Levy Library Blog

Each month Levy Library showcases the achievements of Mount Sinai faculty and researchers by highlighting an article and its altmetrics. Altmetrics are alternative measures of impact that capture non-traditional data like abstract views, article downloads, and social media activity. Our altmetrics data is provided by the PlumX platform. 

This month we highlight a publication from a member of our Library team, Rachel Pinotti. Cytokine elevation in severe and critical COVID-19: a rapid systematic review, meta-analysis, and comparison with other inflammatory syndromes:

SUMMARY

The description of a so-called cytokine storm in patients with COVID-19 has prompted consideration of anti-cytokine therapies, particularly interleukin-6 antagonists. However, direct systematic comparisons of COVID-19 with other critical illnesses associated with elevated cytokine concentrations have not been reported. In this Rapid Review, we report the results of a systematic review and meta-analysis of COVID-19 studies published or posted as preprints between Nov 1, 2019, and April 14, 2020, in which interleukin-6 concentrations in patients with severe or critical disease were recorded. 25 COVID-19 studies (n=1245 patients) were ultimately included. Comparator groups included four trials each in sepsis (n=5320), cytokine release syndrome (n=72), and acute respiratory distress syndrome unrelated to COVID-19 (n=2767). In patients with severe or critical COVID-19, the pooled mean serum interleukin-6 concentration was 36·7 pg/mL (95% CI 21·6–62·3 pg/mL; I²=57·7%). Mean interleukin-6 concentrations were nearly 100 times higher in patients with cytokine release syndrome (3110·5 pg/mL, 632·3–15 302·9 pg/mL; p<0·0001), 27 times higher in patients with sepsis (983·6 pg/mL, 550·1–1758·4 pg/mL; p<0·0001), and 12 times higher in patients with acute respiratory distress syndrome unrelated to COVID-19 (460 pg/mL, 216·3–978·7 pg/mL; p<0·0001). Our findings question the role of a cytokine storm in COVID-19-induced organ dysfunction. Many questions remain about the immune features of COVID-19 and the potential role of anti-cytokine and immune-modulating treatments in patients with the disease.

KEY MESSAGES

• The systemic inflammatory profile of COVID-19 is distinct from that of non-COVID-19 ARDS, sepsis, and CAR T cell-induced cytokine release syndrome; applying the descriptor cytokine storm to COVID-19 might be particularly problematic
• Inflammatory cytokine elevations in patients with severe and critical COVID-19, including elevations of interleukin-6, are profoundly lower than those reported in patients with acute respiratory distress syndrome (ARDS) unrelated to COVID-19, sepsis, and chimeric antigen receptor (CAR) T cell-induced cytokine release syndrome
• In contrast, several non-cytokine biomarkers, including D-dimer, C-reactive protein, and ferritin, are elevated to a similar or greater extent in patients with COVID-19 than in patients with these comparison disorders
• As in other syndromes of critical illness, the role of inflammatory cytokine elevations in the pathobiology of COVID-19 remains unclear

• Alternative models of organ dysfunction in COVID-19, such as endovasculitis, direct viral injury and lymphodepletion, or viral-induced immunosuppression, might be worth considering

View the PlumX profile to learn more about the metrics details of this publication. 

Read this publication in The Lancet Respiratory Medicine

The open access movement has shaken up the publishing landscape. In traditional publishing, research literature could only be accessed through a subscription or individual payments.  Open access literature, in contrast, is freely available online for the general public, and often has few or no copyright restrictions on its use and reuse. This affords many benefits: research is available to more readers, authors get to retain certain rights, and research can be disseminated and built upon much faster. Over 90,000 articles were published for immediate open access in 2020 (Open Access 2020 Initiative [OA2020], 2020). What else has been happening with open access? Here are a couple of updates.

More than 130 transformative agreements, compliant with ESAC guidelines, have been signed to date, representing 19 countries and 32 publishers. These are intended to help organizations transition from a subscription model to open access publishing. cOAlition S, a consortium of funders including the Wellcome Trust, the World Health Organization, and the Bill and Melinda Gates Foundation, has put out a statement saying that, after January 1, 2021, it will no longer financially support agreements that do not adhere to these guidelines (OA2020, 2020).

Preprints (the version of an article that is pre-peer review and -acceptance to a journal) have also made the news this year because of the COVID-19 pandemic. With so much unknown about the virus, research couldn’t get published fast enough, and many have been utilizing preprints to get information on it. Servers like medRxiv and MedRN contain a wealth of information on COVID-19 and other conditions. The National Library of Medicine also announced their NIH Preprint Pilot in June, pulling in preprints from preprint servers so that they can be searched in PubMed.

Now more than ever, having freely available research is vital, and open access helps make this possible.

References: 

Open Access 2020 Initiative. (2020). OA2020 progress report. Retrieved from https://oa2020.org/progress-report/

• To learn more about open access, visit the library's scholarly communications guide at: libguides.mssm.edu/scholcomm.
• To learn more about preprints, check out the library's class on Introduction to Preprints, via our YouTube Channel.

