Here are the stories our MDedge editors across specialties think you need to know about today:
COVID-19 in kids
Children and young adults in all age groups can develop severe illess after SARS-CoV-2 infection, but infants and teens are most likely to be hospitalized, according to retrospective data from 177 children and young adults at a single center. “One patient had features consistent with the recently emerged Kawasaki disease–like presentation with hyperinflammatory state, hypotension, and profound myocardial depression,” , of Children’s National Hospital, Washington, and colleagues reported in the .
Avoiding ageism in COVID resource allocation
The American Geriatrics Society has issued new policy for resource allocation during the COVID-19 pandemic that are aimed at protecting seniors for ageism. When allocating scarce resources in an emergency, officials should equally weigh in-hospital survival and severe comorbidities contributing to short-term mortality, the group wrote. “Age per se should never be used as a means for a categorical exclusion from therapeutic interventions that represent the standard of care. ... Likewise, specific age-based cutoffs should not be used in resource allocation strategies,” AGS officials wrote in the statement.
Preventing addiction-related suicide
Individuals with substance use disorders are at a significant risk for suicide, but there have been few evidence-based options for their treatment. Now a single intervention is showing promise for this high-risk group. In a large, multicenter randomized effectiveness study, a single 3-hour-long group psychosocial intervention resulted in significantly improved knowledge and attitudes regarding suicide that persisted at 6 months of follow-up. The intervention to prevent future suicide was designed specifically for patients who were in intensive outpatient programs for addiction treatment. “We’ve shown that suicide prevention in intensive outpatient program addiction groups is feasible, easy to train, and highly rated by counselors, and I’d say it’s very adaptable, easy to go national in almost any addiction treatment program, right out of the box,” said , director of outpatient psychiatry as well as the psychiatry addiction division at Harborview Medical Center.
TNF inhibitors may hamper COVID-19 severity
Early evidence from the has produced an intriguing result: Patients on tumor necrosis factor inhibitors for their rheumatic disease are less likely to require hospitalization when infected with COVID-19. The registry data also show that taking hydroxychloroquine or other antimalarials at the time of COVID-19 infection had no impact on hospitalization. “A strength of the global registry has been that it provides timely data that’s been very helpful for rheumatologists to rapidly dispel misinformation that has been spread about hydroxychloroquine, especially statements about lupus patients not getting COVID-19. We know from these data that’s not true,” said , professor of medicine at the University of California, San Francisco, and chief of rheumatology at San Francisco General Hospital.
Audrey Hepburn’s lessons in pandemic grace
There are a lot of new skills required for praticing medicine during the COVID-19 pandemic. In his latest MDedge column, , explains that grace is one of them. Dr. Benabio, director of Healthcare Transformation and chief of dermatology at Kaiser Permanente San Diego, looks to Audrey Hepburn for inspiration. “Effort is also required for telephone and video visits,” he writes. “In them, our doctor-patient connection is diminished – no matter how high definition, it’s a virtual affair. Ms. Hepburn would no doubt take the time to ensure she appeared professional, well lit, with a pleasing background. She’d plan for the call to be done in a quiet location and without distraction.”
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