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Annals of Internal Medicine, Ahead of Print.
Annals of Internal Medicine, Ahead of Print.
The COVID-19 pandemic has had devastating consequences globally, and the immediate and short-term consequences of SARS-CoV-2 infection have been well described. Although most individuals recover, many endure longer-lasting effects, referred to as long COVID, post-COVID condition, or postacute sequelae of SARS-CoV-2 (PASC). PASC is composed of a heterogeneous collection of symptoms and conditions that can affect virtually any organ system, with common manifestations including fatigue, cough, malaise, and pain. Those at increased risk for long COVID include females, those hospitalized due to acute COVID-19, and individuals with underlying comorbidities. Several hypotheses have been proposed to explain the underlying pathophysiology, which is likely multifactorial, including immune dysregulation, autoimmunity and immune printing, microvascular clotting with endothelial dysfunction, and impaired neurological signaling.
A phase 3 clinical trial evaluating the safety and efficacy of a messenger RNA (mRNA) combination vaccine for COVID-19 and influenza had mixed results, the vaccine’s manufacturers announced. The vaccine was a collaboration between BioNTech and Pfizer and was tested among more than 8000 healthy adults aged 18 to 64 years.
This observational cohort study examines the symptoms experienced by children after SARS-CoV-2 infection and how these symptoms differ by age (6-11 years vs 12-17 years).
Iniziativa prof.Manfellotto presentata al Panetary Health Verona
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La “AI fear” coinvolge il 70% dei medici Usa e il 20% in Italia
A randomized molnupiravir trial shows slightly lower risk.
Objective
We assessed the association of early statin initiation with inpatient mortality among hospitalised COVID-19 patients.
Design, setting and participants
This observational study emulated a hypothetical target trial using electronic health records data from Northwestern Medicine Health System, Illinois, 2020–2022. We included patients who were ≥40 years, admitted ≥48 hours for COVID-19 from March 2020 to August 2022 and had no evidence of statin use before admission.
Interventions
Individuals who initiated any statins within 48 hours of admission were compared with individuals who did not initiate statins during this period.
Primary outcome measures
Inpatient mortality at hospital days 7, 14, 21 and 28 were determined using hospital records. Risk differences between exposure groups were calculated using augmented inverse propensity weighting (AIPW) with SuperLearner.
Results
A total of 8893 individuals (24.5% early statin initiators) were included. Early initiators tended to be older, male and have higher comorbidity burdens. Unadjusted day 28 mortality was higher in early initiators (6.0% vs 3.6%). Adjusted analysis showed slightly higher inpatient mortality risk at days 7 (RD: 0.5%, 95% CI: 0.2 to 0.8) and 21 (RD: 0.6%, 95% CI: 0.04 to 1.1), but not days 14 (RD: 0.4%, 95% CI: –0.03 to 0.9) and 28 (RD: 0.4%, 95% CI: –0.2 to 1.1). Sensitivity analyses using alternative modelling approaches showed no difference between groups.
Conclusions
Early statin initiation was not associated with lower mortality contrasting with findings of previous observational studies. Trial emulation helped in identifying and addressing sources of bias incompletely addressed by previous work. Statin use may be indicated for other conditions but not COVID-19.
Annals of Internal Medicine, Ahead of Print.
Annals of Internal Medicine, Ahead of Print.
Annals of Internal Medicine, Ahead of Print.
Annals of Internal Medicine, Ahead of Print.
