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 should diabetes be managed in patients who choose to fast during Ramadan?

L’Essentiel

These expert-derived guidelines are updated from <a href="https://www.essentialevidenceplus.com/content/poem/71256">earlier recommendations</a> for managing diabetes in Muslim patients who desire to fast during Ramadan. The updated guidelines focus on newer hypoglycemic agents and management during the COVID-19 pandemic. See the paper for more details. 5

Référence

Hanif S, Ali SN, Hassanein M, Khunti K, Hanif W. Managing people with diabetes fasting for Ramadan during the COVID-19 pandemic: A South Asian Health Foundation update. Diabetic Med 2020;37(7):1094-1102.

Question clinique

Does use of angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) increase the likelihood or severity of COVID-19 infection?

L’Essentiel

This large and well-conducted Italian case-control study found no association between the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and either infection or severe illness with COVID-19. <a href="https://www.nejm.org/doi/10.1056/NEJMoa2008975">Another study</a> in the same issue of the journal used data from New York City and came to the same conclusions. 3b

Référence

Mancia G, Rea F, Ludergani M, Apolone G, Corrao G. Renin-angiotensin-aldosterone system blockers and the risk of COVID-19. N Engl J Med 2020;382(25):2431-2440.

Question clinique

Can patient-collected swabs accurately detect the presence of SARS-CoV-2? What symptoms and laboratory findings are common in patients with COVID-19?

L’Essentiel

Self-collected swabs are accurate in detecting SARS-CoV-2 in ambulatory settings. Fever, cough, elevated C-reactive protein levels, and ground glass opacities are common in patients with COVID-19 in China. 2c

Référence

Tu YP, Jennings R, Hart B, et al. Swabs collected by patients or health care workers for SARS-CoV-2 Testing. N Engl J Med. Published online June 3, 2020. doi: 10.1056/NEJMc2016321 Fu L, Wang B, Yuan T, et al. Clinical characteristics of coronavirus disease 2019 (COVID-19) in China: A systematic review and meta-analysis. J Infect 2020;80(6):656-665.

Auteur(s)

Henry C. Barry, MD, MS

Question clinique

Can corticosteroids reduce mortality in hospitalized patients with COVID-19 who require oxygen or ventilation? Can postexposure prophylaxis with hydroxychloroquine improve outcomes?

L’Essentiel

Corticosteroids reduce mortality in hospitalized patients with COVID-19 who require oxygen or ventilatory support. In healthy people, postexposure prophylaxis with hydroxychloroquine is not effective. 2c

Référence

Boulware DR, Pullen MF, Bangdiwala AS, et al. A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. N Engl J Med. Published online June 3, 2020. doi: 10.1056/NEJMoa2016638

Auteur(s)

Mark H. Ebell, MD, MS

Question clinique

Is remdesivir safe and effective for the treatment of COVID-19?

L’Essentiel

Remdesivir provides a clinically and statistically significant reduction in the duration of symptoms of COVID-19. Questions remain regarding its effects on mortality and on patients who have advanced disease that requires mechanical ventilation or extracorporeal membrane oxygenation (ECMO). 1b

Référence

Beigel JH, Tomashek KM, Dodd LE, et al, for the ACTT-1 Study Group Members. Remdesivir for the treatment of Covid-19: preliminary report. N Engl J Med 2020; DOI: 10.1056/NEJMoa2007764

Auteur(s)

Mark H. Ebell, MD, MS

Question clinique

Can remdesivir improve outcomes in people with COVID-19?

L’Essentiel

Remdesivir shortens recovery time in hospitalized patients with COVID-19 and lower respiratory tract infections (ACTT-1). 4

Référence

Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19 - Preliminary Report [published online ahead of print, 2020 May 22]. N Engl J Med. 2020;10.1056/NEJMoa2007764. doi:10.1056/NEJMoa2007764.

Auteur(s)

Henry C. Barry, MD, MS

Question clinique

How does 10-day compare with 5-day treatment with remdesivir in people with COVD-19?

L’Essentiel

Outcomes similar for 5 vs 10 days remdesivir but trial had flaws. 1b

Référence

Goldman JD, Lye DCB, Hui DS, et al. Remdesivir for 5 or 10 Days in Patients with Severe Covid-19 [published online ahead of print, 2020 May 27]. N Engl J Med. 2020;10.1056/NEJMoa2015301. doi:10.1056/NEJMoa201530.

Auteur(s)

Mark H. Ebell, MD, MS

Question clinique

Is mortality higher in Black people who develop COVID-19?

L’Essentiel

Adjusted in-hospital mortality from COVID-19 in Louisiana no different for Black and White patients. 2b

Référence

Price-Haywood EG, Burton J, Fort D, Seoane L. Hospitalization and Mortality among Black Patients and White Patients with Covid-19. N Engl J Med. 2020 May 27. doi: 10.1056/NEJMsa2011686. Epub ahead of printdoi:10.1001/jamanetworkopen.2020.11102.

Auteur(s)

John Hickner, MD, MS

Question clinique

Is risk of COVID-19-related mortality or morbidity higher in patients receiving biologic agents? Is convalescent plasma safe?

L’Essentiel

Patients taking biologic agents not at greater risk of poor outcomes. Patients receiving convalescent plasma have few transfusion-related serious adverse events. 4

Référence

Haberman R, Axelrad J, Chen A, et al. Covid-19 in Immune-Mediated Inflammatory Diseases - Case Series from New York [published online ahead of print, 2020 Apr 29]. N Engl J Med. 2020;NEJMc2009567. doi:10.1056/NEJMc2009567

Auteur(s)

Mark H. Ebell, MD, MS

Question clinique

Do stay-at-home orders or social distancing policies reduce the spread of COVID-19?

L’Essentiel

Retrospective data suggest that the implementation of stay-at-home and social distancing policies in US counties slowed the spread of COVID-19. 4

Référence

Lyu W, Wehby GL. Comparison of estimated rates of coronavirus disease 2019 (covid-19) in border counties in Iowa without a stay-at-home order and border counties in Illinois with a stay-at-home order. JAMA Netw Open. Published online May 1, 2020. doi:10.1001/jamanetworkopen.2020.11102.

Auteur(s)

John Hickner, 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.