Dermatologic changes with COVID-19: What we do and don’t know
From qurantine toes to patients with chilblains, the skin manifestaions of COVID-19 are being seen and documented. "It was once hypothesized that Coronaviridae was the cause of Kawasaki disease. Then that got debunked. But these cases now raise the question of whether Kawasaki disease may be virally mediated. Is it an immune reaction to an infectious trigger? Is it actually Coronaviridae that triggers it?" READ MORE
Glucose control linked to COVID-19 outcomes in largest study yet
The strong link between glucose control and COVID-19 outcomes has been reaffirmed in the largest study thus far of hospitalized patients with preexisting type 2 diabetes, according to findings published in Cell Metabolism. “We were surprised to see such favorable outcomes in the well-controlled blood glucose group among patients with COVID-19 and preexisting type 2 diabetes,” senior author Hongliang Li said in a statement. READ MORE
FDA approves pomalidomide for Kaposi sarcoma
The FDA has granted accelerated approval to pomalidomide for the treatment of AIDS-related Kaposi sarcoma that is resistant to HAART or that occurs in HIV-negative patients. Pomalidomide is the only oral agent and first new treatment option for Kaposi sarcoma in more than 20 years, according to the company. READ MORE
ER docs ask, 'Where are our patients?'
Across the country, the number of patients arriving in EDs with acute ST-elevation MI, stroke, trauma, and other highest-acuity presentations is down substantially. But the volume of patients with more routine, bread-and-butter conditions typically seen in EDs is down even more, noted Donald M. Yealy, MD, professor and chair of the department of emergency medicine at the University of Pittsburgh. He is concerned for a coming “tsunami of untreated illness," adding that "the safest place in the world to be right now is the ED." READ MORE
Obesity can shift severe COVID-19 to younger groups
The younger an ICU patient with severe COVID-19 is, the more obese that patient tends to be, according to a new analysis published in The Lancet. "If you’re very, very overweight, don’t think that if you’re 35 you’re that much safer than your mother or grandparents or others in their 60s or 70s,” noted David Kass, MD, a professor of cardiology and medicine at Johns Hopkins University School of Medicine in Baltimore. READ MORE
Many hydroxychloroquine prophylaxis trials lack ECG screening
As of April 30, 155 randomized, control trials listed on clinicaltrials.gov had designs that intended to randomize a total of more than 85,000 healthy people to receive hydroxychloroquine or chloroquine, in some cases in combination with azithromycin, to test their efficacy and safety for COVID-19 prophylaxis. All three agents potentially produce lengthening of the corrected QT interval (QTc), Michael H. Gollob, MD, said in an article posted by JAAC. If this happens in a person who starts treatment with a QTc on the high end, the incremental prolongation could push their heart rhythm into a range where their risk for a life-threatening arrhythmia becomes substantial, said Dr. Gollob. “It is ... inexcusable that clinical investigators would dare to include healthy individuals ... without bothering to screen their electrocardiogram,” commented Sami Viskin, MD, an electrophysiologist at Tel Aviv Sourasky Medical Center. READ MORE
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