January 10, 2022
Director, Media & Public Affairs
Institute of Human Virology
University of Maryland School of Medicine
Wednesday, August 17, 2022
Pregnant women who catch COVID-19 are in much greater danger than previously suspected, according to a new study that analyzed data collected from six African countries.
Wednesday, August 17, 2022
Many African countries have fallen behind on delivering COVID shots to kids, despite a higher risk of severe sickness in a massively young population.
Thursday, May 19, 2022
Dan Rodricks: I recently had conversations with a middle-aged man who is extremely careful about what he puts into his body. He eats lots of fruits and vegetables and stays away from red meat and processed foods. He also refuses to get the vaccine against COVID-19, even as infections are on the rise again.
Tuesday, April 19, 2022
Since early on, the pandemic has highlighted inequality both on a micro scale—within countries, between social classes and ethnic groups—and a macro one—between rich and poor countries. It also confirmed what many of those working in global health—particularly in and for low- and middle-income countries—expected: In an emergency, no matter the declared values and intention, people will first and foremost, and in many cases only, care about themselves and their own.
Thursday, March 10, 2022
HIV-1 can be transmitted through vaginal, anal, and oral sex, whether it’s with a same-sex or different-sex partner. But the risk of developing it seems to vary depending on how the disease is transmitted. In fact, the HIV virus may be more virulent when passed between male and female partners who have penile-vaginal sex than among men who have anal sex with other men, according to a new study from the Indian Institute of Science.
Friday, March 04, 2022
Americans, by and large, are putting the pandemic behind them. Now that Omicron is in the rearview mirror and cases are plummeting, even many of those who have stayed cautious for two full years are spouting narratives about “going back to normal” and “living with COVID-19.” But in the global South, COVID-19 is much harder to ignore. More than a year after the start of the mass-vaccination campaign, nearly 3 billion people are still waiting for their first shot.
Wednesday, February 23, 2022
Over two years since the first cases started appearing in Wuhan, China, there is much we don’t know about the origins of SARS-CoV-2, the virus causing COVID-19. But a quick resolution to that question is possible: scientists could find bats in a cave somewhere in China or in southeast Asia and trace a chain leading from those bats to the COVID-19 outbreak in Wuhan. Realistically, however, recent history offers little promise for this to happen quickly.
Tuesday, February 08, 2022
Could a “broad spectrum” booster increase our immunity to many pathogens simultaneously? The first tuberculosis vaccine was developed in 1921, by two French scientists, Albert Calmette and Camille Guérin. It was called Bacillus Calmette-Guérin, or B.C.G., and has long been one of the world’s most widely administered shots. From the beginning, its power was surprising. B.C.G. contains a bacterium similar to the one that causes TB, and engenders an immune defense specific to that disease. But, as Calmette noted in a paper in 1931, those vaccinated with B.C.G. at birth were around seventy-five per cent less likely to die in their early years of any cause.
Friday, January 28, 2022
COVID-19 transmission may have seasonal spikes tied to temperature and humidity, increasing at different times of the year for different locations, a new study in the American Journal of Tropical Medicine and Hygiene suggests.
Wednesday, January 26, 2022
In a study published Wednesday in Science Translational Medicine, researchers looked at 32 patients that had both cancer and HIV and found that pembrolizumab, which revives the immune system and encourages it to attack tumors, also has the ability to flush HIV out of its hiding spot in immune cells.
Tuesday, January 25, 2022
Baltimore Sun: Doctors in Maryland see COVID treatments aiding return to more normal life, once the public can get them
The focus is increasingly on preventing hospitalizations and deaths, rather than stopping all COVID-19 infections, by using new therapies.
Wednesday, December 22, 2021
Washington Post: Remdesivir can help keep unvaccinated, high-risk people with covid-19 out of hospitals, study finds
The antiviral drug remdesivir can help keep unvaccinated people at risk of severe covid-19 out of hospitals, according to a study that found the treatment reduced hospitalization and death by 87 percent when given soon after diagnosis.
Thursday, December 16, 2021
Robert Gallo, director and co-founder of the Institute of Human Virology at the University of Maryland and co-founder of the Global Virus Network, discussed why it is important to vaccinate children against coronavirus.
