NEJM Journal Watch – 06.05.20

Prevalence of asymptomatic disease: An estimated 40–45% of people who test positive for SARS-CoV-2 do not have symptoms at the time of testing, according to a narrative review of 16 cohorts in the Annals of Internal Medicine. In four cohorts with longitudinal data, few of the asymptomatic patients (0–10%) went on to develop symptoms. But in one skilled nursing facility, 89% of initially asymptomatic patients became sick. The researchers say, “It is imperative that testing programs include those without symptoms.” They add, “The early data that we have assembled on the prevalence of asymptomatic SARS-CoV-2 infection suggest that this is a significant factor in the rapid progression of the COVID-19 pandemic.”

COVID-19: Asymptomatic Disease Prevalence / N95 Mask Reuse / Oxygen Management Strategies / Anti-Racism Demonstrations / Studies Retracted

Smoking cigarettes — even one or less per day — is associated with increased mortality risk, a JAMA Network Open study shows.  Researchers combined data from several federal smoking surveys performed between 1992 and 2011. In those surveys, some 500,000 adults reported their smoking histories. National mortality data showed that, compared with never-smokers, daily smokers (averaging 600 cigarettes per month) bore a 2.3-fold higher all-cause mortality risk, with non-daily smokers (averaging 40 per month) sustaining a 1.8-fold higher risk.  Heightened mortality risks became apparent even at levels of 6 to 10 cigarettes per month.  The researchers conclude: “Thus, all smokers should quit, regardless of how infrequently they smoke.”

Infrequent Smoking Carries Heightened Mortality Risk

Fewer U.S. teens smoking, doing drugs, and drinking milk

Kids have shifted from a dairy product rich in calcium and vitamin D to beverages laden with sugar and caffeine, which is likely contributing to the nation’s obesity problem, said Barry Popkin, a University of North Carolina researcher who studies how diets change.

“This is not a healthy trend for our long-term health,” he said.

Read the AP source article here.


FDA Warns Chantix May Up Heart Risk

A meta-analysis ordered by the agency and conducted by drugmaker Pfizer found a higher occurrence of major adverse cardiovascular events — including death, MI, and stroke — with the drug than with placebo.

The FDA noted, however, that such events were uncommon in both groups, and the increased risk wasn’t statistically significant.

via Chantix May Up Heart Risk, FDA Warns.

Quitting smoking is good.  Maybe quitting smoking without a pharmaceutical assist is better.  Additional link to the FDA release follows.

Safety Alerts for Human Medical Products > Chantix (Varenicline): Safety Communication – Updated Safety Review On The Risk of Cardiovascular Adverse Events.