ORIGINAL ARTICLE Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients Robert L. Gottlieb, Carlos E. Vaca, Roger Paredes, et al N Engl J Med 2022; 386:305-315DOI: 10.1056/NEJMoa2116846 Abstract BACKGROUND Remdesivir improves clinical outcomes in patients hospitalized with moderate-to-severe coronavirus disease 2019 (Covid-19). Whether the use of remdesivir in symptomatic, nonhospitalized patients with Covid-19 who are at high risk for...

ICU Management & Practice, Volume 21 - Issue 4, 2021 Should Families Be Allowed To Visit Dying COVID-19 Patients in the ICU? COVID-19 has drastically changed how end-of-life care is practiced in the intensive care unit. Safety concerns for society limits family visitation but is contrary to patient and family-oriented care. This article provides an ethical analysis of the pros and cons of having family members present at the death of a COVID-19 positive ICU...

ARTICLES|ONLINE FIRST Single-dose of adrecizumab versus placebo in acute cardiogenic shock (ACCOST-HH): an investigator-initiated, randomised, double-blinded, placebo-controlled, multicentre trial Mahir Karakas, Ibrahim Akin, Christoph Burdelski, et al Lancet Respir Med Published: December 08, 2021 DOI:https://doi.org/10.1016/S2213-2600(21)00439-2 Summary Background Cardiogenic shock has a high mortality on optimal therapy. Adrenomedullin is released ...

Insights from the PRoVENT-COVID Study Mortality in patients with COVID-19 is much higher in patients who need invasive ventilation for acute respiratory distress syndrome (ARDS). COVID-19 patients with ARDS are a heterogeneous group with diverse evolutions that could be due to different phenotypes and response to care, including invasive ventilation strategies. The Practice of VENTilation in COVID-19 (PRoVENT-COVID) study was conducted to investigate change...

ARTICLES| VOLUME 9, ISSUE 12, P1427-1438, DECEMBER 01, 2021 Effect of anti-interleukin drugs in patients with COVID-19 and signs of cytokine release syndrome (COV-AID): a factorial, randomised, controlled trial Jozefien Declercq, Karel F A Van Damme, Elisabeth De Leeuw, et al Lancet Respir Med 2021; 9: 1427-1438 Summary Background Infections with SARS-CoV-2 continue to cause significant morbidity and mortality. Interleukin (IL)-1 and IL-6 ...

COMMENT|ONLINE FIRST COVID-19 will continue but the end of the pandemic is near Christopher J L Murray Lancet Published:January 19, 2022 DOI:https://doi.org/10.1016/S0140-6736(22)00100-3 The world is experiencing a huge wave of infection with the omicron variant of SARS-CoV-2. Estimates based on Institute for Health Metrics and Evaluation (IHME) models1 suggest that on around Jan 17, 2022 there were 125 million omicron infections a day in the world, which i...

Enriching the Term “Palliative” Palliative care is an important component of the medical course of many patients. This is particularly applicable for patients with cancer, neurodegenerative diseases, and heart, respiratory or liver failure. However, the term palliative is used uniformly, whatever the stages of disease evolution or the specific therapeutic avenues that might still be possible. It might be more practical to use more nuanced and discriminating te...

ARTICLES| VOLUME 9, ISSUE 12, P1419-1426, DECEMBER 01, 2021 Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial RECOVERY Collaborative Group Lancet Respir Med 2021; 9: 1419-1426 Summary Background Colchicine has been proposed as a treatment for COVID-19 based on its anti-inflammatory actions. We aimed to evaluate the efficacy and safety of colchicine in patients admitte...

Timing of Antibiotic Therapy in the Intensive Care Unit Severe infections are common among patients in the ICU. According to findings from the Extended Study on Prevalence of Infection in Intensive Care III (EPIC III), 54% of the study patients had at least one suspected or proven infection on the study day, and 24% of these patients had more than one suspected or proven infection. These infections are generally either bacterial or fungal in origin and...

Original Investigation December 21, 2021 Effect of Therapeutic Drug Monitoring vs Standard Therapy During Maintenance Infliximab Therapy on Disease Control in Patients With Immune-Mediated Inflammatory Diseases: A Randomized Clinical Trial Silje Watterdal Syversen, Kristin Kaasen Jørgensen, Guro Løvik Goll, et al JAMA. 2021;326(23):2375-2384. doi:10.1001/jama.2021.21316 Abstract Importance  Proactive therapeutic drug monitoring (TDM...