COVID-19 Update: Guillain-Barré, States Quarantining Visitors

Rabiya S. Tuma, PhD

June 24, 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:

First US Case of Guillain-Barré Tied to COVID-19

Neurologists in Pennsylvania have reported the first official case of Guillain-Barré syndrome (GBS) associated with COVID-19. The case, in a 54-year old man, resembles those previously reported in China and Italy.

The US patient's symptoms of GBS reportedly occurred within days of being infected with SARS-CoV-2. "This onset is similar to a case report of acute Zika virus infection with concurrent GBS suggesting a parainfectious complication," the researchers write in the Journal of Clinical Neuromuscular Disease.

"Although the number of documented cases internationally is notably small to date, it's not completely surprising that a COVID-19 diagnosis may lead to a patient developing GBS. The increase of inflammation and inflammatory cells caused by the infection may trigger an irregular immune response that leads to the hallmark symptoms of this neurological disorder," the first author said in a news release.

Out-of-State Visitors Face Quarantines

The governors of New York, New Jersey, and Connecticut announced on Wednesday that they would require visitors from states with high coronavirus infection rates to self-quarantine for 14 days upon arrival.

The three states have asked hotels to communicate the restrictions to guests who arrive from high-rate states, which currently include Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Texas, Utah, and Washington.

"In New York we went from the highest number of cases to some of the lowest rates in the country ― no one else had to bend the curve as much as we did, and now we have to make sure that the rate continues to drop in our entire region," Governor Cuomo said in a press conference.

Moving forward, the travel restrictions will apply to visitors from any state that has an infection rate higher than 10 per 100,000 residents over a 7-day rolling average or a state with a 10% or higher positivity rate over a 7-day rolling average.

Metformin May Lower Risk for Death

Women who take the diabetes medication metformin may have a reduced risk for death from COVID-19, according to a study preprint posted this week.

The data, which have not yet been peer reviewed, showed that among more than 6200 adults with diabetes or obesity who were hospitalized with COVID-19, women who had filled prescriptions for metformin were less likely to die than those not taking the medicine.

The researchers did not see a similar benefit among men in the study.

10,000 Excess Cancer Deaths

A new model from the National Cancer Institute (NCI) predicts that tens of thousands of excess cancer deaths will occur over the next decade as a result of missed screenings, delays in diagnosis, and reductions in oncology care caused by the COVID-19 pandemic.

"As director of NCI, I am deeply concerned about the potential impacts of delayed diagnoses and deferred or modified treatment plans on cancer incidence and mortality," said Norman "Ned" Sharpless, MD.

Inside a Hospital Ship Mission

When Los Angeles was heading for a major spike in COVID-19 cases earlier this spring, the US Navy sent the hospital ship Mercy to care for non–COVID-19 patients.

"We normally do partnerships abroad and respond to tsunamis and earthquakes," Commander Erin Blevins said. "This was a slight change in situation, but still disaster relief in the form of a pandemic."

Captain John Rotruck, MD, an anesthesiologist who is commanding officer of Mercy's medical treatment facility, said, "We did adjust to make sure that we had the right staffing mix to meet the parameters that we were assigned. That was the crux of the change: a change in flavors of staffing to ensure that we focused on ICU and ward medical care as opposed to very heavy surgical care in support of a combat operation."

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 for infection. More than 1500 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.

Rabiya S. Tuma, PhD, is an executive editor with Medscape Medical News. She has covered science and medicine for a variety of publications, including The Economist and The Journal of the National Cancer Institute. She can be reached at rtuma@medscape.net.

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