Resources For Health Professionals
Latest Publications and Scientific Information
Chloroquine phosphate, when used without a prescription and supervision of a healthcare provider, can cause serious health consequences, including death. Clinicians and public health officials should discourage the public from misusing non-pharmaceutical chloroquine phosphate (a chemical used in home aquariums). Clinicians should advise patients and the public that chloroquine, and the related compound hydroxychloroquine, should be used only under the supervision of a healthcare provider as prescribed medications.
Journal Pre Proof
Over the course of the current pandemic, it became apparent that some patients can present with abdominal symptoms without fever or respiratory manifestations, and could be overlooked by health care providers.
April 3, 2020
Lessons from Covid-19 Hotspots
Eric J. Rubin, Lindsey R. Baden, and Stephen Morrissey
In this audio interview conducted April 1, the editors draw lessons from the early Covid-19 outbreak in Seattle and the growing crisis in New York City. Listen to the interview.
Clinicians with inadequate access to standard personal protective equipment (PPE) have been compelled to improvise protective barrier enclosures for use during endotracheal intubation. We describe one such barrier that is easily fabricated and may help protect clinicians during this procedure.
The coronavirus disease 2019 (COVID-19) pandemic will present an unprecedented stressor to patients and health care systems across the globe. Because there is currently no vaccine or treatment for the underlying infection, current health efforts are focused on providing prevention and screening, maintaining continuity of treatment for other chronic conditions, and ensuring access to appropriately intensive services for those with the most severe symptoms.
April 2, 2020
The president and all 50 governors have declared health emergencies to counteract the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). While researchers race to develop vaccines, officials are implementing physical distancing, including orders to stay at home, restricting travel, and closing nonessential businesses.
April 1, 2020
Altogether, this suggests active virus replication in upper respiratory tract tissues, where SARS-CoV is not thought to replicate in spite of detectable ACE-2 expression19,20 . At the same time, the concurrent use of ACE-2 as a receptor by SARS-CoV and SARS-CoV-2 corresponds to a highly similar excretion kinetic in sputum, with active replication in the lung.
This case describes uncomplicated labor and vaginal delivery in a woman with Covid-19. Care was taken to avoid infecting hospital staff, and 7 days after the delivery, no caregivers appeared to be infected.
A small number of cases of coronavirus disease 2019 (Covid-19) have been described in children,1,2 and our understanding of the spectrum of illness is limited.3 We conducted a retrospective analysis involving hospitalized children in Wuhan, China.
Rather than stumble through a series of starts and stops and half-measures on both the health and the economic fronts, we should forge a strategy to defeat the coronavirus and open the way to economic revival. If we act immediately, we can make the anniversary of D-Day on June 6, 2020, the day America declares victory over the coronavirus.
As the SARS-CoV-2 pandemic continues to explode, hospital systems are scrambling to intensify their measures for protecting patients and health care workers from the virus. An increasing number of frontline providers are wondering whether this effort should include universal use of masks by all health care workers. Universal masking is already standard practice in Hong Kong, Singapore, and other parts of Asia and has recently been adopted by a handful of U.S. hospitals.
March 31, 2020
Based on preliminary U.S. data, persons with underlying health conditions such as diabetes mellitus, chronic lung disease, and cardiovascular disease, appear to be at higher risk for severe COVID-19–associated disease than persons without these conditions.
Health care workers who come in close contact with a patient’s head and neck are particularly at risk for developing coronavirus disease 2019 (COVID-19) because of the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) through respiratory droplets. This article provides safety recommendations for these health care workers regarding exams and surgical procedures based on a review of the literature and the experiences of physicians with firsthand knowledge of safety procedures during this pandemic.
Lessons learned from the 2003 severe acute respiratory syndrome (SARS) epidemic may help reduce the spread of severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), the cause of coronavirus disease 2019 (COVID-19), to health care workers performing open tracheostomies, a surgical procedure to open an airway that may be required for many patients with COVID-19.
One-third of COVID-19 patients from Hubei, China, had ocular manifestations, occurring frequently in patients with more severe physical conditions.
The authors describe measures taken to reduce the risk of transmitting severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) to medical staff and cancer patients seeking treatment during the COVID-19 outbreak in China.
This article describes treatment initiatives being undertaken for novel coronavirus 2019 at an ophthalmology center in Singapore.
March 30, 2020
Pharyngeal swabs are widely used to determine the appropriateness of a patient's discharge from the hospital and whether isolation continues to be required. We observed 22 patients who had positive RT-qPCR results for SARS–CoV-2 in the sputum or feces after pharyngeal swabs became negative. These finding raise concern about whether patients with negative pharyngeal swabs are truly virus-free, or sampling of additional body sites is needed.
