you miss a dose by less than eight hours, take it as soon as possible. If you miss a dose by more than eight hours, you should skip this dose and resume at your next scheduled dose. You should never take more than one dose in one sitting and should complete your full course of treatment. 

For more information about how to use PAXLOVID, visit this information page. 

Will There Be Any Additional FDA-Approved COVID-19 Treatments? 

The FDA is currently working with additional developers, researchers, and manufacturers, as well as institutions such as the National Institutes of Health (NIH), to provide additional therapeutic medications to COVID-19 patients. To stay up to date on new FDA medication approvals, search the medication name here.

Note that these medications are not meant to be a replacement or substitute for receiving the COVID-19 vaccination. In many cases, COVID-19 treatments are accessible through pharmacies, hospitals, and health clinics. If you have symptoms and tested positive for COVID-19, it’s essential to seek treatment as soon as possible. A healthcare provider will be able to guide you to the appropriate treatment option. 

For more information about COVID-19 and Long COVID, consider reviewing: Long Covid: What You Need To Know

What To Know About Cardiac Stress Testing

While American Heart Month takes place each February, we continue to focus on the ever-important topic of heart disease, as well as the heart-healthy habits that can help you reduce your risk of developing this life-threatening condition. This month, we’d like to take a closer look at cardiac stress testing, how these tests work, what you can expect during these procedures, and more. 

What Is Cardiac Stress Testing and What Is Its Purpose?

Cardiac stress tests are used to determine how a person’s heart responds when performing its hardest. Because the heart pumps more rapidly and intensely during exercise or other physical activity, cardiac stress tests can reveal issues with the heart’s blood flow that were not apparent at rest (as well as other issues such as chest discomfort, shortness of breath, dizziness, etc). A cardiac stress test can also help evaluate issues with: 

  • A person’s heart muscle and valves 
  • The adequacy of blood supply to the heart overall and to specific regions 
  • The electric stability of a person’s heart 

Physicians can also use these tests to determine whether a patient needs additional more invasive testing to confirm a diagnosis, determine the treatment options for someone who has developed heart disease, and whether or not that treatment is effective for a specific person. 

When Is A Cardiac Stress Test Recommended? 

Healthcare providers can learn a lot of valuable information about the health of a person’s heart from the results of a cardiac stress test. While the test is not necessary or suitable for everyone, cardiac stress tests are often recommended by a healthcare provider to:

  • Check the heart before or after a surgery 
  • Diagnose coronary artery disease
  • Diagnose heart rhythm issues 
  • Evaluate exercise-induced symptoms like shortness of breath
  • Guide in the treatment of heart disorders 
  • Look into recurrent fainting spells

If you are unable to complete an exercise-based cardiac stress test due to a medical condition, your doctor may recommend a pharmacologic-based cardiac stress test instead.

What Types of Cardiac Stress Tests Can Be Performed? 

When it comes to exercise-based cardiac stress tests, there are a few options that can be considered: 

In most cases, cardiac stress tests are performed either on a treadmill or stationary bike. As previously stated, if you are unable to perform an exercise-based stress test, your doctor may recommend a different type of stress test involving administration of medicines that either increases heart rate directly or increases blood flow to certain areas of the heart.

During cardiac stress tests, a cardiologist will monitor how fast your heart is beating (using an electrocardiogram or ECG), as well as your blood pressure levels. Imaging-based stress tests are more advanced than standard stress tests, providing more detailed information with imaging of a person’s heart. 

How to Prepare for a Cardiac Stress Test 

In most cases, your healthcare provider will provide you with specific instructions on how to prepare for your stress test. Generally speaking, you may be asked to: 

  • Arrange for transportation post-exam (depending on the type of exam) 
  • Avoid drinking, eating and smoking for a specific amount of time beforehand
  • Avoid consuming caffeine the day before and the day-of 
  • Bring a list of your current medications and dosages 
  • Bring any inhaler (for asthma or other breathing issues) that you may use
  • Pause taking certain medications the day before and the day-of 
  • Wear or bring comfortable clothes and walking shoes

Be sure to let your doctor know if you are currently taking any medications. It’s important to note that you should not stop taking medications unless your doctor instructs you to do so. Before you start your test, your doctor will likely ask you a few medical-related questions to help assess your current state and the appropriate level of exercise (if any).

Standard Cardiac Stress Tests

Generally speaking, stress tests are:

  • Performed in a doctor’s office, an out-patient clinic or a hospital
  • Completed within an hour
  • Non-invasive

Before the exam starts, a cardiologist will review your medical history and ask a few questions about any heart-related symptoms you may be having. Following this, your healthcare provider will ask you to undress from the waist up. Once you’re ready, they will adhere small conductors (electrodes that monitor electricity leaving or entering the body) to your bare upper torso and chest. Patients will generally wear a hospital gown to cover their chests.  For those with thicker body hair, small sections of the chest may need to be shaved in order to ensure that the electrodes will adhere properly. 

During most cardiac stress tests, you will most likely be asked to wear a blood pressure monitor around your arm, as well as an oxygen monitor on your pointer finger. After a baseline recording of your heart rate and blood pressure is taken, the health care provider will ask you to begin to exercise. Every few minutes the intensity of the workout will increase until it is too difficult for you to continue exercising or you are out of breath and unable to continue.

Generally, you will be asked to finish with a few minutes of slow walking/riding as a cool down. Once completed, you will be asked to stay still quietly for roughly 15-20 minutes, while your heart rate, ECG, blood pressure and oxygen saturation continue to be monitored and return to baseline. This process allows the doctors to get an in-depth idea of how your body (specifically your heart) responds to exercise. Your cardiologist will evaluate your ECG at rest and during and after exercise to look for arrhythmias, conduction changes, ischemic changes (often referred to ST segment depression or elevation and T wave changes), and other abnormalities in the electrical activity of the hear.

Echocardiogram and Nuclear Cardiac Stress Tests 

Stress echocardiography and nuclear cardiac stress tests are similar to standard stress tests but are more advanced and can provide doctors with more detailed information about your heart. 

Note that a stress echo uses an ultrasound to produce images of the heart, whereas a nuclear stress echo uses a radioactive material (usually referred to as a radioisotope or radiopharmaceutical) injected into the bloodstream. Another notable difference between these two tests and the standard test is that these tests include imaging of the heart, in addition to monitoring heart rate, oxygen saturation and blood pressure,

Pharmacologic Cardiac Stress Tests

When an exercise stress test is not feasible, a pharmacologic stress test is recommended. During pharmacologic cardiac stress tests, medication is used instead of exercise to increase your heart rate and/or modify blood flow to certain regions of the heart. 

Electrophysiology Stress Test

Electrophysiology tests are more invasive than the aforementioned stress tests and involve advancement of catheters and electrodes through blood vessels to the heart chambers.  These tests are far less commonly used than the non-invasive stress tests described earlier. This can help doctors identify the origins of rhythm irregularities in the heart and the underlying mechanisms for the conduction abnormalities. Exercise electrophysiology studies are performed with the patient on their back in a highly sophisticated cardiac laboratory.  

What Are the Risks? 

Although a cardiac stress test is generally safe, complications can occur. Potential adverse effects include: 

  • Allergic reaction to any of the administered materials (radioactive or otherwise)
  • Chest pain
  • Collapsing/fainting
  • Irregular heart rhythms (arrhythmias)
  • Myocardial infarction (heart attack)
  • Nausea 
  • Low blood pressure (hypotension) 
  • Shortness of breath

What Happens After a Cardiac Stress Test? 

Although it may not be immediate, after any cardiac stress test, your cardiologist will review test findings with you to determine next steps. 

