Here are the stories our MDedge editors across specialties think you need to know about today:
More fatalities in heart transplant patients with COVID-19
COVID-19 infection appears to be associated with a high risk for mortality in heart transplant recipients. The conclusion is based on a case series with 28 patients with a confirmed diagnosis of COVID-19 who received a heart transplant during March and April 2020. There was a case-fatality rate of 25%, according to the study published in JAMA Cardiology. “The high case fatality in our case series should alert physicians to the vulnerability of heart transplant recipients during the COVID-19 pandemic,” senior author Nir Uriel, MD, professor of medicine at Columbia University, New York, said in an interview. “These patients require extra precautions to prevent the development of infection.” Read more.
High costs for type 1 diabetes patients: It’s not just insulin
For privately insured individuals with type 1 diabetes in the United States, out-of-pocket costs for insulin are typically lower than for other diabetes-related supplies. But overall out-of-pocket costs – taking into account everything that is needed to manage diabetes – are still very high. Two separate research letters recently published in JAMA Internal Medicine examined some of the drivers behind these high costs. The first research letter examined all costs for privately insured patients with type 1 diabetes, finding a mean out-of-pocket spend of approximately $2,500 a year. “Policymakers should improve the affordability of all care for type 1 diabetes,” said the lead author of the first research letter, Kao-Ping Chua, MD, PhD, of the department of pediatrics, University of Michigan, Ann Arbor. Read more.
Most rheumatology drugs don’t up COVID-19 hospitalizations
The vast majority of patients with rheumatic and musculoskeletal diseases who contract COVID-19 recover from the virus, regardless of which medication they receive for their rheumatic condition, new international research suggests. Researchers looked at 600 COVID-19 patients from 40 countries, and found that those taking TNF inhibitors for their rheumatic disease were less likely to be hospitalized for COVID-19. Treatment with more than 10 mg of prednisone daily – considered a moderate to high dose – was associated with a higher probability of hospitalization, however. “These results provide, for the first time, information about the outcome of COVID-19 in patients with rheumatic and musculoskeletal diseases,” said study investigator Pedro Machado, MD, PhD, from University College London. “They should provide some reassurance to patients and healthcare providers.” Read more.
A bumpy virtual #ASCO20
Some prominent oncologists gave up on the virtual meeting of the American Society of Clinical Oncology after facing technical problems with online sessions. Despite those glitches, dozens of virtual meeting attendees praised the online effort, which was assembled in just a few months, and called out virtues such as the quick availability of video transcripts as well as the obvious benefits of low cost, zero travel, and overall convenience. But one sentiment was nearly universal: there’s nothing like the real thing. This year’s meeting, which involved 40,000-plus attendees, was shortened to 3 days and limited to scientific presentations because of the COVID-19 pandemic. Education sessions will be held online August 8-10. Read more.
Parenting special needs children: An unlikely model
As families adjust to daily life during a pandemic, the parents of special needs children may be able to offer them some lessons. The chronic struggles of many special needs parents – from staying home often to taking on roles in which they have not been trained – strongly resemble the challenges facing most families in the COVID-19 pandemic, according to Migdalia Miranda Sotir, MD, a psychiatrist in private practice in Wheaton, Ill. “Parents may take on active roles supplementing their developmentally delayed children with educational experiences or therapeutic modalities in their own homes given that the needs might be too great to just rely on the school or therapy time,” she writes on MDedge. Read more.
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