Thomas Lew

All Publications

• Point-of-Care Ultrasound Predicts Clinical Outcomes in Patients With COVID-19. Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine Kumar, A., Weng, I., Graglia, S., Lew, T., Gandhi, K., Lalani, F., Chia, D., Duanmu, Y., Jensen, T., Lobo, V., Nahn, J., Iverson, N., Rosenthal, M., Gordon, A. J., Kugler, J. 2021

  Abstract

  OBJECTIVES: Point-of-care ultrasound (POCUS) detects the pulmonary manifestations of COVID-19 and may predict patient outcomes.METHODS: We conducted a prospective cohort study at four hospitals from March 2020 to January 2021 to evaluate lung POCUS and clinical outcomes of COVID-19. Inclusion criteria included adult patients hospitalized for COVID-19 who received lung POCUS with a 12-zone protocol. Each image was interpreted by two reviewers blinded to clinical outcomes. Our primary outcome was the need for intensive care unit (ICU) admission versus no ICU admission. Secondary outcomes included intubation and supplemental oxygen usage.RESULTS: N=160 patients were included. Among critically ill patients, B-lines (94 vs 76%; P<.01) and consolidations (70 vs 46%; P<.01) were more common. For scans collected within 24hours of admission (N=101 patients), early B-lines (odds ratio [OR] 4.41 [95% confidence interval, CI: 1.71-14.30]; P<.01) or consolidations (OR 2.49 [95% CI: 1.35-4.86]; P<.01) were predictive of ICU admission. Early consolidations were associated with oxygen usage after discharge (OR 2.16 [95% CI: 1.01-4.70]; P=.047). Patients with a normal scan within 24hours of admission were less likely to require ICU admission (OR 0.28 [95% CI: 0.09-0.75]; P<.01) or supplemental oxygen (OR 0.26 [95% CI: 0.11-0.61]; P<.01). Ultrasound findings did not dynamically change over a 28-day scanning window after symptom onset.CONCLUSIONS: Lung POCUS findings detected within 24hours of admission may provide expedient risk stratification for important COVID-19 clinical outcomes, including future ICU admission or need for supplemental oxygen. Conversely, a normal scan within 24hours of admission appears protective. POCUS findings appeared stable over a 28-day scanning window, suggesting that these findings, regardless of their timing, may have clinical implications.

  View details for DOI 10.1002/jum.15818

  View details for PubMedID 34468039

• COVID fallout: Biden wants to stop, not stoke, racism against Asian Americans like me Lew, T. USA Today. 2021
• Severe coronavirus is more likely if you neglect your health. Preventative care is key Lew, T. USA Today. 2020
• COVID doctor: Herd immunity rests on naive and faulty logic. In practice, people will die Lew, T. USA Today. 2020
• Take it from a physician treating COVID-19 patients, 'Frontline Doctors' video is dangerous Lew, T. USA Today. 2020
• Recurrent Multifocal Mycoplasma orale Infection in an Immunocompromised Patient: A Case Report and Review. Case reports in infectious diseases Ketchersid, J., Scott, J., Lew, T., Banaei, N., Kappagoda, S. 2020; 2020: 8852115

  Abstract

  A young woman with mixed connective tissue disease complicated by erosive arthritis, secondary hypogammaglobulinemia due to rituximab, and a history of many infectious complications developed multiple nonhealing wounds, polyarticular joint pain, and leukocytosis. Radiographic studies demonstrated multiple scattered areas of osteomyelitis and complex abscesses. Purulent fluid drained from multiple sites did not yield a microbiologic diagnosis by standard culture technique, but Mycoplasma orale was ultimately identified using 16S ribosomal RNA gene amplification and sequencing. We describe this unique case and review the literature.

