Annals of Internal Medicine News
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Below please find a summary and link(s) of new coronavirus-related content published today in Annals of Internal Medicine. The summary below is not intended to substitute for the full article as a source of information. A collection of coronavirus-related content is free to the public at http://go.annals.org/coronavirus.
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1. COVID-19 hospitalizations, ICU admissions, and deaths highest in December 2020 before vaccines became widely available
Free full text: https://www.acpjournals.org/doi/10.7326/M21-1991
A pooled cross-sectional study between March and December 2020 found that rates of COVID-19 hospitalizations, ICU admissions, and in-hospital deaths peaked in December before vaccines became widely available. Among hospitalized patients with COVID-19, use of effective therapeutics increased while implementation of invasive support measures such as mechanical ventilation waned. The findings are published in Annals of Internal Medicine.
The clinical epidemiology of COVID-19 among U.S. adults has been well described, and older age and underlying conditions have been identified as risk factors for hospitalization and death. However, data on trends in clinical characteristics and outcomes of COVID-19–associated hospitalizations over time are limited.
Researchers from the Centers for Disease Control and Prevention (CDC) used a large, geographically diverse, population-based surveillance network to describe monthly trends in rates of severe outcomes associated with COVID-19 among U.S. adults from March to December 2020. Among hospitalized patients, they also described monthly trends in the distribution of clinical characteristics, interventions, and outcomes. The researchers found that among the 116,743 adults in the analysis, rates of all hospitalization, ICU admission, and in-hospital death were highest among adults aged 65 years or older, males, and Hispanic or non-Hispanic Black persons. Among 18,508 sampled hospitalized adults with detailed information, use of remdesivir and systemic corticosteroids increased while use of mechanical ventilation and other intensive interventions decreased and outcomes improved. These findings suggest that clinical practice evolved based on increasing knowledge, experience, and tools to combat COVID-19 during the pandemic.
Media contacts: A PDF for this article is not yet available. Please click the link to read the full text. The corresponding author, Shikha Garg, MD, MPH, can be reached directly at izj7@cdc.gov.
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2. Opinion: Scientific evidence can and should guide legal interventions to protect the public from COVID-19
Free full text: https://www.acpjournals.org/doi/10.7326/M21-2839
A new commentary from the University of Oslo, Norway suggests that legal interventions intended to protect public health can and should be guided by scientific evidence. The authors suggest that embedded evidence generation is possible during the time of a pandemic as proven by the rapid development of treatment approaches and vaccines for COVID-19. The commentary is published in Annals of Internal Medicine.
Soon after the start of the COVID-19 pandemic, investigators initiated a surge of clinical trials for drugs and vaccines, which have been enormously valuable and contributed to evidence-based improvements in clinical care and disease prevention. However, public health measures, such as social distancing rules, strategies for school openings, and quarantine duration, remain untested. Instead, they are guided by the precautionary principle, which supports policymakers in adopting precautionary measures when scientific evidence about an environmental or health hazard is uncertain but stakes are high. The authors say that by generating high-quality evidence for legal health interventions and mitigation measures, policymakers will better be able to quantify expected benefits, harms, and burdens; maintain trust and understanding; and preserve democratic processes.
Media contacts: A PDF for this article is not yet available. Please click the link to read the full text. The corresponding author, Michael Bretthauer, MD, PhD, can be reached directly at michael.bretthauer@medisin.uio.no.
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Journal
Annals of Internal Medicine