Lauren E. Eggert, MD

All Publications

• Remotely supervised spirometry versus laboratory-based spirometry during the COVID-19 pandemic: a retrospective analysis. Respiratory research Koltowski, L., Basza, M., Bojanowicz, W., Dabrowiecki, P., Solinski, M., Gorska, K., Korczynski, P., Eggert, L. E. 2024; 25 (1): 39

  Abstract

  BACKGROUND: The COVID-19 pandemic has constrained access to spirometry, and the inherent risk of infectious transmission during aerosol-generating procedures has necessitated the rapid development of Remotely Supervised Spirometry (RSS). This innovative approach enables patients to perform spirometry tests at home, using a mobile connected spirometer, all under the real-time supervision of a technician through an online audio or video call.METHODS: In this retrospective study, we examined the quality of RSS in comparison to conventional Laboratory-based Spirometry (LS), using the same device and technician. Our sample included 242 patients, with 129 undergoing RSS and 113 participating in LS. The RSS group comprised 51 females (39.5%) with a median age of 37 years (range: 13-76 years). The LS group included 63 females (55.8%) with a median age of 36 years (range: 12-80 years).RESULTS: When comparing the RSS group to the LS group, the percentage of accurate Forced Expiratory Volume in one second (FEV1) measurements was 78% (n=101) vs. 86% (n=97), p=0.177; for Forced Vital Capacity (FVC) it was 77% (n=99) vs. 82% (n=93), p=0.365; and for both FEV1 and FVC, it was 75% (n=97) vs. 81% (n=92), p=0.312, respectively.CONCLUSIONS: Our findings demonstrate no significant difference in the quality of spirometry testing between RSS and LS, a result that held true across all age groups, including patients aged over 65 years. The principal advantages of remote spirometry include improved access to pulmonary function tests, reduced infectious risk to curtail disease spread, and enhanced convenience for patients.

  View details for DOI 10.1186/s12931-023-02586-0

  View details for PubMedID 38238745

• Low-dose naltrexone use for the management of post-acute sequelae of COVID-19. International immunopharmacology Bonilla, H., Tian, L., Marconi, V. C., Shafer, R., McComsey, G. A., Miglis, M., Yang, P., Bonilla, A., Eggert, L., Geng, L. N. 2023; 124 (Pt B): 110966

  Abstract

  The global prevalence of Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) stands at approximately 43 % among individuals who have previously had acute COVID-19. In contrast, in the United States, the National Center for Health Statistics (NCHS) estimates that around 11 % of individuals who have been infected with SARS-CoV-2 go on to experience long COVID. The underlying causes of PASC remains under investigation, and there are no currently established FDA-approved therapies. One of the leading hypotheses for the cause of PASC is the persistent activation of innate immune cells with increase systemic inflammation. Naltrexone is a medication with anti-inflammatory and immunomodulatory properties that has been used in other conditions that overlap with PASC. We performed a retrospective review of a clinical cohort of 59 patients at a single academic center who received low-dose naltrexone (LDN) off-label as a potential therapeutic intervention for PASC. The use of LDN was associated with a fewer number of symptoms, improved clinical symptoms (fatigue, post-exertional malaise, unrefreshing sleep, and abnormal sleep pattern), and a better functional status. This observation warrants testing in rigorous, randomized, placebo-controlled clinical trials.

  View details for DOI 10.1016/j.intimp.2023.110966

  View details for PubMedID 37804660

• Toward precision sleep medicine: variations in sleep outcomes among disaggregated Asian Americans in the National Health Interview Survey (2006-2018). Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine Wang, R. Z., Jamal, A., Wang, Z., Dan, S., Srinivasan, M., Kim, G., Long, J., Palaniappan, L., Singh, J., Eggert, L. E. 2023

  Abstract

  STUDY OBJECTIVES: Asian Americans (AAs) report higher rates of insufficient sleep than non-Hispanic Whites (NHWs). It is unclear how sleep outcomes differ among disaggregated Asian subgroups.METHODS: The National Health Interview Survey (NHIS) (2006-2018) was used to analyze self-reported sleep duration and quality measures for AA subgroups (Chinese [n=11,056], Asian Indian [n=11,249], Filipino [n = 13,211], and other Asians [n = 21,767]). Outcomes included hours of sleep per day, the number of days reporting trouble falling asleep, staying asleep, waking up rested, and taking sleep medication in the past week. Subsetted multivariate logistic regression was used to assess factors impacting sleep outcomes by ethnicity.RESULTS: 29.2% of NHWs, 26.4% of Chinese, 24.5% of Asian Indians, and 38.4% of Filipinos reported insufficient sleep duration. Filipinos were less likely to report sufficient sleep duration (OR 0.58, [CI95% 0.53-0.63]) and more likely to report trouble falling asleep (1.19, [1.04-1.36]) than NHWs. Chinese and Asian Indians had less trouble staying asleep ((0.66, [0.57-0.76]), (0.50, [0.43-0.58])) and falling asleep ((0.77, [0.67-0.90]), (0.71, [0.61-0.81]) than NHWs, and Asian Indians were more likely to wake feeling well rested (1.71, [1.51-1.92]). All Asian subgroups were less likely to report using sleep medications than NHWs. Foreign-born status had a negative association with sufficient sleep duration in Filipinos, but a positive association in Asian Indians and Chinese.CONCLUSIONS: Filipinos report the highest burden of poor sleep outcomes and Asian Indians report significantly better sleep outcomes. These findings highlight the importance of disaggregating Asian ethnic subgroups to address their health needs.

