Clinical

We told you recently about a pair of studies out of China that suggested elevated fasting blood glucose could be a risk factor for severe disease in patients with COVID-19. Now a third study using the same data pool paints an even darker picture, with the authors concluding that a fasting blood glucose level ≥7.0 mmol/L in patients without a previous diagnosis of diabetes is an independent predictor for higher 28-day mortality. The odds ratio …

Don’t be surprised if patients who have “recovered” from COVID-19 present with concerns that they might not be getting better after all. A research letter just published online by JAMA Network indicates that most patients have persistent symptoms of infection even 60+ days after diagnosis. Based on 143 confirmed cases in Italy, they report that 87.4 of patients complained of at least one symptoms of COVID-19 even after meeting World Health Organization criteria for discontinuing …

Two new studies have shown that elevated fasting blood glucose (FBG), whether a patient has been diagnosed with diabetes or not, could be a risk factor for severe illness in patients with COVID-19. Authors of the first study, based on patients at a hospital in Guangzhou, Guangdong, China and published in Diabetes, Obesity and Metabolism, found an FBG of ≥6.23 mmol/L to be an optimal cutoff for poor prognosis within 30 days of hospital admission, …

A clearer picture of the effects of COVID-19 on the eyes of infected patients is emerging in new data from Hubei province, China. Researchers there have found ocular manifestations including epiphora, conjunctival congestion, and other conditions occur commonly in patients with confirmed COVID-19. While the retrospective study was small (38 patients), it produced several results that could be helpful to urgent care providers who treat patients without other, more definitive signs of disease. Roughly one …

The World Health Organization has been at the forefront of proposing how COVID-19 is transmitted, with the main theory being that one person becomes infected by taking in relatively large droplets expelled when someone with the virus coughs, sneezes, speaks, etc. However, 239 scientists from 32 countries signed a letter claiming that even smaller particles can carry the virus—so small that they’re essentially wafting through the air from one side of a room to another, …

Some states have been accused of “reopening” their economies too soon, with the result being upsurges in COVID-19 cases—and renewed concerns that the healthcare system could be overwhelmed. This may not reflect a resurgence at all, however, but instead reveal the number of cases that had gone unrecognized previously. Robert Redfield, MD, director of the Centers for Disease Control and Prevention, suggested recently that for every documented case of COVID-19, there are probably 10 more …

The Centers for Disease Control and Prevention continues to refine its guidance on which patients are most likely to experience severe disease when infected with COVID-19—with some of their statements reflecting a change from earlier advice. Early on in the pandemic, the CDC suggested that hypertension would put infected patients at higher risk than those without hypertension; now, however, the agency now says hypertension does not confer significant additional risk. Obesity, however, is associated with …

Readers of JUCM News may recall that, for the most part, patients have been putting off annual physicals, follow-up exams for chronic conditions, and well-child visits since the COVID-19 pandemic took hold in the U.S. However, new data from the CDC show that too many patients also avoided care for immediate needs. Over a 10-week period at the start of various state stay-at-home recommendations, 20% fewer patients sought care for what ended up being heart …

A patient presents to your urgent care center with palpitations and neck pain radiating to her jaw. She also has a painful, enlarged thyroid on palpation. Concerns for heart attack and malignancy were ultimately ruled out upon further evaluation in this real-world case published in The Journal of Clinical Endocrinology & Metabolism. The patient, who it was later learned had recently recovered from COVID-19, was found to have subacute thyroiditis (SAT), presumed to have stemmed …

Several drugs (and even, dangerously, household cleaning products) have been put forth as possible preventive or curative agents for COVID-19. They’ve all been discredited for that purpose, ultimately, so far. Now, however, researchers in the UK are suggesting that a commonly used glucocorticosteroid may hold some promise. As part of the Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial, dexamethasone was shown to reduce death from COVID-19 by one third in ventilated patients and by one …