Mayo Clinic proceedings
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Mayo Clinic proceedings · Nov 2020
Artificial Intelligence ECG to Detect Left Ventricular Dysfunction in COVID-19: A Case Series.
Coronavirus disease 2019 (COVID-19) can result in deterioration of cardiac function, which is associated with high mortality. A simple point-of-care diagnostic test to screen for ventricular dysfunction would be clinically useful to guide management. We sought to review the clinical experience with an artificial intelligence electrocardiogram (AI ECG) to screen for ventricular dysfunction in patients with documented COVID-19. ⋯ One other patient had a pre-existing EF less than or equal to 40%, accurately detected by the algorithm before and after COVID-19 diagnosis, and another was found to have a low EF by AI ECG and echocardiography with the COVID-19 diagnosis. The area under the curve for detection of EF less than or equal to 40% was 0.95. This case series suggests that the AI ECG, previously shown to detect ventricular dysfunction in a large general population, may be useful as a screening tool for the detection of cardiac dysfunction in patients with COVID-19.
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Mayo Clinic proceedings · Nov 2020
ReviewRecognizing Axial Spondyloarthritis: A Guide for Primary Care.
Axial spondyloarthritis (axSpA) is an important cause of chronic low back pain and affects approximately 1% of the US population. The back pain associated with axSpA has a characteristic pattern referred to as inflammatory back pain (IBP). Features of IBP include insidious onset before age 45 years, association with morning stiffness, improvement with exercise but not rest, alternating buttock pain, and good response to treatment with nonsteroidal anti-inflammatory drugs. ⋯ No date range was formally selected, as we were interested in providing an overview of the evolution of these concepts in clinical practice. We supplemented the review with insights based on our clinical expertise. Patients with chronic back pain should be screened for IBP and other SpA features; suspicion for axSpA should trigger referral to a rheumatologist for further evaluation.
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Mayo Clinic proceedings · Nov 2020
Multicenter StudyGM-CSF Neutralization With Lenzilumab in Severe COVID-19 Pneumonia: A Case-Cohort Study.
To assess the efficacy and safety of lenzilumab in patients with severe coronavirus disease 2019 (COVID-19) pneumonia. ⋯ In high-risk COVID-19 patients with severe pneumonia, granulocyte-macrophage colony-stimulating factor neutralization with lenzilumab was safe and associated with faster improvement in clinical outcomes, including oxygenation, and greater reductions in inflammatory markers compared with a matched control cohort of patients hospitalized with severe COVID-19 pneumonia. A randomized, placebo-controlled clinical trial to validate these findings is ongoing (NCT04351152).
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Mayo Clinic proceedings · Nov 2020
Observational StudyImpact of the SARS-CoV-2 Pandemic on Emergency Department Presentations in an Integrated Health System.
To quantify the impact of the severe acute respiratory syndrome coronavirus 2 pandemic on emergency department volumes and patient presentations and evaluate changes in community mortality for the purpose of characterizing new patterns of emergency care use. ⋯ Fewer patients presenting with acute and time-sensitive diagnoses suggests that patients are deferring care. This may be further supported by an increase in out-of-hospital mortality. Understanding which patients are deferring care and why will allow us to develop outreach strategies and ensure that those in need of rapid assessment and treatment will do so, preventing downstream morbidity and mortality.