Climate
· An author affiliated with the Department of Health & Human Performance at the University of Tennessee presents the 2018 Social Vulnerabilities for the American Indian and Alaska Native people (AIAN) by tribal geographic areas and calls attention to the high risk of contracting COVID-19 and its associated complications among the AIAN people. The author highlights the potential value of utilizing these resources in order to understand the COVID-19 impact on AIAN communities and their ability to recover from the pandemic.
Understanding the Pathology
· A group of pharmacists and toxicologists in Spain discuss neurological invasion by SARS-CoV-2 and the therapeutic potential of high dose melatonin in limiting the neurological impact of the virus namely in its ability to reduce the permeability of the blood brain barrier and counteract neuroinflammation.
Management
· A prospective study of 386 hospitalized patients admitted for COVID-19 in Iran found that the development of cardiac injuries was associated with a four-fold increase in-hospital mortality rate and that preexisting cardiovascular disease, malignancy, hypoxia, leukocytosis and lymphopenia upon presentation were independently associated with an increased risk of developing cardiac injuries.
· Endocrinologists at the University of Michigan observed that severe hyperglycemia and insulin resistance were associated with increased inflammatory markers among two diabetic COVID-19 patients at their facility. The authors share their guidelines and protocols for insulin regimens and monitoring inflammatory markers, suggesting that their protocol may improve glycemic control and, thus, patient outcomes in this population.
· Researchers performed neurological examination and brain imaging on 140 COVID-19 patients admitted to the ICU to investigate the prevalence of delirium and other neurological abnormalities. The findings highlight a high prevalence of neurological abnormalities in COVID-19 patients admitted to the ICU (118/140, 84.3%) and suggest a role for assessing a patient's neurological state to accurately allocate hospital resources and provide proper care to maximize recovery rates.
Adjusting Practice During COVID-19
· A survey conducted by University of Illinois-Chicago Cancer Center among 609 patients with breast cancer found 45% of patients reported cancer treatment delays during the COVID-19 pandemic. Younger patients self-reported greater delays than older patients, with no significant differences found based on race, insurance, site of care, or cancer stage. These delays in cancer treatment for younger patients indicates potential for increased rates of disease progression, mortality, and pain due to delay, highlighting the need for protective processes and managing strategies for this vulnerable population during the pandemic.
· A study compared 30-day complication rates, readmission, and mortality among 183 hip fracture patients at a tertiary care center in Argentina prior to and during the COVID-19 pandemic. Results showed increased time waiting for surgery during the lockdown time period, as well as higher rate of thromboembolic events and a higher mortality rate during the pandemic.
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