  • If your results come back normal, your cardiologist may not recommend any further testing (of course, subject to your symptoms, if any, and your family history). 
  • If your results are normal, but you are still experiencing symptoms, your cardiologist can order further testing to investigate what other diseases might be causing these issues or a repeat study with one of the imaging methods discussed, or repeat testing at a later date.
  • If your results are abnormal, that information can inform a treatment plan and potentially the need for additional more invasive diagnostic tests, such as cardiac catheterization and coronary angiography or cardiac CT, both with contrast. 

Although additional testing is often required for definitive diagnosis, abnormal stress results indicate that you may have one or more forms of heart disease. In addition to developing a treatment plan, your doctor may recommend you consider making heart-healthy lifestyle changes to help prevent the development or worsening of any heart-related issues. 

Heartlanta: How It’s Changing The Cardiac Stress Test Experience for Women and Why It Matters 

For those experiencing a standard cardiac stress test for the first time, you may be unaware that these tests are typically performed shirtless or in a hospital gown (meaning no bran for women). For some, this may not be cause for concern. For most women, this can be an extremely uncomfortable, awkward and embarrassing experience. These tests were originally designed for the male physique. Historically, the field of cardiology has been male-dominated, which has led to some unfortunate oversight and gender bias, impacting the treatment of and the screening of heart disease compared to other diseases like cancer.

According to the American Heart Association, more women die from heart disease than from all other cancers combined, and the number of women getting screened for heart disease is widely underreported. Although cardiovascular disease is the leading cause of death for women in America, women only make up 38% of participants in all heart-related research studies nationwide.

Thankfully, heart disease awareness has been on the rise in recent years. That said, screening, prevention, and early detection are critical components of fighting this life-threatening condition. The Heartlanta Bra may become an important way of creating inclusive, accessible screening for heart disease for all people. The Heartlanta company strives to improve the experience of stress echocardiograms for all, and advocates for women’s heart health. 

The Design

The Heartlanta Bra is the only patented bra specifically designed to be compatible with the stress echocardiogram and other cardiac stress tests. This bra effortlessly lifts breast tissues away from electrodes and provides ready access for ultrasound imaging using a hook-and-loop closure at the center. The bra is designed to feel comfortable to the wearer while providing sufficient support during the exam.

In addition to the bra providing a better experience for women, it also aims to provide more accurate test results. A recent article in the Journal of Cardiovascular Imaging reports that 24% of stress echos result in a false positive interpretation. By lifting up and removing breast tissues from the area of electrodes and providing better access for the ultrasound transducer, cardiologists have observed less interference on readouts, allowing for more accurate results. 

The Mission of Heartlanta

Inspired by actor and women’s advocate Jennifer Beals’ own personal experience with the stress echocardiogram, the Heartlanta Bra was developed in collaboration with three dedicated physicians – Ob-Gyn Sherry Ross, MD, cardiologist Nicole Weinberg, MD., and cardiologist and imaging specialist Harvey Berger, MD.

The Heartlanta Bra mission is simple: 

  • Empower women to have a more dignified, comfortable stress echocardiogram experience. 
  • Offer a first-of-its-kind medical bra to be worn during a stress echocardiogram, providing comfort to female patients as well as more accurate test results for physicians.
  • Demystify stress echocardiogram procedures for women and increase access to better health.

To learn more about Heartlanta, visit their website here. To learn more about heart disease and what you can do to prevent and/or lower your risk, consider my previous article: Everything You Need to Know About Heart Disease

Disclosure: I am a shareholder in and unpaid advisor to the Heartlanta Bra company. I have worked with co-founders, Dr. Ross and Ms. Beals for several years focusing on medical, regulatory and business matters.

Everything You Need to Know About Heart Disease

In the last few months leading up to American Heart Month, we’ve been focusing on heart disease and heart-healthy habits. This is a time to shine a light on heart disease specifically and remind ourselves just how crucial it is to prioritize heart health. As previously mentioned, heart disease has been named the leading cause of illness and death in the United States. In fact, 1 in every 5 deaths was caused by heart disease in 2020 alone (this equates to roughly 670,000 people).

Prevention and awareness are two key components of limiting the effects of heart disease. Although there may be a genetic predisposition in some cases, there are many things that can be done to limit the chances of developing heart disease, as well as its effects once developed. Let’s take a closer look at heart disease and what factors may contribute to this life-threatening condition.

What Is Heart Disease?

Also referred to as cardiovascular disease, heart disease refers to any disease that affects the heart muscle, valves or blood vessels. These diseases can be asymptomatic for long periods of time, meaning that they can cause damage long before a person is aware there is a problem. 

In general, heart disease can cause issues involving: 

  • irregular heart rhythms
  • heart muscle and valves that don’t function properly
  • narrowing of the blood vessels in your heart and other organs

What Types of Heart Disease Are There? 

Although most forms of heart disease develop over time, there are some types of heart disease that a person can be born with. Let’s take a look at the different forms of heart disease and what differentiates them. 

Congenital heart disease refers to any heart condition or defect that a person is born with. Congenital heart disease is the most common type of birth defect in the United States and affects roughly 40,000 births each year. In some cases, it can cause critical complications and structural issues, for example, a missing ventricle, or a problem with the connection between main arteries. Common congenital heart defects include: 

  • atresia: a missing heart valve
  • atypical heart valves: where valves do not open properly or leak
  • septal defect: a hole in the wall between the lower or upper two chambers of the heart

Coronary artery disease (also referred to as coronary heart disease and CAD) is the most common type of heart disease and was the cause of death for 382,820 people in 2020 alone. CAD develops gradually over time as plaque accumulates in the arteries that supply blood to the heart. If left unaddressed, the plaque build-up begins to narrow the arteries, blocking blood flow and stopping the heart from receiving oxygen. This can cause further heart complications and other forms of heart disease, such as: 

  • arrhythmia
  • angina (a type of chest pain caused by the reduced flow of blood to the heart muscle)
  • heart attacks
  • heart failure
  • pericardial disease 
  • and more.

Heart Arrhythmias describe issues with the rate and/or rhythm of the heartbeat. Some arrhythmias are very brief, having little to no effect on the heart in the long term. Others are longer, causing events where the heart rate is too fast (known as tachycardia) or too slow (known as bradycardia), and in some cases even erratic (which is known as fibrillation). 

The most common type of arrhythmia is called atrial fibrillation (AF), which is where the heart beats irregularly and faster than normal. This type of arrhythmia is a common cause of stroke. Having this type of arrhythmia makes a person’s risk of stroke five times higher than that of someone with a normal heart rhythm. When the heart doesn’t beat properly, it has a harder time pumping blood effectively. Without proper blood flow, the lungs, brain and other vital organs are unable to work adequately, potentially causing long-term damage. 

Heart Attacks occur when there is a severe lack of blood flow to the heart usually caused by complete blockage of one or more of the coronary arteries. The lack of blood flow then causes the tissue in the heart to start to die. According to the CDC, roughly 805,000 people have heart attacks each year. Research also indicates that about one in every five heart attacks are “silent,” meaning the person is not aware they’ve had a heart attack. Unfortunately, even when a person does not realize they’ve had a heart attack, the heart muscle can still incur long-term damage. 

Heart Failure, sometimes referred to as congestive heart failure, is a chronic, progressive condition that occurs when the heart muscle is weakened and unable to pump enough blood throughout the body. In order to try and compensate for the difference, the heart will enlarge, develop more muscle mass and even pump faster to increase its output. Unfortunately, these coping mechanisms are not a long-term solution and eventually, the heart is unable to maintain its efforts. This often leads to a buildup of fluid in the lungs and extremities, leading to fatigue and difficulty breathing (which usually signifies the need for a doctor’s visit).