Wednesday, December 15, 2021
Conversations on Health Care: Robert Gallo, Scientist Who Co-Discovered HIV Offers Guidance to Patients as Omicron Increases
Dr. Gallo says their network of scientists knew early in the COVID-19 pandemic that the mRNA vaccines would be effective, but for a limited time, and that boosters will be required until the global outbreak is brought under control. He says it’s too soon to predict the full impact of the omicron variant, but that it is likely to overwhelm many countries.
Monday, December 13, 2021
Reuters Health via Medscape: Passive Exposure to Oral Polio Vaccine May Protect Against COVID-19 for at Least 6 Months
Mothers of children immunized with the oral polio vaccine, which is made from a live attenuated virus, seemed to be protected against symptomatic COVID-19 for at least six months based on a study in Iran.
Tuesday, November 02, 2021
In an accompanying commentary, Dr. Mohammad Sajadi of the Institute of Human Virology at the University of Maryland School of Medicine, argued that the findings are part of a growing body of work that suggests "room for improvement" with the J&J vaccine.
Tuesday, October 26, 2021
Correio Braziliense: "It's obvious that no vaccine causes AIDS," says one of the virologists who discovered HIV
The virologist, and one of the discoverers of HIV, speaks to Correio about statements by President Bolsonaro live on social media
Friday, October 22, 2021
Experts say there are a number of reasons they prefer organ transplant recipients receive vaccinations against COVID-19 as well as other diseases before surgery.
Friday, October 15, 2021
Even as the fourth wave of COVID-19 cases trends downward, one aspect of the pandemic remains strong: differing opinions on the value of COVID-19 immunization and vaccine mandates across the U.S.
Thursday, September 02, 2021
Yahoo! Finance: Adamis Pharmaceuticals Doses First Patients in Phase 2/3 Clinical Trial for Tempol in the Treatment of COVID-19
Adamis Pharmaceuticals Corporation announced the initiation of patient dosing in the Phase 2/3 clinical trial for Tempol, an oral antiviral product candidate, in adult patients with confirmed COVID-19 infection. In preclinical studies, Tempol has been shown to have antiviral, anti-inflammatory and antioxidant activity.
Monday, August 16, 2021
Dr. Katya Prakash-Haft discusses why organ transplant recipients and other immune compromised people need COVID booster shots
Friday, August 13, 2021
The federal agency’s decision follows the FDA’s move to authorize the additional shot of the Pfizer and Moderna vaccine. It comes after research has shown the vaccine isn’t as effective for immunocompromised people compared to the general population.
Tuesday, July 27, 2021
The Chronicle of Higher Education: New CDC Mask-Wearing Guidance Could Alter Colleges’ Return-to-Campus Plans
The Centers for Disease Control and Prevention updated its guidance on Tuesday, recommending that vaccinated Americans wear masks indoors in certain circumstances due to the highly transmissible Delta variant of Covid-19. This may throw a wrench in return-to-campus plans for colleges that aimed to resume pre-pandemic operations.
Monday, July 26, 2021
As COVID-19 cases surge and the highly infectious delta variant spreads across the United States, drugmakers and federal health officials remain divided over when and if people who have been vaccinated might need booster shots to bolster their immunity.
Friday, July 23, 2021
Panelists will discuss the threat posed by new COVID variants and continued vaccine hesitancy.
Friday, July 23, 2021
People online claim the Olympics are in jeopardy because the country has no plan to vaccinate its population. That's false.
Tuesday, July 20, 2021
With vaccination campaigns underway in some countries while others weigh the options, Nature looks at the evidence for vaccinating younger people.
Wednesday, July 14, 2021
As the U.S. faces down the COVID-19 Delta variant – now fast-becoming the nation's dominant strain – reports of a new Lambda variant that first emerged in Peru in August 2020 are gaining the attention of public health officials worldwide. News of this coronavirus variant is concerning, especially what it could mean for new COVID-19 cases, hospitalizations and deaths, all of which had been declining in the last few months. But one tweet being shared across social media claims new viral strains are nothing to be worried about.
Thursday, July 08, 2021
Dr. Robert Gallo, The Global Virus Network Co-founder and Director at University of Maryland says COVID-19 is a solvable problem, as obviously it was easy to get a solvable vaccine.
