Papers by Jared J Eddy
Perspectives in Biology and Medicine
Vaccine hesitancy continues to pose a formidable obstacle to increasing national COVID-19 vaccina... more Vaccine hesitancy continues to pose a formidable obstacle to increasing national COVID-19 vaccination rates in the US, but this is not the first time that American vaccination efforts have confronted resistance and apathy. This study examines the history of US vaccination efforts against smallpox, polio, and measles, highlighting persistent drivers of vaccine hesitancy as well as factors that helped overcome it. The research reveals that logistical barriers, negative portrayals in the media, and fears about safety stymied inoculation efforts as early as the 18th century and continue to do so. However, vaccine hesitancy has been markedly diminished when trusted community leaders have guided efforts, when ordinary citizens have felt personally invested in the success of the vaccine, and when vaccination efforts have been tied to broader projects to improve public health and social cohesion. Deliberately cultivating such factors could be an effective strategy for lessening opposition today, when COVID-19’s distinctive characteristics make addressing vaccine hesitancy more urgent than it has ever been.
Diagnostic Microbiology and Infectious Disease
Antimicrobial susceptibility testing for rapidly growing mycobacteria (RGM) is uncommon or only p... more Antimicrobial susceptibility testing for rapidly growing mycobacteria (RGM) is uncommon or only performed in large reference laboratories. Here we developed a cumulative antibiogram for 14 RGM using the largest sample size to date (N = 3860). All RGM showed 82% to 100% susceptibility to amikacin. Mycobacterium abscessus showed low percentages of susceptibility to most antimicrobials; of antimicrobials without interpretations, the minimum inhibitory concentration-90 for clofazimine was low (≤0.5mg/L). All three subspecies had ≤2.6% rrl resistance mutations, however intact erm(41) was detected in 70% to100% of M. abscessus abscessus and bolletii. Mycobacterium chelonae had a similar susceptibility pattern to M. abscessus subsp. massiliense and Mycobacterium immunogenum except that it was susceptible to tobramycin (87%). Mycobacterium fortuitum complex and similar organisms showed higher frequency of susceptibility to fluoroquinolones, beta-lactams, linezolid, and trimethoprim/sulfamethoxazole. Although relatively small published RGM antibiograms showed substantial variance, a comprehensive antibiogram can help influence treatment and monitoring patterns of resistance.
The Southwest Respiratory and Critical Care Chronicles
Introduction: As an increasing number of patients present for ambulatory care following acute COV... more Introduction: As an increasing number of patients present for ambulatory care following acute COVID-19, we set out to characterize and identify clinical predictors of prolonged symptoms and antibody seroconversion. We hypothesized that patients who present with a high symptom burden are more likely have prolonged post-acute sequelae of COVID-19 (PASC). Methods: All adults with confirmed SARS-CoV-2 infection evaluated at a single ambulatory center between April and September 2020 were studied retrospectively using a logit model and ANOVA; the importance of variables associated with prolonged symptoms and seroconversion was determined using machine learning methodology. Results: The most common initial symptoms of 276 subjects were fatigue, dyspnea, cough, fever, and myalgia, with ~30% experiencing all five. Those with prolonged sequelae (>4 weeks) reported higher initial symptom burden compared to those without PASC (mean 8.2 vs. 3.3 symptoms, p<0.0001). Anosmia (odds ratio, OR...
Annals of Biomedical Engineering, 2020
The global COVID-19 pandemic disrupted supply chains across the world, resulting in a critical sh... more The global COVID-19 pandemic disrupted supply chains across the world, resulting in a critical shortage of personal protective equipment (PPE) for frontline healthcare workers. To preserve PPE for healthcare providers treating COVID-19 positive patients and to reduce asymptomatic transmission, the Department of Bioengineering at the University of Colorado, Denver | Anschutz Medical Campus collaborated with National Jewish Health to design and test patterns for cloth face coverings. A public campaign to sew and donate the final pattern was launched and over 2500 face coverings have been donated as a result. Now that nearly three million cases of COVID-19 have been confirmed in the United States, many state and local governments are requiring cloth face coverings be worn in public. Here, we present the collaborative design and testing process, as well as the final pattern for non-patient facing hospital workers and community members alike.
