Clinical

On the heels of JUCM’s study of chest x-rays in urgent care patients with COVID-19, the Journal of the American Medical Association just published an article that reveals the most common presenting characteristics, comorbidities, and outcomes of infected patients, based on 5,700 hospitalized patients in New York City, Westchester County, and Long Island, NY. The data show that 14% of hospitalized COVID-19 patients wound up in the ICU; 12% received invasive mechanical ventilation; 3% had …

We’ve become accustomed to the fact that outcomes projections, testing methods, and information about mode of SARS-CoV-2 infection change regularly. Add symptoms to the list of moving targets regarding COVID-19, as the Centers for Disease Control and Prevention has added several new ones based on growing data. In addition to fever, cough and shortness of breath, the CDC now says urgent care providers and other clinicians need to be vigilant for chills, repeated shaking with …

In the absence of evidence-based guidelines, clinicians in urgent care and other settings have been relying largely on their own clinical experience in caring for patients with COVID-19. That’s about to change, though, as the National Institutes of Health has released guidelines drawn from published and preliminary data and the advice of a panel of physicians, statisticians, and public health experts. It’s important to note amid speculation that certain drugs and nondrug agents “could be” …

Even as some states report that the much-discussed “curve” is actually starting to flatten, the Centers for Disease Control and Prevention warns against perceiving that to mean the worst is over for the U.S. CDC Director Robert Redfield, MD suggested that a second wave could actually be worse than this one if it occurs in the fall, just as the next influenza season is getting started—which some health officials and researchers say is a distinct …

The Centers for Disease Control and Prevention has issued a new advisory clarifying steps that should be taken to decrease risk of COVID-19 infection in critical infrastructure workers—while also reconfirming that those workers “be permitted to continue work following potential exposure to COVID-19, provided they remain asymptomatic and additional precautions are implemented to protect them and the community. Interim Guidance for Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a …

After an outright cure for or a vaccine to prevent COVID-19, the Holy Grail of the pandemic is a reliable method of testing patients who may have been infected. A new study out of the University of Insubria, Varese, Italy shows that testing saliva could be as reliable as anything else. Researchers got positive tests from their first salivary swab in all 25 patients who took part. Interestingly, two of those patients had negative pharyngeal …

We’ve all been operating under the guidance that 6 feet could be considered relatively “safe” distancing between individuals in order to slow the spread of the SARS-CoV-2 virus. However, new data from Huoshenshan Hospital in Wuhan, China indicate that the transmission distance might be twice that or more—at least 4 meters, or 13.1 feet-plus according to a study of air samples there. The researchers based their findings on swab samples from the intensive care unit …

The Urgent Care Association has teamed up with the College of Urgent Care Medicine and the American College of Emergency Physicians to issue a one-page risk stratification guide that suggests best practices when dealing with suspected or confirmed COVID-19 cases. The complete guide, which separates patients into Risk Category I (consider discharge and home monitoring) or Risk Category II (consider transfer to ED) is available here.

Studies of COVID-19 from around the world are just starting to bear fruit. One, just published in The Lancet Infectious Diseases, reveals that the salivary viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highest in the first week after symptom onset. While viral RNA was detected 25 days after symptoms onset in one patient, serum samples from 16 patients were negative at 14 days. Serial viral load was ascertained through reverse transcriptase …

Some urgent care operators are employing telemedicine to help identify patients who need to be tested or who need treatment for COVID-19 vs those who don’t—the idea being to keep people at home and out of healthcare facilities for as long as possible, if they need to go anywhere at all. ZOOM+Care is going one step further toward that goal by piloting a saliva-based, self-sample test that patients can do for themselves at home. The …