Saturday, July 03, 2021
India Today: Exclusive: Virologist Dr. Robert Gallo Speaks On Third Wave, Effects On Children & Other COVID Issues
Will India and the world see a third wave, if yes then when? How much the third wave will affect children? If mRNA vaccine is the future of COVID-19 vaccines? World's top virologist, Dr. Robert Gallo, answers these and many other questions related to COVID-19 and its vaccination in an exclusive conversation with Rajdeep Sardesai.
Friday, June 25, 2021
Dr. Marc Siegel talks to the Co-founder & Director of the Institute of Human Virology at the University of Maryland School of Medicine and Co-founder for the Global Virus Network, Dr. Robert Gallo, as well as the President of the Global Virus Network, Dr. Christian Brechot, about COVID-19 Origin, Immunity, Vaccines, and Variants.
Friday, June 25, 2021
Weather Channel: Mystery Thickens Over COVID-19's Origin; Claims of Hidden Early Genetic Information Attracts Further Scrutiny
COVID-19 pandemic has been wreaking worldwide havoc for nearly 20 months now. Yet, Its origin and early spread continue to be one of the most intriguing scientific puzzles of recent history. Claims that the earliest coronavirus strains leaked out from a lab in the Wuhan Institute of Virology in China have resurfaced and subsided multiple times, throughout the course of the pandemic. While many such claims were eventually disregarded as unfounded speculations of conspiracy theorists, allegations have continued against the Wuhan lab having known about the infection and its subsequent threat, much before the world at large was aware.
Tuesday, June 22, 2021
The Wuhan lab has drawn global scrutiny because of its research on bat coronaviruses in the city where the pandemic began. The events have shined a light on a research niche that — in China, the United States and elsewhere — operates with heightened secrecy because of the national security risks of handling deadly pathogens.
Monday, June 21, 2021
A third wave of coronavirus infections is likely to hit India by October, and although it will be better controlled than the latest outbreak the pandemic will remain a public health threat for at least another year, according to a Reuters poll of medical experts.
Thursday, June 17, 2021
What has COVID-19 taught us about preparing for future epidemics? Can we trigger innate immune responses – our first lines of defense - to mitigate novel infections? Can we use live-attenuated vaccines (LAV) meant for other infections to protect us while we develop specific vaccines for new pathogens? On this episode, we talk to virologists Konstantin Chumakov and Robert Gallo about their recent paper entitled “Old vaccines for new infections”.
Thursday, June 03, 2021
More than a year into the COVID-19 pandemic, scientists still aren’t sure where exactly the virus that caused this mess came from, and how it was able to spread so rapidly among humans. With the origins of the coronavirus still up in the air, there’s been a lot of talk of the so-called lab leak theory—the idea that the virus spread to people in a laboratory accident, rather than jumping from a wild animal to a human. In recent days, there’s been a flurry of speculation, and it can be hard to parse what the lab leak theory is all about, how likely it is, and why it matters at all. Here’s our attempt to sort some of that out.
Tuesday, May 18, 2021
Institute of Human Virology Leadership Contributes to Global Virus Network Analysis Suggesting Measles, Polio and Tuberculosis Vaccines May Boost Immunity to Coronavirus
Institute of Human Virology at the University of Maryland School of Maryland scientists, who are also members of the Global Virus Network (GVN), a coalition comprised of human and animal virologists from 63 Centers of Excellence and 11 Affiliates in 35 countries, and colleagues today published a perspective proposing that live attenuated vaccines (LAVs), such as those for tuberculosis, measles, and polio, may induce protective innate immunity that mitigate other infectious diseases, triggering the human body’s natural emergency response to infections including COVID-19 as well as future pandemic threats.
Monday, April 19, 2021
Dr. Robert Gallo, co-founder of the Global Virus Network and director of the Institute of Human Virology at the University of Maryland School of Medicine, discusses the global rollout of Covid-19 vaccines. Global cases passed 141 million, and deaths exceeded 3 million. Gallo speaks with Haidi Stroud-Watts and Shery Ahn on "Bloomberg Daybreak: Australia."
Monday, April 19, 2021
In an exclusive interview with CBN, Dr. Robert Gallo, a world-renowned virus expert, speculated that certain components of Johnson & Johnson and AstraZeneca vaccines may induce the immune system to produce an antibody, which can cause a very small number of people. Heparin-induced thrombocytopenia, thrombosis.
