1.
Clinical and bioethical implications of health care interruption during the COVID-19 pandemic: A cross-sectional study in outpatients with rheumatic diseases.
Guaracha-Basáñez, GA, Contreras-Yáñez, I, Hernández-Molina, G, González-Marín, A, Pacheco-Santiago, LD, Valverde-Hernández, SS, Peláez-Ballestas, I, Pascual-Ramos, V
PloS one. 2021;(7):e0253718
Abstract
BACKGROUND To determine the impact of health care interruption (HCI), on clinical status of the patients reincorporated to an outpatient clinic for rheumatic diseases (OCDIR), from a tertiary care level center who was temporally switched to a dedicated COVID-19 hospital, and to provide a bioethical analysis. METHODS From March to June 2020, the OCDIR was closed; since June, it is limited to evaluate 25% of the ongoing outpatients. This cross-sectional study surveyed 670 consecutive rheumatic outpatients between June 24th and October 31th, concomitant to the assessment of the rheumatic disease clinical status by the attendant rheumatologist, according to disease activity level, clinical deterioration and adequate/inadequate control. Multiple logistic regression analysis identified factors associated to HCI and to clinical deterioration. RESULTS Patients were middle-aged females (86.7%), with median disease duration of 10 years, comorbidity (38.5%) and 138 patients (20.6%) had discontinued treatment. Primary diagnoses were SLE and RA, in 285 (42.5%) and 223 (33.3%) patients, respectively. There were 344 patients (51.3%) with HCI. Non-RA diagnosis (OR: 2.21, 95%CI: 1.5-3.13), comorbidity (OR: 1.7, 95%CI: 1.22-2.37), patient's need for rheumatic care during HCI (OR: 3.2, 95%CI: 2.06-4.97) and adequate control of the rheumatic disease (OR: 0.64, 95%CI: 0.45-0.9) were independently associated to HCI. There were 160 patients (23.8%) with clinical deterioration and associated factors were disease duration, substantial disease activity previous HCI, patients need for rheumatic care and treatment discontinuation. CONCLUSIONS HCI during COVID-19 pandemic impacted course of rheumatic diseases and need to be considered in the bioethical analysis of virus containment measures.
2.
COVID-19 Launches Retinal Telemedicine into the Next Frontier.
Raparia, E, Husain, D
Seminars in ophthalmology. 2021;(4):258-263
Abstract
INTRODUCTION Telemedicine in ophthalmology, and specifically in retinal diseases, has made significant advancements in recent years. The COVID-19 pandemic has launched telehealth into a new era by creating demand from patients and physicians alike, while breaking down previous insurance, reimbursement, access and educational barriers. METHODS This paper reviews mulitple studies demonstrating the use of telemedicine in managing various retinal conditions before and during the COVID-19 pandemic. CONCLUSION Moving forward, promising new devices and models of care ensure that tele-retinal care will continue to expand and become a vital part of how we screen, diagnose and monitor retinal diseases.
3.
Cardiovascular Disease Prevention and Implications of Coronavirus Disease 2019: An Evolving Case Study in the Crescent City.
Razavi, AC, Kelly, TN, He, J, Fernandez, C, Whelton, PK, Krousel-Wood, M, Bazzano, LA
Journal of the American Heart Association. 2020;(13):e016997
Abstract
Medicine and public health have traditionally separated the prevention and treatment of communicable and noncommunicable diseases. The coronavirus disease 2019 (COVID-19) pandemic has challenged this paradigm, particularly in the setting of cardiovascular disease (CVD). Overall, individuals with underlying CVD who acquire severe acute respiratory syndrome coronavirus 2 experience up to a 10-fold higher case-fatality rate compared with the general population. Although the impact of the pandemic on cardiovascular health continues to evolve, few have defined this association from a frontline, public health perspective of populations disproportionately affected by CVD and COVID-19. Louisiana is ranked within the bottom 5 states for cardiovascular health, and it is home to several parishes that have experienced among the highest COVID-19 case-fatality rates nationally. Herein, we review CVD prevention and implications of COVID-19 in New Orleans, LA, a city holding a sobering yet resilient history with previous public health disasters. In particular, we discuss potential pandemic-driven changes in access to health care, preventive pharmacotherapy, and lifestyle behaviors, all of which may adversely affect CVD prevention and management, while amplifying racial disparities. Through this process, we highlight proposed recommendations for how CVD prevention efforts can be improved in the midst of the current COVID-19 pandemic and future public health crises.
4.
Let food be the medicine, but not for coronavirus: Nutrition and food science, telling myths from facts.
El Ghoch, M, Valerio, A
Journal of population therapeutics and clinical pharmacology = Journal de la therapeutique des populations et de la pharmacologie clinique. 2020;(S Pt 1):e1-e4
Abstract
The entire globe is facing a dangerous pandemic due to the coronavirus disease (COVID-19). The medical and scientific community is trying to figure out and adopt effective strategies that can lead to (i) preventing virus expansion; (ii) identifying medications for the management of critical care and reducing rates of mortality; and (iii) finally discovering the highly anticipated vaccine. Nutritional interventions have attained considerable scientific evidence in disease prevention and treatment. The main question, "What is the role of nutrition and food science in this scenario?" requires urgent answer as many theories suggesting that specific food or dietary supplements can fight coronavirus infection have received extensive coverage in most popular social media platforms. In this editorial, we focus on some frequent statements on the role of nutrition and food science in the battle against COVID-19, distinguishing between myths and facts. We highlight that social distancing and hygiene precautions are the best practices for reducing the risk of COVID-19 transmission. We further underline the importance of nutrition in its wholistic concept, pointing out the risk of unproven dietary options that could lead individuals to weaken effective precautionary measures.