Clinical

The World Health Organization made headlines for stating that transmission of coronavirus by infected, asymptomatic people “very rare”—only to clarify hours later that asymptomatic carriers do contribute to spread of the virus. The WHO also acknowledged that more study is needed to understand what role asymptomatic patients play in infecting others. Complicating the issue is a shortfall in health literacy; according to the WHO, many patients mistake the word asymptomatic to mean having only mild symptoms, …

With social distancing in effect across the U.S., regular cannabis users may find it difficult to maintain their typical rate of usage, possibly leading to withdrawal from the drug. A newly published article in JAMA Network Open reveals that 47% of 23,518 patients who were part of a meta-analysis of cannabis users experienced withdrawal when they stopped or reduced their usage. Concurrent cannabis, tobacco, and other substance use disorders were associated with a higher prevalence …

A new study published in the journal Diabetologia indicates that poor glycemic control, while clearly a threat to anyone with diabetes, is not as foreboding as excessive body mass index when it comes to predicting poor prognosis in patients with COVID-19 and diabetes. The authors called BMI “an independent prognostic factor for disease severity in this population, whereas chronic [glycemic] control and routine therapies, such as RAAS blockers and DPP-4 inhibitors, did not impact the immediate …

A study published in JAMA Internal Medicine shares news of a risk assessment tool that is purported to predict which patients with COVID-19 will become severely ill. Derived from research at The First Affiliated Hospital of Guangzhou Medical University in Guangzhou, China, and reflecting data from 1,590 patients with COVID-19 who were hospitalized between February 20 and March 17, 2020, the tool uses 10 variables readily available at the time of hospital admission—many of which …

Some television news reports make it seem as if antibody tests for COVID-19 will be the key to reopening the economy and diminishing restrictions about group gatherings and protective measures in public spaces. A Forbes magazine piece penned by an infectious disease expert notes that the best response to that idea is probably, Not so fast. In the article, Matthew Binnicker, PhD, director of clinical virology at the Mayo Clinic, acknowledges that while serology tests …

Patients who have previously tested positive for COVID-19 and then declared to be “recovered” by virtue of a negative test, only to test positive again at a later time, do not appear to be infectious, according to data from the Korean Centers for Disease Control and Prevention. This led the researchers to propose those “re-positive” patients could have developed antibodies that would prevent them from having active illness again. Their conclusions were based on studying …

Gastrointestinal complaints and hepatic symptoms are more common in patients ultimately diagnosed with COVID-19 than previously thought, according to a paper to be published in the journal Gastroenterology. The research, based on retrospective study of 1,059 patients at two hospitals in New York City, reveals that 33% of patients who went on to test positive for COVID-19 had at least one GI symptom at presentation; 22% had diarrhea, 7% had abdominal pain, 16% were nauseous, …

Newly published research indicates that remdesivir shortens disease course in patients hospitalized with COVID-19.  Data from the National Institute of Allergy and Infectious Diseases, published in the New England Journal of Medicine, show that patients who received a 10-day course of remdesivir had a reduced recovery time of 11 days, vs 15 days to recovery in patients who did not receive remdesivir. The findings were consistent with preliminary data released by the NIAID weeks ago.

Fears that patients could be suffering with bacterial pneumonia are driving many clinicians to prescribe antibiotics—only to discover after the fact that the patients’ symptoms are actually due to coronavirus. Those premature prescriptions are now stoking concerns that antibiotic resistance could be on the rise, according to an article published recently by MedPage Today. This all comes on the heels of a report from the General Accounting Office that indicated there has been minimal progress …

Recently, a New York City intern posted a blog in which she said her experience during the COVID-19 pandemic as left her feeling “so terribly, soul-crushingly helpless.” An article published in Physicians Practice noted that fear, anxiety, hopelessness, and guilt may be common feelings among providers who are overwhelmed with more patients than they can help. The same goes for urgent care providers who are worried about their jobs because their location has seen patient …