Perspectives in Biology and Medicine, 2023
Vaccine hesitancy continues to pose a formidable obstacle to increasing national COVID-19 vaccina... more Vaccine hesitancy continues to pose a formidable obstacle to increasing national COVID-19 vaccination rates in the US, but this is not the first time that American vaccination efforts have confronted resistance and apathy. This study examines the history of US vaccination efforts against smallpox, polio, and measles, highlighting persistent drivers of vaccine hesitancy as well as factors that helped overcome it. The research reveals that logistical barriers, negative portrayals in the media, and fears about safety stymied inoculation efforts as early as the 18th century and continue to do so. However, vaccine hesitancy has been markedly diminished when trusted community leaders have guided efforts, when ordinary citizens have felt personally invested in the success of the vaccine, and when vaccination efforts have been tied to broader projects to improve public health and social cohesion. Deliberately cultivating such factors could be an effective strategy for lessening opposition today,
when COVID-19’s distinctive characteristics make addressing vaccine hesitancy more urgent than it has ever been.
Southwest Respiratory and Critical Care Chronicles, 2022
Introduction: With an increasing number of ambulatory visits for acute COVID-19 follow-up, we set... more Introduction: With an increasing number of ambulatory visits for acute COVID-19 follow-up, we set out to characterize and identify clinical predictors of prolonged symptoms and antibody seroconversion. We hypothesized that patients who present with a high symptom burden are more likely to have prolonged post-acute sequelae of COVID-19 (PASC). Methods: All adults with confirmed SARS-CoV-2 infection evaluated at a single ambulatory center between April-September 2020 were studied retrospectively using a logit model and ANOVA, and the importance of variables associated with prolonged symptoms and seroconversion was determined by machine learning methodology. Results: The most common initial symptoms of 276 subjects were fatigue, dyspnea, cough, fever, and myalgia, with ~30% experiencing all five. Those with prolonged sequelae (>4 weeks; PASC) reported higher initial symptom burden compared to those without PASC (mean 8.2 vs. 3.3 symptoms, p < 0.0001). Anosmia (odds ratio, OR 23.0), myalgia (OR 12.8), and dyspnea (OR 10.8) had the highest predictive values for PASC. Neither lung function nor pre-existing lung disease correlated with PASC pulmonary symptoms (p = 0.17, p = 0.5, respectively). Natural post-COVID-19 seroconversion rate was 78%, with the male gender having higher-and corticosteroid treatment and elevated creatinine having lower seroconversion. Conclusion: Ambulatory patients display a broad range of symptoms following acute COVID-19. A high initial symptom burden may predict PASC development. In unvaccinated, antibody seroconversion may be influenced by gender, corticosteroid use, and renal function.
Annals of Biomedical Engineering, 2020
The global COVID-19 pandemic disrupted supply chains across the world, resulting in a critical sh... more The global COVID-19 pandemic disrupted supply chains across the world, resulting in a critical shortage of personal protective equipment (PPE) for frontline healthcare workers. To preserve PPE for healthcare providers treating COVID-19 positive patients and to reduce asymptomatic transmission, the Department of Bioengineering at the University of Colorado, Denver | Anschutz Medical Campus collaborated with National Jewish Health to design and test patterns for cloth face coverings. A public campaign to sew and donate the final pattern was launched and over 2500 face coverings have been donated as a result. Now that nearly three million cases of COVID-19 have been confirmed in the United States, many state and local governments are requiring cloth face coverings be worn in public. Here, we present the collaborative design and testing process, as well as the final pattern for non-patient facing hospital workers and community members alike.
Diagnostic Microbiology and Infectious Disease, 2023
Antimicrobial susceptibility testing for rapidly growing mycobacteria (RGM) is uncommon or only p... more Antimicrobial susceptibility testing for rapidly growing mycobacteria (RGM) is uncommon or only performed in large reference laboratories. Here we developed a cumulative antibiogram for 14 RGM using the largest sample size to date (N = 3860). All RGM showed 82% to 100% susceptibility to amikacin. Mycobacterium abscessus showed low percentages of susceptibility to most antimicrobials; of antimicrobials without interpretations, the minimum inhibitory concentration-90 for clofazimine was low (≤0.5mg/L). All three subspecies had ≤2.6% rrl resistance mutations, however intact erm(41) was detected in 70% to100% of M. abscessus abscessus and bolletii. Mycobacterium chelonae had a similar susceptibility pattern to M. abscessus subsp. massiliense and Mycobacterium immunogenum except that it was susceptible to tobramycin (87%). Mycobacterium fortuitum complex and similar organisms showed higher frequency of susceptibility to fluoroquinolones, beta-lactams, linezolid, and trimethoprim/sulfamethoxazole. Although relatively small published RGM antibiograms showed substantial variance, a comprehensive antibiogram can help influence treatment and monitoring patterns of resistance.
