Dr K K Aggarwal
President Confederation of Medical Associations of Asia and Oceania,
HCFI and Past National President IMA
With regular inputs from Dr Monica Vasudev
717:
COVID Neurological manifestations
Five more cases of Guillain–Barré syndrome (GBS) in
association with COVID-19 have been identified.
The cases from Italian researchers, comes a little more than 2 weeks
following the first reported case of COVID-19 presenting as GBS. The article,
with lead author Gianpaolo Toscano, MD, IRCCS C. Mondino Foundation, Pavia,
Italy, was published online April 17 in the New England Journal of Medicine.
718:
COVID high sugar link
Diabetes and hyperglycemia among people without prior
diabetes are strong predictors of mortality among hospitalized patients with
COVID-19. The data suggest that although glycemic control may not be at the
forefront of most clinicians' minds when it comes to COVID-19, it is important,
and paying more attention to it could save lives, say the researchers, led by
Bruce Bode, MD, of Atlanta Diabetes Associates, Georgia, and colleagues,
including employees of Glytec, an insulin management software company. The results
were published online April 17 in the Journal of Diabetes Science and
Technology.
719: Gating criteria before phasing-in elective
procedures.
1. A
downward trajectory of influenza-like illnesses reported within a 14-day period
2. A
downward trajectory of documented COVID-19 cases or a downward trajectory of
positive tests as a percentage of total tests within a 14-day period
3. A
"robust" testing program in place for at-risk healthcare workers,
including emerging antibody testing
720: According
to a study published in the Journal of Infection, saliva is a reliable tool to
detect SARS-CoV-2.
Lorenzo Azzi, MD, University of Insubria, Varese,
Italy, and colleagues analysed salivary samples of 25 patients with COVID-19
and compared the results with their clinical and laboratory data. SARS-CoV-2 was detected in all 25 patients’
first salivary swab. Eight patients underwent a second salivary swab after 4
days, and the results were consistent with the first analysis, without relevant
differences in variable threshold cycles (Ct). A striking feature was
highlighted in 2 patients who showed positive salivary results on the same days
when their pharyngeal or bronchoalveolar swabs proved to be negative.
721: A study, published in Clinical Infectious
Diseases, showed that detectable serum SARS-Cov-2 RNA (RNAaemia) in patients
with COVID-19 was associated with elevated IL-6 concentration and poor
prognosis.
According to Xiaohua Chen, General Hospital of Central
Theater Command, Wuhan, China, and colleagues RNAaemia was diagnosed only in
critically ill patients with COVID-19, and seemed to reflect the severity of
the disease. Furthermore, the level of inflammatory cytokine IL-6 in critically
ill patients increased significantly, almost 10 times that in other patients.
More importantly, the extremely high IL-6 level was closely correlated with the
detection of RNAaemia (R = 0.902). The extremely high level of IL-6 is a
hallmark and important driving force of cytokine storm, which may cause
multiple organ dysfunction in critically ill patients.
722: A study
published in Journal of Thrombosis and Haemostasis showed that thrombocytopenia
is common in patients with COVID‐19, and is associated with increased risk of
in‐hospital mortality.
Xiaobo Yang, MD, Tongji Medical College, Wuhan, and
colleagues retrospectively analysed data from 1,476 patients with COVID-19
treated at Jinyintan Hospital in Wuhan. Of the patients, 238 (16.1%) died.
Compared with survivors, non‐survivors were older, were more likely to have
thrombocytopenia, and had lower nadir platelet counts. Among the patients, 306
(20.7%) had thrombocytopenia. The in‐hospital mortality was 92.1% for patients
with nadir platelet count 0 to 50, 61.2% for patients with counts 50 to 100,
17.5% for patients with platelet count 100 to 150, and 4.7% for patients with
platelet counts ≥150. Thrombocytopenia
is common in patients with COVID‐19, and it is associated with increased risk
of in‐hospital mortality,” the authors concluded. “The lower the platelet count
is, the higher the mortality becomes. [DG]
723:
Universal testing: in pregnant women?
A policy of universal screening of pregnant women for
the COVID-19 virus identified a high proportion of women who tested positive
and were asymptomatic, based on data from 215 pregnant women in New York City.
In a letter published in the New England Journal of
Medicine, the researchers reviewed their experiences with 215 pregnant women
who delivered infants during March 22–April 4, 2020, at the New
York–Presbyterian Allen Hospital and Columbia University Irving Medical Center.
All the women were screened for symptoms of the COVID-19 infection on
admission.
Overall, four women (1.9%) had fevers or other
symptoms on admission, and all of these women tested positive. The other 211
women were afebrile and asymptomatic at admission, and 210 of them were tested
via nasopharyngeal swabs. A total of 29 asymptomatic women (13.7%) tested
positive for COVID-19 infection.
Thus, 29 of the 33 patients who were positive for
SARS-CoV-2 at admission (87.9%) had no symptoms of COVID-19 at presentation.
Three of the 29 COVID-19-positive women who were
asymptomatic on admission developed fevers before they were discharged from the
hospital after a median stay of 2 days. Of these, two received antibiotics for
presumed endomyometritis and one patient with presumed COVID-19 infection
received supportive care. In addition, one patient who was initially negative
developed COVID-19 symptoms after delivery and tested positive 3 days after her
initial negative test.
Our use of universal SARS-CoV-2 testing in all
pregnant patients presenting for delivery revealed that at this point in the
pandemic in New York City, most of the patients who were positive for
SARS-CoV-2 at delivery were asymptomatic,” Dr. Sutton and colleagues said.
724:
Most fine-needle aspiration
procedures for thyroid nodules can be safely delayed
Most fine-needle
aspiration procedures for thyroid nodules can be safely delayed for 6 months or longer during the COVID-19
pandemic; data show such delays do not influence the long-term prognosis for
common forms of thyroid cancer, according to an editorial published in Clinical Thyroidology.
No comments:
Post a Comment