Clinical

Obesity, hypertension, lung ailments, and any number of conditions have been linked to increased risk for complications in patients with COVID-19. While chronic kidney disease has not often gotten much attention, a new study published by PLOS ON indicates that CKD could actually be the leading risk factor for hospitalization in infected patients. The paper reflects analysis of the electronic health records of 12,971 individuals, 1,604 of whom had CKD; of those, 354 (22%) required …

Readers of JUCM News know the Centers for Disease Control and Prevention shortened the amount of time it recommends quarantining for certain people with, or who have been exposed to, COVID-19. Now the College of Urgent Care Medicine is advising urgent care providers to read the proverbial fine print in that guidance. The CUCM stresses that the CDC statement offers “acceptable alternatives” to the quarantine periods, in spite of the fact that multiple media reports …

The first evidence that rates of venous and arterial thromboembolism are high in patients with COVID-19 has arrived, in the form of an article just published in The Lancet’s online journal EClinicalMedicine. The meta-analysis of 42 studies involving 8,271 patients notes that rates range anywhere from 20% to 70% among patients who have been diagnosed with the virus. Overall mortality rate among patients with COVID-19 and thromboembolism was 23%, vs 13% without thromboembolism. The authors concluded …

Just last week we told you about an Emergency Use Authorization from the Food and Drug Administration for a home COVID-19 test—along with an admonition that self-testing may make already-insufficient reporting of COVID-19 data even worse. As the pandemic continues and we wade deeper into flu season, the FDA has now authorized the first home dual test for COVID-19 and influenza A and B. Available by prescription only, the Quest Diagnostics product includes a self-collection …

Anecdotal evidence that ongoing direct oral anticoagulant (DOAC) use might reduce a patient’s risk for severe disease with COVID-19 appears to have been wishful thinking, if the results of a study just published in the Journal of Internal Medicine are any indication. The authors found no association between DOAC use and lower incidence of hospital admission for COVID-19, or a composite of intensive care unit admission of death. As such, they concluded that DOAC use …

As many as 40 million doses of coronavirus vaccine may be available in the United States by the end of this year. While that’s clearly good news, it’s significantly fewer than will be needed to offer widespread protection and make a dent in the pandemic. That being the case, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has issued its official recommendations on who should be able to be immunized first …

Patients who are concerned they may have contracted a sexually transmitted infection may favor urgent care over their “regular” doctor due to both the convenience and relative anonymity of this setting. Recognizing that such patients are likely to have engaged in unsafe sex practices, should any related counseling routinely include discussion of pre-exposure prophylaxis against HIV (PrEP)? Northwell Health-GoHealth Urgent Care apparently thinks so, as the company is pledging to include discussion of PrEP when …

Baloxavir marboxil (Xofluza) was approved to help patients in the early stages of influenza infection. However, as the reinvigorated COVID-19 pandemic now coincides with flu season, the Food and Drug Administration has approved it as a preventive measure for patients who have simply been exposed to influenza. As with the original indication, it is approved for patients 12 years of age and older. In a statement accompanying the FDA announcement, Debra Birnkrant, MD, director of …

Less than 6% of patients who present to the emergency room with an exacerbation of asthma receive guideline-directed medical therapy, according to research presented at the Virtual 2020 Annual Meeting of the American College of Allergy, Asthma and Immunology. The data reflect patients between the ages of 22 and 75 who were admitted to the ED of an urban tertiary cancer center between May 1, 2013 and May 1, 2015. The research team used the …

As you may know by now, the Food and Drug Administration recently granted emergency use authorization for the first at-home COVID-19 test. The benefits are obvious: patients don’t have to interact in close proximity to other possibly infected individuals or the healthcare professionals testing people all day long. Further, the home test kits promise results within 30 minutes. The less obvious benefit on the provider side is that fewer people are coming in and possibly …