· A research letter published in JAMA that analyzed pharmacy records during the pandemic, found a 1,977% increase in fills for Hydroxychloroquine/Chloroquine. The authors warn that this sharp increase in demand may lead to medication shortages for patients who require these for treatment for their chronic conditions, such a s Systemic Lupus Erythematosus and Rheumatoid Arthritis.
· Clinical statisticians outline recommendations on how to adapt clinical trials both during and after the pandemic, emphasizing the balance between safety and protecting the integrity of the trials.
· A retrospective cohort study of 92 patients in Italy analyzing obesity and COVID-19 severity, found that younger obese patients (67.0±12.6 years vs. 76.1±13.0 years, p<0.01) had a higher risk of ICU admission and assisted ventilation, even after adjusting for age, sex, and commodities.
· In pediatrics, a case series conducted at the Children’s Hospital of Philadelphia found evidence to support Multisystem Inflammatory Syndrome in Children (MIS-C) in six patients with COVID-19. They report two notable findings associated with the condition include the development of neurological symptoms and hyponatremia. They note MIS-C resembles Kawasaki disease in clinical features and response to therapeutics, emphasizing the need for further research to determine if MIS-C is distinct clinical syndrome or an atypical presentation of Kawasaki disease.
Understanding the Pathology
· Molecular docking analysis found an increased affinity (–8.6 kcal/mol) between dithymoquinone (an active ingredient in black seed) and the SARS-CoV-2 S protein: human ACE2 receptor interface. This binding could disrupt host recognition and the S-protein pathway for disease progression, suggesting dithymoquinone as a potential natural antiviral worth further studying.
· Guidelines for COVID-19 patient management from today include:
o Nutritional therapy delivery to critically ill patients
· Clinicians at New York Presbyterian Hospital describe their protocol to place non-intubated, awake, mobile, and hemodynamically stable COVID-19 patients in the prone position in order to prevent worsening respiratory failure.