Category: COVID

Categories : Cardiovascular Disease COVIDTags :

New ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID

On By ModernMedia
Anatomical model of a human heart
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The American College of Cardiology has issued an expert consensus decision pathway for the evaluation and management of adults with key cardiovascular consequences of COVID. The document discusses myocarditis and other types of myocardial involvement, patient-centred approaches for long COVID and guidance on resumption of exercise following COVID. The clinical guidance was published today in the Journal of the American College of Cardiology.

“The best means to diagnose and treat myocarditis and long COVID following SARS-CoV-2 infection continues to evolve,” said Ty Gluckman, MD, MHA, co-chair of the expert consensus decision pathway. “This document attempts to provide key recommendations for how to evaluate and manage adults with these conditions, including guidance for safe return to play for both competitive and non-competitive athletes.”

Myocarditis

Myocarditis is a condition defined by the presence of cardiac symptoms such as chest pain, an elevated cardiac troponin, and abnormal ECG, cardiac imaging and/or cardiac biopsy findings.

Although rare, myocarditis with COVID is more commonly seen in men, and since it is associated with a higher risk of cardiac complications, a proactive management plan should be in place. For mild or moderate myocarditis, hospitalisation is recommended to closely monitor for worsening symptoms, while undergoing follow-up testing and treatment. Patients with severe myocarditis should ideally be hospitalised at appropriately equipped centres.

Myocarditis following COVID-19 mRNA vaccination is also rare and the benefits outweigh the risks. It is most commonly seen in younger males (40.6 cases per million for ages 12–29). Although most cases of myocarditis following COVID mRNA vaccination are mild, it should be diagnosed and treated similarly to myocarditis following COVID infection.

Long COVID

Post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID, is reported by up to 10-30% of infected individuals. It is defined by a constellation of new, returning or persistent health problems experienced by individuals four or more weeks after COVID infection. While individuals with this condition may experience wide-ranging symptoms, tachycardia, exercise intolerance, chest pain and shortness of breath represent some of the symptoms that draw increased attention to the cardiovascular system.

The writing committee has proposed two terms to better understand potential aetiologies for those with cardiovascular symptoms:

PASC-CVD, or PASC-Cardiovascular Disease, refers to a broad group of cardiovascular conditions (including myocarditis) that manifest at least four weeks after COVID infection.

PASC-CVS, or PASC-Cardiovascular Syndrome, includes a wide range of cardiovascular symptoms without objective evidence of cardiovascular disease following standard diagnostic testing.

Generally, patients with long COVID and cardiovascular symptoms should undergo evaluation with laboratory tests, ECG, echocardiogram, ambulatory rhythm monitor and/or additional pulmonary testing based on the clinical presentation. Cardiology consultation is recommended for abnormal test results, with additional evaluation based on the suspected clinical condition (eg, myocarditis).

Because multiple factors likely underlie PASC-CVS, evaluation and management may be best driven by the predominant cardiovascular symptom(s). For those with tachycardia and exercise intolerance, increased bedrest and/or a decline in physical activity may trigger cardiovascular deconditioning with progressive worsening of symptoms.

“There appears to be a ‘downward spiral’ for long COVID patients. Fatigue and decreased exercise capacity lead to diminished activity and bedrest, in turn leading to worsening symptoms and decreased quality of life,” said Nicole Bhave, MD, co-chair of the expert consensus decision pathway. “The writing committee recommends a basic cardiopulmonary evaluation performed upfront to determine if further specialty care and formalized medical therapy is needed for these patients.”

For PASC-CVS patients with tachycardia and exercise intolerance, upright exercise (walking or jogging) should be replaced with recumbent or semi-recumbent exercise (rowing, swimming or cycling) to avoid worsening fatigue. Exercise intensity and duration should be low initially, with gradual increases in exercise duration over time. Transition back to upright exercise can be done as  symptoms improve. Additional interventions (increased salt and fluid intake, elevation of the head during sleep, support stockings) and pharmacological treatments (beta-blockers) should be considered on a case-by-case basis.