Friday, April 09, 2021
As the United States ramps up its COVID-19 inoculation campaign, aiming to make vaccines available to all adults by April 19, some doctors and health workers are concerned that brand preferences among potential vaccine recipients could hurt attempts to slow the spread of the virus.
Thursday, April 08, 2021
Just how important is timing when it comes to the second dose of the Pfizer and Moderna vaccines? Walgreens is now adjusting its vaccine scheduling process after being asked to do so by the CDC. They were spacing Pfizer vaccines 28 days apart instead of recommended 21 days, because it was just easier to schedule them the same as the Moderna shot.
Tuesday, March 30, 2021
Data seems to be indicating that survivors of COVID-19 may not need two doses of mRNA vaccine, which would free up more doses for others.
Tuesday, March 16, 2021
ABC7 WJLA - 7 On Your Side: Doctor rates COVID-19 risks for activities in a partially-vaccinated world
“We see people come in, it's still with really severe disease,” said Dr. Eleanor Wilson, an infectious disease specialist and an associate professor of medicine at the Institute of Human Virology at the University of Maryland School of Medicine.
Sunday, February 21, 2021
The research, while preliminary, found that the previously infected people generated protection against the disease quickly and at dramatically higher levels after a first shot.
Thursday, February 18, 2021
With emergency authorizations for several COVID-19 vaccines under our belt, the question remains if these vaccines will be enough to carry us through the end of the pandemic. Experts agree that there will likely need to be additional vaccines to achieve full recovery. In this two-part series, we discuss what a next-generation COVID-19 vaccine might look like, and which candidates are in the running for authorizations.
Tuesday, February 16, 2021
The Baltimore Sun: Maryland sees little flu this season as researchers wonder if flu vaccine staves off COVID-19
February is typically the cruelest month for the flu with thousands of infections, hundreds hospitalized and some dying in Maryland. Not this year. Due in part to the coronavirus pandemic and preventative measures associated with it, the influenza virus is downright rare in Maryland and across the nation. But researchers are wondering if there’s a chance that the flu shot you got in the fall may yet fend off a nasty infection — of COVID-19.
Friday, February 12, 2021
The Washington Post: Scientists said claims about China creating the coronavirus were misleading. They went viral anyway.
The spread of the unverified assertions by Chinese scholar Li-Meng Yan, widely dismissed as “flawed,” show how vulnerable scientific sites are to misuse and misunderstanding.
Friday, February 12, 2021
The Great Coronavirus Pandemic of 2019−2021: the Future and the Requirement for China-America Cooperation - Over the past century, the great pandemics and most epidemics (defined as virus presence and disease induction presenting more than the expected number of infections in a population) were caused by the sudden outbreak of an RNA virus such as the pandemics of influenza, polio, and HIV/AIDS and the epidemics of influenza, Ebola, Dengue, Zika, West Nile, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and Chikungunya.
Thursday, February 04, 2021
None of the trials conducted on the Moderna and Pfizer-BioNTech vaccines tested them on people who already had been infected by the coronavirus. Now, a study involving people previously infected with COVID-19 suggests the immune response from getting sick may act like getting a first dose of those double-shot vaccines.
Tuesday, February 02, 2021
Business Insider: People who had COVID-19 may develop 10 times more antibodies after a single vaccine dose - a sign they might only need one shot
Business Insider - People who had COVID-19 developed at least 10 times more antibodies after their first vaccine dose than the average uninfected person who received two doses, new research shows. Another preliminary study similarly found that healthcare workers who had COVID-19 responded to their first shot the way most people respond to their second. The researchers both suggested that post-COVID patients may only need one shot to sufficiently protect them from the disease again.
Friday, January 22, 2021
Baltimore (WBFF) — If you test positive for COVID-19, doctors are reminding you to get treatment right away even if your symptoms aren't bad in the moment. Dr. Anthony Amoroso, infectious disease specialist at the University of Maryland School of Medicine, joins the morning show to talk about why that's important.
