Résumés de recherche sur la COVID-19 par Essential Evidence Plus (EE+)

Résumés de recherche sur la COVID-19 par Essential Evidence Plus (EE+)

Alors que la pandémie de COVID-19 continue d’évoluer, l’équipe de Joule travaille en étroite collaboration avec le Dr Mark Ebell, rédacteur en chef d’EE+ et avec l’équipe de la maison d’édition Wiley pour transmettre aux médecins les résumés de recherche les plus récents.

Les personnes abonnées à POEMs* recevront des résumés de recherche liés à la COVID-19 la plupart des fins de semaine et certains jours en semaine. Vous pouvez voir ces mises à jour ci-dessous, vous abonner pour recevoir des résumés de recherche POEMs quotidiens, consulter les archives de POEMs (connexion au compte amc.ca requise) pour commenter ces résumés ou obtenir des crédits de DPC, ou consulter la page Web d’Essential Evidence Plus consacrée à la COVID-19.

Essential Evidence Plus (EE+) offre un accès gratuit à des renseignements pertinents sur la COVID-19 pour aider les médecins à soigner les patients du monde entier. Les sujets liés aux Infections au Coronavirus SRAS-CoV-2 (COVID-19) sont mis à jour lorsqu’il y a de nouveaux développements.

Question clinique

How long do symptoms persist in patients who were hospitalized with COVID-19?

L’Essentiel

This study provides further evidence of the long-term persistence of COVID-19 symptoms. Approximately 30% of patients hospitalized with COVID-19 infection will have persistent symptoms for at least 60 days. 2c

Référence

Chopra V, Flanders SA, O'Malley M, Malani AN, Prescott HC. Sixty-day outcomes among patients hospitalized with COVID-19. Ann Intern Med. Published online November 11, 2020. doi: 10.7326/M20-5661.

Auteur(s)

John Hickner, MD, MS

Question clinique

Is fluvoxamine a promising treatment for COVID-19?

L’Essentiel

This small randomized trial finds some benefit with fluvoxamine in the treatment of COVID-19. 2b

Référence

Lenze EJ, Mattar C, Zorumski CF, et al. Fluvoxamine vs placebo and clinical deterioration in outpatients with symptomatic COVID-19: a randomized clinical trial. JAMA. Published online November 12, 2020. doi: 10.1001/jama.2020.22760.

Auteur(s)

Mark H. Ebell, MD, MS

Question clinique

What is the age-specific infection fatality ratio of COVID-19?

L’Essentiel

The infection fatality rate (IFR) of COVID-19 is lowest in patients aged 5 years to 9 years and is highest among those 80 years and older. 2c

Référence

O'Driscoll M, Dos Santos GR, Wang L, et al. Age-specific mortality and immunity patterns of SARS-CoV-2. Nature. Published online November 2, 2020. doi: 10.1038/s41586-020-2918-0.

Auteur(s)

Mark H. Ebell, MD, MS

Question clinique

Does working in health care increase the risk of being hospitalized with COVID-19?

L’Essentiel

Frontline health-care workers and their families are at an increased risk of hospitalization from COVID-19. 2c

Référence

Shah ASV, Wood R, Gribben C, et al. Risk of hospital admission with coronavirus disease 2019 in health care workers and their households: nationwide linkage cohort study. BMJ 2020;371:m3582.

Auteur(s)

Henry C. Barry, MD, MS

Question clinique

How has the case fatality ratio due to COVID-19 changed since March 2020?

L’Essentiel

The case fatality rate due to COVID-19 seems to be declining, but it's unclear whether this is caused by more testing, a demographic shift toward younger patients, or better treatment. 2c

Référence

Horwitz LI, Jones SA, Cerfolio RJ, et al. Trends in COVID-19 risk-adjusted mortality rates. J Hosp Med. Published online October 21, 2020. doi: 10.12788/jhm.3552.

Auteur(s)

Mark H. Ebell, MD, MS

Question clinique

What effect has COVID-19 had on mortality by age, race, and ethnicity in the United States between January 2020 and October 2020?

L’Essentiel

Since January 2020, the United States has experienced almost 300,000 more deaths than would otherwise have been expected. The largest percentage increases were seen among 25- to 44-year-old persons and among Hispanic persons. Only two-thirds of the excess deaths been classified as COVID-19 deaths, suggesting an undercounting of COVID-19 as a cause of death. 2c

Référence

Rossen LM, Branum AM, Ahmad FB, Sutton P, Anderson RN. Excess deaths associated with COVID-19, by age and race and ethnicity — United States, January 26–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69(42):1522-1527.

Auteur(s)

Henry C. Barry, MD, MS

Question clinique

Can tocilizumab improve symptoms in patients with COVID-19?

L’Essentiel

RCTs and observational studies of tociluzumab for patients with COVID-19 yield inconsistent results but, overall, results suggest it may not be effective. 2b

Référence

Parr JB. Time to reassess tocilizumab's role in COVID-19 pneumonia. JAMA Intern Med. Published online October 20, 2020. doi:10.1001/jamainternmed.2020.6557.

Auteur(s)

John Hickner, MD, MS

Question clinique

What effect has COVID-19 had on the mortality rate in the United States between March and August 2020?

L’Essentiel

Between March and August 2020, the United States has experienced 20% more deaths than otherwise would have been expected, two-thirds of which were directly attributed to COVID-19. 2c

Référence

Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L, Taylor DDH. Excess deaths from COVID-19 and other causes, March–July 2020. JAMA 2020 Oct 20;324(15):1562-1564.

Auteur(s)

Henry C. Barry, MD, MS

Question clinique

How long do COVID-19 symptoms persist in people with mild to moderate infection?

L’Essentiel

Symptoms (weight loss, severe dyspnea or asthenia/fatigue, chest pain, palpitations, anosmia/ageusia, headache, cutaneous signs, arthralgia, myalgia, digestive disorders, fever, or sick leave) persist at 60 days for two-thirds of people with mild to moderate COVID infection. 2c

Référence

Carvalho-Schneider C, Laurent E, Lemaignen A, et al. Follow-up of adults with non-critical COVID-19 two months after symptoms' onset. Clin Microbiol Infect 2020; S1198-743X (20)30606-6.

Auteur(s)

John Hickner, MD, MS

Question clinique

How effective are tests for diagnosing COVID-19?

L’Essentiel

The sensitivity of polymerase chain reaction for detection of COVID-19 declines rapidly over time; rapid antigen tests lack sensitivity for diagnosing COVID-19. 2a

Référence

Kucirka LM, Lauer SA, Laeyendecker O, Boon D, Lessler J. Variation in false-negative rate of reverse transcriptase polymerase chain reaction–based SARS-CoV-2 tests by time since exposure. Ann Intern Med 2020;173(4):262-267.

Auteur(s)

Mark H. Ebell, MD, MS

 

 

*Avertissement : L’abréviation « POEMs » vient de « Patient-Oriented Evidence that Matters » (données probantes et pertinentes axées sur les patients). Les POEMs sont publiés par John Wiley and Sons, Inc. et distribués par Joule comme service aux membres de l’AMC. Tous les éléments du contenu sont présentés à titre informatif et éducatif seulement et ne remplacent en rien les conseils d’un médecin. Joule se dégage de toute responsabilité civile ou légale découlant de toute erreur ou omission, ou de l’utilisation de tout renseignement contenu aux présentes.