  View details for DOI 10.1155/2020/8852115

  View details for PubMedID 32850161

• Young doctor; I have coronavirus advice for people my age. Step back, stay healthy Lew, T. K. USA Today. 2020
• Lean-Based Redesign of Multidisciplinary Rounds on General Medicine Service. Journal of hospital medicine Kane, M. n., Rohatgi, N. n., Heidenreich, P. n., Thakur, A. n., Winget, M. n., Shum, K. n., Hereford, J. n., Shieh, L. n., Lew, T. n., Horn, J. n., Chi, J. n., Weinacker, A. n., Seay-Morrison, T. n., Ahuja, N. n. 2018

  Abstract

  Multidisciplinary rounds (MDR) facilitate timely communication amongst the care team and with patients. We used Lean techniques to redesign MDR on the teaching general medicine service.To examine if our Lean-based new model of MDR was associated with change in the primary outcome of length of stay (LOS) and secondary outcomes of discharges before noon, documentation of estimated discharge date (EDD), and patient satisfaction.This is a pre-post study. The preperiod (in which the old model of MDR was followed) comprised 4000 patients discharged between September 1, 2013, and October 22, 2014. The postperiod (in which the new model of MDR was followed) comprised 2085 patients between October 23, 2014, and April 30, 2015.Lean-based redesign of MDR.LOS, discharges before noon, EDD, and patient satisfaction.There was no change in the mean LOS. Discharges before noon increased from 6.9% to 10.7% (P < .001). Recording of EDD increased from 31.4% to 41.3% (P < .001). There was no change in patient satisfaction.Lean-based redesign of MDR was associated with an increase in discharges before noon and in recording of EDD.

  View details for PubMedID 29394300

• Acute, Unilateral Breast Toxicity From Gemcitabine in the Setting of Thoracic Inlet Obstruction. Journal of oncology practice / American Society of Clinical Oncology Weiskopf, K., Creighton, D., Lew, T., Caswell, J. L., Ouyang, D., Shah, A. T., Hofmann, L. V., Neal, J. W., Telli, M. L. 2016; 12 (8): 763-764

  View details for DOI 10.1200/JOP.2016.014241

  View details for PubMedID 27511721

• Why celebrity mental health matters Lew, T. USA Today. 2021
• If you saw my COVID patients, you’d know we’re still in danger. Don’t be a vaccine straggler Lew, T. USA Today. 2021
• My patient got COVID and died. He thought life was back to normal, but we aren't there yet Lew, T. USA Today. 2021
• COVID vaccines save lives. Get one even if your own life isn't back to normal overnight Lew, T. USA Today. 2021
• Don't get lulled by COVID-19 vaccine. Stay careful and free up hospital space for others Lew, T. USA Today. 2021
• Fake news about the coronavirus is hazardous to your health. Don’t fall for it: Doctor Lew, T. USA Today. 2020
• Don’t let COVID-19 fears stop you from seeking medical treatment Lew, T. San Jose Mercury. 2020
• Opinion: Don’t believe nonsense that COVID-19 deaths are vastly overstated Lew, T. San Jose Mercury. 2020
• Toxic outside, contagious inside: Fire and COVID rage all around me. Can't we do better? Lew, T. USA Today. 2020
• Mr. President, people with COVID-19 are somebody to me, not 'nobody' Lew, T. USA Today. 2020
• Trump hit with COVID-19: Anyone can get sick. Anyone can spread the deadly disease Lew, T. USA Today. 2020
• Getting COVID-19 didn't help Trump evolve his thinking Lew, T. USA Today. 2020
• Doctor: Settle for virtual holidays this year amid COVID-19, starting with Thanksgiving Lew, T. USA Today. 2020
• Please don't cave to COVID-19 fatigue. Cases are exploding and we need your help. Again Lew, T. USA Today. 2020
• We failed Thanksgiving and COVID is surging. For Christmas, let's stay home and stay safe Lew, T. USA Today. 2020
• My COVID-19 vaccine was like a flu shot. I got one and went right back to work Lew, T. USA Today. 2020