Below please find link(s) to new coronavirus-related content published today in Annals of Internal Medicine. All coronavirus-related content published in Annals of Internal Medicine is free to the public. A complete collection is available at https://annals.org/aim/pages/coronavirus-content.
1. NFL employee and player surveillance program enabled early detection of COVID-19, even among those who were asymptomatic
Free full text: https://www.acpjournals.org/doi/10.7326/M21-0319
Frequent, routine testing within the National Football League (NFL) enabled early detection of COVID-19 infection among players and employees, even among those who were asymptomatic. The study is among the first to summarize the use of daily testing for COVID-19 surveillance. A brief research report is published in Annals of Internal Medicine.
Researchers from the NFL and IQVIA studied results for more than 600,000 tests administered to over 11,600 NFL players and staff during the 2020 football season to describe results of a rigorous, large-scale COVID-19 testing and monitoring program. Testing was conducted daily using 2 reverse transcription polymerase chain reaction (RT-PCR) platforms: a transcription mediated amplification platform, and an antigen point-of-care. Test results were reported as "positive," "negative," "presumptive positive," or "inconclusive." Cycle thresholds (Cts), which can approximate viral load, were reported where possible. In addition to routine testing, the Program included ongoing player and staff education, physical distancing and masking requirements, environmental disinfection, and contact tracing protocols to decrease risk for transmission.
That data showed that overall, frequent RT-PCR surveillance allowed for detection of new infections, including those early in the clinical course and patients who were not experiencing symptoms at the time of testing. Quantitative values proved useful for understanding test results, with Ct values signaling early infection. The researchers noted that antigen POC testing was unable to reliably rule out COVID-19 early in infection.
According to the authors, these findings may be used to inform understanding and development of population-level SARS-CoV-2 testing and surveillance strategies to mitigate spread of the virus.
Media contacts: A PDF for this article is not yet available. Please click the link to read full text. For more information or to speak with the corresponding authors, please contact Megan Grant at Megan.Grant@nfl.com.
2. Vaccination rates in urban hospital less than ideal, especially among Black and Hispanic employees
Free full text: https://www.acpjournals.org/doi/10.7326/M21-1513
A brief research report found that vaccination rates of health care system employees during the COVID-19 pandemic were less than ideal, particularly among Black and Hispanic people. Understanding SARS-CoV-2 vaccination among health care workers is important because they are at high risk for occupational exposure and may be convincing advocates for vaccination among their patients. The findings are published in Annals of Internal Medicine.
Researchers from The MetroHealth System and Case Western Reserve University studied health records for more than 7,800 employees in an urban safety-net hospital system to determine the relationship between social and demographic characteristics of health care workers and receipt of vaccination. They found sizeable disparities in vaccination rates by race/ethnicity and occupational category. Adjusted probability of vaccination among Black employees was approximately 30% and about 55% among Hispanics. This rate was highest among Asian employees at about 68% and about 65% among Whites. Physicians, dentists, and psychologists had the highest rate of vaccination (81%), while nurses (54%) and facilities staff had the lowest (35%).
According to the researchers, these findings are concerning given the high burden of COVID-19 affecting in Black and Hispanic communities. The low vaccination rate among nurses was also deemed concerning given their higher rate of occupational exposure to SARS-CoV-2 and likely higher risk for death due to COVID-19. Understanding SARS-CoV-2 vaccination among health care workers is important because they are at high risk for occupational exposure and may be convincing advocates for vaccination among their patients. Barriers to vaccination cannot explain low uptake, as availability, efficacy, and safety of the vaccines were widely publicized to all employees by e-mail, intranet, flyers posted on bulletin boards, and word of mouth and vaccination scheduling could occur at any time via patient portal or by telephone. These findings suggest that more must be done to understand and overcome barriers to vaccination among health care employees and especially for Black and Hispanic populations.
Media contacts: A PDF for this article is not yet available. Please click the link to read full text. To speak with the corresponding author, J. Daryl Thornton, MD, MPH, please contact Dorsena Drakeford at ddrakeford@metrohealth.org.
3. Medicalized hotels a safe alternative to conventional hospitals for patients with noncritical COVID-19 infection
Free full text: https://www.acpjournals.org/doi/10.7326/M21-1873
A team of researchers from Hospital Clinic de Barcelona (HCB) found that medicalized hotels are a safe alternative to conventional hospitals for patients with noncritical COVID-19 infection. Their brief research report is published in Annals of Internal Medicine.
During the first wave of the pandemic in Barcelona, the Catalonia Plaza Hotel in Barcelona was medicalized to provide hospital-level care to patients with COVID-19. Staff from different HCB departments were recruited to work in the hotel hospital (HH). From March to May 2020, 2,410 patients with COVID-19 were admitted to HCB and about one fifth of those patients were transferred to the HH. The cumulative median length of stay was 15 days for the HCB and HH combined and 9 days for the HH. Just over 5% of the patients in the HH required transfer back to HCB because of clinical deterioration or other medical complications and 2 of those patients died.
According to the researchers, these finding suggest that medicalized hotels can be used to reduce pressure on hospitals, allowing them to be used for patients who are more complex and critically ill. Their report provides preliminary guidance on how to adapt of hotels for medical use and how to determine admission criteria for selecting appropriate patients.
Media contacts: A PDF for this article is not yet available. Please click the link to read full text. To speak with the corresponding author, David Nicolás, MD, PhD, please contact HCB PR at premsa@clinic.cat or Ms. Núria Boutin nboutin@clinic.cat.
4. NIH panel discusses lessons learned from developing treatment guidelines during a pandemic health crisis
Free full text: https://www.acpjournals.org/doi/10.7326/M21-1647
In March 2020, the White House Coronavirus Task Force, through the Secretary of Health
and Human Services, asked the National Institutes of Health (NIH) to develop evidence-based
guidelines for the treatment of patients with COVID-19. In a new commentary published in Annals of Internal Medicine, members of the National Institutes of Health COVID-19 Treatment Guidelines Panel discuss the important lessons the process has provided for responding to an unprecedented public health emergency.
Media contacts: A PDF for this article is not yet available. Please click the link to read full text. To speak with the corresponding authors, Safia Kuriakose, PharmD, and Kanal Singh, MD, MPH, please contact the NIAID Office of Communications and Government Relations at 301-402-1663 or niaidnews@niaid.nih.gov.