The International Journal of Tuberculosis and Lung Disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2021
Dear Editor, The COVID-19 pandemic has increased the need to free-up hospital rooms. We have cond... more Dear Editor, The COVID-19 pandemic has increased the need to free-up hospital rooms. We have conducted a quasiexperimental retrospective study of an intervention to decrease time in airborne infection isolation (AII) rooms while waiting for tests for TB. 1 The collection and processing of multiple sputum specimens (as recommended by the Centers for Disease Control and Prevention) 2 is a complex endeavor requiring the patient's cooperation and coordination of various health professionals, with frequent delays. Dedicated measures can improve AII efficiency, thereby leading to better infection control, patient flow, savings in healthcare expenditure and psychological impact on patients. 3-5 Moreover, standardized order sets permit uniform, efficient, protocolized care across hospital systems. 6 Boston Medical Center (BMC) is an urban 514-bed academic medical center catering to a diverse patient population. In 2016-2017, approximately 16% of Massachusetts' 400 cases of active TB were diagnosed at BMC (written personal communication, with consent, K M Gadani Massachusetts Department of Public Health, Boston, MA, USA, January 2020). BMC policy for discontinuation of AII stipulates three negative acid-fast bacilli stains or two negative nucleic-acid amplification (NAAT) tests (i.e., Xpert w MTB/RIF assay, Cepheid, Sunnyvale, CA, USA). 7 However, because many patients remain in AII for the collection of a third sputum sample for culture, NAAT results were not included in our definition of time in AII (see below). Providers order the collection or induction of sputum specimens for mycobacterial microscopy/ culture and NAATs electronically, either by placing individual orders, or by utilizing an order set. In the autumn of 2016, a multidisciplinary panel including infectious disease physicians, respiratory therapists (RTs), and nurses assisted information technology specialists in devising a new order set in Epic TM (Epic Systems Corporation; Verona, WI, USA) the electronic medical record (EMR), to decrease time in AII. Orders were streamlined to incorporate NAAT testing on the same specimens sent for culture. Options were created for expectorated sputum every 8 h and sputum inductions twice daily, including one first-morning collection, and timed according to RT staffing, nursing and laboratory workflows, and
Journal of Thoracic Disease, 2018
Tuberculosis (TB) infection and disease have plagued human civilization across time and led to im... more Tuberculosis (TB) infection and disease have plagued human civilization across time and led to immeasurable morbidity and mortality. This review article focuses on the most currently available information regarding the diagnostic workup, radiologic presentation and treatment of drug-sensitive active TB. As discussed, if adequate resources and methods are available to diagnose, evaluate, and treat patients, drug sensitive TB is an imminently curable disease.
Tuberculosis (Edinburgh, Scotland), Jan 19, 2015
The formation of the Roman Empire constituted an unprecedented joining of Mediterranean and Europ... more The formation of the Roman Empire constituted an unprecedented joining of Mediterranean and European lands and peoples, centering on the capital of Rome. During the late Roman Republic and early Roman Empire (ca. 200B.C.-ca. 200 A.D.) urbanization and population growth led to conditions favorable to the spread of tuberculosis throughout Italy and especially within Rome itself. Trade and military expansion would have acted as vehicles for the further extension of tuberculosis to the provinces via direct transmission from Italian-born Romans to the native populations. However, an alternative explanation may better explain the increase in the number of archeological cases of tuberculosis with the start of the Roman era. A literature review of Roman-era cases and their locations suggests that the development of an urban, Roman way of life resulted in significant increases in prevalence in regions where tuberculosis had previously been endemic only at a low level.
Open Forum Infectious Diseases, 2020
We examined Massachusetts tuberculosis surveillance data from to 2009 to 2018. Of 1533 culture-co... more We examined Massachusetts tuberculosis surveillance data from to 2009 to 2018. Of 1533 culture-confirmed cases, 190 (12.4%) demonstrated resistance to isoniazid including 32 (2.1%) with rifampin resistance. In multivariable analysis, isoniazid resistance increased significantly over time (per-year odds ratio = 1.07, 95% confidence interval = 1.01–1.13, P = .018) and was associated with younger age, foreign birth, and prior tuberculosis treatment.
Respiratory Medicine, 2022
Rationale: SARS-CoV-2 continues to cause a global pandemic and management of COVID-19 in outpatie... more Rationale: SARS-CoV-2 continues to cause a global pandemic and management of COVID-19 in outpatient settings remains challenging.