  View details for DOI 10.5664/jcsm.10558

  View details for PubMedID 36883375

• Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is common in post-acute sequelae of SARS-CoV-2 infection (PASC): Results from a post-COVID-19 multidisciplinary clinic. Frontiers in neurology Bonilla, H., Quach, T. C., Tiwari, A., Bonilla, A. E., Miglis, M., Yang, P. C., Eggert, L. E., Sharifi, H., Horomanski, A., Subramanian, A., Smirnoff, L., Simpson, N., Halawi, H., Sum-Ping, O., Kalinowski, A., Patel, Z. M., Shafer, R. W., Geng, L. C. 2023; 14: 1090747

  Abstract

  The global prevalence of PASC is estimated to be present in 0·43 and based on the WHO estimation of 470 million worldwide COVID-19 infections, corresponds to around 200 million people experiencing long COVID symptoms. Despite this, its clinical features are not well-defined.We collected retrospective data from 140 patients with PASC in a post-COVID-19 clinic on demographics, risk factors, illness severity (graded as one-mild to five-severe), functional status, and 29 symptoms and principal component symptoms cluster analysis. The Institute of Medicine (IOM) 2015 criteria were used to determine the Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) phenotype.The median age was 47 years, 59.0% were female; 49.3% White, 17.2% Hispanic, 14.9% Asian, and 6.7% Black. Only 12.7% required hospitalization. Seventy-two (53.5%) patients had no known comorbid conditions. Forty-five (33.9%) were significantly debilitated. The median duration of symptoms was 285.5 days, and the number of symptoms was 12. The most common symptoms were fatigue (86.5%), post-exertional malaise (82.8%), brain fog (81.2%), unrefreshing sleep (76.7%), and lethargy (74.6%). Forty-three percent fit the criteria for ME/CFS, majority were female, and obesity (BMI > 30 Kg/m2) (P = 0.00377895) and worse functional status (P = 0.0110474) were significantly associated with ME/CFS.Most PASC patients evaluated at our clinic had no comorbid condition and were not hospitalized for acute COVID-19. One-third of patients experienced a severe decline in their functional status. About 43% had the ME/CFS subtype.

  View details for DOI 10.3389/fneur.2023.1090747

  View details for PubMedID 36908615

  View details for PubMedCentralID PMC9998690

• Severity of COVID-19 in Patients on Biologics for Allergic Disease: A Retrospective Study of Two Tertiary Healthcare Systems Pathak, C., Jiang, S., Cao, S., Collins, W., Eggert, L., Chinthrajah, R. S., Akuthota, P. AMER THORACIC SOC. 2022

  View details for Web of Science ID 000792480402262

• Precision Sleep Medicine: Variations in Sleep Quality Among Asian Americans in the National Health Interview Survey (2006-2018) Wang, R., Wang, Z., Jamal, A., Dan, S., Srinivasan, M., Eggert, L. AMER THORACIC SOC. 2022

  View details for Web of Science ID 000792480403643

• COVID-19 and Biologics in Severe Asthmatic Patients: A Multicenter Retrospective Analysis Jiang, S. Y., Pathak, C., Cao, S., Collins, W., Eggert, L., Akuthota, P., Chinthrajah, R. S. AMER THORACIC SOC. 2022

  View details for Web of Science ID 000792480400274

• Use of home pulse oximetry with daily short message service messages for monitoring outpatients with COVID-19: The patient's experience DIGITAL HEALTH Vaughan, L., Eggert, L. E., Jonas, A., Sung, A., Singer, S. 2021; 7: 20552076211067651

  Abstract

  Studies have shown COVID-19 patients may have a low oxygen saturation (SpO2) independent of visible respiratory distress, a phenomenon termed "silent hypoxia." Silent hypoxia creates uncertainty in the outpatient setting for clinicians and patients alike. In this study, we examined the potential for pulse oximeters in identifying early signs of clinical deterioration. We report descriptive results on COVID-positive patients' experiences with a comprehensive home monitoring tool comprised of home SpO2 measurements with a novel symptom-tracking short message service/text messaging application. Of patients who required hospitalization, 83% sought care as a result of low pulse oximeter readings. Nearly all patients who did not require hospitalization reported that having a pulse oximeter provided them with the confidence to stay at home. Essentially all patients found a home pulse oximeter useful. Keeping COVID-19-positive patients at home reduces the potential for disease spread and prevents unnecessary costs and strain on the healthcare system.

