Critical Care
Admission respiratory status predicts mortality in COVID-19 – hypoxemic patients (oxygen saturation less than 92%) had a 1.8- to 4.0-fold increased mortality risk; those with respiratory rates over 22 breaths per minute were at 1.9- to 3.2-fold elevated mortality risk.
25 May, 2021 | 08:56h | UTCAdmission respiratory status predicts mortality in COVID-19 – Influenza and Other Respiratory Virus
Commentaries: COVID-19 mortality associated with 2 signs easily measured at home – University of Washington School of Medicine AND Low oxygen levels, shallow breathing tied to COVID death – CIDRAP
2 signs easily measured at home can indicate increased Covid mortality risk—respiration rate & blood-oxygen saturation. Both are distinctly predictive of higher mortality. Anyone receiving a positive Covid test can easily monitor for these signs at home https://t.co/8n7oc0d4E4 pic.twitter.com/02ysVaElsL
— delthia ricks 🔬 (@DelthiaRicks) May 24, 2021
Secondary analysis of RCT finds Tocilizumab was beneficial to patients hospitalized with Covid-19 if CRP levels were greater than 15.0 mg/dL, but not if CRP levels were 15.0 mg/dL or less.
25 May, 2021 | 08:52h | UTC
AHA/ASA Guideline: Prevention of stroke in patients with previous stroke and transient ischemic attack – prevention efforts should be based on the cause of the first ischemic event.
25 May, 2021 | 08:43h | UTCNews Release: Risk of second stroke can be reduced with prevention efforts based on cause of first stroke – American Heart Association
Consensus report: Postoperative acute kidney injury in adult non-cardiac surgery.
25 May, 2021 | 08:34h | UTC
CDC is investigating several reports that teenagers and young adults may have developed myocarditis after receiving mRNA vaccines. Most cases were mild, more often in males than females, more often following dose 2 than dose 1, and typically, within 4 days after vaccination.
24 May, 2021 | 08:41h | UTCCommentaries: C.D.C. Is Investigating a Heart Problem in a Few Young Vaccine Recipients – The New York Times AND U.S. CDC looking into heart inflammation in some young vaccine recipients – Reuters
Related: Israel said probing link between Pfizer shot and heart problem in men under 30 – The Times of Israel
[Preprint] RCT: Both REGEN-COV 2400mg and 1200mg antibody cocktails significantly reduced Covid-19-related hospitalization or all-cause death compared to placebo (71.3% reduction and 70.4% reduction, respectively).
24 May, 2021 | 08:46h | UTCREGEN-COV Antibody Cocktail Clinical Outcomes Study in Covid-19 Outpatients – medRxiv
Commentary on Twitter
REGEN-COV Antibody Cocktail(casirivimab with imdevimab) Clinical Outcomes Study in Covid-19 Outpatients: N:>4000 pts
Both 1200mg IV&2400mg REGEN-COV led to a ≥70% ⬇️ (vs placebo) in Covid-19 hospitalization or all-cause death over 28 days after treatmenthttps://t.co/NJxF4BjZRs pic.twitter.com/CFdvEEIWEL— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) May 21, 2021
M-A: Tocilizumab in COVID-19 – “For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required”.
24 May, 2021 | 08:39h | UTC
Commentary on Twitter
Tocilizumab as IL-6 antagonist in hospitalized #COVID19 pts, SR/MA/TSA:
➡️10 RCTs/6493 pts (52.2% ➡️ tocilizumab)
➡️some evidence suggests tocilizumab may be associated with short-term mortality benefit
➡️tocilizumab may prevent disease progression to MVhttps://t.co/sWR4Y351sl pic.twitter.com/JPD31Nb5rn— Intensive Care Medicine (@yourICM) May 22, 2021
Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection – moderate-to-severe COVID-19 was associated with age 25 years and older, healthcare occupation, pre-pregnancy obesity, chronic lung disease, chronic hypertension, and pregestational diabetes mellitus.
24 May, 2021 | 08:34h | UTC
RCT: Endovascular therapy for stroke due to basilar-artery occlusion – “endovascular therapy and medical therapy did not differ significantly with respect to a favorable functional outcome”.
24 May, 2021 | 08:27h | UTCEndovascular Therapy for Stroke Due to Basilar-Artery Occlusion – New England Journal of Medicine (link to abstract – $ for full-text)
M-A: Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens – The pooled prevalence of co-infection at the time of a SARS-CoV-2 diagnosis was 19%, and that of superinfection was 24%.
21 May, 2021 | 08:48h | UTC
AARC Guideline: Management of adult patients with tracheostomy in the acute care setting.
21 May, 2021 | 08:26h | UTC
M-A: In patients with anaphylaxis, the use of multiple epinephrine doses is necessary in 7.7% of cases.
21 May, 2021 | 08:19h | UTCCommentary: How Often Does Anaphylaxis Require Redosing of Epinephrine? – Journal Feed
Characteristics associated with Multisystem Inflammatory Syndrome among adults with SARS-CoV-2 infection
20 May, 2021 | 08:52h | UTCCommentary: COVID-related inflammatory syndrome looks different in adults – CIDRAP
[Preprint] RECOVERY Trial: Colchicine does not improve outcomes in patients admitted to hospital with COVID-19.
