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COVID-19

Search for a COVID-19 Solution – the Sequel

By Dr. Martin Lustick

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In our March 24th blog, “Search for a Solution,” we shared a list of nine studies related to COVID-19 that were open for recruitment.  A revisit to the website, Clinicaltrials.gov, reveals that the number of studies has now blossomed to 65 in the U.S., and we represent only 15% of the almost 400 studies being conducted worldwide.  Outside our borders, the bulk of this research is being done in Europe, with 106 listed studies, and China with 85. 

The scope of these efforts range from narrow, focused studies with as few as 10 patients to broad observational studies involving 200,000 people.  At the narrow end of the spectrum, there is examination of the specific dynamics of COVID-19 in the HIV infected population, and one focused on cardiovascular complications.  There are a series of studies examining differing approaches to managing ICU patients, such as whether Nitric Oxide reduces ventilation/perfusion mismatch or whether Positive End Expiratory Pressure (PEEP) reduces the need for ventilators.

The majority of studies continue to be focused on medical treatments to prevent, cure, or reduce severity of disease related to COVID-19, with Hydroxychloroquine receiving the most attention.  In the U.S. alone, 14 of the 65 studies currently described are focused on the use of Hydroxychloroquine, and if you look worldwide, you’ll find 54 separate studies. Antivirals, anti-inflammatories, and other anti-infectious agents continue to lead the list of drugs being explored.

But it isn’t just the infectious disease experts who have gotten involved.  There are two particularly interesting studies at the University of Alabama on the use of Tranexamic acid, a lysine derivative, on both outpatient and hospitalized patients with COVID-19.  Tranexamic acid, known to inhibit the conversion of plasminogen to plasmin, has been used to reduce postoperative bleeding.  Elevated plasmin found in patients with diabetes, hypertension and other chronic diseases has been proposed as the mechanism that puts them at higher risk from COVID-19 by increasing the binding of the virus to human cells. By blocking plasmin formation, tranexamic acid might reduce viral binding to cells and thereby reduce the severity of illness.

If you’re interested in going beyond the highly technical interventions, there are still plenty of COVID-19 related studies for you. Researchers at Wake Forest University are exploring the use of virtual mindfulness meditation services for both patients and providers.  Additionally, there are studies on the use of Vitamins C, D, and E, and on natural supplements such as sweet woodworm, evening primrose, and omega-3 fatty acids. Whatever your specific interest or expertise, we encourage you to visit Clinicaltrials.gov to learn more about all that is being done from every possible perspective to ease the burden of this pandemic. It is inspiring to witness such an aligned commitment of expertise and resources to solve the world’s most immediate challenge. 


Dr. Martin Lustick

Senior Vice President, NextGen® Advisors

Dr. Martin Lustick is a principal and senior vice president with NextGen Healthcare focused on supporting provider organizations in their successful transition from volume to value-based care…

Dr. Martin Lustick is a principal and senior vice president with NextGen Healthcare focused on supporting provider organizations in their successful transition from volume to value-based care.

Dr. Lustick earned a BA in History from Cornell and an MD from Columbia. After completing his pediatric residency at Children’s Hospital National Medical Center in Washington, DC, he was in clinical practice for 17 years with Kaiser Permanente of the Mid-Atlantic States. While there, Dr. Lustick held various management and leadership roles, including chief operating officer for the 800-physician medical group. He oversaw development of their hospitalist program, population health capability, and open access delivery model.

Dr. Lustick then served as chief medical officer for ThompsonHealth—a small health system in Canandaigua, NY—where he provided clinical oversight for hospital, SNF, nursing home, IT, and out-patient physician practices.

In 2005, Dr. Lustick assumed the role of SVP & CMO for Excellus BCBS which covers 1.6 million lives comprised of Medicare, Commercial, and Medicaid. In his 13+ year tenure there he led a variety of strategic initiatives, including a patient-centered medical home program which served as the foundation for the plan’s value-based payment strategy. He also led the implementation of an automated authorization program for care management services, development of a clinical quality improvement strategy, and creation of innovative programs in management of low back pain, screening and prevention, opioid addiction, and chronic disease management.

Dr. Lustick has also been very active in the community, serving on boards and committees confronting issues such as: healthcare capacity planning, Health Information Exchange, mental health, substance use disorders, social determinants of health, and childhood obesity.

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