COVID-19 research briefs by Essential Evidence Plus (EE+)

COVID-19 research briefs by Essential Evidence Plus (EE+)

As the COVID-19 pandemic continues to evolve, the Joule team is working closely with Dr. Mark Ebell, Editor-in-Chief of EE+ and the team at Wiley Publishing to share current research summaries with physicians.

POEMs* subscribers will receive COVID-19 related research briefs on most weekends and on select weekdays. You can view these updates below, subscribe to receive daily POEMS, refer to the POEMs archive (cma.ca login required) to comment on these summaries or collect CPD credits, or refer to the Essential Evidence Plus COVID-19 website.

Essential Evidence Plus (EE+) is making relevant COVID-19 information freely available, to help physicians caring for patients around the world. Topic updates on Coronavirus SARS-CoV2 infection (COVID-19) are being made as new information becomes available.

Clinical Question

How should diabetes be managed in patients who choose to fast during Ramadan?

Bottom line

These expert-derived guidelines are updated from <a href="https://www.essentialevidenceplus.com/content/poem/71256">earlier recommendations</a> for managing diabetes in Muslim patients who desire to fast during Ramadan. The updated guidelines focus on newer hypoglycemic agents and management during the COVID-19 pandemic. See the paper for more details. 5

Author(s)

David C. Slawson, MD

Clinical Question

Does use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) increase the likelihood or severity of COVID-19 infection?

Bottom line

This large and well-conducted Italian case-control study found no association between the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and either infection or severe illness with COVID-19. <a href="https://www.nejm.org/doi/10.1056/NEJMoa2008975">Another study</a> in the same issue of the journal used data from New York City and came to the same conclusions. 3b

Author(s)

Mark H. Ebell, MD, MS

Clinical Question

Can patient-collected swabs accurately detect the presence of SARS-CoV-2? What symptoms and laboratory findings are common in patients with COVID-19?

Bottom line

Self-collected swabs are accurate in detecting SARS-CoV-2 in ambulatory settings. Fever, cough, elevated C-reactive protein levels, and ground glass opacities are common in patients with COVID-19 in China. 2c

Author(s)

Henry C. Barry, MD, MS

Clinical Question

Can corticosteroids reduce mortality in hospitalized patients with COVID-19 who require oxygen or ventilation? Can postexposure prophylaxis with hydroxychloroquine improve outcomes?

Bottom line

Corticosteroids reduce mortality in hospitalized patients with COVID-19 who require oxygen or ventilatory support. In healthy people, postexposure prophylaxis with hydroxychloroquine is not effective. 2c

Author(s)

Mark H. Ebell, MD, MS

Clinical Question

Is remdesivir safe and effective for the treatment of COVID-19?

Bottom line

Remdesivir provides a clinically and statistically significant reduction in the duration of symptoms of COVID-19. Questions remain regarding its effects on mortality and on patients who have advanced disease that requires mechanical ventilation or extracorporeal membrane oxygenation (ECMO). 1b

Author(s)

Mark H. Ebell, MD, MS

Clinical Question

Can remdesivir improve outcomes in people with COVID-19?

Bottom line

Remdesivir shortens recovery time in hospitalized patients with COVID-19 and lower respiratory tract infections (ACTT-1). 4

Author(s)

Henry C. Barry, MD, MS

Clinical Question

How does 10-day compare with 5-day treatment with remdesivir in people with COVD-19?

Bottom line

Outcomes similar for 5 vs 10 days remdesivir but trial had flaws. 1b

Author(s)

Mark H. Ebell, MD, MS

Clinical Question

Is mortality higher in Black people who develop COVID-19?

Bottom line

Adjusted in-hospital mortality from COVID-19 in Louisiana no different for Black and White patients. 2b

Author(s)

John Hickner, MD, MS

Clinical Question

Is risk of COVID-19-related mortality or morbidity higher in patients receiving biologic agents? Is convalescent plasma safe?

Bottom line

Patients taking biologic agents not at greater risk of poor outcomes. Patients receiving convalescent plasma have few transfusion-related serious adverse events. 4

Author(s)

Mark H. Ebell, MD, MS

Clinical Question

Do stay-at-home orders or social distancing policies reduce the spread of COVID-19?

Bottom line

Retrospective data suggest that the implementation of stay-at-home and social distancing policies in US counties slowed the spread of COVID-19. 4

Author(s)

John Hickner, MD, MS

 

 

*DisclaimerPOEMs stands for Patient-Oriented Evidence that Matters. POEMs is a publication of John Wiley and Sons, Inc. and distributed by Joule as a CMA Member service. All content is provided for information and education and not as a substitute for the advice of a physician. Joule assumes no responsibility or liability arising from any error or omission or from the use of any information contained herein.