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Johns Hopkins Biocontainment Unit

Biocontainment Unit Research

Johns Hopkins Precision Medicine Center of Excellence for COVID-19

The team at the Johns Hopkins Precision Medicine Center of Excellence for COVID-19 is working to improve the care of patients infected with SARS-CoV-2 by studying COVID-19 pathobiology, likelihood of disease progression and impact of specific therapeutic interventions.

Learn more about the center.
Doctor in lab.

The Biocontainment Unit conducts research into areas of biocontainment to help further understanding of patient care.

  1.  Bowring MG, Wang Z, Xu Y, Betz J, Muschelli J, Garibaldi BT*, Zeger SL. Outcome Stratified Analysis of Biomarker Trajectories for Patients with SARS-CoV-2 Infection. Am J of Epidemiology. 2021. In press.*Co-senior author.
  2. Andersen KM, Mehta HB, Palamuttam N, Ford D, Garibaldi BT, Auwaerter PG, Segal J, Alexander GC.  Association Between Chronic Use of Immunosuppresive Drugs and Clinical Outcomes From Coronavirus Disease 2019 (COVID-19) Hospitalization: A Retrospective Cohort Study in a Large US Health System. Clinical Infectious Diseases. [published online ahead of print, 2021 Jan 7]
  3. Ignatius EH, MD, MSc, Wang K, Karaba A, Robinson M,  Avery RK, Blair P,  Chida N, Jain T, Petty BG, Siddiqui Z, Melia MT, Auwaerter PG, Xu Y, Garibaldi BT. Tocilizumab for the treatment of COVID-19 among hospitalized patients: A matched retrospective cohort analysis [published online ahead of print, 2020 December 28]. OFID. 2020
  4. Kalil AC, Patterson TF, Mehta AK, et al (ACTT-1 Study Group*).Baricitinib plus Remdesivir for Hospitalized Adults with Covid-19 [published online ahead of print, 2020 December 11]. N Engl J Med. 2020 (*BTG is a site co-investigator for ACTT-1)
  5. Garfinkel E., Lopez S., Troncoso R., Leon D., Hubble H., Bowman C., Margolis A. A Critical Care Transport Program's Innovative Approach to Safety during the COVID-19 Pandemic. Air Medical Journal. 2020 Dec. doi: https://doi.org/10.1016/j.amj.2020.12.002
  6. Geller, G., Duggal, P., Thio, C.L. et al. Genomics in the era of COVID-19: ethical implications for clinical practice and public health. Genome Med 12, 95 (2020). https://doi.org/10.1186/s13073-020-00792-9
  7. Hayek SS, Brenner SK, Azam TU, and the STOP-COVID Investigators.* In-hospital cardiac arrest in critically ill patients with covid-19: multicenter cohort study. BMJ. 2020 Sep 30;371:m3513. PMID: 32998872. (*BTG is a site co-investigator for STOP COVID)
  8. Borromeo Flinn J, Benza JJ, Sauer LM, Sulmonte C, Hynes NA, Garibaldi BT. The Risk of Not Being Ready: A Novel Approach to Managing Constant Readiness of a High-Level Isolation Unit During Times of Inactivity. Health Secur. 2020 May/Jun;18(3):212-218. doi: 10.1089/hs.2019.0130. PMID: 32559152.
  9. Flinn JB, Hynes NA, Sauer LM, Maragakis LL, Garibaldi BT. The role of dedicated biocontainment patient care units in preparing for COVID-19 and other infectious disease outbreaks. Infect Control Hosp Epidemiol. 2020 Sep 4:1-4. doi: 10.1017/ice.2020.451. Epub ahead of print. PMID: 32883382; PMCID: PMC7503040.
  10. Garibaldi BT, Fiksel J, Muschelli J, Robinson ML, Rouhizadeh M, Perin J, Schumock G, Nagy P, Gray JH, Malapati H, Ghobadi-Krueger M, Niessen TM, Kim BS, Hill PM, Ahmed MS, Dobkin ED, Blanding R, Abele J, Woods B, Harkness K, Thiemann DR, Bowring MG, Shah AB, Wang MC, Bandeen-Roche K, Rosen A, Zeger SL, Gupta A. Patient Trajectories Among Persons Hospitalized for COVID-19 : A Cohort Study. Ann Intern Med. 2020 Sep 22:M20-3905. doi: 10.7326/M20-3905. Epub ahead of print. Erratum in: Ann Intern Med. 2020 Nov 10;: PMID: 32960645; PMCID: PMC7530643.
