Risk Factors for Death From COVID-19 Identified in Wuhan

Fei Zhou, MD, from the Chinese Academy of Medical Sciences, and colleagues conducted a retrospective, observational, multi-center cohort study of 191 patients, 137 of whom were discharged and 54 of whom died in the hospital.

The study, published online today in The Lancet, included all adult inpatients with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital who had been discharged or died by January 31 of this year. Severely ill patients in the province were transferred to these hospitals until February 1.

Overall, 91 (48%) of the 191 patients had comorbidity. Most common was hypertension (30%), followed by diabetes (19%) and coronary heart disease (8%)…The average age of survivors was 52 years compared to 69 for those who died. Liu cited weakening of the immune system and increased inflammation, which damages organs and also promotes viral replication, as explanations for the age effect.

Click the link below for the full source article.

Risk Factors for Death From COVID-19 Identified in Wuhan Patients

 

Infectious Disease Doctor: What Does (And Doesn’t) Scare Me About The Coronavirus

Your daily dose of Covid-19.

The full article (link below) is worth reading.

Dr. Paul Sax is the clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital,  Professor of Medicine at Harvard Medical School, and blogs on infectious disease here.

Infectious Disease Doctor: What Does (And Doesn’t) Scare Me About The Coronavirus

Update:

A reader informed me the link above isn’t working.

Try this link instead.

 

 

 

A Physician’s Chilling COVID-19 Diagnostic Journey -KevinMD

Madilyn and I waited for communication from her sister and were shocked that she landed in DFW, on a plane with 348 passengers with masks, and no one asked any questions about exposure or symptoms — there was no screening at all. She quickly realized her mask at DFW looked conspicuous, so she removed it and awaited her connecting flight home.

A physician’s chilling COVID-19 diagnostic journey

Here’s your daily dose on Covid-19.

If you are suffering from Covid-19 anxiety disorder please don’t read the full article.

Be Proactive – Be Prepared

Marler Clark is a law firm in Seattle Washington.  Outstandingly proactive and quoted here for my readers to view.

I especially liked the generous financial contribution to the employees and the last item on the list to stock in your pantry.

Here is what I sent my staff late last week:

All, see symptoms below – if you are sick, please stay home.

https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html

I have asked Chris and Michelle to give me some ideas on recommendations on how to responsibly deal with this from a medical issue.  We will give you all our thoughts early next week.

All, please email to Leslie all your contact information and a close contact too.  Leslie, please share that with all.

All, please let me know if anyone needs any technology to work from home if necessary if this becomes a bigger problem.  Think about what you might need to work from home for an extended period of time.  What do you need to effectively do your job from home – computer, paper, pens, etc.?  COVID-19 is not an excuse to work from home, but I want to be prepared and sensible.

Also, let’s look at travel schedules over the coming months to see if there are alternatives.  Please shoot me your travel over the next 30-60 days.

All, take a hard look at your cases – what deadlines might be impacted by Court and other office closures, etc.  I want us to be proactive and think ahead.  I do not want deadlines missed.

Finally, not to be a “prepper,” but Kelli, please drop $2,500 (pre-tax) into everyone’s account on Monday to be used as they see fit to prepare for some disruptions.  I have not thought of exactly what those needs might be, but there are probably a few websites that have suggestions.

Here are some ideas for being prepared for home:

All medications (over the counter *ibuprofen* , allergy, cold etc and prescriptions )

All household products you will need for two weeks (toilet paper, soap, paper towels, laundry detergent, cleaning supplies, etc)

Supply of water for two weeks

Food for two weeks

         ⁃        Chicken broth

         ⁃        Beans

         ⁃        Onions

         ⁃        Garlic

         ⁃        Potatoes – sweet, Yukon, etc

         ⁃        Pasta

         ⁃        Canned tomatoes

         ⁃        Steel cut oats

         ⁃        Peanut butter

         ⁃        Bread *freezer*

         ⁃        Eggs

         ⁃        Frozen meat

         ⁃        Canned fish

         ⁃        Jerky or dried meat

         ⁃        Dried nuts and fruit

         ⁃        Popcorn

         ⁃        Chocolate

         ⁃        Wine/booze of choice

Link to the full article post.

