Risk of mortality in patients with COVID-19 with use of NSAID’s
In this meta-analysis, authors discuss how the use of NSAID’s have been thought to contribute to adverse outcomes in patients who acquire COVID-19 and aim to review evidence to support or discredit this theory. The authors performed a systematic literature search to review outcomes that included a fatal course of COVID-19. The meta-analysis of three studies totaling 2,414 patients with COVID-19 were analyzed. The analysis revealed no difference in those who used NSAIDs and those who did not. The authors conclude that NSAIDs should not be avoided in patients when appropriately indicated during the COVID-19 pandemic.
Preventing COVID-19 spread in closed facilities with regular testing
In this article, researchers evaluate the efficiency of regular testing of employees within closed facilities (long term care facilities and prisons) to protect the high-risk individuals within. Public health authorities have suggested the use of routine screening of residents, employees, and visitors to protect the residents. The authors discuss the quality of PCR testing, processing time, test sensitivity, antigen testing, and economic considerations as well as considerations for incarceration settings. The results indicate that regular COVID-19 screening of employees by testing successfully reduces the number of cases and deaths in residential settings and among employees. However, even with thorough testing a reduction of approximately 50% of cases and be achieved and only in combination with strong distancing measures. The authors go on to describe the best-case scenario for testing and best plans for reducing cases in residential and incarceration settings.
Characterization of post-acute sequalae of COVID-19
In this article, authors used a national healthcare database to systematically and comprehensively identify 6-month incident sequalae including diagnosis, medication use, and lab abnormalities in 30-day survivors of COVID-19. Beyond the first 30 days of illness, people with COVID-19 exhibit higher risk of death and health resource utilization. The authors identified incident sequalae involving the respiratory system and several others including nervous system, neurocognitive and mental health disorders, metabolic and cardiovascular disorders, gastrointestinal disorders, malaise, fatigue, myalgias, and anemia. The findings of this article indicate that beyond the acute illness phase, COVID-19 survivors experience a substantial burden of health loss which span across multiple body systems. The authors encourage health system planning and development of multidisciplinary care strategies to reduce chronic health loss among COVID-19 survivors.
Characteristics and outcomes of patients with COVID-19 and rheumatic disease
In this study, authors assessed the baseline characteristics and clinical outcomes in patients with rheumatic diseases and COVID-19 and identify risk factors associated with severe COVID-19 pneumonia. This retrospective study was conducted in a tertiary care center from 3/2020 and 11/2020 and included all adults patients with rheumatic disease who had a positive PCR test. The study included 47 patients, mostly female, who were diagnosed with rheumatoid arthritis, systemic lupus erythematosus, and psoriatic arthritis. The patients were treated with methotrexate and hydroxychloroquine for their rheumatic disease. This study found that patients with a mean age of 65.3 years were more likely to develop severe COVID-19 pneumonia (RR rate >30 bpm, severe respiratory distress, or oxygen saturation 65 years with rheumatic disease are more likely to have a poor outcome in terms of developing COVID-19 pneumonia and authors suggest further studies to assess outcomes in this patient population.