Return to Play

Concerns arose about return to play for athletes after COVID due to observations of cardiac injury among some hospitalised COVID patients, along with uncertainty around cardiovascular sequelae after mild illness. However, data do not show a low prevalence of clinical myocarditis and no increase of cardiac events.

For athletes recovering from COVID with ongoing cardiopulmonary symptoms or those requiring hospitalisation with increased suspicion for cardiac involvement, further evaluation with triad testing (ECG, cardiac troponin and echocardiogram) should be performed. For those with abnormal test results, further evaluation with cardiac MRI should be considered. Individuals diagnosed with clinical myocarditis should abstain from exercise for three to six months.

Cardiac testing is not recommended for asymptomatic individuals following COVID infection. Individuals should abstain from training for three days to ensure that symptoms do not develop. For those with mild or moderate non-cardiopulmonary symptoms (fever, lethargy, muscle aches), training may resume after symptom resolution. For those with remote infection (≥ three months) without ongoing cardiopulmonary symptoms, a gradual increase in exercise is recommended without the need for cardiac testing.

Based on the low prevalence of myocarditis observed in competitive athletes with COVID-19, the authors note that these recommendations can be reasonably applied to high-school athletes (aged ≥ 14 years) along with adult recreational exercise enthusiasts. Future study is needed, however, to better understand how long cardiac abnormalities persist following COVID infection and the role of exercise training in long COVID.

Source: American College of Cardiology

Categories : COVIDTags :

Losartan is Not Effective in Reducing Lung Injury from COVID

On By ModernMedia
SARS-CoV-2 virus
SARS-CoV-2 virus. Source: Fusion Medical Animation on Unsplash

In a study published in JAMA Network Open, researchers reported that the blood pressure medication losartan is not effective in reducing lung injury in patients with COVID.

This drug was investigated based on early reports suggesting benefit in preclinical models of the 2003 SARS virus, a close family member to the current SARS-CoV-2 virus.

The research team sought to determine if a common blood pressure medication might decrease lung injury in patients hospitalised with COVID. Their results found that losartan treatment did not reduce lung injury in patients admitted with COVID, and had no effect on mortality.

In addition, critically-ill patients treated with losartan needed additional, temporary blood pressure support. However, this did not result in worse outcomes overall.

“Even though this particular drug was not effective for the treatment of COVID-19, repurposing inexpensive and relatively safe medications remains an important approach to contain healthcare costs,” said study co-author Michael Puskarich, MD, an associate professor in emergency medicine.

“Finding effective treatments for COVID that can be widely used across both the developed and developing world remains an important ongoing area of investigation,” Dr Puskarich added.

The researchers noted that more studies of protein and cellular signalling from ALPS-COVID trial participants are ongoing.

“We hope that future study findings of these proteins may show insights into why the body responds the way it does to COVID,” said co-author Christopher Tignanelli, MD, MS, FACS, FAMIA, an assistant professor in surgery. “Critically, this will help us understand why some people develop severe disease following COVID infection and others are asymptomatic.”

Source: University of Minnesota Medical School

Categories : COVID PaediatricsTags :

Croup – A Previously Unrecognised COVID Complication in Young Children

On By ModernMedia
Parent with a sick child
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With the spread of omicron infections in young children, doctors have observed the rise of a previously unrecognised COVID complication: croup. Published in Pediatrics, physicians at Boston Children’s Hospital reported on 75 children admitted to the emergency department (ED) with croup and COVID.

The children appeared at the ED from from March 1, 2020 through January 15, 2022. Some cases were surprisingly severe, requiring hospitalisation and more medication doses compared to croup caused by other viruses. Just over 80% occurred during the omicron period. The report was published March 8 in a pre-publication in.

“There was a very clear delineation from when omicron became the dominant variant to when we started seeing a rise in the number of croup patients,” said  Ryan Brewster, MD, first author of the report.