Friday, December 11, 2020
Dr. Robert Gallo, co-founder and international scientific advisor of the Global Virus Network and the co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine, discusses the rollout of the Covid-19 vaccines. The first Covid-19 vaccine expected to be deployed in the U.S. won the backing of a panel of government advisers, a step that will likely help clear the way for emergency authorization by the Food and Drug Administration. Gallo, who co-discovered HIV as the cause of AIDS in 1984, speaks with Haidi Stroud-Watts and Shery Ahn on "Bloomberg Daybreak: Australia." (Source: Bloomberg)
Wednesday, November 11, 2020
Dr. Robert C. Gallo, The Homer & Martha Gudelsky Distinguished Professor in Medicine, co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine and co-founder and international scientific advisor of the Global Virus Network, discusses the timeline and safety of Covid-19 vaccine trials. He speaks with Shery Ahn and Haidi Stroud-Watts on "Bloomberg Daybreak: Asia".
Sunday, November 01, 2020
As researchers test existing vaccines for nonspecific protection against COVID-19, immunologists are working to understand how some inoculations protect against pathogens they weren’t designed to fend off.
Friday, October 30, 2020
Since the beginning of Covid-19, major questions have been asked and some still linger; how long are you contagious and can you be re-infected once you've had the virus Infectious disease physician at the University of Maryland School of Medicine Institute of Human Virology, Dr. Rohit Talwani, joined Fox 45 Morning News Friday to answer those burning questions.
Monday, October 12, 2020
Social distancing, hand hygiene and face masks can help curb the spread of the highly contagious coronavirus but if you do get sick, how long can you spread COVID to others? 7 On Your Side went looking for answers.
Friday, August 28, 2020
A safe, effective vaccine against Covid-19 could resurrect jobs, send kids back to classrooms--change our lives. But how safe and effective? And how quickly can we have it? Dr. Robert Gallo, the AIDS-research pioneer now leading virus science at the Institute of Human Virology at the University of Maryland School of Medicine and the Global Virus Network, argues we could get much of the benefit by inoculating people with an old, very cheap drug -- the oral Polio vaccine developed seven decades ago. Gallo contends it would trigger our ‘innate immunity’-- the body’s emergency response when a threat shows up.
Friday, August 21, 2020
Institute of Human Virology and Italian Researchers identify a SARS-CoV-2 Viral Strain with Deletion in a Protein, Possibly Reducing Fatalities
The Institute of Human Virology (IHV) at the University of Maryland School of Medicine, a Global Virus Network (GVN) Center of Excellence, in collaboration with scientists from Campus Biomedico in Rome, Italy announced today the results of studies showing the emergence of a SARS-CoV-2 viral strain with a deletion in a protein known as nsp1. These data, accepted for publication today by the Journal of Translational Medicine, (link here) may indicate the emergence of a less pathogenic viral strain.
Monday, August 03, 2020
Virologist Robert Gallo, MD, has had a long and storied career in academic and government research. He is the Homer & Martha Gudelsky Distinguished Professor in Medicine, co-founder and director of the Institute Human Virology (IHV) at the University of Maryland School of Medicine and co-founder and international scientific adviser of the Global Virus Network. Despite his deep roots in HIV, Dr. Gallo’s current focus is, not surprisingly, COVID-19, which emerged in China last year and within four months morphed into a full-blown pandemic. As usual, Dr. Gallo’s research strategy has raised eyebrows. Unlike the antibody and RNA vaccines that are all the rage in COVID-19 science, Gallo is putting his energies behind repurposing the oral polio virus vaccine developed in the 1950s by Albert Sabin.
Monday, August 03, 2020
Social distancing is one of the curses of COVID-19, and may fall more heavily on people with HIV than on those without this burden. “People with HIV, and in particular certain subsets of that group—the LGBTQ community, older adults aging with HIV, etc.—face more mental health issues than the general population,” said Sarah Schmalzle, MD, an assistant professor of medicine at the Institute of Human Virology, University of Maryland School of Medicine, in Baltimore. “Many of our patients also already face significant isolation and loneliness due to a combination of HIV stigma, losses of friends and family to HIV, and aging.”
Friday, July 31, 2020
Dr. Robert Gallo, director of the Institute for Human Virology at the University of Maryland School of Medicine, joins the show to give his take on the prospects for an effective COVID-19 vaccine. Gallo is skeptical of the approach many organizations are taking with antibody vaccines, citing the similarly low efficacy those treatments had with HIV due to the low durability of the antibodies. Dr. Gallo’s research is mainly related to Oral Polio Vaccine, which he thinks needs to be tested more in regard to innate immunity.