  11. Ehmann MR, Zink EK, Levin AB, Suarez JI, Belcher HM, Daugherty Biddison EL, Doberman DJ, D'Souza K, Fine DM, Garibaldi BT, Gehrie EA, Golden SH, Gurses AP, Hill PM, Hughes MT, Kahn J, Koch CG, Marx JJ, Meisenberg BR, Natterman J, Rushton CH, Sapirstein A, Selinger SR, Stephens RS, Toner ES, Unguru Y, van Stone M, Kachalia A.Operational recommendations for scarce resource allocation in a public health crisis. Chest. 2020 Sep 26:S0012-3692(20)34804-2. doi: 10.1016/j.chest.2020.09.246. Epub ahead of print. PMID: 32991873; PMCID: PMC7521357.
  12. Kreps S, Prasad S, Brownstein JS, Hswen Y, Garibaldi BT, Zhang B, Kriner DL.Factors Associated With US Adults' Likelihood of Accepting COVID-19 Vaccination. JAMA Netw Open. 2020 Oct 1;3(10):e2025594. doi: 10.1001/jamanetworkopen.2020.25594. PMID: 33079199; PMCID: PMC7576409.
  13. Casciola-Rosen L, Thiemann DR, Andrade F, Trejo Zambrano MI, Hooper JE, Leonard E, Spangler J, Cox AL, Machamer C, Sauer L, Laeyendecker O, Garibaldi BT, Ray SC, Mecoli C, Christopher-Stine L, Gutierrez-Alamillo L, Yang Q, Hines D, Clarke W, Rothman RE, Pekosz A, Fenstermacher K, Wang Z, Zeger SL, Rosen A.IgM autoantibodies recognizing ACE2 are associated with severe COVID-19. medRxiv [Preprint]. 2020 Oct 15:2020.10.13.20211664. doi: 10.1101/2020.10.13.20211664. PMID: 33083808; PMCID: PMC7574257.
  14. Chen Y, Klein SL, Garibaldi BT, Li H, Wu C, Osevala NM, Li T, Margolick JB, Pawelec G, Leng SX. Aging in COVID-19: Vulnerability, immunity and intervention. Ageing Res Rev. 2020 Oct 30:101205. doi: 10.1016/j.arr.2020.101205. Epub ahead of print. PMID: 33137510; PMCID: PMC7604159.
  15. COVID-19 'Prediction model' uses data that can help determine if patients’ conditions are likely to worsen.
  16. Ehmann MR, Zink EK, Levin AB, Suarez JI, Belcher HM, Daugherty Biddison EL, Doberman DJ, D'Souza K, Fine DM, Garibaldi BT, Gehrie EA, Golden SH, Gurses AP, Hill PM, Hughes MT, Kahn J, Koch CG, Marx JJ, Meisenberg BR, Natterman J, Rushton CH, Sapirstein A, Selinger SR, Stephens RS, Toner ES, Unguru Y, van Stone M, Kachalia A. Operational recommendations for scarce resource allocation in a public health crisis. Chest. 2020 Sep 26. PMID: 32991873
  17. Garibaldi BT*, Fiksel J, Muschelli J, Robinson ML, Rouhizadeh M, Perin J, Schumock G, Nagy P, Gray JH, Malapati H, Ghobadi-Krueger M, Niessen TM, Kim BS, Hill PM, Ahmed MS, Dobkin ED, Blanding R, Abele J, Woods B, Harkness K, Thiemann DR, Bowring MG, Shah AB, Wang MC, Bandeen-Roche K, Rosen A, Zeger SL, Gupta A. Patient Trajectories Among Persons Hospitalized for COVID-19: A Cohort Study. Ann Intern Med. 2020 Sep 22. doi: 10.7326/M20-3905. Epub ahead of print. PMID: 32960645.(*corresponding author)
  18. Flinn JB, Hynes NA, Sauer LM, Maragakis LL, Garibaldi BT*. The role of dedicated biocontainment patient care units in preparing for COVID-19 and other infectious disease outbreaks. Infect Control Hosp Epidemiol. 2020 Sep 4:1-14. doi: 10.1017/ice.2020.451. Online ahead of print. PMID: 32883382 (*corresponding author)
  19. Beigel JH, Tomashek KM, Dodd LE, et al (ACTT-1 Study Group*). Remdesivir for the Treatment of Covid-19 - Preliminary Report [published online ahead of print, 2020 May 22]. N Engl J Med. 2020 PMID: 32445440 (*BTG is a site co-investigator for ACTT-1).
  20. Goldhaber-Fiebert SN, Greene JA, Garibaldi BT. Low-flow nasal cannula and potential nosocomial spread of COVID-19. British Journal of Anaesthesia. 2020 May 17.
  21. Ehmann M, Zink EK, Levin AB, Suarez JI, Belch HME, Biddison LD, Doberman DJ, D’Souza K, Fine DM, Garibaldi BT, Gehrie EA, Golden SH, Gurses AP, Hill PM, Hughes MT, Kahn J, Koch CG, Marx JJ, Meisenberg BR, Natterman J, Rushton CH, Sapirstein A, Selinger SR, Stephens RS, Toner ES, Unguru Y, van Stone M, Kachalia A. Operational recommendations for scarce resource allocation in a public health crisis. Chest 2020 [in press].
  22. Gupta S, Hayek SS, Wang W, et al (STOP COVID Investigators*).Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US. JAMA Intern Med. 2020 Jul 15. PMID 32667668. (* BTG is a site co-investigator for Stop COVID).