Laryngotracheitis, commonly known as croup, is a common respiratory illness in babies and young children. It is marked by a distinctive barking cough and sometimes stridor. It happens when viral infections cause swelling around the upper respiratory tract. In severe cases, including some seen at Boston Children’s, it can dangerously constrict breathing.

COVID studies in animals have found that the omicron strain ‘prefers’ the upper airway more than earlier variants, which mainly targeted the lower respiratory tract. This may account for the sudden appearance of croup during the omicron surge, said Dr Brewster.

In keeping with the general pattern of croup, most of the children with COVID and croup were under two years old, and 72% were boys. Except for one child with a common cold virus, none had a viral infection other than SARS-CoV-2.

Although all the children survived, nine of the 75 children with COVID-associated croup (12%) required hospitalisation and four of them (44%, or 5%of the total) required intensive care. (By comparison, before COVID, fewer than 5% of children with croup were hospitalised, and of those, only 1 to 3% required intubation.)

Overall, 97% of the children were treated with dexamethasone, a steroid. All of those who were hospitalised received racemic epinephrine via nebuliser, which is reserved for moderate or severe cases, as did 29% of children treated in the ED. Those who were hospitalised needed a median of six doses of dexamethasone and 8 nebulised epinephrine treatments to control their symptoms.

“Most cases of croup can be managed in the outpatient setting with dexamethasone and supportive care,” said Dr Brewster. “The relatively high hospitalisation rate and the large number of medication doses our COVID croup patients required suggests that COVID might cause more severe croup compared to other viruses. Further research is needed to determine the best treatment options for these children.”

Source: EurekAlert!

Categories : COVID Medical IndustryTags :

Life Insurance Premium Hike on the Cards for the Unvaccinated

On By ModernMedia
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After a staggering increase of R24.9 billion in claims from COVID, South African life insurers are faced with little option but to implement a premium hike on policies for the unvaccinated. Death rates among unvaccinated people could remain elevated even as the pandemic eases, despite the lower severity of Omicron.

The Association for Savings and Investment SA (Asisa) provided death claims data from 1 April 2021 to 30 September 2021, a period which covered the third COVID wave (May to September). Compared to the same pre-pandemic period in 2019, there was a 53% surge in claims was reported, with a more than doubling of value of death claims. There were 565 522 claims, totalling R44.42 billion, compared to the pre-pandemic period’s 369 892 claims of R19.53 billion.

Though deaths were greatly reduced in the fourth wave, with Asisa acknowledging “anecdotal evidence” showing reduced severity from the Omicron variant, there was still “overwhelming evidence” that COVID mortality risks are far higher for the unvaccinated. Asisa’s data reflects that of the South African Medical Research Council (SAMRC), which shows a huge increase in the number of excess deaths over that period.

This information comes as the government debates easing lockdown measures even as various institutions warn of an impending fifth wave, which according to Absa bank could come as early as next month. However, Absa noted that its life claims were much reduced over the fourth wave as compared to the third, and therefore expects the fifth wave to be less severe.

Hennie de Villiers, the deputy chair of Asisa’s life and risk board committee, said that the importance of life insurance cover had been clearly demonstrated. “The reality is that most of us know at least one person who lost his or her life due to COVID. We also know of many more people who lost their income during the pandemic, highlighting the importance of having access to savings.”

He cautioned that, “While the death rate has been lower during the fourth wave than in previous waves due to vaccinations and the emergence of the Omicron variant, death claims rates have not yet returned to pre-pandemic levels. Also, less than 50% of our adult population has been vaccinated.

“There is overwhelming evidence that the risk of severe illness or death is significantly lower in those who are fully vaccinated.”

He added in a later statement that if the situation does not change and vaccinations are not embraced by the country, insurers may have “little choice but to adjust premiums in line with the higher risk presented by someone who is not vaccinated and therefore more likely to die from COVID”.