Monday, July 20, 2020
Dr. Robert Gallo is quoted about an experimental vaccine candidate being developed by AstraZeneca and Oxford University to protect against COVID-19 that triggered an immune response against the coronavirus and appeared to be safe.
Tuesday, July 07, 2020
A United Nations program aimed at eliminating HIV/AIDS released a report Monday showing that the global response to the epidemic has fallen far short of goals set for 2020, in large part due to the coronavirus pandemic.
Monday, July 06, 2020
On today's episode of Loud & Clear, Brian Becker and John Kiriakou are joined by Robert Gallo, MD, the Homer & Martha Gudelsky Distinguished Professor in Medicine, co-founder and director of the Institute Human Virology at the University of Maryland School of Medicine and co-founder and international scientific adviser of the Global Virus Network. What would you think if someone told you that we already have a vaccine that at least helps fight Covid-19? That may already be the case. Two American scientists, Dr. Robert Gallo and Dr. Konstantin Chumakov, are positing that decades-old live vaccines for things like polio and tuberculosis strengthen the immune system’s first line of defense a more general way to fight infection. And the history books show us that that sometimes translates into at least some cross-protection against completely different viruses.
Tuesday, June 30, 2020
Wall Street Journal Op-Ed: An Old Vaccine May Help Against Coronavirus: A tablet for polio boosts innate immunity, which fights other viruses.
In this op-ed coauthored by Dr. Robert C. Gallo and Daniel J. Arbess, they discuss how “An Old Vaccine May Help Against Coronavirus: A tablet for polio boosts innate immunity, which fights other viruses.”
Monday, June 29, 2020
Dr. Robert Gallo is featured in Baltimore Magazine's special edition, "On the Front Lines: Acts of Courage and Kindness in the Age of Coronavirus."
Friday, June 26, 2020
Links to news stories featuring the IHV from June 11 to June 25, 2020.
Friday, June 12, 2020
Institute of Human Virology and Italian Researchers Find Higher Daily Temperatures Lead to a Decrease in COVID-19 Related Deaths
Insights into population density and daily temperatures provide a path to public health strategies. The Institute of Human Virology (IHV) at the University of Maryland School of Medicine, a Global Virus Network (GVN) Center of Excellence, in collaboration with scientists from Campus Biomedico in Rome and Ulisse Biomed and University of Trieste, in Trieste, Italy announced today the results of studies showing an inverse correlation between average high daily temperatures and COVID-19 related death rates in different geographical areas.
Friday, June 12, 2020
CNN: There is plenty of evidence that existing inoculations such as polio vaccines protect children against a wide range of infections and it's worth trying them out against the new coronavirus, a team of experts wrote in Science magazine Thursday.
Thursday, June 11, 2020
NBC News: As the world waits for a coronavirus vaccine, some scientists are proposing that existing vaccines could give the body’s immune system a much-needed temporary boost to stave off infection. It’s still unclear whether such an approach would work, and some experts are skeptical. Others — including researchers in Israel, the Netherlands and Australia — are already investigating whether a tuberculosis vaccine could help jump-start the immune system and make COVID-19 less deadly, though the World Health Organization strongly advises against using that vaccine until it’s proven effective against the coronavirus.
Tuesday, June 02, 2020
UM School of Medicine’s Institute of Human Virology Awarded Grants to Strengthen COVID-19 Response in Sub-Saharan Africa
The Center for International Health, Education and Biosecurity (Ciheb) at the University of Maryland School of Medicine’s Institute of Human Virology was awarded $4 million from the U.S. Centers for Disease Control and Prevention (CDC) to support coronavirus disease 2019 (COVID-19) response activities in Botswana, Nigeria, Malawi, and Mozambique.
Thursday, March 19, 2020
(Source: Business Insider) According to the World Health Organization-China Joint Mission on COVID-19, as of February 20, 80% of laboratory-confirmed cases were mild to moderate, 14% were severe, and 6% were critical. Just to be clear, a mild case of COVID-19 is not like a mild cold. The symptoms will still be pretty severe. Anything less than needing oxygen puts you in this category. Severe cases do need supplemental oxygen, and critical ones are defined by respiratory or multi-organ failure.