COVID-19 Daily: Critically Ill NYC Patients, Severe Disease in Kids

Ellie Kincaid

May 19, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Here are the coronavirus stories Medscape's editors around the globe think you need to know about today: 

Critically Ill NYC Patients

In the latest report of patient outcomes on the COVID-19 pandemic front lines, physicians from Columbia University Irving Medical Center and NewYork-Presbyterian Hospital in New York City detail the clinical characteristics of critically ill patients in a prospective observational cohort study published in the Lancet .

Out of 1150 adults admitted to two hospitals with laboratory-confirmed COVID-19, 257 (22%) were classified as critically ill with acute hypoxemic respiratory failure. Thirteen of the critically ill were healthcare workers. With a minimum of 28 days of follow-up, 101 patients had died and 94 remained hospitalized. A majority of the critically ill patients, 203, received invasive mechanical ventilation, and 79 received renal replacement therapy. 

Severe Disease in Kids

More new data shed light on how children with COVID-19 fare. Children and young adults in all age groups can develop severe illness after SARS-CoV-2 infection, but the oldest and youngest appear more often to be hospitalized and possibly critically ill, based on a retrospective cohort study of 177 pediatric patients seen at a single center published in the Journal of Pediatrics

Physicians from Children's National Hospital in Washington, DC, reviewed data from 44 hospitalized and 133 nonhospitalized children and young adults with COVID-19. Children aged less than 1 year and adolescents aged over 15 years each represented 32% of the 44 hospitalized patients, nine of which were critically ill.

Billing for Telephone vs Telemedicine Visits

The Centers for Medicare & Medicaid Services says it will now pay for telephone visits during the public health emergency at the same rate as for in-office visits. Expert Betsy Nicoletti, MS, explains how to code and bill these services properly during the pandemic.

Shutdown-Related Weight Gain

National reports from the American Heart Association and Mayo Clinic have raised concerns about weight gain as Americans have been confined to their homes and gyms, schools, and some parks have been closed as part of efforts to slow the spread of COVID-19. Results from a new WebMD reader poll find that, among the 1012 survey participants, about 47% of women said they gained weight "due to COVID restrictions." About 22% of men said they gained weight.

The Banana Peel of COVID-19 Research

So-called "collider bias" represents a major problem in many current studies that aim to determine the risk factors underlying COVID-19 infection and severity, according to Tim T. Morris, MSc, PhD, who works in the MRC Integrative Epidemiology Unit at the University of Bristol and the Bristol Medical School. He refers to it as "the big banana peel that a lot of studies may be slipping on." 

"Unlike many of the biases that we tend to be well aware of, such as confounding and generalizability bias, collider bias is quite unintuitive," Morris writes in a Medscape column explaining the concept

COVID-19 Critical Illness Prediction Calculator 

A new calculator on the Medscape app and at QxMD produces a clinical risk score to predict critical illness in hospitalized COVID-19 patients. 

In Memoriam

As front-line healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. More than 1000 throughout the world have died. 

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form

Ellie Kincaid is Medscape's associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine.

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