De Villiers said a “staggering” 1.59-million death claims were received in the 18 months from 1 April 2020 to 30 September, with life insurers paying out benefits of R92 billion.

Group life insurance premiums have already increased for the unvaccinated, De Villiers pointed out. Employers with mandatory vaccination policies are meanwhile benefitting from preferential rates.

When unvaccinated status is combined with age and comorbidities, premium increases, this resulted in premium increases of as much as 100% and in some cases coverage was even declined.

Source: Business Live

Categories : COVIDTags :

Global COVID Death Toll Likely Three Times Higher than Official Estimates

On By ModernMedia
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According to an analysis of excess mortality published in The Lancet, COVID’s global death toll could be as much as three times higher than official estimates.

From the start of 2020 to the end of 2021, official estimates of the global deaths directly attributed to COVID-19 5.9 million, however this new estimate puts excess deaths at a staggering 18.2 million.

The highest number of excess deaths were reported for India (4.07 million), more than eight times its 489 000 reported COVID deaths, followed by the U.S. (1.13 million), where the official count reached 824,000 by the end of 2021. According to the study, the excess mortality rate in the US (179.3 per 100 000) was about on par with Brazil (186.9 per 100,000). South Africa’s mortality rate was 293·2 per 100 000, just below the rate for Southern Sub-Saharan Africa (308.6 per 100 000). Sub-Saharan Africa’s mortality rate was 101.6 per 100 000, as a result of significant regional variation.

First author Haidong Wang, PhD, of the University of Washington, said in a statement: “Understanding the true death toll from the pandemic is vital for effective public health decision-making. Studies from several countries including Sweden and the Netherlands, suggest COVID-19 was the direct cause of most excess deaths, but we currently don’t have enough evidence for most locations.”

The massive undertaking derived models using all-cause mortality reports for 74 countries and territories and 266 subnational locations, which included 31 locations in low and middle-income countries. These locations reported all-cause death from 2020-2021, and up to 11 years prior. Excess mortality reports were also obtained for the 9 South African provinces 12 Indian states.

Overall, the global rate of estimated excess mortality from COVID was 120.3 deaths per 100 000. A total of 21 countries exceeded 300 per 100 000, with Bolivia having the highest mortality rate at 734.9 per 100 000. Bulgaria, Eswatini, North Macedonia, and Lesotho had the next highest mortality rates. Iceland had the lowest excess mortality rate (-47.8 per 100 000). Australia, Singapore, New Zealand, and Taiwan also had negative excess mortality rates.

Behind India and the U.S. for most excess deaths were Russia (1.07 million), Mexico (798 000), Brazil (792 000), Indonesia (736 000), and Pakistan (664 000). These seven countries were noted to account for more than half of the excess deaths globally during the study period.

Changes in mortality rates also reflected the impact of other diseases suppressed by the same measures that limited the spread of COVID. The researchers wrote: “The most compelling evidence to date of a change in cause-specific mortality in the pandemic period is the decrease, especially in the Northern Hemisphere, in flu and respiratory syncytial virus (RSV) deaths seen in the months of January to March, 2021,” they added. “Given the scarce and inconsistent evidence of the effect of the COVID-19 pandemic on cause-specific deaths, and the extremely scarce high-quality data on causes of death during the pandemic, our excess mortality estimates reflect the full impact of the pandemic on mortality around the world … not just the deaths directly attributable to SARS-CoV-2 infection.”

Limitations included different modelling strategies being used to estimate excess mortality rate, and excess mortality rate by week or month was not estimated.

Source: MedPage Today

Categories : COVIDTags :

Three Doses are Needed for Same Protection against Omicron

On By ModernMedia
Syringe injection into the upper arm
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According to a large study published in The BMJ, mRNA vaccines are highly effective in preventing COVID hospital admissions related to the alpha, delta, and omicron variants. However, three doses are needed to achieve similar protection against omicron that two doses provide against delta and alpha.