19 May, 2021 | 08:51h | UTC
Commentary on Twitter (thread – click for more)
RECOVERY pre-print: Colchicine
11340 patients hospitalised with COVID-19
Randomised to colchicine vs usual care
No significant improvement in:
– 28-day mortality
– discharge alive at 28 days
– progression to invasive mechanical ventilation or deathhttps://t.co/mEtYq2qwkL pic.twitter.com/B0MNJWDi6e— Martin Landray (@MartinLandray) May 18, 2021
M-A: Encephalitis as Neurological Complication of COVID‐19.
19 May, 2021 | 08:41h | UTC
ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections.
19 May, 2021 | 08:37h | UTC
Commentary on Twitter
📢New ACG Clinical Guideline on Prevention, Diagnosis & Treatment of C. difficile Infections
Focus on clinical challenges – diagnostic issues in diarrhea, distinguishing C. diff colonization from active infection + eval/mgmt of CDI in IBD
Full guideline: https://t.co/QTCzeLB9Ri pic.twitter.com/mqZUN4r4jA
— AJG – The American Journal of Gastroenterology (@AmJGastro) May 18, 2021
Fluid-induced harm in the hospital: look beyond volume and start considering sodium. From physiology towards recommendations for daily practice in hospitalized adults.
19 May, 2021 | 08:32h | UTC
[Preprint] Practice Changing RCT: Therapeutic-dose anticoagulation with heparin (LMWH or unfractionated heparin) improves outcomes in non-critically ill patients with Covid-19 – the superiority of therapeutic-dose anticoagulation was seen in both high and low D-dimer groups.
18 May, 2021 | 08:04h | UTCTherapeutic Anticoagulation in Non-Critically Ill Patients with Covid-19 – medRxiv
Commentary on Twitter
Final results of the mpRCT now on preprint server. In non-critically ill patients with COVID-19 (n=2219), therapeutic-dose anticoagulation with heparins increases survival to hospital discharge with reduced use of organ support. https://t.co/TkhGs5qow5
— Ryan Zarychanski (@RZarychanski) May 17, 2021
#ACC21 – [Not published yet] RCT: Among hospitalized patients with Covid-19 and elevated D-Dimer, therapeutic anticoagulation with Rivaroxaban 20 mg was not associated with improved outcomes and resulted in increased major bleeding.
18 May, 2021 | 08:01h | UTCAntiCoagulaTIon cOroNavirus – ACTION – American College of Cardiology
Commentary: ACTION: Full-Dose Rivaroxaban Doesn’t Help in Hospitalized COVID-19 – TCTMD
M-A: Incidence and mortality of COVID‐19‐associated pulmonary aspergillosis – The incidence and mortality in the ICU were estimated to be 10.2% and 54.9%, respectively.
18 May, 2021 | 07:50h | UTC
Expert consensus on peri-operative myocardial injury screening in noncardiac surgery.
18 May, 2021 | 07:12h | UTCInvited Commentary: Expert consensus on peri-operative myocardial injury screening in noncardiac surgery
WSES-AAST guidelines: Management of inflammatory bowel disease in the emergency setting.
18 May, 2021 | 07:15h | UTC
RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.
17 May, 2021 | 08:56h | UTCInvited commentary: Convalescent plasma in patients hospitalised with COVID-19
Commentaries on Twitter
Convalescent plasma:
Yet another example of
Don’t guess, don’t gamble
Randomize… and learn
I’ve heard it said that it was deemed “too difficult” to do a randomised controlled trial. Really? If that’s the case, we must (and can) fix that problem. Pts deserve better. https://t.co/zxIiK5U63v
— Martin Landray (@MartinLandray) May 15, 2021
NEW #COVID19 research—In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Read https://t.co/7Sbe8V9THp. #RECOVERY #RECOVERYtrial pic.twitter.com/D0OLZKxZc4
— The Lancet (@TheLancet) May 16, 2021
#ACC21 – [Not published yet] RCT: DARE-19: Dapagliflozin is safe, but did not significantly improve outcomes among high-risk patients hospitalized with COVID-19.
17 May, 2021 | 08:49h | UTC
Commentaries on Twitter
DARE-19 trial #ACC21 @ACCinTouch
Dapa did not reduce clinical endpoints in #COVID19, but excellent safety profile
🎯 Do not discontinue SGLT2i in 🏥 for #COVID19
Full slideset available in 👇https://t.co/RPi5mpPbbN pic.twitter.com/B9VQdSSAFu
— Enrique Santas (@SantasEnrique) May 16, 2021
DARE-19 findings presented at #ACC21 show #dapagliflozin didn’t significantly ⬇️ risk of organ failure or death or improve recovery in patients hospitalized w/ #COVID19. However, data suggest the SGLT2 inhibitor was well tolerated in acutely ill patients. https://t.co/YjYxbuc952 pic.twitter.com/J4PqwvGpLJ
— American College of Cardiology (@ACCinTouch) May 16, 2021
#ACC21 – RCT: In patients with STEMI undergoing complete revascularization, an FFR-guided strategy did not improve outcomes compared to an angiography-guided strategy.
17 May, 2021 | 08:26h | UTCMultivessel PCI Guided by FFR or Angiography for Myocardial Infarction – New England Journal of Medicine (link to abstract – $ for full-text)