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Emergency Medicine

COVID-19 Imaging: What we know now and what remains unknown.

9 Jun, 2021 | 08:27h | UTC

COVID-19 Imaging: What We Know Now and What Remains Unknown – Radiology

 

M-A: Hospital-at-home interventions for patients with chronic disease who present to the emergency department – similar mortality risk, lower risk for readmission, lower depression and anxiety scores, and a lower risk for long-term care admission vs. in-hospital stay.

9 Jun, 2021 | 08:20h | UTC

Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis – JAMA Network Open

Invited commentary: Hospitalization at Home for Patients With Acute Exacerbation of Chronic Disease—Further Evidence to Inform Practice – JAMA Network Open

Related: Pandemic Boosts an Old Idea—Bringing Acute Care to the Patient AND Randomized trial: Admission Avoidance Hospital at Home + Geriatric Assessment led to similar outcomes compared to hospital admission for older persons AND Most COVID-19 patients receiving home-based hospital care did not require escalation to traditional hospital setting – Approximately 1 in 5 were admitted within 14 days. Higher oxygen saturation was associated with decreased odds of transfer, whereas higher comorbidity burden was associated with increased risk.

 

Short review: Neurological complications of COVID-19.

8 Jun, 2021 | 09:36h | UTC

Neurological complications of COVID-19 – Intensive Care Medicine

 

Commentary on Twitter

 

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

7 Jun, 2021 | 00:01h | UTC

Therapeutic versus prophylactic anticoagulation for patients admitted to hospital with COVID-19 and elevated D-dimer concentration (ACTION): an open-label, multicentre, randomised, controlled trial – The Lancet

Related: #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.

 

Commentary on Twitter

 

Case report: Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).

6 Jun, 2021 | 23:55h | UTC

Successful treatment of vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) – Journal of Thrombosis and Haemostasis

Commentary: COVID-19 vaccination: Thrombosis can be prevented by prompt treatment, researchers report – Medical University of Vienna

 

Another study shows a high frequency of antibiotic use among patients hospitalized with Covid-19 (85.2%), despite low rates of confirmed secondary bacterial infections.

4 Jun, 2021 | 10:43h | UTC

Co-infections, secondary infections, and antimicrobial use in patients hospitalised with COVID-19 during the first pandemic wave from the ISARIC WHO CCP-UK study: a multicentre, prospective cohort study – The Lancet Microbe

Commentaries: Very high use of antibiotics in COVID-19 treatment could be reduced – University of Glasgow AND More evidence of frequent antibiotic use noted in COVID patients – CIDRAP AND Covid-19: Antimicrobial use was high during first wave despite bacterial co-infections being rare, study finds – The BMJ

Related: Many hospitalized Covid-19 patients are given antibiotics. That’s a problem – STAT

 

Commentary on Twitter (thread – click for more)

 

M-A: Prehospital Tranexamic Acid reduces mortality among bleeding trauma patients without increasing the risk of venous thromboembolism.

6 Jun, 2021 | 23:34h | UTC

The impact of prehospital TXA on mortality among bleeding trauma patients: A systematic review and meta-analysis – Journal of Trauma and Acute Care Surgery (link to abstract – $ for full-text)

Commentary: Prehospital TXA for Trauma – Meta-analysis – JournalFeed

 

In a Mendelian randomization study, researchers found no genetic evidence to support an association between Vitamin D levels and COVID-19 susceptibility, severity, or hospitalization.

4 Jun, 2021 | 10:35h | UTC

Vitamin D and COVID-19 susceptibility and severity in the COVID-19 Host Genetics Initiative: A Mendelian randomization study – PLOS Medicine

Commentary: Vitamin D may not provide protection from COVID-19 susceptibility or disease severity, study suggests – PLOS

Related: Living systematic review: The evidence is insufficient to determine the benefits and harms of vitamin D supplementation as a treatment of COVID‐19. AND RCT: Vitamin D3 does not improve outcomes in hospitalized patients with moderate to severe COVID-19

 

RCT: No benefit from passive leg raising during cardiopulmonary resuscitation in out-of-hospital cardiac arrest.

