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Emergency Medicine Reports ; 42(11), 2021.
Article in English | ProQuest Central | ID: covidwho-1250773


* Emergency departments have a unique role in public health. They care for a disproportionate number of patients who lack access to care in other venues. Emergency departments currently provide tetanus vaccines to millions of patients per year. Many emergency departments are expanding their role to provide COVID-19 vaccine to patients who might not receive it otherwise. Such programs can be carried out without interfering with emergency care for that patient or others in the department. * Emergency departments also can play a role in decreasing vaccine hesitancy, providing information to patients on the vaccine, answering their questions, and correcting misinformation when it is present. * Most of the side effects associated with the COVID-19 vaccines are mild — one to two days of fever, headache, or fatigue. These are most common on the second shot of those vaccines that require two injections. A very rare but serious side effect has been described four to 30 days following the Johnson & Johnson or AstraZeneca vaccines. Vaccine-induced thrombotic thrombocytopenia is similar in many ways to heparin-induced thrombocytopenia. It presents with signs of significant thrombosis, such as central venous sinus thrombosis. Heparin should be avoided. Platelet transfusion may increase clotting, and the physician should consider the risk/benefit to the patient. Patients can receive treatment with intravenous immune globulin and a non-heparin anticoagulant. * Emergency departments should consider vaccine programs for other immunizations depending on their patient population and the local access to other sites. Many emergency departments provide influenza vaccine and some hepatitis A vaccine to specific high-risk populations.

Nat Commun ; 12(1): 1967, 2021 03 30.
Article in English | MEDLINE | ID: covidwho-1159789


Type III interferons have been touted as promising therapeutics in outpatients with coronavirus disease 2019 (COVID-19). We conducted a randomized, single-blind, placebo-controlled trial (NCT04331899) in 120 outpatients with mild to moderate COVID-19 to determine whether a single, 180 mcg subcutaneous dose of Peginterferon Lambda-1a (Lambda) within 72 hours of diagnosis could shorten the duration of viral shedding (primary endpoint) or symptoms (secondary endpoint). In both the 60 patients receiving Lambda and 60 receiving placebo, the median time to cessation of viral shedding was 7 days (hazard ratio [HR] = 0.81; 95% confidence interval [CI] 0.56 to 1.19). Symptoms resolved in 8 and 9 days in Lambda and placebo, respectively, and symptom duration did not differ significantly between groups (HR 0.94; 95% CI 0.64 to 1.39). Both Lambda and placebo were well-tolerated, though liver transaminase elevations were more common in the Lambda vs. placebo arm (15/60 vs 5/60; p = 0.027). In this study, a single dose of subcutaneous Peginterferon Lambda-1a neither shortened the duration of SARS-CoV-2 viral shedding nor improved symptoms in outpatients with uncomplicated COVID-19.

Antiviral Agents/administration & dosage , COVID-19/drug therapy , Interleukins/administration & dosage , Polyethylene Glycols/administration & dosage , Adult , Aged , COVID-19/virology , Female , Humans , Injections, Subcutaneous , Male , Middle Aged , Outpatients , SARS-CoV-2/drug effects , SARS-CoV-2/physiology , Single-Blind Method , Treatment Failure , Virus Shedding/drug effects , Young Adult
Emergency Medicine Reports ; 41(13), 2020.
Article in English | ProQuest Central | ID: covidwho-1130261


• Coronavirus disease 2019 (COVID-19) is caused by a coronavirus, which is responsible for diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), but also for the common cold. • Many patients with COVID-19 may be asymptomatic but capable of spreading the disease. Older patients and those with comorbidities are at risk for more severe disease and death. Healthcare workers tend to get more severe disease as well. • Children do not seem to be as susceptible to the disease, but there are reports of a Kawasaki-like illness associated with COVID. • To date, there is no effective treatment for the disease other than supportive care. • There are many different presentations of the disease, not just respiratory. Therefore, precautions should be taken to protect oneself during the pandemic.