HJNO May/Jun 2020

34 MAY / JUN 2020  I  HEALTHCARE JOURNAL OF NEW ORLEANS   Healthcare Briefs from their blood. The next goal of Hu’s team is to incorporate the biomarker profiling with their well-developed nanoplasmonic detection assay for a rapid clini- cal translation. GEE Appointed CEO of Health Care Services Division Dr. Larry Hollier, chancellor of LSU Health New Orleans, has appointed Rebekah Gee, MD, MPH, CEO of the Health Care Services Division. Gee served as Louisiana’s Secretary of Health, a governor’s cabinet appointment, during Gov. John Bel Edwards’ first term. She oversaw a suc- cessful implementation of Medicaid expansion, and led efforts to improve health outcomes, health care quality, and reduce maternal mortal- ity. She also spearheaded an innovative first in the nation’s approach to drug pricing that has led to unlimited access to a cure for Hepatitis C patients in Medicaid or correctional facilities. Gee also retains her faculty joint appointments in the School of Medicine and School of Public Health. She will focus on an array of initiatives that broaden the impact of work being done by LSU Health in the areas of community health, health care quality, medical care, and research. She will also lead efforts to apply technology and digital health solutions to traditional public health pro- grams and strategies. “Dr. Gee is a visionary leader who is helping to not only to define health care challenges but improve outcomes,” noted Hollier. “She recog- nizes that LSU has the opportunity to improve health by partnering with both rural and urban communities throughout the state. “LSU Health has always been the beating heart of clinical training and care for underserved popu- lations for the state,” added Gee. “As Louisiana’s flagship health university, it has a unique opportu- nity to lead the path forward toward better health for our state.” Ace Inhibitors, Angiotensin Receptor Blockers May Increase the Risk of Severe COVID-19 James Diaz, MD, MHA, MPH & TM, Dr PH, professor and head of Environmental Health Sci- ences at LSU Health New Orleans School of Pub- lic Health, has proposed a possible explanation for the severe lung complications being seen in some people diagnosed with COVID-19.. The SARS beta coronaviruses, SARS-CoV, which caused the SARS (Severe Acute Respiratory Syn- drome) outbreak in 2003 and the new SARS- CoV-2, which causes COVID-19, bind to angio- tensin converting enzyme 2 (ACE2) receptors in the lower respiratory tracts of infected patients to gain entry into the lungs. Viral pneumonia and potentially fatal respiratory failure may result in susceptible persons after 10-14 days. “Angiotensin-converting enzyme inhibi- tors (ACEIs) and angiotensin receptor blockers (ARBs) are highly recommended medications for patients with cardiovascular diseases includ- ing heart attacks, high blood pressure, diabetes, and chronic kidney disease to name a few,” noted Diaz. “Many of those who develop these diseases are older adults. They are prescribed these medi- cations and take them every day.” Research in experimental models has shown an increase in the number of ACE2 receptors in the cardiopulmonary circulation after intravenous infusions of ACE inhibitors. “Since patients treated with ACEIs and ARBS will have increased numbers of ACE2 receptors in their lungs for coronavirus S proteins to bind to, they may be at increased risk of severe dis- ease outcomes due to SARS-CoV-2infections,” explained Diaz. Diaz writes, this hypothesis is supported by a recent descriptive analysis of 1,099 patients with laboratory-confirmed COVID-19 infections treated in China during the reporting period of Dec. 11, 2019 to Jan. 29, 2020. This study reported more severe disease outcomes in patients with hypertension, coronary artery disease, diabetes, and chronic renal disease. All patients with the diagnoses noted met the recommended indica- tions for treatment with ACEIs or ARBs. Diaz says that two mechanisms may protect chil- dren from COVID-19 infections—cross- protective antibodies from multiple upper respiratory tract infections caused by the common cold-causing alpha coronaviruses, and fewer ACE2 receptors in their lower respiratory tracts to attract the binding S proteins of the beta coronaviruses. He recommends future case-control studies in patients with COVID-19 infections to further con- firm chronic therapy with ACEIs or ARBs may raise the risk for severe outcomes. In the meantime he cautions, “Patients treated with ACEIs and ARBs for cardiovascular diseases should not stop taking their medicine, but should avoid crowds, mass events, ocean cruises, pro- longed air travel, and all persons with respiratory illnesses during the current COVID-19 outbreak in order to reduce their risks of infection.” Emergency Rules Enacted by LA State Board of Nursing Respond to COVID-19 The Louisiana State Board of Nursing (LSBN) passed two emergency rules in response to COVID-19. The rules extend and/or reinstate expired temporary permits of registered nurse (RN) applicants and allow advanced practice reg- istered nurses (APRNs) practicing with a previ- ously approved collaborating physician to extend their practice to new sites not previously reported to the board during the public health emergency. LSBN Chief Executive Officer Karen Lyon, PhD, said, “The actions taken today will increase the number of RNs and Advanced Practice RNs avail- able to take care of all Louisianans during this current health crisis. It will allow more ‘boots on the ground,’ to coin a military phrase, to provide the urgent nursing care needed by our families, friends, and neighbors at this time. LSBN will con- tinue to work with our colleagues at the Louisi- ana Department of Health and in the Governor’s office to insure safe and competent practitioners are available to care for all patients in our health- care system.” The first emergency rule amended LAC 46:XLVII.3329 relating to temporary permits issued to RN applicants. Under the emergency provisions, the LSBN may extend the expiration of a temporary permit or reinstate an expired per- mit for nursing graduates who have not taken the NCLEX-RN provided that the meets the three stipulations identified in the emergency rule. Any permit extended or reinstated in accordance with the public health emergency exception shall be valid for 120 days and may be extended for addi- tional 90-day increments. The LSBN is notifying RN Applicants regard- ing the extension/reinstatement of their tempo- rary permits via e-mail. Temporary permits may be verified on the LSBN’s website using the License