Katherine Regling, DO
Alexander Glaros, MD
In ancient times, the Babylonians made commitments to their gods at the start of each year to return borrowed objects and pay their debts. The Romans made similar promises to the god Janus, for whom the month of January is named. And still today, with each new year, people around the world practice the tradition of “New Year Resolutions.” This year started off no differently; yet, the human race was quickly greeted by seemingly endless and relentless misfortunes. Rewind to January 2020 and the overwhelming sadness the world felt watching images of Australia on fire. In the United States, February brought the loss of a sports hero, role model, and top-notch “girl-dad,” Kobe Bryant. Then, headline after headline revealed how far our African American communities have to go in their fight against systemic racism. Every person has been affected differently by the various events of 2020, but the most universal and relentless battle all have had to face has been the global pandemic. Coronavirus, COVID-19, SARS-CoV-2 — whichever name you choose to call it — has impacted each and every one of us. First-responders, respiratory therapists, nurses, physicians, and so many others found the word “essential” redefined.
For hematologists, the early recognition of coagulation-related complications and their effect on overall outcomes, especially in critically ill patients, brought countless research opportunities aimed at better understanding the clinical sequelae and optimal management of COVID. Thus, it comes as no surprise that COVID-19 was a crucial component to this year’s content at the ASH annual meeting.
To kick things off, Dr. Amanda Payne, an epidemiologist from the Centers for Disease Control and Prevention, organized the Scientific Workshop on Infectious Disease and Coagulation, a one-of-a-kind session that covered the basic science, clinical translation, and public health impact of COVID-19 and how the pathophysiologic mechanisms may be able to aid in patient care. The workshop provided a forum for experts in a variety of fields to share information at the intersection of coagulation and infectious disease, highlighting the similarities and differences between COVID-19 and previously studied infections. “We have a history of infections, but the sheer volume of COVID-19 cases has allowed for robust, early data collection, and the ability to make the connection between infection, inflammation, and coagulation on a grand scale,” said moderator Dr. Shannon Meeks.
Over the course of the annual meeting, viewers were able to listen to more than 20 oral sessions (available on demand) pertaining to COVID-19, covering everything from the use of convalescent plasma therapy, the correlation of disease severity to ABO blood groups, and the use of anticoagulants for preventing thrombotic complications, among other topics. Dr. Filip Ionescu presented work on anticoagulant dosing and survival in hospitalized patients with COVID-19, and Dr. Rachel Rosovsky presented work relating to continuous venovenous hemofiltration (CVVH) filter clotting in COVID-19 infection (oral abstracts available on demand). As has always been the case, but is perhaps only now being widely recognized and publicized, the story of health in America is inextricably linked to the story of racial inequality. Dr. Ashima Singh presented work from the Medical College of Wisconsin on COVID-19, sickle cell disease (SCD), and the Black population. Their evidence indicated that SCD imposes additional risk for severe COVID-19 illness and hospitalization, but that no significant difference has existed in overall outcomes between Black patients, with or without SCD. In addition to this work, a highlight for many was the captivating presence of sessions surrounding race and various hematologic and oncologic diseases. A must-watch, on-demand talk is the Special Scientific Session on Race and Science.
Perhaps, the most anticipated discussion of ASH 2020 was the Fireside Chat with Dr. Anthony Fauci and ASH president Dr. Stephanie Lee (available on demand). Recognizing that although COVID-19 has some similarities to past outbreaks, its unprecedented impact on the entire world is vastly different. “We are living through something that is medically and public health historic,” said Dr. Fauci. The focal points of the discussion included everything from the development of immunity, viral mutations, and the much anticipated vaccine. He emphasized our ability to “crush COVID-19” with implementation of public health measures to keep the virus under control until we have an equitable distribution of the vaccine across the globe.
As this year closes, we must say a hopeful “see you next year” to our friends, colleagues, and newfound connections at ASH. We must remember to be thankful for the health and safety of our immediate and extended families. And we must continue to practice yearly traditions, even if it means finding new (socially distant), creative ways to do so. As for me, my 2021 resolutions will be broad: Adapt. Understand. Grow. Love. Inspire.
Dr. Regling and Dr. Glaros indicated no relevant conflicts of interest.