4 Jun, 2021 | 10:28h | UTC

Clinical outcomes and safety of passive leg raising in out-of-hospital cardiac arrest: a randomized controlled trial – Critical Care

 

Commentary on Twitter

 

What We Know About the Dangerous COVID B.1.617.2 (Delta) Variant – “the Delta variant may soon become the most dominant COVID strain in the world and lead to rapid outbreaks in countries without high vaccination rates”.

3 Jun, 2021 | 11:05h | UTC

What We Know About the Dangerous COVID B.1.617.2 (Delta) Variant – Intelligencer

 

Commentary on Twitter

 

Guideline: Diagnosis and management of acute lower gastrointestinal bleeding.

3 Jun, 2021 | 10:49h | UTC

Diagnosis and management of acute lower gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Endoscopy

 

New IDSA Guidelines on antigen testing for the diagnosis of COVID-19.

31 May, 2021 | 08:25h | UTC

IDSA Guidelines on the Diagnosis of COVID-19: Antigen Testing – Infectious Diseases Society of America

 

COLCORONA RCT: Colchicine for community-treated patients with COVID-19 – findings suggest it may lower death and hospital admission rates, but further studies are required.

28 May, 2021 | 08:27h | UTC

Colchicine for community-treated patients with COVID-19 (COLCORONA): a phase 3, randomised, double-blinded, adaptive, placebo-controlled, multicentre trial – The Lancet Respiratory Medicine

Invited Commentary: Exploiting an early immunological window of opportunity in COVID-19 – The Lancet Respiratory Medicine

 

RCT: First-attempt intubation success is increased with the use an endotracheal tube + stylet vs. an endotracheal tube alone.

27 May, 2021 | 08:16h | UTC

Effect of the use of an endotracheal tube and stylet versus an endotracheal tube alone on first-attempt intubation success: a multicentre, randomised clinical trial in 999 patients – Intensive Care Medicine

 

Commentary on Twitter

 

[Preprint] Meta-analysis of RCT: Ivermectin for the treatment of COVID-19 – no effect on all-cause mortality, length of stay, or viral clearance

26 May, 2021 | 08:41h | UTC

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – medRxiv

 

Commentary on Twitter

 

RCT: Continuous infusion of 20% hypertonic saline does not improve neurological outcomes in patients with traumatic brain injury

26 May, 2021 | 08:22h | UTC

Effect of Continuous Infusion of Hypertonic Saline vs Standard Care on 6-Month Neurological Outcomes in Patients With Traumatic Brain Injury: The COBI Randomized Clinical Trial – JAMA (free for a limited period)

 

Commentary on Twitter

 

Short review: Diagnosis and management of acute respiratory distress syndrome

26 May, 2021 | 08:19h | UTC

Diagnosis and management of acute respiratory distress syndrome – Canadian Medical Association Journal

 

Commentary on Twitter

 

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 | UTC

Admission 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

 

 

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

Effectiveness of Tocilizumab in Patients Hospitalized With COVID-19: A Follow-up of the CORIMUNO-TOCI-1 Randomized Clinical Trial – JAMA Internal Medicine

 

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 | UTC

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association – Stroke

News Release: Risk of second stroke can be reduced with prevention efforts based on cause of first stroke – American Heart Association

 

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 | UTC

COVID-19 VaST Work Group Technical Report – May 17, 2021 – Centers for Disease Control and Prevention

Commentaries: 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 | UTC

REGEN-COV Antibody Cocktail Clinical Outcomes Study in Covid-19 Outpatients – medRxiv

 

Commentary on Twitter

 

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

Tocilizumab in COVID-19: a meta-analysis, trial sequential analysis, and meta-regression of randomized-controlled trials – Intensive Care Medicine

 

Commentary on Twitter

 

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

Risk factors for illness severity among pregnant women with confirmed SARS-CoV-2 infection – Surveillance for Emerging Threats to Mothers and Babies Network, 22 state, local, and territorial health departments, March 29, 2020 -March 5, 2021 – Clinical Infectious Diseases

 

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 | UTC

Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion – New England Journal of Medicine (link to abstract – $ for full-text)

 

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