In many cases, heart failure is preempted by coronary artery disease, but it can also be caused by hypertension, cardiomyopathy, congenital heart disease, past heart attacks, abnormal heart valves and other conditions. 

Heart valve disease occurs when one or more of the four valves in the heart are unable to open or close properly. This causes disruption of blood flow to your heart. There are two main types of heart valve disease; endocarditis and rheumatic heart disease. Endocarditis is caused by bacteria that enters the blood during illness, after surgery or after using intravenous drugs. This type of heart disease is often treated with high doses of antibiotics (usually intravenously) but can be life-threatening if left untreated. 

Rheumatic heart disease develops when the heart muscles and valves are damaged by rheumatic fever (which is linked to strep throat and other illnesses). In modern-day America, rheumatic heart disease is considered rare; however, it is present in low-income and developing parts of the world. In the U.S. and other developed nations, we are able to prevent rheumatic heart disease by utilizing antibiotics when treating the types of illnesses that lead to it. 

Pericardial Disease specifically addresses diseases that affect the pericardium which is the fibroelastic sac surrounding the heart. This type of heart disease is often caused by an infection from a virus, inflammatory diseases (like rheumatoid arthritis or lupus), or injury to the heart and pericardium. Types of pericardial disease include:

  • cardiac tamponade: pressure on the heart that occurs when blood/fluid builds up between the sac and the heart muscle 
  • pericardial effusion: the buildup of too much fluid in the sac
  • pericarditis: an inflammation of the sac

Cardiomyopathy (also known as heart muscle disease) is any disorder or disease that affects the heart muscle. In most cases, cardiomyopathy causes the heart to become weakened and lowers its ability to pump blood effectively throughout the body. The clinical course of the disease tends to be highly variable. In some cases, it is progressive, at times worsening quickly; in other cases, it is transient and mild, resolving quickly and without intervention. In some cases, cardiomyopathy is genetic, while at other times, it can be caused by the body’s reaction to a drug, a vaccine or a toxin, a viral infection, or even chemotherapy. In the past two years, there has been a focus on COVID-19 and the mRNA COVID-19 vaccines as potential causes of myocarditis. In general, the vaccine-associated forms of myocarditis tend to be self-limiting and not a significant cause for concern. Exact causes are not always known, and every case needs to be evaluated carefully. 

What Are the Symptoms of Heart Disease? 

It’s important to note that some symptoms of heart disease are forms of heart disease in and of themselves. Symptoms vary and overlap depending on the specific type of heart disease that a person may have. In many cases, there are no visible symptoms for long periods of time. 

Unfortunately, it is not uncommon for a person to be completely unaware they even have heart disease until they experience a heart attack (usually chest pain) or heart failure (usually shortness of breath). 

That said, the following symptoms can signify a heart problem: 

  • chest pain, tightness, pressure, or discomfort (angina)
  • cold sweats
  • dizziness/lightheadedness/fainting 
  • extreme fatigue
  • heartburn or indigestion
  • irregular heartbeats that feel rapid, pounding or fluttering
  • nausea
  • low blood pressure
  • pain, numbness or tingling, weakness or coldness in the extremities
  • pain or discomfort that spreads to the shoulder, arm, back, neck, jaw, teeth or sometimes the upper belly (indicating possible heart attack)
  • persistent cough or wheezing with white or pink blood-tinged mucus (indicating possible heart failure)
  • shortness of breath 
  • swollen legs, ankles or feet
  • reduced ability to exercise

If you are experiencing any, or a combination of, these symptoms, it’s important to reach out to a doctor for examination and testing. The sooner a diagnosis is made, the better chance you likely have of managing your heart disease. 

What Causes Heart Disease? 

Similar to the symptoms of heart disease, its causes can vary depending on the form. For example, coronary artery disease and peripheral artery disease are most often caused by plaque buildup in the arteries. Arrhythmias can be caused by coronary artery disease, scarring of the heart muscle, genetic factors and a body’s reaction to different medications. Aging, infections and other diseases/conditions can also trigger different forms of heart disease. In some cases the direct cause is unknown. 

That said, there are risk factors that can contribute to the likelihood of a person developing this life-altering condition.

What Are The Risk Factors?

Smoking, high blood pressure, and high cholesterol (especially LDL) are all major risk factors for heart disease. The CDC estimates that one or more of these three risk factors are present in about 47% of Americans. Alongside these risk factors, heart disease can also be triggered by the following:

  • age
  • alcohol, drug, and tobacco abuse 
  • a sedentary/inactive routine 
  • an unbalanced/unhealthy diet 
  • being postmenopausal
  • congenital heart defects
  • damage to all, or any part of the heart
  • diabetes
  • gender
  • high anxiety 
  • high stress levels 
  • family history
  • sleep apnea
  • secondhand smoke exposure 
  • obesity or excess weight
  • uncontrolled stress, depression, and anger

While some risk factors can not be altered such as age, being post-menopausal and having a genetic predisposition, there are things you can do to lower your risk of developing heart disease. Before diving into preventive practices, let’s explore how heart disease is diagnosed and how it can be treated.

How Is Heart Disease Diagnosed?

In most cases, the doctor will start by taking a personal and family medical history alongside a recording of a patient’s past and current symptoms. Following that, there are several tests that can be used to evaluate heart disease. Some are non-invasive (meaning that there are no medical instruments inserted into the body), while others are a bit more invasive and require insertion of catheters into the blood vessels or heart. Doctors and physicians will often use a combination of the following tests to confirm a diagnosis. 

Blood Tests 

  • Alanine Transaminase (ALT) and Aspartate Aminotransferase (AST): measures the amount of AST enzymes in blood and detects inflammation/damage in the liver
  • Blood Urea Nitrogen (BUN) and Creatinine: measures kidney function by detecting how much waste product a person has in their blood
  • C-Reactive Protein (CRP): measures the level of c-reactive protein (CRP) in a sample of blood. CRP is produced in the liver as a part of the body’s response to injury. The higher the level of CRP in the bloodstream, the more inflammation in the body. Higher levels of CRP can indicate a significant health issue. 
  • Complete Blood Count (CBC): measures your white blood cells, red blood cells, platelets, hemoglobin, hematocrit and mean corpuscular volume (MCV) 
  • Fasting Glucose and Hemoglobin A1c: measures blood sugar after an overnight fast. This test is commonly performed when diagnosing diabetes and pre-diabetes but is also utilized when diagnosing heart disease and other conditions. The HbA1c estimates what your blood sugar was over the past two to three months and is an excellent predictor of insulin insensitivity.
  • Homocysteine: measures the amount of homocysteine (an amino acid) in a sample of blood. This amino acid is used in the production of protein and building/maintaining tissue. Having a high level of homocysteine can damage the inside of the arteries and increase a person’s risk of forming blood clots and having a stroke.
  • Troponin: measures the levels of troponin T or troponin I proteins in the blood. These proteins are released when the heart muscle has been damaged, such as occurs with a heart attack. The more damage there is to the heart, the greater the amount of troponin there will be in the blood. Recently, high sensitivity versions of the test have been developed, which add to the accuracy and utility of the test in patients suspected of having a heart attack.
  • Lipid Profile: measures total cholesterol, LDL (low-density lipoprotein), cholesterol, HDL (high-density lipoprotein), and triglycerides in a sample of blood. This test helps determine a person’s risk of plaque buildup in the arteries. 
  • Lipoprotein (a): measures a special type of lipid-containing protein in the blood that carries cholesterol through the bloodstream to the cells. Higher levels can indicate a higher risk for heart disease and stroke.
  • Sodium and Potassium Levels: helps detect issues with the electrolyte balance in body fluids 
  • Thyroid Stimulating Hormone (TSH): measures thyroid function and the amount of TSH in your blood

Non-blood Related Invasive Tests

  • Cardiac Catheterization: a common diagnostic procedure in which a catheter is guided through a blood vessel to the heart. This test can show narrowing in the blood vessels, whether a heart is pumping blood effectively, if the valves are operating optimally, and more. During this process, additional tests can be performed, treatments can be delivered and in some cases, a piece of heart tissue is removed for further examination.
  • Electrophysiology (EP) Study: a test that captures the electrical activity of the heart. For this test, a doctor safely triggers an arrhythmia and then tests specific medications to see which can control it best. An EP study can be used to find a specific spot in the heart muscle that causes the irregular heart beat making it possible to ablate (remove) the source of the arrhythmia.  

