Climate
· A cross-sectional study conducted by researchers at multiple US medical centers investigated patients from 52 clinical sites from the Type 1 diabetes (T1D) Exchange clinical network from April to August 2020. They found that among 180 patients with lab-confirmed COVID-19 and T1D, 79 (44%) were non-Hispanic (NH) whites, 55 (31%) were NH Black, and 46 (26%) Hispanic. NH Black and Hispanic patients had higher median HbA1C values, were less likely to be using an insulin pump or continuous glucose monitoring, more likely to be hospitalized for COVID-19, and had increased prevalence of DKA compared to NH white patients. Age-adjusted COVID-19 mortality was found to be higher in Hispanic and NH Black groups compared to NH White patients highlighting current racial inequities in COVID-19 patients with T1D.
Understanding the Pathology
· Researchers from the Department of Radiology and Cardiology at multiple Chinese hospitals and the Perelmen School of Medicine at University of Pennsylvania in Philadelphia conducted a single-center, prospective observational study at No. 2 People's Hospital in Anhui, China from May to September 2020 involving 40 patients who recovered from COVID-19 with moderate or severe pneumonia without either symptoms or past medical history of cardiac conditions. Cardiac MRI revealed increased extracellular volume fraction (ECV) > 29% in 24/40 patients, as well as subclinical changes in myocardial function leading to reduction in left ventricular 2D-global longitudinal strain in 28/40 patients after recovering from moderate or severe COVID-19 compared to healthy controls. These findings suggest that cardiac MRI could prove to be a sensitive tool in identifying cardiac involvement of SARS-CoV-2 infection, however further investigation is needed to fully understand the prevalence of subclinical myocardial findings in association with COVID-19 infection.
Management
· Pulmonologists and a radiologist from the United Kingdom conducted a single-center prospective observational study of 837 adult COVID-19 patients four weeks after hospital discharge. They found evidence of post-COVID interstitial lung disease (ILD) in 35 patients (4.8%), and that early treatment with corticosteroids resulted in significant radiologic and symptomatic improvement. Authors suggest that early treatment of post-COVID ILD may prevent further functional impairment and recommend further studies on its natural history and management.
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