 

Internet Book of Critical Care (IBCC) Online Medical Education on Emergency Department (ED) Critical Care, Trauma, and Resuscitation

The Internet Book of Critical Care is an online textbook written by Josh Farkas (@PulmCrit), an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.

Covid-19

This online source is highly technical and written for Emergency Medicine specialists.  I only know about this source because of Project #1.  But if you’re interested in a deep dive into Covid-19 this website offers fascinating reading.

My #1 takeaway:

 It remains unclear what fraction of patients are hospitalized.

  • There may be lots of patients with mild illness who don’t present to medical attention and aren’t counted.

  • The vast majority of infected patients (e.g. >80%) don’t get significantly ill and don’t require hospitalization.

Stay calm.

Covid-19 — Navigating the Uncharted – MUST READ

This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.2

Click here to read the full NEJM Editorial.

I’m hoping the NEJM editorial gets read and shared widely.  Clearly all individuals and businesses need to be prepared for the worst case scenario.  If you manage a large company, go back and review/revise your disaster recovery/business continuation plans. I’d make absolutely certain your tele-commuting platform is A+ and working as well as possible.  You may even consider expanding your remote work capabilities because every one of your employees might be using it.  Soon.

 

 

First Covid-19 outbreak in a U.S. nursing home

Washington state reported on Saturday the first death in the U.S. from the new coronavirus, the first health care worker to be infected with the disease, and most worrying, the first known outbreak in a long-term care facility.

At a nursing facility in Kirkland, Wash, approximately 27 of the 108 residents and 25 of the 180 staff have some symptoms, health officials said during a teleconference with the Centers for Disease Control and Prevention. Authorities report that some among them have pneumonia.

Read the full article here at statnews.com

COVID-19 – Coronavirus Deep Dive

What were the demographics of the forty-one admitted 2019-nCoV patients included in this study?

  • Most were men (30/41 patients; 73%)

  • Median age = 49 years

  • 13/41 patients (32%) had underlying disease (e.g. diabetes, hypertension, cardiovascular disease, COPD, cancer)

What kind of symptoms did the forty-one admitted 2019-nCoV patients included in this study have?

  • Fever (40/41 patients; 98%)

  • Cough (31/41 patients; 76%)

  • Myalgia or Fatigue (18/41 patients; 44%)

  • These three symptoms were the major ones. There were patients who had sputum production, headache, hemoptysis, and diarrhea; however, these symptoms were less common.

  • Dyspnea occurred in 55% later in the course, with mean time to onset of dyspnea at 8 days.

Here’s a nice short summary of a recent study published in Lancet.  The balance of the source article can be found at emDOCs.net

And if you want to maintain your sanity regarding this emerging infectious disease threat avoid social media. 

Social media, for all its many ills and its few redeeming qualities, identifies idiots.

Can we turn serious for a minute? Are you on social media, talking to people that you don’t know about things that you know nothing about? If so, what are you doing? There’s a great big wonderful wide world out there. Why not trying exploring it? Talk to people. See things. Read stuff that is longer than 14 words.

Berry Tramel: Garth Brooks’ Barry Sanders jersey brings out the idiots, thinking he was endorsing Bernie Sanders

 

 

Corona Sales Plummet in China Amid Coronavirus Pandemic — VinePair

Despite the fact that the COVID-19 coronavirus has nothing whatsoever to do with Corona, the parent company of the Mexican lager has nonetheless suffered a crushing financial loss due to the growing pandemic. Anheuser-Busch InBev (A-B InBev), the international producer and distributor of Corona beer, reported Thursday that a decline in Chinese on- and off-premise…

via Corona Sales Plummet in China Amid Coronavirus Pandemic — VinePair

Yikes!