During the first 3 weeks of the Covid-19 outbreak in the Seattle area, the most common reasons for admission to the ICU were hypoxemic respiratory failure leading to mechanical ventilation, hypotension requiring vasopressor treatment, or both. Mortality among these critically ill patients was high.
The recent report of 2 critically ill emergency physicians infected by the novel coronavirus disease 2019 (COVID-19) is a sobering reminder of the vulnerability of the nation’s health care workforce.1 While all members of the health care workforce are vital as the health care system faces perhaps its greatest challenge in memory, physicians and nurses are the caregivers who typically have the most direct contact with patients, whether through advising, triaging, or treating those who require hospitalization.
The world is united regarding the goal of ending the coronavirus disease 2019 (COVID-19) pandemic but not the strategy to achieve that goal. One stark example is the debate over whether to prescribe available therapies, such as quinine-based antimalarial drugs (eg, chloroquine or hydroxychloroquine), or test these drugs in randomized clinical trials (RCTs). At the heart of the problem is one of the oldest dilemmas in human organizations: the “exploitation-exploration” trade-off.
March 27, 2020
Myocardial injury is significantly associated with fatal outcome of COVID-19, while the prognosis of patients with underlying CVD but without myocardial injury is relatively favorable. Myocardial injury is associated with cardiac dysfunction and arrhythmias. Inflammation may be a potential mechanism for myocardial injury. Aggressive treatment may be considered for patients at high risk of myocardial injury.
In this uncontrolled case series of 5 critically ill patients with COVID-19 and acute respiratory distress syndrome (ARDS), administration of convalescent plasma containing neutralizing antibody was followed by an improvement in clinical status.
In the context of rapidly escalating Covid-19 outbreaks, proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19.
March 26, 2020
From the collected data (88 patients), 18 patients (20.4%) developed cutaneous manifestations. 8 patients developed cutaneous involvement at the onset, 10 patients after the hospitalization. Cutaneous manifestations were erythematous rash (14 patients), widespread urticaria (3 patients) and chickenpox-like vesicles (1 patient). Trunk was the main involved region. Itching was low or absent and usually lesions healed in few days. Apparently there was not any correlation with disease’s severity.
Although 2 recent studies1,2 have shown that there were no clinical findings or investigations suggestive of COVID-19 in neonates born to affected mothers, and all samples, including amniotic fluid, cord blood, and breast milk, were negative for SARS-CoV-2, the vertical maternal-fetal transmission cannot be ruled out in the current cohort. Therefore, it is crucial to screen pregnant women and implement strict infection control measures, quarantine of infected mothers, and close monitoring of neonates at risk of COVID-19.
As of March 25, 2020, WHO’s online coronavirus disease 2019 (COVID-19) situation dashboard reveals that the pandemic spans 195 countries and territories with 375 498 cases. With this rapid expansion of the pandemic comes a growing need to ensure that accurate and credible information is accessible to public health authorities, researchers, and the wider public.
March 25, 2020
Our projections show that physical distancing measures were most effective if the staggered return to work was at the beginning of April; this reduced the median number of infections by more than 92% (IQR 66–97) and 24% (13–90) in mid-2020 and end-2020, respectively.
How sad that the people who remember the last major pandemic — influenza in 1968 — are the primary victims of today’s. How sad that despite the many medical advances that have been made since then — critical care, extracorporeal membrane oxygenation (ECMO), emergency medicine, and emergency medical services, to name a few — the treatments offered to many patients in areas where Covid-19 has exploded are the same ones they might have received in that era. Perhaps the lessons they remember, those of quarantine, isolation, and social distancing, are the ones that will save us again.
March 24, 2020
Although many drugs have in vitro activity against different coronaviruses, no clinical evidence currently supports the efficacy and safety of any drug against any coronavirus in humans, including SARS-CoV-2. Numerous drugs that have been highly promising in vitro for other infectious diseases have failed in clinical studies.
This overview analyzes the best information from the early research, including epidemiologic and demographic features from SARS-CoV-1 and MERS-CoV viruses; lessons learned from the experience of an emergency physician in Northern Italy, where the outbreak has devastated the healthcare system
Among those with COVID-19, there is a higher prevalence of cardiovascular disease and more than 7% of patients suffer myocardial injury from the infection (22% of the critically ill).
Endothelial damage and subsequent clotting is common in severe and critical COVID-19 coronavirus, which may have implications for treatment, Chinese clinicians said at a webinar co-sponsored by the Chinese Cardiovascular Association and American College of Cardiology.
Psychiatric appointments across the country have been going virtual as mental health professionals try to limit potential exposures by moving to home offices and keeping outpatient visits to a minimum.
March 23, 2020
This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology.