  23. Flinn JB, Benza JJ, Sauer LM, Sulmonte C, Hynes NA, Garibaldi BT*. (2020). "The Risk of Not Being Ready: A Novel Approach to Managing Constant Readiness of a High-Level Isolation Unit During Times of Inactivity." Health Security 18(3): 212-218. PMID: 32559152 (*corresponding author)
  24. Garibaldi BT, Conger NG, Withers MR, Hatfill SJ, Gutierrez-Nunez JJ, Christopher GW. Aeromedical Evacuation of Patients with Contagious Infections. In Hurd WW and Beninati W, eds. Aeromedical Evacuation: Management of Acute and Stabilized Patients. New York: Springer, 2019.
  25. Andonian J, Kazi S, Therkorn J, Benishek L, Billman C, Schiffhauer M, Nowakowski E, Osei P, Gurses AP, Hsu YJ, Drewry D, Forsyth ER, Garibaldi BT, Rainwater-Lovett K, Trexler P, Maragakis LL. 2019. Effect of an Intervention Package and Teamwork Training to Prevent Healthcare Personnel Self-Contamination During Personal Protective Equipment Doffing. Clinical Infectious Diseases, 2019 Oct; 69, Issue Supplement_3, S248–S255. PMID: 31517976
  26. Therkorn J, Drewry D, Andonian J, Benishek L, Billman C, Forsyth ER, Garibaldi BT, Nowakowski E, Rainwater-Lovett K, Sauer L, Schiffhauer M, Maragakis LL. 2019.Development and Comparison of Complementary Methods to Study Potential Skin and Inhalational Exposure to Pathogens During Personal Protective Equipment Doffing. Clinical Infectious Diseases, 2019 Oct; 69, Issue Supplement_3, S231–S240. PMID: 31517983
  27. Garibaldi BT and Maragakis LL. Ebola outbreak reminds us that we need pandemic preparedness. The Hill. 2019 Feb 4.
  28. Andonian J, Galusha K, Maragakis LL, Garibaldi BT. The impact of high-level isolation units beyond high consequence pathogen preparedness. Health Security, 2019 Jan/Feb; 17(1):69-73. PMID: 30779609
  29. Boyce A, Garibaldi BT. Host genetic information about high-consequence infections: emerging science, anticipatory ethics. Health Security, 2019 Jan/Feb; 17(1):62-6 PMID:30724614
  30. Sauer LM, Romig M, Andonian J, Flinn JB, Hynes N, Maloney R, Maragakis LL, Garibaldi BT. Application of the Incident Command System to the Hospital Biocontainment Unit Setting. Health Security, 2019 Jan/Feb; 17(1):27-34. PMID:30779610
  31. Kogutt B, Sheffield J, Maragakis LL, Golden C, Garibaldi BT.Simulation of a Spontaneous Vaginal Delivery and Neonatal Resuscitation in a Biocontainment Unit. Health Security, 2019 Jan/Feb; 17(1):18-2 PMID: 30779606
  32. Garibaldi BT, Ruparelia C, Shaw-Saliba K, Sauer LM, Maragakis LL, Glancey M. Subah M, Nelson AR, Wilkason C, Litwin L, Osei P, Yazdi Y.A novel PPE coverall was rated higher than standard Ebola PPE in terms of comfort, mobility and perception of safety when tested by healthcare workers in Liberia and in a US Biocontainment Unit. Am J Infect Control, 2018, Oct 6. PMID: 30301656
  33. Therkorn J, Drewry III D, Pilholski T, Shaw-Saliba K, Bova G, Maragakis L, Garibaldi BT, Sauer LM.Impact of Air Handling System Exhaust Failure on Dissemination Pattern of Simulant Pathogen Particles in a Clinical Biocontainment Unit. Indoor Air, 2018, Sep 7. PMID: 30192404
  34. Sauer LM, Drewry III D, Shaw-Saliba K, Therkorn J, Pilholski T, Rainwater-Lovett K, Garibaldi BT. A Novel Approach to Identify Potential Provider and Environmental Contamination in a Clinical Biocontainment Unit Using Aerosolized Pathogen Simulants. Health Security, 2018 Mar/Apr; 16(2). PMID 29624490
  35. Garibaldi BT and Chertow DS. High-Containment Pathogen Preparation in the Intensive Care Unit. Infect Dis Clin North Am. 2017 Sep;31(3):561-576. PMID: 28779833
  36. *Garibaldi BT, Kelen GD, Brower RG, Bova G, Ernst N, Reimers M, Langlotz R, Gimburg A, Iati M, Smith C, MacConnell S, James H, Lewin JL, Trexler P, Black MA, Lynch C, Clarke W, Marzinske MA, Sokoll L, Carroll KC, Parrish NM, Dionne K, Biddison ELD, Gwon HS, Sauer L, Hill P, Newton SM, Garrett MR, Miller RG, Perl TM, Maragakis LL. The Creation of a Biocontainment Unit at a Tertiary Care Hospital: The Johns Hopkins Medicine Experience. Annals of the American Thoracic Society, 2016 May; 13(5): 600-608. PMID: 27057583 [SI/QI] *corresponding author