  View details for DOI 10.1177/20552076211067651

  View details for Web of Science ID 000731017000001

  View details for PubMedID 34925873

  View details for PubMedCentralID PMC8679026

• The allergic asthma phenotype, associated comorbidities, and long-term symptoms in COVID-19 Lee, A. S., He, Z., Eggert, L. E., Collins, W., Dhondalay, G., Jiang, S. Y., Fitzpatrick, J., Snow, T. T., Desai, M., Sindher, S. B., Nadeau, K. C., Chinthrajah, R. S., Cao, S. WILEY. 2021: 199-200

  View details for Web of Science ID 000718612200366

• Asthma phenotypes, associated comorbidities, and long-term symptoms in COVID-19. Allergy Eggert, L. E., He, Z., Collins, W., Lee, A. S., Dhondalay, G., Jiang, S. Y., Fitzpatrick, J., Snow, T. T., Pinsky, B. A., Artandi, M., Barman, L., Puri, R., Wittman, R., Ahuja, N., Blomkalns, A., O'Hara, R., Cao, S., Desai, M., Sindher, S. B., Nadeau, K., Chinthrajah, R. S. 2021

  Abstract

  BACKGROUND: It is unclear if asthma and its allergic phenotype are risk factors for hospitalization or severe disease from SARS-CoV-2.METHODS: All patients over 28 days oldtesting positive for SARS-CoV-2 between March 1 and September 30, 2020, were retrospectively identified and characterized through electronic analysis at Stanford. A sub-cohort was followed prospectively to evaluate long-term COVID-19 symptoms.RESULTS: 168,190 patients underwent SARS-CoV-2 testing, and 6,976 (4.15%) tested positive. In a multivariate analysis, asthma was not an independent risk factor for hospitalization (OR 1.12 [95% CI 0.86, 1.45], p=0.40). Among SARS-CoV-2 positive asthmatics, allergic asthma lowered the risk of hospitalization and had a protective effect compared to non-allergic asthma (OR 0.52 (0.28, 0.91), p=0.026); there was no association between baseline medication use as characterized by GINA and hospitalization risk. Patients with severe COVID-19 disease had lower eosinophil levels during hospitalization compared to patients with mild or asymptomatic disease, independent of asthma status (p=0.0014). In a patient sub-cohort followed longitudinally, asthmatics and non-asthmatics had similar time to resolution of COVID-19 symptoms, particularly lower respiratory symptoms.CONCLUSIONS: Asthma is not a risk factor for more severe COVID-19 disease. Allergic asthmatics were half as likely to be hospitalized with COVID-19 compared to non-allergic asthmatics. Lower levels of eosinophil counts (allergic biomarkers) were associated with a more severe COVID-19 disease trajectory. Recovery was similar among asthmatics and non-asthmatics with over 50% of patients reporting ongoing lower respiratory symptoms three months post-infection.

  View details for DOI 10.1111/all.14972

  View details for PubMedID 34080210

• Asthma as a predictor of more severe outcomes in COVID-19 infection Eggert, L., Cao, S., He, Z., Dhondalay, G., Jiang, S., Collins, W., Sindher, S., Nadeau, K., Sharon Chinthrajah, R. MOSBY-ELSEVIER. 2021: AB44

  View details for Web of Science ID 000629158000139

• Asthma as a predictor of more severe outcomes in COVID-19 infection Journal of Allergy and Clinical Immunology Eggert, L. E., Cao, S., He, Z., Sindher, S., Nadeau, K., Chinthrajah, R. 2021; 147 (2)

  View details for DOI 10.1016/j.jaci.2020.12.191

• Asthma phenotypes, associated comorbidities, and long-term symptoms in COVID-19 European Journal of Allergy and Clinical Immunology Eggert, L. E., He, Z., Collins, W., Lee, A. S., Nadeau, K., Chinthrajah, R. 2021

  View details for DOI 10.1111/all.14972

• Asthma in Adults BMJ Best Practice Eggert, L., Majumdar, S. 2020
• Acute Asthma Exacerbation in Adults BMJ Best Practice Majumdar, S., Eggert, L. 2020
• Oncotype recurrence score (RS) and discordance in patients with secondary invasive breast events (SIBE). Zimmerman, B., Cascetta, K., Blanter, J., Eggert, L., Molot, M., Ru, M., Nayak, A., Bleiweiss, I., Jaffer, S., Tiersten, A. AMER SOC CLINICAL ONCOLOGY. 2019

  View details for DOI 10.1200/JCO.2019.37.15_suppl.e12016

  View details for Web of Science ID 000487345800015

• Switching and Combining Biologics in Severe Asthma: Experience from a Large Academic Teaching Center Eggert, L., Chinthrajah, R. S. AMER THORACIC SOC. 2019

  View details for Web of Science ID 000466771100311

• Retrospective analysis of oncotype DX recurrence score (RS) and discordance in patients with node-negative, ER+ breast cancer with recurrence Zimmerman, B. S., Cascetta, K. P., Ru, M., Eggert, L., Molot, M., Nayak, A., Bleiweiss, I., Tiersten, A. 2018

  View details for DOI 10.1158/1538-7445

• One-Year Experience After Implementation of a Multidisciplinary Pulmonary Embolism Team ATS Eggert, L., Klipper, K., Kadian-Dodov, D., Reddy, R., DePalo, L., Lookstein, R., Poor, H. 2016