These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
Implementing the combined intervention of quarantining infected individuals and their family members, workplace distancing, and school closure once community transmission has been detected could substantially reduce the number of SARS-CoV-2 infections.
March 22, 2020
Chloroquine, the old malaria drug, is making news as a potential therapy for coronavirus. Does it belong in the headlines for its antiviral properties, or is it just hype and bluster? Will it become a drug? Let's find out.
March 21, 2020
March 20, 2020
LH significantly inhibits the SARS-COV-2 replication, affects virus morphology and exerts anti-inflammatory activity in vitro. These findings indicate that LH protects against the virus attack, making its use a novel strategy for controlling the COVID-19 disease.
March 19, 2020
Systematically summarizes the epidemiology, clinical characteristics, diagnosis, treatment and prevention of knowledge surrounding COVID-19.
March 18, 2020
March 17, 2020
March 16, 2020
March 13, 2020
March 12, 2020
March 11, 2020
March 4, 2020
March 3, 2020
See important LSU Healthcare Network COVID-19 information and updates, as well as how to request a patient appointment at the buttons below.COVID-19 Updates Request an Appointment
General Information and Guidance
Louisiana Department of Health
CovidActNow.org was created by a team of data scientists, engineers, and designers in partnership with epidemiologists, public health officials, and political leaders to help understand how the COVID-19 pandemic will affect their region. This tool is built to enable political leaders to quickly make decisions in their Coronavirus response informed by best available data and modeling.
Preliminary research has shown the potential of convalescent plasma therapy to improve clinical outcomes of patients with severe disease related to COVID-19.
Adults who are prescribed glucocorticoid therapy for common conditions, such as asthma, allergies and arthritis, as well as individuals with adrenal insufficiency, are at high risk for developing serious complications from COVID-19 due to an inability to mount a normal stress response, according to an editorial published in the Journal of Clinical Endocrinology & Metabolism.\
Starting this week, Abbott Laboratories ABT +1.46% plans to make a rapid test available for use in physicians’ offices, urgent-care clinics and other settings through an Abbott device. The test can detect the virus in a patient sample in as few as five minutes and return negative results in 13 minutes.
FDA approved 3 additional kits today (2 PCR, 1 RAPID), 31 March 2020. Total registered COVID-19 Test Kits for commercial use is now 26. Click this link for details.
Johnson & Johnson today announced the selection of a lead COVID-19 vaccine candidate from constructs it had been working on since January 2020, with expected initiation of human clinical studies by September 2020 at the latest.
The novel coronavirus pandemic has led to numerous quarantine and social isolation measures throughout the United States and the world. Thus, psychiatric patients may be unable to attend an in-person appointment with their clinician.
During a White House Rose Garden event, CMS Administrator Seema Verma unveiled the hospitals without walls program.
"Under the CMS's temporary new rules, hospitals will be able to transfer patients to outside facilities, such as ambulatory surgery centers, inpatient rehabilitation hospitals, hotels, and dormitories, while still receiving hospital payments under Medicare. For example, a healthcare system can use a hotel to take care of patients needing less intensive care while using its inpatient beds for COVID-19 patients," CMS noted in a press release.
But how to accurately display and project the spread of the disease has proven difficult, particularly given the limited number of tests available to confirm where cases of COVID-19 actually are.
Researchers have created an artificial intelligence tool that may help physicians predict which patients will develop severe lung disease, even if they initially have a mild case of the novel coronavirus.
In a study published in Computers, Materials & Continua, NYU and Chinese researchers used data from a small group of COVID-19 patients in two Chinese hospitals.They found that patients with mildly elevated liver enzymes and body aches were most likely to develop acute respiratory distress syndrome.
As labs and diagnostic developers race to meet demand for assays to detect the SARS-CoV-2 coronavirus, 360Dx is updating this tracker on a regular basis in order to provide readers with up-to-date and accurate information on the regulatory status of these tests in the US, European, and Asian markets.
The tracker includes only those tests that are available for diagnostic use. Links to primary regulatory decisions are provided where available.
The American Hospital Association (AHA) today announced a national initiative to secure millions of masks for the physicians, nurses and caregivers who are treating coronavirus patients and at greater risk due to a nationwide shortage of personal protective equipment. The effort will facilitate private sector partnerships to address these shortages in the fight against COVID-19.
The AHA March 24 urged the Department of Health and Human Services to clarify the Emergency Medical Treatment and Labor Act and Health Insurance Portability and Accountability Act waivers issued under the public health and national emergency declarations.
The AHA has asked the Department of Labor to accurately define "health care provider" as it promulgates regulations implementing key sections of the recently-enacted Families First Coronavirus Response Act and clarify how this policy will be operationalized, including how it interacts with state law.