What your doctor is reading on Medscape.com:
APRIL 30, 2020 — Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today:
How Many Hospitalized Patients With COVID-19 Die?
A new preprint study of almost 17,000 patients with COVID-19 admitted to 166 hospitals in the United Kingdom between February 6 and April 18 indicates that 33% died. This rose to 53% when considering those who received mechanical ventilation.
These latest figures confirm that obesity is a significant risk factor for poor outcomes, including a significantly increased risk of death, along with other previously recognized comorbidities such as cardiovascular disease and diabetes. Yet almost half (47%) of hospitalized patients with COVID-19 had no documented comorbidity.
“We must do everything humanly possible to understand this disease, so that we are better prepared for the next wave of this pandemic,” said Calum Semple, PhD, from the University of Liverpool, who led the study.
New Trial Causes Controversy
Doctors are raising eyebrows at the decision by AstraZeneca to begin a randomized placebo-controlled trial of its popular type 2 diabetes drug dapagliflozin (Farxiga, AstraZeneca) to see if it reduces the risks of disease progression and clinical complications in patients with mild-to-moderate COVID-19 and a medical history of diabetes, cardiovascular disease, or chronic kidney disease.
There is concern and skepticism because several expert groups have advised that drugs in this class — the sodium-glucose cotransporter 2 (SGLT2) inhibitors — be stopped in all patients hospitalized with COVID-19.
“Giving SGLT2 inhibitors to patients in the DARE-19 study is a dangerous proposition because these drugs can induce ketoacidosis during the stress of acute illness such as COVID-19,” nephrologist Bruce R. Leslie, MD, told Medscape Medical News.
New PPE Guidelines
The Infectious Disease Society of America has released its latest guidelines on the use and reuse of personal protective equipment (PPE) during COVID-19, most of which address the use of face protection.
Panel chair John Lynch III, MD, MPH, said of the eight new recommendations, “A large part of them are really focused on masks, but there are a huge number of other disparate questions that need to be answered where there is really no good evidence basis.”