Copy-editor: Rob Camp
Prevention
Bahethi RR, Liu BY, Asriel B, et al. The COVID-19 Student Workforce at the Icahn School of Medicine at Mount Sinai: A Model for Rapid Response in Emergency Preparedness. Acad Med. 2020 Dec 1. PubMed: https://pubmed.gov/33264110. Full-text: https://doi.org/10.1097/ACM.0000000000003863
From March 15, 2020 to June 14, 2020, student volunteers recorded 29.602 hours (2277 hours per week) in 7 different task forces which operated at 7 different hospitals throughout the health system. Volunteers included students from all years of medical school as well as PhD, master’s, and nursing students.
Ghram A, Briki W, Mansoor H, Al-Mohannadi AS, Lavie CJ, Chamari K. Home-based exercise can be beneficial for counteracting sedentary behavior and physical inactivity during the COVID-19 pandemic in older adults. Postgrad Med. 2020 Dec 4. PubMed: https://pubmed.gov/33275479. Full-text: https://doi.org/10.1080/00325481.2020.1860394
Lockdowns, quarantine and self-isolation are periods characterized by cessation of outdoor exercise. To avoid the harmful effects of periods of not doing exercise, physical activity (PA) could be prescribed to older adults, which is of great importance for breaking their sedentary lifestyle and improving their immunity. The authors discuss the importance of performing PA to reduce the harmful effects of COVID-19.
Clinical
Mikuls TR, Johnson SR, Fraenkel L, et al. American College of Rheumatology Guidance for the Management of Rheumatic Disease in Adult Patients During the COVID-19 Pandemic: Version 3. Arthritis Rheumatol. 2020 Dec 5. PubMed: https://pubmed.gov/33277981. Full-text: https://doi.org/10.1002/art.41596
This document provides guidance to rheumatology providers on the management of adult rheumatic disease in the context of the COVID‐19 pandemic.
Co-morbidities
Gulersen M, Staszewski C, Grayver E, et al. Coronavirus Disease 2019 (COVID-19)-Related Multisystem Inflammatory Syndrome in a Pregnant Woman. Obstet Gynecol. 2020 Dec 3. PubMed: https://pubmed.gov/33278275. Full-text: https://doi.org/10.1097/AOG.0000000000004256
Case report of a woman at 28 weeks gestation, diagnosed with COVID-19 4 weeks prior, and admitted with chest pain. Evaluation indicated myocarditis and marked elevations of inflammatory markers consistent with multisystem inflammatory syndrome in adults. Treatment with intravenous immunoglobin and corticosteroids was associated with a favorable outcome.
Fernandez CE, Franz CK, Ko JH, et al. Imaging Review of Peripheral Nerve Injuries in Patients with COVID-19. Radiology. 2020 Dec 1:203116. PubMed: https://pubmed.gov/33258748. Full-text: https://doi.org/10.1148/radiol.2020203116
Peripheral nerve injury can occur in COVID-19 patients secondary to post-infectious inflammatory neuropathy, prone positioning-related stretch/compression injury, systemic neuropathy, or nerve entrapment from hematoma. MR neurography and high-resolution ultrasound are excellent diagnostic tools for peripheral nerve injury. For COVID-19 patients and survivors with neuromuscular complications, imaging of peripheral nerves can aid medical decision-making, rehabilitative care, and patient/family counseling.
Pediatrics
Zimmermann P, Curtis N. Why is COVID-19 less severe in children? A review of the proposed mechanisms underlying the age-related difference in severity of SARS-CoV-2 infections. Arch Dis Child. 2020 Dec 1:archdischild-2020-320338. PubMed: https://pubmed.gov/33262177. Full-text: https://doi.org/10.1136/archdischild-2020-320338
Compared with older adults, severe or fatal COVID-19 disease is much less common in infants, children and young adults. In this review, the authors discuss proposed hypotheses for the age-related difference in severity of COVID-19. The observed age-gradient seems to most closely parallel changes in immune and endothelial/clotting function.
Collateral Effects
Heaton HA, Luke A, Sztajnkrycer MD, Clements CM, De Moraes AG, Raukar NP. Best Practices in Managing Cardiac Arrest in the Emergency Department During the COVID-19 Pandemic. Mayo Clin Proc. 2020 Dec;95(12):2704-2708. PubMed: https://pubmed.gov/33276842. Full-text: https://doi.org/10.1016/j.mayocp.2020.10.009
Patients with COVID-19 are at increased risk of cardiac complications including cardiac arrest. Of admitted patients, almost 30% may have evidence of myocardial injury with mortality among hospitalized patients as high as 70%. The resuscitation of these patients requires a conscious effort to minimize the spread of SARS-CoV-2. The authors present a best-practice model based on four guiding principles: (1) reduce the risk of exposure to the entire health care team; (2) decrease the number of aerosol-generating procedures; (3) use a small resuscitation team to limit potential exposure; and (4) consider early termination of resuscitative efforts.
Fuady A, Houweling TAJ, Richardus JH. COVID-19 and Tuberculosis-Related Catastrophic Costs. Am J Trop Med Hyg. 2020 Dec 2. PubMed: https://pubmed.gov/33269683. Full-text: https://doi.org/10.4269/ajtmh.20-1125
Interruptions of TB control programs could potentially prolong diagnostic delays and worsen TB treatment outcomes. In addition, the upcoming economic recession could lead to a reduction of income and a rise in unemployment rates in TB-affected households. All of these factors increase the risk of TB incidence and the economic impact on TB-affected households.
Indini A, Cattaneo M, Ghidini M, et al. Triage process for the assessment of coronavirus disease 2019-positive patients with cancer: The ONCOVID prospective study. Cancer. 2020 Dec 3. PubMed: https://pubmed.gov/33270908. Full-text: https://doi.org/10.1002/cncr.33366
General measures to keep COVID‐19–free cancer divisions have been adopted worldwide. In this prospective clinical trial, the authors evaluated the efficacy of triage to identify COVID‐19 among patients with cancer. Of 562 enrolled patients, 6 (1%) were diagnosed with COVID‐19, of whom 4 (67%) had the disease detected through telehealth triage, and 2 patients (33%) without suspect symptoms at triage had the disease detected later. The authors conclude that telehealth triage was helpful in detecting suspect patients and to keep a COVID‐19–free cancer center. The overall incidence of COVID‐19 diagnosis (1%) and antibody positivity (13%) in patients with suspect symptoms was similar to that observed in the general population.
Peach E, Rutter M, Lanyon P, et al. Risk of death among people with rare autoimmune diseases compared to the general population in England during the 2020 COVID-19 pandemic. Rheumatology (Oxford). 2020 Dec 4:keaa855. PubMed: https://pubmed.gov/33271595. Full-text: https://doi.org/10.1093/rheumatology/keaa855
The risk of all-cause death is more prominently heightened during COVID-19 among people with rare autoimmune rheumatic diseases (RAIRD) than among the general population. This is a result of an analysis which included 168.691 people with a recorded RAIRD diagnosis alive on 01/03/2020. The age-standardized mortality rate (ASMR) among people with RAIRD was 1.44 times higher than the average ASMR during the same months of the previous 5 years, whereas in the general population of England it was 1.38 times higher. The authors suggest quantifying how much risk is due to COVID-19 and how much is due to a disruption to healthcare services.
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By Christian Hoffmann &
Bernd Sebastian Kamps
Copy-editor: Rob Camp