Editor's Note November 12, 2020 COVID-19 Infection—Preventing Clinical Deterioration Christopher W. Seymour, Howard Bauchner, Robert M. Golub JAMA. Published online November 12, 2020. doi:10.1001/jama.2020.21720 More than 38 million individuals worldwide have been infected with severe acute respiratory syndrome coronavirus 2, the virus causing coronavirus disease 2019 (COVID-19). For primary prevention, traditional public health approaches inclu...

Life After COVID-19 Hospitalisation Findings from a new study show that surviving a case of COVID-19 that is severe enough to require hospitalisation can be quite challenging, but life after the ICU stay is also not a bed of roses.  The study includes data from 1250 patients treated in 38 hospitals. The average age of the participants is 62 years, and 83% of the patients lived at home after being hospitalised for COVID-19.  The study reports that approximately 7%...

ORIGINAL ARTICLE Efficacy of Tocilizumab in Patients Hospitalized with Covid-19 John H. Stone, Matthew J. Frigault, Naomi J. Serling-Boyd, et al N Engl J Med 2020; 383:2333-2344DOI: 10.1056/NEJMoa2028836 Abstract BACKGROUND The efficacy of interleukin-6 receptor blockade in hospitalized patients with coronavirus disease 2019 (Covid-19) who are not receiving mechanical ventilation is unclear. METHODS We performed a randomized, double-blind, placebo-...

Improving Outcomes for ICU Survivors In response to the many challenges faced by ICU survivors today, there has been an increasing need to relieve this burden. Despite that many clinical trials have been implemented to find new strategies, postintensive care syndrome is still a common possibility for both patients and families. A recent study has identified key enablers and barriers faced by hospitals and patients when implementing ICU follow-up clinics and peer sup...

Preliminary Communication November 12, 2020 Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial Eric J. Lenze, Caline Mattar, Charles F. Zorumski, et al JAMA. Published online November 12, 2020. doi:10.1001/jama.2020.22760 Abstract Importance Coronavirus disease 2019 (COVID-19) may lead to serious illness as a result of an excessive immune response. Fluvoxamine may prevent...

Early Prediction of Sepsis From Clinical Data Sepsis continues to be a leading cause of death in hospitalised patients. Approximately 1.7 million individuals develop sepsis each year in the US and of these, around 270,000 die from the infection. Sepsis affects nearly 30 million patients worldwide and nearly 6 million die from sepsis each year. Billions of dollars are required to manage sepsis, far exceeding the cost of most other healthcare disorders. Sepsis is trea...

Viewpoint October 26, 2020 Preventing the Spread of SARS-CoV-2 With Masks and Other “Low-tech” Interventions Andrea M. Lerner, Gregory K. Folkers, Anthony S. Fauci JAMA. 2020;324(19):1935-1936. doi:10.1001/jama.2020.21946 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), has caused a global pandemic of historic proportions in the 10 months since cases were first reported in Wuhan, China, in Dec...

BLAZE Trial: Efficacy and Safety of LY-CoV555 COVID-19 patients can have a wide range of disease severity, with some patients experiencing only mild symptoms while others are infected quite severely. However, approximately 10% of asymptomatic and mild cases lead to severe outcomes, including respiratory distress that would require hospitalisation. Many risk factors for severe disease have been proposed, including old age, obesity, hypertension and underlying medic...

Original Investigation November 17, 2020 Effect of an Emergency Department Care Bundle on 30-Day Hospital Discharge and Survival Among Elderly Patients With Acute Heart Failure: The ELISABETH Randomized Clinical Trial Yonathan Freund, Marine Cachanado, Quentin Delannoy, et al JAMA. 2020;324(19):1948-1956. doi:10.1001/jama.2020.19378 Abstract Importance Clinical guidelines for the early management of acute heart failure in the emergency dep...

Lung Histopathology: COVID-19 Compared to SARS, H1N1 The coronavirus disease has spread throughout the world and has resulted in many challenges for healthcare systems. It is a new disease with a significant burden of respiratory failure. This has led to questions about the pathogenesis and pulmonary pathology of COVID-19.  Patients with severe COVID-19 have respiratory failure with hypoxaemia, and acute bilateral pulmonary infiltrates. This is consistent with ...