Clinical

Patients with “underlying conditions” are at increased risk for severe disease and poor outcomes if they have COVID-19. That drum has been beaten long and loud. However, new data published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews illustrate how great the threat is to patients who have diabetes, in particular. Meta-analysis showed that diabetes was associated with composite poor outcomes (risk ratio = 2.38, 95% confidence interval 1.88-3.03), including mortality (RR 2.12, 95% …

As One Possible COVID-19 Treatment Gets a Closer Look, Another Prompts Safety Concerns While the world hopes for a “magic bullet” that will put COVID-19 down, or at least prevent it, researchers remain committed to exploring all available options. Most recently, the Food and Drug Administration issued an emergency use authorization for the investigational antiviral drug remdesivir for the treatment of suspected or laboratory-confirmed COVID-19 in adults and children hospitalized with severe disease. Acknowledging that …

Paradoxically, patients who may be at greatest risk for complications due to COVID-19 are opting out of the very care that could keep them from suffering with severe disease, according to research published by Patient Care Online. The concern is especially great among those with chronic conditions such as asthma and type 2 diabetes. The problem, simply, is that they’re scared; 40% said they’re “worried/very worried” about going to a medical facility, including the emergency …

When it first became apparent there is a wide range in how severely patients are affected by COVID-19, there seemed little rhyme or reason, aside from existing clinical characteristics, as to why one patient fared worse than another—or how a patient’s likelihood of developing severe disease could be predicted. Now a study just published in Critical Care suggests that predicting disease progression can be aided by looking at sputum viral load. The research, out of …

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 …