Objective: We sought to describe characteristics of patients with chronic respiratory disease (CRD) experiencing symptoms consistent with COVID-19, who were seen in a novel Acute Respiratory Clinic, prior to widely available testing, emergence of variants, COVID-19 vaccination, and post-vaccination (breakthrough) SARS-CoV-2 infections.
Methods: Retrospective electronic medical record data were analyzed from 907 adults with presumed COVID-19 seen between March 16, 2020 and January 7, 2021. Data included demographics, comorbidities, medications, vital signs, laboratory tests, pulmonary function tests, patient disposition, and co-infections. The overdispersed data (aod) R package was used to create a logit model using COVID-19 diagnosis by PCR as the dichotomous outcome variable. Univariate, conventional multivariate and elastic net machine learning were used to analyze data.
Results: Male gender, elevated baseline temperature, and respiratory rate predicted COVID-19 diagnosis. Eosinopenia, neutrophilia, and lymphocytosis were also associated with COVID-19 diagnosis. However, asthma and COPD diagnoses were not associated with SARS-CoV-2 PCR positive test. Male gender, low oxygen saturation, and lower forced expiratory volume in 1 s (FEV1) were associated with higher hospital referral.
Conclusions: CRD patients with acute respiratory symptoms in the ambulatory setting were more likely to have COVID-19 if male, febrile and tachypneic. Patients with lower pre-morbid FEV1 and lower SPO2 are more likely to be referred to the hospital. A composite of vitals sigs and WBC differential help risk stratify CRD patients seeking care for presumed COVID-19.
The Journal of Infectious Diseases , 2020
Background. Mycobacterium tuberculosis (Mtb) and human immunodeficiency virus (HIV) coinfection i... more Background. Mycobacterium tuberculosis (Mtb) and human immunodeficiency virus (HIV) coinfection increases mortality, accelerates progression to acquired immune deficiency syndrome, and exacerbates tuberculosis disease. However, the impact of pre-existing Mtb infection on subsequent HIV infection has not been fully explored. We hypothesized that Mtb infection creates an immunological environment that influences the course of HIV infection, and we investigated whether pre-existing Mtb infection impacts the susceptibility of CD4 + T cells to HIV-1 infection. Methods. Plasma and blood CD4 + T cells isolated from HIV-negative individuals across the Mtb infection spectrum and non-Mtb-infected control individuals were analyzed for inflammation markers and T-cell phenotypes. CD4 + T cells were infected with HIV-1 in vitro and were monitored for viral replication. Results. We observed differences in proinflammatory cytokines and the relative proportion of memory T-cell subsets depending on Mtb infection status. CD4 + T cells derived from individuals with latent Mtb infection supported more efficient HIV-1 transcription , release, and replication. Enhanced HIV-1 replication correlated with higher percentages of CD4 + T EM and T TD cells. Conclusions. Pre-existing Mtb infection creates an immunological environment that reflects Mtb infection status and influences the susceptibility of CD4 + T cells to HIV-1 replication. These findings provide cellular and molecular insights into how pre-existing Mtb infection influences HIV-1 pathogenesis.
Journal of Thoracic Disease, 2018
Tuberculosis (TB) infection and disease have plague human civilization across time and led to imm... more Tuberculosis (TB) infection and disease have plague human civilization across time and led to immeasurable morbidity and mortality. This review article focuses on the most currently available information regarding the diagnostic workup, radiologic presentation and treatment of drug-sensitive active TB. As discussed, if adequate resources and methods are available to diagnose, evaluate, and treat patients, drug sensitive TB is an eminently curable disease.
Summer and Academic Year Student Reports, 2002
Tuberculosis (Edinburgh, Scotland), 2015
The formation of the Roman Empire constituted an unprecedented joining of Mediterranean and Europ... more The formation of the Roman Empire constituted an unprecedented joining of Mediterranean and European lands and peoples, centering on the capital of Rome. During the late Roman Republic and early Roman Empire (ca. 200 B.C.-ca. 200 A.D.) urbanization and population growth led to conditions favorable to the spread of tuberculosis throughout Italy and especially within Rome itself. Trade and military expansion would have acted as vehicles for the further extension of tuberculosis to the provinces via direct transmission from Italian-born Romans to the native populations. However, an alternative explanation may better explain the increase in the number of archeological cases of tuberculosis with the start of the Roman era. A literature review of Roman-era cases and their locations suggests that the development of an urban, Roman way of life resulted in significant increases in prevalence in regions where tuberculosis had previously been endemic only at a low level.