The results also show that, although severity of disease among patients admitted to hospital is lower with the omicron versus delta variant, patients with omicron are still at risk of critical illness and death.

In order to guide vaccination policies and development of new vaccines, it is essential to understand COVID variants and vaccine efficacy.

Early studies suggested reduced vaccine effectiveness against infection and hospital admissions for omicron compared with earlier variants, but little is known about the effectiveness of vaccines to prevent the most severe manifestations of COVID, including respiratory failure and death, for patients with infection due to the omicron variant.

To address this, the researchers assessed COVID severity in the alpha, delta, and omicron variants among hospitalised adults and compared the effectiveness of two and three doses of mRNA vaccines (Pfizer-BioNTech and Moderna) in preventing hospital admissions related to each variant.

Their findings are based on 11 690 adults admitted to 21 hospitals across the United States between March 2021 and January 2022: 5728 cases with COVID and 5962 controls without COVID.

Patients were classified into alpha, delta or omicron based on viral gene sequencing or by the predominant circulating variant at the time of hospital admission.

Vaccine effectiveness was then calculated for each variant and variants’ disease severity was compared with the World Health Organization’s clinical progression scale.

Effectiveness of two doses of an mRNA vaccine to prevent COVID hospital admission was found to be lower for the omicron variant than alpha and delta variants (65%, 85%, and 85%, respectively), whereas three doses were found to achieve 86% effectiveness against the omicron variant, similar to two doses against the alpha and delta variants.

Among unvaccinated adults hospitalised with COVID, the delta variant was associated with the most severe disease, followed by the alpha variant and then the omicron variant.

The omicron variant was, however, associated with substantial critical illness and death, with 15% of patients admitted to hospital with the omicron variant (vaccinated and unvaccinated) progressing to invasive mechanical ventilation, and 7% dying in hospital.

Nevertheless, vaccinated patients hospitalised with COVID had significantly less sever disease than unvaccinated patients across all variants.

As an observational study, cause cannot be established, and some variant misclassification may have occurred. Changes in clinical management during the periods when the alpha, delta, and omicron variants predominated were not accounted for. These could have affected outcomes, the researchers acknowledged.

Nevertheless, this was a large study with rigorous evaluation of vaccination status and of outcomes beyond hospital admission, suggesting that the results are robust.

As such, they say that mRNA vaccines “were associated with strong protection against hospital admissions with COVID due to the alpha, delta, and omicron variants” and that vaccination against COVID including a third dose of an mRNA vaccine, “is critical for protecting populations against COVID-associated morbidity and mortality.”

They concluded: “As the COVID pandemic continues to evolve, routine monitoring of vaccine effectiveness, especially against severe disease, and surveillance programmes to identify viral variants will be essential to inform decisions about booster vaccine policies and vaccine strain updates.”

Source: EurekAlert!

Categories : COVIDTags :

Aspen to Locally Produce COVID Vaccine ‘Aspenovax’ for the African Continent

On By ModernMedia
Syringe withdrawing from vaccine vial
Photo by Mufid Majnun

In a news release, pharma giant Aspen has announced that it has concluded an agreement with Johnson & Johnson to manufacture an Aspen-branded COVID vaccine, Aspenovax, and to make it available throughout Africa.

This follows on from the November 2021 announcement of an agreement of terms between the two companies. This new agreement will expand the existing technical transfer and manufacturing agreements between the companies.

The agreement will grant Aspen’s South African subsidiary the rights to manufacture finished Aspenovax product from drug substance supplied by J&J. It will also make Aspenovax available to markets in Africa through transactions with designated multilateral organisations and with national governments of member states of the African Union.

Under the agreement, Aspen has secured the necessary intellectual property from Johnson & Johnson for production. There is also a good faith undertaking between the companies to expand the agreement to cover any new versions of the drug substance, such as those developed for new variants or a different formulation for administration as a booster.

The agreement will last through to the end of 2026.