Non-Invasive Tests

  • Electrocardiogram (ECG or EKG): a common and painless test that records the electrical signal from the heart to check for different heart conditions. This test can be done at rest or during exercise (a treadmill or bicycle). 
  • Echocardiogram (“Echo”): an ultrasound that provides images that show the heart’s structure and checks how well it is functioning. This test provides information about the size, shape and strength of the heart, if valves are working properly, if there is any leaking, the thickness of the muscle walls, etc.
  • Stress Echocardiogram: performed to see how the heart performs under stress. This test is usually performed on a treadmill or stationary bicycle or during infusion of a medicine that may pharmacologically increase the heart rate (like exercise) or blood supply to certain areas of the heart. Blood pressure and EKG are monitored throughout the duration of the test and for a few minutes thereafter. One of the challenges of the stress echo is the need for the patient to exercise vigorously while providing access to the ultrasound technician to position the ultrasound transducer (measuring device) on the chest in particular locations. This test is particularly challenging in female patients.
  • Nuclear Stress Test: made up of two components; a stress test (like in a stress echo) and a scanning of the heart after the injection of a radioactive material  (called a radionuclide or nuclear tracer).The radionuclide can track the heart’s metabolism, blood flow or perfusion, or viability. The test is performed to determine these parameters during stress, as well as at rest.  
  • Carotid Artery Doppler Ultrasound: monitors blood flow through the carotid arteries on both sides of the neck and evaluates a person’s risk of stroke.
  • Abdominal Ultrasound: screens for potential abdominal aortic aneurysm (along with a chest x-ray).
  • Holter Monitor: a small, portable machine is worn on the body for 24-48 hours or longer. The monitor provides an ongoing recording of the EKG during a person’s daily activities and can detect arrhythmias that may not have otherwise been shown on a single resting EKG.. 
  • Event Recorder/Loop Recorder: similar to the Holter monitor in that this recording device is worn on the body for a length of time. Patients wear this machine for several weeks, which is helpful for those infrequent symptoms. The monitor “loops” a 2-5 minute recording, which is continually overwritten. When a person begins to experience symptoms, they press the “record” button. These recordings are transmitted to a monitoring station and sent to the doctor’s office or facility for review.

Once a diagnosis has been established, your physician will be able to review treatment options with you. 

What Are the Treatments for Heart Disease?

Treatment options for heart disease vary depending on the type of heart disease a person has. Making lifestyle changes (like eating a balanced diet, exercising regularly, etc.), taking medications and undergoing surgery, or any combination of the three are common strategies when looking to lessen the effects of heart disease. 

Common medication options include: 

  • anticoagulants (blood thinners)
  • antiplatelet therapies (aspirin and similar medications)
  • angiotensin-converting enzyme (ACE) inhibitors
  • angiotensin II receptor blockers (ARB)
  • angiotensin receptor neprilysin-like inhibitors
  • beta-adrenergic blockers
  • calcium channel blockers 
  • cholesterol-lowering medications (like statins)
  • Digitalis
  • diuretics
  • nitrates like glyceryl trinitrate (GTN) tablets or lingual spray
  • vasodilators

Common surgical options include: 

  • Coronary Artery Bypass Surgery: a common procedure that allows blood flow to reach a part of the heart when an artery is blocked.
  • Aneurysmectomy: a procedure to remove and close up an area of expanded ventricular muscle or aortic wall.
  • Coronary Angioplasty: widens narrow/blocked coronary arteries, often combined with the insertion of a drug-eluting stent (a wire-mesh tube that assists with blood flow)
  • Valve Replacement or Repair: the replacement or repair of a valve that is not functioning properly; may be done surgically or through a catheter
  • Structural Repair Surgery: a repair for congenital heart defects, aneurysms, and related issues
  • Device Implantation: devices such as pacemakers, intra-aortic balloon catheters, or other devices are placed to regulate heartbeat, cardiac function and support blood flow
  • Maze Surgery: new paths for electrical signals to pass through are created by a surgeon. This procedure may help treat atrial fibrillation. 

What Can Be Done to Prevent Heart Disease? 

Creating a life full of heart-healthy practices and eliminating risk factors is one of the most effective ways to prevent the development of heart disease, as well as to limit its effects once developed. Here are six things you can start doing today to promote heart health:

  1. Eat a healthy, balanced diet 
  2. Eliminate smoking and avoid secondhand smoke 
  3. Exercise regularly and incorporate daily movement 
  4. Maintain a healthy weight
  5. Limit the use of alcohol 
  6. Practice good sleep patterns 
  7. Talk to a doctor about getting regular health screenings 

For more information about preventing heart disease with heart-healthy habits, check out last month’s article here.

Preventing Heart Disease With Heart-Healthy Habits

Did you know one person passes away from heart disease every 34 seconds? Both the Center for Disease Control and Prevention (CDC) and the Chronic Disease Research Group (CDRG) have named heart disease (cardiovascular disease) as the leading cause of illness and death in the United States. In fact, roughly 670,000 people passed away from heart disease in 2020 alone. 

Although there can be a genetic predisposition, there are things you can implement in your everyday life to help prevent and limit the effects of heart disease. Let’s start by reviewing what heart disease is and what typically causes this life-threatening condition.

What Is Heart Disease?

Simply put, the term “heart disease” refers to several different types of heart conditions. One example is coronary artery disease, also referred to as CAD. which affects blood flow to the heart. CAD is the most common type of heart disease, but other types include but aren’t limited to: 

  • Cardiomyopathy (Heart Muscle Disease)
  • Congenital Heart Disease
  • Heart Valve Disease
  • Pericardial Disease

Symptoms that can indicate heart disease include heart attacks, arrhythmias, heart failure, chest pain (including pressure or discomfort), shortness of breath, pain in the neck or jaw, numbness, weakness, or coldness in the legs or arms. 

Heart disease may also act “silent” for a period of time. It is not uncommon for a person to be unaware that they have heart disease until they experience symptoms of a heart attack or heart failure. 

What Are The Risk Factors for Heart Disease? 

High blood pressure, high cholesterol, and smoking are all significant risk factors for heart disease. According to the CDC, roughly 47% of people in the United States have one or more of these three risk factors. That said, heart disease can be triggered by several other medical conditions and lifestyle choices:

  • Alcohol, Drug, and Tobacco Abuse 
  • A Sedentary or Inactive Routine 
  • An Unbalanced/Unhealthy Diet 
  • Congenital Heart Defects
  • Diabetes 
  • Family History
  • Secondhand Smoke Exposure 
  • Obesity 

In addition, it should be noted that while heart disease can occur at any point in a person’s life, it becomes more of a risk as you age

What Can Be Done To Prevent Heart Disease? 

