COVID-19 Update: NEJM, Lancet Studies Retracted; A Look at One Key Author

Ryan Syrek, MA

June 04, 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: 

Two Journal Studies Retracted

Authors of a hydroxychloroquine (HCQ) analysis published in The Lancet and a cardiovascular disease study in the New England Journal of Medicine (NEJM) have retracted both studies. The researchers cited concerns related to the integrity of the information provided by the Surgisphere Corporation. After independent reviewers were unable to validate key data from the company to confirm the studies' findings, the authors requested the retractions.

These retractions came shortly after major journals had raised concern about the Surgisphere database underlying the studies. The founder of that company, Sapan S. Desai, MD, PhD, was a coauthor on both papers. Medscape investigated Desai’s publication history and found several warnings against research misconduct as well as multiple specialty-focused registry studies.

Meanwhile, findings from a separate study also in NEJM that did not use the Surgisphere database shows that HCQ failed to reduce the risk for infection in people exposed to patients with confirmed COVID-19. The trial included 821 patients from multiple sites in the United States and Canada. Results indicated that the incidence of new illness compatible with COVID-19 did not differ significantly between those who received HCQ and those who received placebo.

Ibuprofen Investigated as COVID-19 Treatment

Researchers in London have begun clinical testing to determine whether ibuprofen is a viable treatment for patients hospitalized with COVID-19. The trial will use "lipid ibuprofen," which is different than the over-the-counter pain relief tablets.

The hope is that this formulation, which dissolves ibuprofen into fat, will help keep hospitalized patients from requiring mechanical ventilation. The trial will evaluate how three doses of the drug affects disease progression, length of critical care stay, length of hospital stay, and overall survival from COVID-19.

Convalescent Plasma in COVID-19 Effective, Safe

A small, peer-reviewed study found that convalescent plasma was safe and effective in 19 of 25 (76%) of patients with severe COVID-19. The treatment involves infusing patients with plasma from those who have developed antibodies after recovering from COVID-19. Patients in the study ranged in age from 19 to 77 years.

Clinical improvement was gauged on a modified World Health Organization six-point scale, with nine patients demonstrating at least a one-point improvement in clinical status at day 7 post transfusion. No major safety concerns were reported.

ED Visits Down More Than 40% During Pandemic

A new report from the Centers of Disease Control and Prevention (CDC) found that emergency department (ED) visits were down by 42% during a 4-week period early in the COVID-19 pandemic. Compared with the same time period in 2019, visits from March 29 to April 25 of this year declined from a weekly mean of nearly 2.2 million to just over 1.2 million.

As expected, the proportion of patients presenting to the ED for infectious disease-related reasons was significantly higher, as were visits for lower respiratory diseases (not including influenza, asthma, or bronchitis), cardiac arrest and ventricular fibrillation, and pneumonia not caused by tuberculosis.

COVID-19 and the Rise of Pseudoscience

A new commentary argues that opinion-based medicine is on the rise thanks to COVID-19. From supplements to unproven therapies, anecdotes may be driving medical behaviors as much as validated scientific information, worries Harpreet S. Bajaj, MD, MPH.

Afraid of preventable injuries and deaths, Bajaj calls on the scientific and medical community to "douse this raging fire of pseudoscience" by raising their voices, countering misinformation, and even exploring legal action.

Sex and Gender Differences in COVID-19

From infection rates to case fatalities, researchers have found numerous differences between men and women affected by COVID-19. JoAnn Manson, MD, DrPH, considers what these findings may mean.

She concludes that both biological and behavioral/sociocultural factors may be at work. Manson urges researchers to consider these sex and gender-based differences when pursuing the development of treatment and prevention strategies.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk of 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

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Ryan Syrek, MA, is the section editor for Medical Student and Resident content at Medscape.

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