Commenting on this agreement, Dr Matshidiso Moeti, World Health Organization Regional Director for Africa said: “This important agreement on sharing know-how and technologies for the production of COVID vaccines is a huge leap forward towards realising our shared vision for medicines and vaccines to be manufactured on the African soil for the African people. Vaccines are our best way out of this pandemic and local production is an essential recipe for our success.”

Stephen Saad, Aspen Group Chief Executive said: “Even with all the support in the world, none of this would be possible without the competence of our teams at Gqeberha. They knew the weight of a continent’s ambitions rested on their shoulders. They persevered and succeeded in becoming a significant supplier within the Johnson & Johnson network. Aspenovax has become a reality due to the confidence placed in their abilities. They are our African heroes.”

Categories : COVID GenderTags :

The Pandemic’s Negative Impact on Women in Academic Medicine

On By ModernMedia
Female scientist in laboratory
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Like women in every other sector of the economy, the COVID pandemic has negatively impacted those working in academic medicine according to a commentary which appears in Nature Medicine.

Co-author Anne B. Curtis, MD, professor at the University at Buffalo, laid out the problem: “During the first year of the pandemic, when schools shut down and went to 100% remote learning, we saw that it affected women disproportionately, having to stay home and teach their children while their research languished.”

Even before the COVID pandemic, women in academic medicine were paid less than men in comparable positions, received lower startup funds for laboratory research and were promoted later.

Additionally, they wrote that, compared to men, women have fewer “conventional markers of achievement” in academia, such as principal investigator positions on research grants. Women write fewer grant applications; they have fewer grant renewals; they get lower funding amounts for initial grants; and are first or last author on fewer papers.

The reasons for these are well known, the authors wrote.

“Society expects women to assume the major portion of the burden for child rearing, and women themselves feel an obligation to put family above their own needs, to the detriment of their own career development,” she said. “There still isn’t the sharing of responsibilities in two-career families to mitigate these problems.”

The paper includes a detailed ‘menu’ of proposed solutions. These include providing financial support to hire technicians for two to three years to carry on lab research while women researchers focus on child care at home, or otherwise supporting child care at home so women can continue their lab research.

The paper also proposes slowing down tenure clocks, delaying the tenure decision by two to three years to make up for lost time while women give birth and care for young children.

In addition to such programs, the list includes a category of solutions termed “cultural,” described as creating the cultural expectation that gender equity is a shared responsibility and incorporating those expectations into bonuses and merit raises of institutional leaders. Also included is the need to engage university and hospital boards of trustees to support gender equity.

Prof Curtis said that the paper aims to highlight the persistence of these gender differences persist and that global phenomena like the pandemic only worsen them.

“As much as we would like to think that gender differences in career development no longer exist, they do, and they adversely affect women more than men,” she said. “Understanding these issues and implementing solutions are the best ways to minimise potentially adverse effects on women’s careers.”

As the pandemic and its associated restrictions ease, Prof Curtis warned, “The situation is improving now that schools are open, but the next pandemic may only be a mutation away.”

Source: Buffalo University

Categories : COVIDTags :

COVID Battle not Over as Many Countries Continue to Struggle

On By ModernMedia
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Two years into the pandemic, and the COVID battle is not over for much of the world, warns the International Federation of Red Cross and Red Crescent Societies (IFRC). Many countries lack the capacities to transition to ‘a new normal’: high vaccination coverage, strong healthcare systems or testing capacities. The crisis will not be over until everyone has the same access to these tools, the IFRC says.

Francesco Rocca, IFRC President, said: “’Living with the virus’ is a privilege that many countries and communities around the world cannot enjoy. Ensuring equitable access to vaccines, diagnostics and treatments will not only save lives, but will also protect the world against the emergence of new and more dangerous variants. It is the only path to normalcy. None of us is safe until we all are.”