While some risk factors can not be helped or changed, creating a lifestyle full of heart-healthy habits can go a long way toward prevention. Heart-healthy habits help keep your blood pressure, cholesterol, and blood sugar levels balanced, lowering your risk of heart disease. Consider implementing the following practices when looking to lower your chances of getting heart disease.

Eliminate Smoking 

Eliminating the use of tobacco is one of the best things you can do not only for your heart but for your overall health. The act of smoking can cause our blood to become viscid, making it more likely to clot. These clots can block blood flow throughout the body including to the heart and brain. Smoking also: 

  • Causes blood vessels to thicken and narrow
  • Damages the cells that line blood vessels 
  • Increases the building up of plaque in blood vessels 
  • Raises triglycerides 
  • Lowers HDL (good cholesterol) 
  • and more

This are just some of the potential issues. Smoking and tobacco use can also lead to increased blood pressure and heart complications. In fact, secondhand smoke can cause heart disease and leads to over 30,000 early deaths each year

Regardless of how long you have been a smoker, quitting can only benefit you. According to the Mayo Clinic, your risk of heart disease may start  to drop in as little as a day after quitting, and after a year, your risk is cut in half compared to that of a current smoker. 

Limit the Use of Alcohol

Although it has been rumored that alcohol can be good for your heart, this idea isn’t fully backed by science. A few studies have linked moderate alcohol consumption to a lower risk of heart disease, but it is difficult to determine the cause and effect within those studies.

On the other hand, heavy alcohol usage has been proven to cause a wide range of negative health issues including high blood pressure, weight gain, stroke, arrhythmias, and cancer (most of which can lead to heart disease). Chronic consumption of alcohol (especially in excess) can lead to alcoholic cardiomyopathy where your heart muscles weaken. In fact, doctors often recommend avoiding alcohol for those who already have heart conditions or a history of heart failure.

According to the CDC, excessive drinking typically looks like four or more drinks for women and five or more drinks for men on any one single occasion. Heavy drinking is defined as eight or more drinks per week for women and 15 or more drinks per week for men. If your habits align with either of the above, health experts encourage you to speak with your doctor for more information about alcohol abuse and that you begin to limit your consuption of alcohol in general. 

Incorporate Daily Exercise 

A sedentary lifestyle is one of the top five risk factors for heart disease. Remember that just like any other muscle, the heart needs regular exercise. Research shows that consistent exercise is another one of the top ways to prevent heart disease, and that exercise can actually reverse some of the risk factors when paired with a heart-healthy diet. Routine physical activity can:

  • Help balance cholesterol levels
  • Improve your muscle’s ability to pull oxygen out of your blood
  • Increase your sensitivity to insulin 
  • Lower your blood pressure and heart rate 
  • Lower your risk of diabetes
  • Help you maintain a healthy body weight
  • Reduce inflammation throughout the body 
  • Reduce stress

These are just some of the potential advantages of exercise that can lower your chances of heart disease by lowering how hard your heart has to work overall. Incorporating thirty minutes to an hour of exercise into your daily routine, or at least most days of the week, can dramatically reduce your risk. 

Eat A Heart-Healthy Diet 

Exercising and eating a heart-healthy diet work in tandem to lower your overall risk of heart disease. Healthy foods work to protect your heart, keep your blood pressure and cholesterol regulated, reduce your risk of diabetes and help you maintain a healthy overall weight; all contributing towards a happy healthy heart. While diet requirements may vary for some depending on their current health status and allergies, in general, a heart-healthy diet consists of: 

  • Beans and other legumes
  • Healthy fats
  • Fruits
  • Lean meats and fish 
  • Low-fat or fat-free dairy products
  • Whole grains
  • Vegetables

In addition, it is important to limit the intake of: 

  • Alcohol 
  • Salt 
  • Sugar 
  • Processed carbohydrates 
  • Saturated fat (think rd meat and full-fat dairy products)
  • Trans fat (think fried food and baked goods)

Make High-Quality Sleep A Priority 

A minimum seven hours of sleep is needed for the average adult person per night. Those who consistently do not get enough high-quality sleep are at a higher risk of developing high blood pressure, diabetes, weight gain, and heart disease. It’s important to set a consistent sleep schedule, going to bed and waking up at the same time each day. In addition, your bedroom should be dark, cool, and quiet with white noise playing if needed (so long as it’s not distracting). 

If you find that you are sleeping the recommended amount of hours and still feel consistently tired throughout the day, talk to your doctor to see if you should be evaluated for any sleep disorders. For example, obstructive sleep apnea is a condition that can lead to heart disease. Those with this condition stop breathing for short periods of time during sleep, which jolts them awake. A person with obstructive sleep apnea may not be aware that they are waking up in the night, falling back asleep, and repeating the cycle. 

Making high-quality sleep a priority will lower your overall chances of developing heart disease, as well as improve brain function, and help keep weight under control. 

Get Regular Health Screenings

In addition to practicing habits that aim to keep our bodies happy, healthy and regulated, it is also important to schedule regular health screenings in order to monitor changes in our bodies. This allows us to know when it is time to take further action.

The following are recommended health screenings timeframes that if followed, can help prevent/limit the effects of heart disease. 

Test: Starting Age: Frequency: 
Blood Pressure Screening 18 Every 2 Years 
Cholesterol Levels 20 Every 4-6 years 
Type 2 Diabetes Screening 45 Every 3 years 

If you are showing signs of heart disease, your doctor may recommend several tests for diagnosis. Often, these tests will include an exercise test with or without imaging studies, an echocardiogram, a nuclear scan for function or perfusion, an electrocardiogram (EKG), and a cardiac CT among others. If diagnosed, your doctor can provide more information about managing and limiting the effects of heart disease. 

If you or someone you know has been diagnosed, incorporating these heart-healthy habits can help to reverse certain types of heart disease, as well as keep symptoms under control.

What Is the Heartlanta Bra?

Imagine for a moment, you’re someone with a family history of heart disease or you are exhibiting signs of heart disease. Imagine, you speak with your doctor about your concerns and they advise you to undergo a stress echocardiogram, which is a procedure to determine how well your heart and blood vessels are working. You arrive at your appointment, and the cardiology technician asks you to remove the clothing necessary to attach the machine’s wires to your chest. Once secured, the technician instructs you to hop on the treadmill just as you are, without redressing. Here, you are expected to run as fast as you can, on an incline, in front of medical staff while they take your blood pressure intermittently, check your electrocardiogram, and observe you during exercise. 

Now, if you’re imagining this scenario from the point of view of a man – or a person without breasts – you may not recognize a problem at this stage in the test. If you’re a woman – or a person who does have breasts – you’ve likely been hit with a wave of embarrassment, discomfort, pain, and possibly even shame. None of these emotional reactions will help you exercise or push yourself to a diagnostically interpretable study. 

This is the reality for thousands of people who take the Standard Stress Echocardiogram or Stress Test each year. It was also the reality for Heartlanta Bra co-founder and actress Jennifer Beals. 

What Is Wrong With the Standard Stress Echocardiogram? 

Historically, the field of cardiology has been male-dominated. Unfortunately, this imbalance has led to gender bias impacting both the treatment of and screening for heart disease. Although it is a potentially life-changing diagnostic test, it was not designed with breasts in mind. The test is almost exclusively conducted only wearing an open hospital gown on the upper half of the body, because conventional clothing interferes with the electrodes and ultrasound imaging. Although unintentional, the test puts women and those with breasts in both a physically and emotionally painful position; one that men generally do not endure. 

