Clinical

Anecdotal evidence that ongoing direct oral anticoagulant (DOAC) use might reduce a patient’s risk for severe disease with COVID-19 appears to have been wishful thinking, if the results of a study just published in the Journal of Internal Medicine are any indication. The authors found no association between DOAC use and lower incidence of hospital admission for COVID-19, or a composite of intensive care unit admission of death. As such, they concluded that DOAC use …

As many as 40 million doses of coronavirus vaccine may be available in the United States by the end of this year. While that’s clearly good news, it’s significantly fewer than will be needed to offer widespread protection and make a dent in the pandemic. That being the case, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices has issued its official recommendations on who should be able to be immunized first …

Patients who are concerned they may have contracted a sexually transmitted infection may favor urgent care over their “regular” doctor due to both the convenience and relative anonymity of this setting. Recognizing that such patients are likely to have engaged in unsafe sex practices, should any related counseling routinely include discussion of pre-exposure prophylaxis against HIV (PrEP)? Northwell Health-GoHealth Urgent Care apparently thinks so, as the company is pledging to include discussion of PrEP when …

Baloxavir marboxil (Xofluza) was approved to help patients in the early stages of influenza infection. However, as the reinvigorated COVID-19 pandemic now coincides with flu season, the Food and Drug Administration has approved it as a preventive measure for patients who have simply been exposed to influenza. As with the original indication, it is approved for patients 12 years of age and older. In a statement accompanying the FDA announcement, Debra Birnkrant, MD, director of …

Less than 6% of patients who present to the emergency room with an exacerbation of asthma receive guideline-directed medical therapy, according to research presented at the Virtual 2020 Annual Meeting of the American College of Allergy, Asthma and Immunology. The data reflect patients between the ages of 22 and 75 who were admitted to the ED of an urban tertiary cancer center between May 1, 2013 and May 1, 2015. The research team used the …

As you may know by now, the Food and Drug Administration recently granted emergency use authorization for the first at-home COVID-19 test. The benefits are obvious: patients don’t have to interact in close proximity to other possibly infected individuals or the healthcare professionals testing people all day long. Further, the home test kits promise results within 30 minutes. The less obvious benefit on the provider side is that fewer people are coming in and possibly …

While some experts find it difficult to identify an endpoint or starting point to distinguish one wave of COVID-19 from another, there is now evidence that the current upsurge in cases may be partially due to diverse genotypes. A study published in mBio reports that the most recent cases have been caused by strains with the Gly614 variant of spike protein, which exhibits significantly higher viral loads in the nasopharynx than did the Asp614 variant …

Patients are not likely to present to urgent care a primary complaint of delirium. That doesn’t mean patient exhibiting signs (such as hallucinations, but also more subtle things like restlessness, agitation, or lethargy) won’t come in for other reasons, however. There’s a very important reason to have delirium on your radar right now, though, as a new, retrospective study published in JAMA Open Network reveals that delirium is a common finding in patients who were …

Even though COVID-19 cases are through the roof (again), most areas are not seeing the same excessively high death rate they did last spring and over the summer. While this is clearly good news, the risk is that patients could interpret this as a sign that the virus is weakening. An article just published in MedPage Today points out why the data could be dangerously deceiving. With advances in both testing and treatment, more patients …

As you probably know from the inescapable mainstream media reports lately, the COVID-19 pandemic is in the midst of a surge that parallels or exceeds the conditions of last spring. Unfortunately, it’s about to get worse, in all likelihood. First, the weather is getting colder across the country, meaning less opportunity for outdoor, well-spaced social outlets. Secondly, college kids are descending on their hometowns and are eager to celebrate the holiday season with family and …