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COVID-19 news from Annals of Internal Medicine

All coronavirus-related content published in Annals is free

American College of Physicians

Research News

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

1. Down Syndrome associated with a 10-fold increased risk for COVID-19-related death

At the start of the COVID-19 pandemic, many national health organizations emphasized quarantining or physical distancing, especially for those deemed to be extremely vulnerable on the basis of certain medical conditions. Although Down syndrome was not specifically mentioned on official lists of conditions that put people at increased risk, the condition is associated with immune dysfunction, congenital heart disease, and pulmonary pathology. Therefore, it may be an unconfirmed risk factor for severe COVID-19.

Researchers from the University of Oxford, the University of Nottingham, the London School of Hygiene & Tropical Medicine, and the University College London studied a cohort of 8.26 million adults through a QResearch database to evaluate if Down syndrome is a risk factor for death from COVID-19. The authors found an estimated a 4-fold increased risk for COVID-19-related hospitalization and a 10-fold increased risk for COVID-19-related death in persons with Down syndrome. They stress this novel evidence should be used by public health organizations, policymakers, and health care workers to strategically protect vulnerable individuals. Read the full text:

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead author, Julia Hippisley-Cox, MD, can be reached through Helen Jacques at or can be reached directly at

2. Ensuring Safe Access to Mifepristone During the Pandemic and Beyond

Mifepristone, one of two drugs used together to induce a medication abortion, was approved 20 years ago by the U.S. Food and Drug Administration (FDA), yet it cannot be routinely prescribed and dispensed in the U.S. because it is covered by a risk evaluation and mitigation strategy, or REMS program. REMS programs are intended to minimize harms from special safety risks through such precautions as distribution controls, laboratory testing requirements, and a more robust process of informed consent.

Although many health care providers have long called for reconsideration of the mifepristone REMS program, the COVID-19 pandemic has brought new attention to the issue, in part because of the risk of in-person visits. Authors from Brigham and Women's Hospital and Harvard Medical School and George Washington University Milken Institute School of Public Health discuss the implications of the REMS on mifepristone and suggest that the FDA releasing the REMS on mifepristone would represent a meaningful step for women's health and the exercise of their constitutional rights. Read the full text:

Media contacts: A PDF for this article is not yet available. Please click the link to read full text. The lead author, Ameet Sarpatwari, PhD, JD, can be reached directly at


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