For a person with breasts, running on a treadmill in front of other people, without the securement of a bra can not only be a humiliating task but also one that may cause physical discomfort from the aggressive movement of the breast tissue, as well as from friction caused by the attached electrodes. These and other issues have likely resulted in up to 20-25% of false positive results. The dedicated team at Heartlanta Bra is working hard to set a new standard for diagnosing heart disease in women and those with breasts. 

How Does the Heartlanta Bra Work?

Specifically designed to be compatible with the stress echocardiogram test, the Heartlanta Bra lifts breast tissue away from electrodes and provides easy access for ultrasound imaging utilizing a hook-and-loop closure center. The patented bra’s nylon grade material is said to feel similar to that of a swimsuit top, ensuring modesty and reducing discomfort for the wearer by supporting breast tissue – all while providing accurate results. The Heartlanta Bra is also size inclusive; each bra can fit up to eight cup sizes. It is far more than a sports bra; the Heartlanta Bra was specifically designed to optimize a patient’s experience during the stress test and imaging with echocardiography.

Why is Heartlanta Bra Important?

According to the Chronic Disease Research Group (CDRG) as well as the CDC (Center for Disease Control and Prevention, heart disease (cardiovascular disease) is the preeminent cause of sickness and death in the United States. Although awareness of the condition is on the rise, many are still unaware that heart disease is the number one cause of  death in women across the U.S.

When it comes to heart disease, prevention and early detection are critical. Unfortunately, a lack of awareness, alongside the discomfort and embarrassment around taking a standard stress echocardiogram, prevents women and those with breasts from receiving optimal care. The Heartlanta Bra company was created in an effort to improve the stress echo screening experience, advocate for women’s heart health, and empower women across the globe. 

What Has Been The Response to the Heartlanta Bra? 

In an interview with Veronica Beard, Beals shares that the response has been overwhelmingly positive. “Every cardiologist who has shared Heartlanta with their patients has told us how grateful their patients were,” says Beals. “Heartlanta doesn’t interfere with the medical technician’s work and it allows women to feel more physically and mentally comfortable in what is a stressful situation.”

Developed in collaboration with OB/GYN and women’s health expert Dr. Sherry Ross, actor and activist Jennifer Beals, and a leading team of cardiologists, the Heartlanta Bra is providing opportunities for people to learn more about their own bodies, and empowering them to take necessary steps towards a healthier life. 

For more information about the Heartlanta Bra, visit their website, here.

Disclosure: I am a shareholder in and unpaid advisor to the Heartlanta Bra company. I have worked with Dr. Ross and Ms. Beals for several years focusing on medical, regulatory and business matters.

The Pandemic Isn’t Over Yet

A recent poll reveals that 1 in 3 Americans believe the pandemic is in fact over. With much of the global population having packed away their masks, and returned back to what is considered “normal life,” it would be easy to reach that conclusion. Unfortunately, that conclusion is not only incorrect,  but it is also dangerously incorrect. Although cases have fallen dramatically from their once record-breaking highs, we continue to have thousands of new COVID-19 infections each day, hundreds of which result in death. Of note, new cases are particularly common in children of all ages in school. I have seen this first hand with many cases every week at the schools attended by my children (all of whom wear well-fitted masks indoors).

In fact, a recent report from the University of Washington’s Institute for Health Metrics and Evaluation (IHME) predicts daily global COVID-19 infections will gradually increase to about 18.7 million by February 2023. The current average is 16.7 million cases per day. 

So why is the pandemic still ongoing? What information is leading scientists to predict a continued increase in COVID-19 cases over the foreseeable future

How We Know The Pandemic Isn’t Over Yet and Why

According to The International Epidemiology Association’s Dictionary of Epidemiology, a pandemic is, “an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.” One of the most obvious ways we are able to tell the pandemic is still prevalent is the previously mentioned increased number of global infection cases, along with many patients being hospitalized. We are still seeing consistent outbreaks of the virus, in what has now become several different variants, circulating around the world. This is compounded by the concurrent spread of influenza and other respiratory viruses such as RSV.  

Vaccine Inequality 

Vaccines offer us the most hopeful path out of the pandemic. Unfortunately, another major reason behind the aforementioned increased infection predictions is the current lack of vaccine equity. This will only lead to the creation of more and more variants of the virus. These new variants can be widely unpredictable, and although some have been labeled as “mild,” they still come with their own set of dangerous consequences. For example, the Omicron (B.1.1.529) variant may be considered less deadly overall, however it can still result in serious long-term health complications, illness, and even death, especially in unvaccinated individuals. We generally have been measuring the prevalence of COVID-19 by the number of cases, hospitalizations and deaths, but the greatest concern may be the growing number of Long COVID cases in patients of all ages – the shift from acute to chronic COVID-19.  

Vaccine inequality is due in large part to vaccine hoarding in wealthy countries. This report from ONE.org reveals that twice as many people who live in wealthier nations have received a booster shot compared to those in lesser developed areas. It also states that at the current rate, it will take over ten years for these parts of the population to reach vaccination rates comparable to those in higher-income locations. Further exacerbating the problem is the practice of pharmaceutical companies to allow higher-income countries to place a claim on large vaccine quantities  before others could access them. This further perpetuates the problem, leaving millions unvaccinated and vulnerable to infection. 

Lifted Restrictions 

Against the advice of most knowledgeable scientists and researchers across the world, most COVID-19 restrictions surrounding testing and isolation, as well as mask-wearing have either been lessened or lifted altogether. Restrictions have been reinforced in certain areas of the world during major outbreaks of the virus, but in areas such as North America and the UK, they are primarily gone. These changes have also made free or low-cost testing less accessible (if not non-existent), leading to even further spread. The availability of easy-to-use home antigen tests has made a significant difference in some communities, but the tests are not inexpensive in the U.S. and require compliance.

These lifted restrictions have had a significant impact on the spread of the virus. With a large percentage of our population back in offices, classrooms, restaurants, and other close quarters, the virus has had (and continues to have) endless opportunities to spread and mutate. As previously mentioned, this increased infection rate could potentially lead to a deadlier, even more contagious variant of the virus, setting us back to where we were at the height of the pandemic


Misinformation has contributed to COVID-19 and its ability to spread and spread quickly, since the beginning of the pandemic. The misuse of social media, the internet, and other communication platforms has largely facilitated the spread of this misinformation. Unfortunately, these tools have been used to perpetuate dangerous ideas that inevitably resulted in the rejection of face masks, vaccines, and the use of medicines with scant scientific support, ultimately raising morbidity and mortality.

Many politicians and government leaders have also contributed to the spread of misinformation. While statements are not always made with mal-intent, they can be equally as dangerous as those that are. For example, this past September (two months before the mid-term elections in the U.S.), there was what I would describe as a politically motivated Presidential statement declaring the pandemic was over. This statement led to significant complications in U.S public-health efforts against COVID-19. The statement was made at the same time as public health officials were pushing citizens to get their next booster shot, causing further confusion about whether vaccinations are truly needed or not. Some politicians then used the statement to argue against the mandatory vaccination policies currently in place for federally funded programs and our military. This line of thinking is becoming more and more widespread, regardless of the fact that the virus has killed over 200,000 people this year alone.