We always love it when we are able to add resources that our patrons suggest to us! We've recently added some really great journals to our electronic collection with subjects in radiology, psychology and respiratory and sleep medicine. You can check them out in our library catalog, Research Discovery right now, but here's a sneak peek of the titles we just added:

New Titles from Radiological Society of North America

• Radiology- Imaging Cancer:  Held to the same high editorial standards as Radiology, Radiology: Imaging Cancer, a new RSNA journal launched in fall 2019, covers the best clinical and translational cancer imaging studies across organ systems and modalities, including leading-edge technological developments. These studies foster communication across radiological subspecialties and support collaborations within the broader oncological research and clinical communities.
• Radiology - Cardiothoracic Imaging:  Held to the same high editorial standards as Radiology, Radiology: Cardiothoracic Imaging, a new RSNA journal launched in early 2019, emphasizes research advances and technical developments in medical imaging that drive cardiothoracic medicine.
• Radiology - Artificial Intelligence: Held to the same high editorial standards as Radiology, Radiology: Artificial Intelligence, a new RSNA journal launched in early 2019, highlights the emerging applications of machine learning and artificial intelligence in the field of imaging across multiple disciplines.
• Radiology Select: Radiology Select is a continuing series of selected Radiology articles that highlight developments in imaging science, techniques and clinical practice. Each volume highlights an important topic in the field and is supplemented by commentaries, author interviews and podcasts in select volumes.

Mount Sinai Community Requests and Favorites Just Added!

• Canadian Journal of Respiratory, Critical Care, and Sleep Medicine: Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, or the Red and White Journal, is the only peer-reviewed Canadian journal dedicated to publishing critically important guidelines and position papers, as well as original research and clinical articles from Canada and around the world related to lung health. The journal will also publish review articles, case studies, a “pulmonary image feature” and editorials.
• Structural Heart: the journal of the Heart Team: Structural Heart: The Journal of the Heart Team, is an official journal of the Cardiovascular Research Foundation focused upon diseases of the heart valves, myocardium, pericardium, and great vessels as well as congenital heart disease. Structural Heart publishes peer-reviewed clinical and experimental manuscripts on all aspects of these cardiovascular diseases. The Journal emphasizes the important role of the heart team in diagnosing and treating these disorders. Topics covered include diagnostic techniques, percutaneous interventional procedures, cardiovascular surgery, drug treatment, findings from the laboratory, and clinical trials. Symposia, clinical reviews and updates, editorial commentary, and letters are regular features, with occasional publication of opinion pieces and commentary. Structural Heart also publishes consensus documents and white papers with recommendations on current topics in cardiovascular disease.
• Journal of Psychology: The Journal of Psychology (founded in 1935) is an interdisciplinary journal that publishes empirical research, theoretical articles, and selected reviews in applied areas of psychology (other than applied experimental or human factors).
• Modern Rheumatology Case Reports: Modern Rheumatology Case Reports is an online-only journal dedicated to publishing original single and series case reports and letters in English on rheumatism, connective tissue diseases, musculoskeletal disorders including osteoporosis, orthopedic/spine surgery, rehabilitation and their associated areas such as pathology, physiology, immunology, microbiology and pharmacology.

  We encourage case reports worthy of discussion and clinical lessons particularly around aspects of differential diagnosis, decision making, management, treatment approach, uncommon adverse events, clinical guidelines and pathology.

To read any of these new journals you can search for them in our catalog, Research Discovery or add them to your bookshelf in Browzine.

As a librarian, and sometimes curator of information, I often make it my mission to push our library’s online databases as the holy grail for information seekers, in their pursuit of quality information. I like to refer to these databases, accessible via the library website, as a treasure-trove of tools for the researcher, in pursuit of vetted information. Librarians, as a rule, tend to push these types of resources for a variety of reasons. Research databases from companies like EBSCO, ProQuest, Ovid and others, provide users with an opportunity to leverage these resources in ways a blind search via Google can fall short. In addition, knowledge is power, and good information isn’t always free. These powerful research tools provided through the library do not come cheaply. When used properly, a savvy database searcher can pull up a vast amount of quality, and sometimes very esoteric results, that a simple search of the world wide web never could. So why, might you ask, am I about to contradict myself and tell you that sometimes a search of Google can also produce very useful results?

So let’s talk about the world wide web, in terms of Google and other commercial search engines. Google and search engines like Yahoo! and Bing  makes their money through ads, and through selling user data. Information is money, and it will be paid for somehow. Aside from all the big brother stuff, that goes along with searching an ad driven search engine, the discerning searcher can still glean a great amount of intelligence though commercial search engines. It just takes a little more work on the part of the searcher to sift through the information and evaluate it. There are plenty of organizations, governmental and educational institutions, that put quality content out there without any type of paywall. The National Library of Medicine (PubMed), World Health Organization, and Census Bureau are just the tip of the iceberg when it comes to finding good information to base research on. These are obvious free tools for researchers, but what can searchers do to find other quality and freely available sources on the web. To start with, be wary of sites that end in .com. As with anything users can find through the world wide web, this is a guideline and not a hard pressed rule. When doing a Google search, throw in your keywords but maybe add edu, org or gov to the search and see what you can pull up. Domains often play a large role in the type of information they contain. When viewing your results, keep things in mind, such as a date when the information was posted, the credentials behind the author or organization that created the information. It is also important to assess the bias any organization or author may have. 

In closing, there is a lot of great information on the world wide web, but unlike a research database, created with structures and tools in place to leverage your search, commercial search engines require you to do a lot of the leg work. Many institutions freely share very useful information online, and this is a fact that should not be ignored. If you do your due diligence in vetting the information, a great deal can be produced for your research needs and endeavors

In his role as Library Manager, Access Services, Edmund’s responsibilities include managing library circulation and interlibrary loan, overseeing course reserves, managing library facilities, and providing reference services and instructional support. Edmund earned his MLS from Queens College, and Masters in Communications from New York Institute of Technology Old Westbury. He previously worked as a Librarian at NYIT at their Columbus Circle location.