Articles and Book Chapters (peer-reviewed) by Jared J Eddy
Perspectives in Biology and Medicine, 2023
Vaccine hesitancy continues to pose a formidable obstacle to in- creasing national COVID-19 vacci... more Vaccine hesitancy continues to pose a formidable obstacle to in- creasing national COVID-19 vaccination rates in the US, but this is not the first time that American vaccination efforts have confronted resistance and apathy. This study examines the history of US vaccination efforts against smallpox, polio, and measles, highlighting persistent drivers of vaccine hesitancy as well as factors that helped over- come it. The research reveals that logistical barriers, negative portrayals in the media, and fears about safety stymied inoculation efforts as early as the 18th century and continue to do so. However, vaccine hesitancy has been markedly diminished when trusted community leaders have guided efforts, when ordinary citizens have felt per- sonally invested in the success of the vaccine, and when vaccination efforts have been tied to broader projects to improve public health and social cohesion. Deliberately cultivating such features could be an effective strategy for lessening opposition today, when COVID-19’s distinctive characteristics make addressing vaccine hesitancy more urgent than it has ever been.
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Papers by Jared J Eddy
when COVID-19’s distinctive characteristics make addressing vaccine hesitancy more urgent than it has ever been.
Objective: We sought to describe characteristics of patients with chronic respiratory disease (CRD) experiencing symptoms consistent with COVID-19, who were seen in a novel Acute Respiratory Clinic, prior to widely available testing, emergence of variants, COVID-19 vaccination, and post-vaccination (breakthrough) SARS-CoV-2 infections.
Methods: Retrospective electronic medical record data were analyzed from 907 adults with presumed COVID-19 seen between March 16, 2020 and January 7, 2021. Data included demographics, comorbidities, medications, vital signs, laboratory tests, pulmonary function tests, patient disposition, and co-infections. The overdispersed data (aod) R package was used to create a logit model using COVID-19 diagnosis by PCR as the dichotomous outcome variable. Univariate, conventional multivariate and elastic net machine learning were used to analyze data.
Results: Male gender, elevated baseline temperature, and respiratory rate predicted COVID-19 diagnosis. Eosinopenia, neutrophilia, and lymphocytosis were also associated with COVID-19 diagnosis. However, asthma and COPD diagnoses were not associated with SARS-CoV-2 PCR positive test. Male gender, low oxygen saturation, and lower forced expiratory volume in 1 s (FEV1) were associated with higher hospital referral.
Conclusions: CRD patients with acute respiratory symptoms in the ambulatory setting were more likely to have COVID-19 if male, febrile and tachypneic. Patients with lower pre-morbid FEV1 and lower SPO2 are more likely to be referred to the hospital. A composite of vitals sigs and WBC differential help risk stratify CRD patients seeking care for presumed COVID-19.
Articles and Book Chapters (peer-reviewed) by Jared J Eddy
when COVID-19’s distinctive characteristics make addressing vaccine hesitancy more urgent than it has ever been.
Objective: We sought to describe characteristics of patients with chronic respiratory disease (CRD) experiencing symptoms consistent with COVID-19, who were seen in a novel Acute Respiratory Clinic, prior to widely available testing, emergence of variants, COVID-19 vaccination, and post-vaccination (breakthrough) SARS-CoV-2 infections.
Methods: Retrospective electronic medical record data were analyzed from 907 adults with presumed COVID-19 seen between March 16, 2020 and January 7, 2021. Data included demographics, comorbidities, medications, vital signs, laboratory tests, pulmonary function tests, patient disposition, and co-infections. The overdispersed data (aod) R package was used to create a logit model using COVID-19 diagnosis by PCR as the dichotomous outcome variable. Univariate, conventional multivariate and elastic net machine learning were used to analyze data.
Results: Male gender, elevated baseline temperature, and respiratory rate predicted COVID-19 diagnosis. Eosinopenia, neutrophilia, and lymphocytosis were also associated with COVID-19 diagnosis. However, asthma and COPD diagnoses were not associated with SARS-CoV-2 PCR positive test. Male gender, low oxygen saturation, and lower forced expiratory volume in 1 s (FEV1) were associated with higher hospital referral.
Conclusions: CRD patients with acute respiratory symptoms in the ambulatory setting were more likely to have COVID-19 if male, febrile and tachypneic. Patients with lower pre-morbid FEV1 and lower SPO2 are more likely to be referred to the hospital. A composite of vitals sigs and WBC differential help risk stratify CRD patients seeking care for presumed COVID-19.