[2021年1月25日，WHO在其官方网站发布了新版新冠肺炎诊疗指南。现简要介绍新版指南的改动情况，供临床医生参考] COVID-19 Clinical management: living guidance https://www.who.int/publications/i/item/WHO-2019-nCoV-clinical-2021-1 注：新版指南增加了有条件推荐(conditional recommendation)以及最佳实践声明(Best practice statement)。 筛查、分诊与临床评估：早期识别新冠肺炎患者 （有条件推荐）：对于门诊或医院评估的任何严重程度的新冠肺炎患者，我们建议根据临床判断（包括考虑到...

ORIGINAL ARTICLE A Neutralizing Monoclonal Antibody for Hospitalized Patients with Covid-19 ACTIV-3/TICO LY-CoV555 Study Group N Engl J Med 2021; 384:905-914DOI: 10.1056/NEJMoa2033130 Abstract BACKGROUND LY-CoV555, a neutralizing monoclonal antibody, has been associated with a decrease in viral load and the frequency of hospitalizations or emergency department visits among outpatients with coronavirus disease 2019 (Covid-19). Data are needed on the effec...

Editorials Prophylactic anticoagulation for patients in hospital with covid-19 Beverley J Hunt, Erich V De Paula, Claire McLintock, et al BMJ 2021; 372: n487 doi: https://doi.org/10.1136/bmj.n487 (Published 19 February 2021) Risk-benefit balance may depend on illness severity Most people with covid-19 have mild disease, but after 5-10 days an important minority develop pneumonia and require hospital admission to treat hypoxia. This group is in a marked prot...

Original Investigation February 23, 2021 Effect of High-Dose Baclofen on Agitation-Related Events Among Patients With Unhealthy Alcohol Use Receiving Mechanical Ventilation: A Randomized Clinical Trial Mickael Vourc’h, Charlotte Garret, Arnaud Gacouin, et al JAMA. 2021;325(8):732-741. doi:10.1001/jama.2021.0658 Abstract Importance Unhealthy alcohol use can lead to agitation in the intensive care unit (ICU). Objective To assess whethe...

Research Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study Christopher T Rentsch, Joshua A Beckman, Laurie Tomlinson, et al BMJ 2021; 372: n311 doi: https://doi.org/10.1136/bmj.n311 (Published 11 February 2021) Abstract Objective To evaluate whether early initiation of prophylactic anticoagulation compared with ...

EDITORIAL Interleukin-6 Receptor Inhibition in Covid-19 — Cooling the Inflammatory Soup Eric J. Rubin, Dan L. Longo, Lindsey R. Baden N Engl J Med February 25, 2021DOI: 10.1056/NEJMe2103108 Viruses cannot replicate by themselves. Instead, they rely on the host for almost all their replicative functions. Similarly, many viruses are unable to cause damage without the host immune system. Because of this, two strategies can often ameliorate disease — antivirals, w...

Editor's Note February 23, 2021 Funding and DSMB Membership in the VICTAS Clinical Trial Howard Bauchner, Phil B. Fontanarosa, Robert M. Golub JAMA. 2021;325(8):751-752. doi:10.1001/jama.2020.25952 Two unusual circumstances arose in the conduct, review, and publication of the VICTAS randomized clinical trial.1 First, the funder reportedly withdrew financial support for the study after enrollment of only 25% of the planned study sample, resu...

ORIGINAL ARTICLE Terlipressin plus Albumin for the Treatment of Type 1 Hepatorenal Syndrome Florence Wong, S. Chris Pappas, Michael P. Curry, et al N Engl J Med 2021; 384:818-828DOI: 10.1056/NEJMoa2008290 Abstract BACKGROUND The vasoconstrictor terlipressin is used for type 1 hepatorenal syndrome (HRS-1) in many parts of the world and is part of the clinical practice guidelines in Europe. METHODS We conducted a phase 3 trial to confirm the efficacy...

Original Investigation January 21, 2021 Effect of Bamlanivimab as Monotherapy or in Combination With Etesevimab on Viral Load in Patients With Mild to Moderate COVID-19: A Randomized Clinical Trial Robert L. Gottlieb, Ajay Nirula, Peter Chen, et al JAMA. 2021;325(7):632-644. doi:10.1001/jama.2021.0202 Abstract Importance Coronavirus disease 2019 (COVID-19) continues to spread rapidly worldwide. Neutralizing antibodies are a potential treatment for C...

ORIGINAL ARTICLE A Randomized Trial of Albumin Infusions in Hospitalized Patients with Cirrhosis Louise China, Nick Freemantle, Ewan Forrest, et al N Engl J Med 2021; 384:808-817 Abstract BACKGROUND Infection and increased systemic inflammation cause organ dysfunction and death in patients with decompensated cirrhosis. Preclinical studies provide support for an antiinflammatory role of albumin, but confirmatory large-scale clinical trials are lacking. Wh...