What Can You Do To Protect Yourself From COVID-19

At this point in time, we can’t be sure when the pandemic will end. In the meantime, it’s important to continue doing all you can to protect yourself and those around you. It is highly recommended that you: 

  • Continue to stay up-to-date on your COVID-19 vaccinations (primary set and subsequent boosters, including variant-specific forms).
  • Continue to wear a well-fitted mask when indoors, traveling via public transportation, or while in any other crowded setting (especially on airplanes).
  • Know that just because you are not required to wear a mask, does not mean it’s safe to go without one.
  • Host gatherings outside whenever possible. If infection rates are rising in your particular community, reschedule plans for a later date. 
  • Try to avoid close contact with others at any gatherings you do attend.
  • Wash or sanitize your hands before eating or touching your face.
  • Get tested when you have COVID-19-related symptoms. Isolate as appropriate if you receive positive results and do not return to work or school until you have tested negative with rapid tests (ideally two consecutive days).
  • Stay educated on the topic. Look to trusted scientists and sources when looking for guidance on the most effective COVID-19 protective measures.

An easy way to remember the key points in COVID-19 protections is to “Avoid the 3Cs”; closed doors, crowded spaces, and close contact. For more information on COVID-19, check out this related article from my blog: The Journey of the COVID-19 Vaccine.

Long Covid: What You Need To Know 

After recovering from COVID-19 (SARS-CoV-2), approximately 10-30% of individuals who contract the virus will continue to experience symptoms. This is referred to as “long COVID,” ”post COVID,” or “long-haul COVID.” So what is long COVID, what causes it, and how can it affect the body long term? Let’s take a closer look.

What is Long COVID? 

“Long COVID” is a term used to describe the lasting effects COVID-19 can continue to have for weeks, months, or even years beyond the initial or acute infection. Damage to various organs, including the heart, kidneys, lungs, and brain, are common signifiers of the condition. 

Someone experiencing COVID-19 symptoms anywhere from four weeks or more following the initial infection, where symptoms can not be otherwise explained, is likely suffering from long COVID. Research to better define long COVID and its symptoms are ongoing.  Some physicians equate this paradigm to chronic heart failure (CHF) after acute heart failure or decompensation. 

How Can Long COVID Affect the Body? 

As we emerge from a pandemic that caught much of the world off guard, governments and scientists are now starting to systematically study the area. Unfortunately, this means there is currently a lack of knowledge regarding COVID-19’s possible long-term effects. What we know right now is there are over 200 symptoms that can be present in long COVID patients. That said, those same symptoms can present in many other illnesses. This can make long COVID hard to definitively diagnose. 

Long COVID and the Physical Body

The most common long COVID symptoms are fatigue, shortness of breath, loss of smell and taste, cognitive limitations, and muscle pain. Other symptoms include but are not limited to: 

  • amnesia
  • brain fog (difficulty thinking or concentrating)
  • bowel incontinence
  • changes in order or taste
  • chest or stomach pain
  • diarrhea
  • difficulty breathing
  • difficulty with motor function or speech
  • erectile dysfunction
  • fever
  • impaired respiratory function
  • issues with sleep
  • hallucinations
  • heart palpitations (racing or pounding heart)
  • headaches
  • fatigue or exhaustion 
  • lightheadedness
  • memory loss
  • menstrual cycle fluctuations 
  • mood swings
  • muscle or joint pain
  • nausea
  • persistent coughing
  • pins and needles sensation (neuropathy)
  • post-exertional malaise (symptoms that worsen after physical or mental strain)
  • rashes or other skin irritations
  • shortness of breath

Long COVID and Diabetes 

When thinking of long-term COVID-19 symptoms, people first think of cognitive issues, fatigue, or breathing issues. While those are common symptoms of long COVID, some individuals who survive COVID-19 are being diagnosed with diabetes. Diabetes is a chronic condition that affects how your body turns food into energy and occurs either when the pancreas is no longer able to produce insulin or when the body can’t make use of the insulin it does produce. 

This new symptom is leading scientists to believe there are likely several different forms of long COVID. One particular type of long COVID is thought to be distinguished by cardiometabolic complications that appear after COVID-19. According to a recent study, individuals who have recently recovered from SARS-CoV-2 infection are 40% more likely than uninfected individuals to be given a new diagnosis of diabetes. This will require further confirmation in larger trials.

This elevated risk correlates to roughly 1% of people (8.28 per 1000 individuals at 12 months) who have had COVID-19 developing diabetes and would not have otherwise, potentially resulting in millions of new cases across the world. Most participants of the study were diagnosed with Type 2 diabetes rather than Type 1. Some scientists believe COVID-19 and long COVID may trigger a brand new form of diabetes in which specific cells may cause blood sugar levels to rise rather than lower them. Research is ongoing. 

Warning signs that an individual may have developed diabetes after a COVID-19 infection include: 

  • cuts, bruises, and other wounds are slow to heal
  • inability to regain weight that was lost while ill
  • excessive fatigue 
  • increased thirst connected to blurred vision
  • frequent/increased need for urination

If you suspect you may have developed diabetes after a COVID-19 infection, it’s important to contact your healthcare provider as soon as possible. High blood sugar levels that go unchecked can cause irreversible harm to the body’s blood vessels and nerves, which can negatively affect the heart, kidneys, eyes, and more.

Long COVID and Cancer 

We know from previous research that certain viruses may cause cancer. Examples include Human papillomaviruses (HPV), Epstein-Barr Virus (EBV), Hepatitis B and C, Human immunodeficiency virus (HIV), and more. In order to replicate and create new virions, a virus needs to enter a living cell and commandeer the cell’s machinery. Some viruses carry out this action by integrating their own DNA (or RNA) into the host cell’s. The host cell may be pushed toward developing cancer if the DNA or RNA has an impact on its genes.

Though not yet proven, some speculate a long-term inhibition of protein p53 by SARS-CoV-2 could be cancer-causing. Because it controls the expression of about 500 target genes and is a crucial component of the apoptotic (cell death) signaling pathway, the onco-suppressive protein p53 plays a part in cell-cycle arrest, cell aging, cell death, and other processes. In order to determine whether or not p53 is dysregulated during acute SARS-CoV-2 infection and long COVID, the study looked at three gene-expression datasets. Long-term p53 deficiency could be a considered risk factor in carcinogenesis.

Another article from the NIH suggests long COVID may make recovered patients more prone to developing cancer and hasten the progression of the disease. Mounting data supports this theory, showing how SARS-CoV-2 can modulate oncogenic pathways, increase chronic low-grade inflammation, and result in tissue damage. Further research is ongoing.

Long COVID and Suicidal Ideation 

Studies on long COVID and its connection to suicide are still in their early stages. This means there is no current authoritative data on the frequency of suicides among sufferers. That said, there are hundreds of documented cases that have popped up over the last two years where long COVID patients who are suffering from the more extreme side of their symptoms (loss of cognitive function, muscle pain, exhaustion, and more) admit to experiencing suicidal ideation. In fact, a poll conducted by the long COVID advocacy group SURVIVOR CORPS (May 2022) revealed 44% of participants had thought about suicide, which is significantly higher than the 18% reported just one year prior. There are also many individual cases of suicide in these patients reported on social media and in the literature. The causal relationship and potential mechanisms are under study. 

Institutions such as the NIH in the U.S.,, Britain’s medical data-collection agency, and others are starting to look into a possible connection based on evidence of an increase in the incidence of depression and suicidal thoughts among those with long COVID, as well as an increase in the number of known fatalities. 

One of the main issues researchers are investigating is whether the virus has the ability to change an individual’s brain biology or the loss of ability to function as they had pre-COVID-19 triggers suicidal ideation. With other chronic medical conditions, the latter has been seen. For instance, there is a strong correlation between brain inflammation and pain disorders (both of which have been linked to long COVID in numerous studies). 