Red Cross Red Crescent staff and volunteers are constantly working to close the equity gap, ensuring that vaccines make it to the vulnerable individuals and communities that desperately need them. Their role is crucial, not only in vaccination but in informing communities, building trust, and dispelling COVID vaccine misinformation. They have now reached over 300 million people through immunisation activities.

In countries like Zambia, where health systems are fragile and rumours around vaccines are spreading fast, vaccine supply is just one of numerous obstacles. The Zambia Red Cross Society’s mobile COVID vaccination campaign takes vaccines directly to people in hard-to-access areas. Volunteers mobilise communities for vaccination, raise awareness about the mobile vaccination centres, provide information about vaccines and engage local leaders as advocates for healthy behaviour change.

Afghanistan’s health system is struggling as a new wave of COVID infections hits. Afghan Red Crescent is ramping up services at its health clinics across the country and its COVID hospital in Kabul, while supporting nationwide vaccination efforts and running information campaigns on preventing the spread of the virus.

A record surge of infections in the Pacific region is threatening to overwhelm hospitals and health systems which, until now, have largely avoided the worst of the pandemic. In countries like Fiji and Vanuatu, with more than 165 inhabited islands, Red Cross volunteers have been travelling by car, boat and foot to reach remote communities to increase awareness about COVID and get people vaccinated.

COVID not only thrives on inequality but deepens it. Women, urban communities and migrants have been disproportionately affected by the devastating socioeconomic impacts. More than 5 million children have also lost a parent or another caregiver to COVID. Psychosocial support has been at the centre of Red Cross Red Crescent work, and volunteers are seeing a significant rise in mental health support needs.

Source: International Federation of Red Cross and Red Crescent Societies (IFRC)

Categories : COVID HospitalsTags :

Cohorting an Effective Response for an Emerging Pandemic

On By ModernMedia
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During the extenuating circumstances of an emerging pandemic, grouping patients together in one area or facility, a practice known as cohorting, was successful in providing high-quality care and containing infectious patients, according to a new study published in JAMA Open.

The University of Minnesota Medical School researchers reported that cohorting was implemented by M Health Fairview early in the pandemic when there was little known about how to effectively treat patients with COVID.

“This study highlights the academic and clinical expertise of the M Health Fairview system to deliver outstanding medical care to the people of Minnesota,” said Dr Greg Beilman, a critical care surgeon at the U of M Medical School and was a co-lead of the M Health Fairview COVID response team. “In this study we demonstrated our ability to rapidly bring new developments in science to the patient’s bedside and improve outcomes for patients affected by this frequently dire disease.”

Because every person being treated in the cohorts had COVID, frontline healthcare workers quickly gained experience in COVID care. These experienced specialists worked side by side with academic physicians who were translating the latest medical research into new solutions they could apply in real time to patient care. COVID patients had access to leading-edge clinical trials, internal COVID testing capabilities, and innovative technology.

The study found that dedicated COVID units in Minnesota were associated with a 2% overall improvement in in-hospital survival rates when patients were properly matched for severity of illness. Complications associated with COVID were significantly better in this group as was the swift implementation of new care processes by health care providers.

“The opportunity to care for patients at our COVID cohort hospitals was a shining light in a dark time for many of us,” said Dr Andrew Olson, medical intensivist at the U of M Medical School and medical director of COVID hospital medicine at M Health Fairview. “We watched our colleagues develop expertise, conduct research and care for one another while staying healthy in a challenging time.”

The research team hopes the cohorting method could be implemented during other infectious disease outbreaks, like viral pneumonia. The framework helps provide infectious patients the best care during times of rapid learning in scientific research.

“As the pandemic progressed, we had broad availability of personal protective equipment, vaccinations, and more health care workers developed familiarity with treatment of COVID,” said Dr Beilman. “These developments combined with the fact that the incidence of COVID decreased last year – this care model was no longer necessary.”

Researchers plan to further investigate which patients benefit most from care at such facilities, as well as evaluate the experience for those healthcare professionals who work in them.

Source: University of Minnesota Medical School