People with chronic illnesses are more likely to have suicidal thoughts, attempt suicide, and actually commit suicide—-COVID- related or otherwise. This report from the health data firm Truveta states that patients with long COVID were nearly twice as likely to receive a first-time antidepressant prescription within 90 days of their initial COVID diagnosis when compared to other populations. More than 1.3 million adults with a COVID diagnosis and 19,000 with a long COVID diagnosis between May 2020 and July 2022 were included in the analysis.

If you are experiencing symptoms of suicidal ideation, whether or not you are also experiencing known symptoms of long COVID, it’s important to reach out urgently to your healthcare professional. However, recognize that physicians are still learning about Long COVID, and many may not be as well informed as you would like or hope for. 

What Causes Long COVID? 

Given the wide range of long-term symptoms, scientists believe there may be more than one cause of long COVID. 

Originally, experts felt an overactive autoimmune response to the virus underlying COVID-19 causes the immune system to produce autoantibodies that gradually attack the body’s tissues and organs. But they’ve since found that long COVID actually seems to be associated with a suppressed immune system. While blocking its activity, the antibody can stabilize CCR5 expression on the cell surface, leading to the upregulation of other immune receptors and processes.

One particularly intriguing concept is that once infected, many patients harbor the virus for extended periods of times. The more research scientists complete, the more they are concluding that the lingering virus is likely the dominant cause of long COVID. According to recent research, the SARS-CoV-2 spike protein can be found in the blood of long-term COVID patients up to one year after infection but not in those who have fully recovered. Scientists have also discovered the virus in tissues such as the brain, lungs, and lining of the stomach and intestines many months after acute infection. These findings importantly point to possible treatment options – anti-viral medicines (e.g., Paxlovid) or anti-inflammatory medicines.

Another hypothesis is that long COVID symptoms are caused by organ damage the initial or subsequent infections may have caused. With reference to the cognitive or nervous system impact, this has been referred to as a neuroinflammatory disease – one of the most troubling of the long-term symptoms of COVID-19.

How Long Does Long COVID Last? 

Unfortunately, because the condition is still relatively new, we don’t have a full understanding of how long the effects of long COVID last. What we do know is recovery times vary from patient to patient.. Reported cases have lasted anywhere from several weeks to several years. In some cases, patients report symptoms disappearing and reappearing over time, perhaps due to fluctuations in the level of residual virus in the body..

Are COVID-19 Patients Contagious?

The duration of COVID-19 patients’ contagiousness is a complex and hard question to answer with a precise time frame. Varying levels of natural immunity brought on by prior infection, primary vaccination status, use of booster vaccinations, and emerging variants can all affect how quickly someone can clear the virus from their system. The Center of Disease Control (CDC) states that in general, those with COVID-19 infections should remain isolated for at least five days, and those with a more severe COVID inflection or those who are immunocompromised should remain isolated for longer periods of time. There is controversy as to how long patients should be quarantined following testing positive for COVID-19, but in any case, the best way to remain safe is to perform rapid COVID-19 testing at home and consider yourself as contagious (able to pass the virus to others, including family members) until testing negative for two consecutive days. .

However, long COVID patients are no longer in the contagious stage and can not spread the virus to others unless reinfected.

If I Have Long COVID, Will I Test Positive? 

After the initial positive COVID test and illness, results with PCR tests performed in clinical laboratories may continue to be positive for several weeks. Positive COVID tests beyond 90 days are most likely the result of a new infection. Long COVID itself is not contagious as it simply refers to the persistent damage and continued symptoms caused by the original infection.

Is There A Specific Test for Long COVID? 

Since long COVID is a newly developed condition and isn’t yet completely understood, there is not currently a single diagnostic test. Researchers are in the process of looking for ways to distinguish between long COVID and other illnesses. 

Is There Treatment for Long COVID? 

Unfortunately, there are no proven treatments for long COVID at this time. Uncertainty regarding the underlying cause of long-COVID has been a major obstacle in developing effective treatments. 

A handful of treatment trials are currently exploring the use of various currently available medicines. The most promising approach is the use of the anti-viral medicines approved for use in the acute phase of COVID-19, such as Paxlovid, which should lower the levels of residual virus in the body and potentially eliminate the ongoing impact of exposure to the virus in various organ systems. . While most trials are small and in the early stages of implementation, they are steps in the right direction. Numerous treatment theories have gained traction over the last two years, and researchers are hoping to gain evidence of their effectiveness to create and offer helpful treatment options. 

As previously stated, there is growing proof that residual SARS-CoV-2 may continue to have long-lasting effects on the immune system. Additionally, the infection may produce antibodies that mistakenly target the body’s own protein and potentially cause harm years after the initial infection. Each hypothesized cause comes with its own treatment hypothesis. For example, a misguided immune response may be stopped by immunosuppressive medications, whereas microthrombosis may be prevented by medicines that target the clotting cascade, such as in pulmonary embolism and deep venous thrombosis. .

The NIH RECOVER project (which has received $1.15 billion in funding) is the most heavily funded research project for Long COVID, but it has yet to test any treatments. Researchers agree that when the results of the pilot projects become more promising, larger trials should be done quickly and expansively. The pathology underlying long COVID is becoming much clearer to physician-scientists working in this field. Important trials for medications that target blood clots, the immune system, or latent coronavirus fragments are expected in  the upcoming year. 

How Can I Prevent Long COVID? 

COVID-19 prevention and long COVID prevention go hand in hand. There are several things you can do to help reduce your chances of a COVID-19 infection.

COVID 19 Vaccine and Boosters

The original goals of the COVID-19 vaccines were to prevent serious illness and death. Fortunately, these goals have largely been met; vaccines and boosters have been proven to reduce the overall risk of COVID-19 infection, as well as the seriousness of the illness if contracted. 

The COVID-19 vaccine also appears to reduce the risk of long COVID after recovering from a breakthrough COVID-19 infection, though having the vaccine does not guarantee you won’t contract the illness or experience long-term effects. Those who are unvaccinated are at a much higher risk of developing long COVID. This is supported by data from the Office for National Statistics (ONS), which demonstrates that receiving the vaccine twice could cut the risk of developing Long COVID by 40% (in people 18-69 years of age).

Masks and COVID-19 Cautiousness 

The likelihood of spreading and contracting COVID-19 is decreased by wearing a properly fitted mask, along with vaccination, self-testing, and physical separation, which helps to protect you and others. It is also a good idea to check your local COVID-19 community level for information on COVID spikes in your area and additional precautionary measures you can take but keep in mind that wearing a mask indoors or in crowds is the best and simplest way to decrease the spread of the disease.

How Many People Have Been Affected by Long COVID?

The University of Washington’s Institute for Health Metrics and Evaluation (IHME) estimates that within the first two years of the pandemic nearly 145 million people worldwide have developed long-lasting symptoms

What Support Is There for Long-COVID Patients? 

Levels of support for those suffering from long COVID vary across the world. In the U.S., the current administration has released a Memorandum on Addressing the Long-Term Effects of COVID-⁠19 (which calls for a government-wide response). This memorandum includes two major reports: 

  1. Services and Supports for Longer-Term Impacts of COVID-19: Outlines federally funded support services for those affected by COVID-19 and long COVID.
  2. The National Research Action Plan on Long COVID: Proposes an extensive and equitable research strategy to guide our country’s response to long COVID. 

Emotional support and resources are available through additional support groups such as the Survivor Corps and Long COVID Support. The Administration for Community Living, which is an operating division of the U.S. Department of Health and Human Services also released this document that outlines “How ACL’s Disability and Aging Networks Can Help People with Long COVID.”

The information above was last updated/accurate as of 9/14/2022. As research continues and information becomes available, updates may occur.