COVID-19 Therapy Roundtable: Addressing Inpatient Clinical Care
In this week’s episode, of our COVID-19 Therapies roundtable, the panel discusses therapies and care for COVID-19 inpatients, focusing on mechanical ventilation, extracorporeal membrane oxygenation (ECMO), and remdesivir. Although hospitalizations have significantly decreased since the height of the pandemic, occasional waves of severe cases still require advanced interventions. ECMO, which was more commonly used when treatment options were limited, may still benefit certain patients, but treatment protocols have evolved. Remdesivir, an antiviral therapy, is now a standard part of treatment for severe inpatients, with evidence supporting its role in reducing mortality. Experts highlight how these therapies have adapted as new treatments and strategies have emerged in the fight against COVID-19.
FDA Grants Breakthrough Designation Status for Test for Patients with Suspected Sepsis
The FDA has granted breakthrough device designation (BDD) to MeMed’s MeMed Severity test, a rapid diagnostic tool designed to aid in the management of sepsis. The test, which provides results in under 15 minutes, uses host-response technology and machine learning to assess the risk of severe outcomes, such as organ failure or mortality, in patients with acute infections. This can significantly assist clinicians in emergency departments with triage and treatment decisions. Sepsis is a challenging condition to diagnose, and the MeMed Severity test aims to fill a critical gap by quickly identifying patients at high risk. Sepsis affects over 1.7 million Americans annually, with many experiencing life-threatening complications, including organ failure and death. The CDC continues to work on improving sepsis management, including the publication of its Hospital Sepsis Program Core Elements guideline and supporting the establishment of sepsis committees in hospitals.
VRE Colonization Linked to Higher Mortality in Sepsis Patients
A recent study in Infection Prevention in Practice found that colonization with vancomycin-resistant enterococci (VRE) is linked to higher mortality, as well as an increased need for mechanical ventilation and renal replacement therapy (RRT) in sepsis patients. Analyzing over 7,000 septic patients, the study revealed that VRE colonization was associated with a 7% higher mortality rate compared to non-colonized patients (26% vs. 19%). In contrast, methicillin-resistant Staphylococcus aureus (MRSA) colonization showed a smaller impact on mortality (4% higher), and Clostridioides difficile colonization did not significantly affect mortality. These findings emphasize the need for more research into how drug-resistant organisms like VRE impact sepsis outcomes.
Hepatitis C and Homelessness: Assessing Risk Factors
A new study published in JAMA Network highlights the high prevalence of Hepatitis C virus (HCV) among people experiencing homelessness (PEH) in Madrid, Spain. Of the 2,709 PEH screened, nearly half with HCV antibodies were found to have active infections. Key risk factors identified include injection drug use (IDU), lack of financial income, and alcohol misuse. Active HCV infection rates were significantly higher among those with a history of IDU, no financial income, and alcohol misuse. The study underscores the importance of targeted prevention policies and support systems to reduce HCV infection rates, especially through education and intervention in at-risk groups. In the US, the CDC reported over 4,800 new HCV cases in 2022, highlighting the ongoing public health challenge posed by the virus globally.
E coli Outbreak Linked to Iceberg and Romaine Lettuce Blend
A multistate outbreak of E coli O157:H7 infections has been linked to an iceberg and romaine lettuce blend served at catering events, restaurants, and schools. As of December 9, 2024, 69 cases have been reported across 10 states. The FDA’s traceback investigation has identified this lettuce blend as the source of the outbreak, although the affected product appears to be past its shelf life and is no longer available. E coli O157:H7 can cause severe foodborne illness, including bloody diarrhea and kidney failure, and antibiotics can worsen the condition. Vulnerable populations, including young children, the elderly, and immunocompromised individuals, are at higher risk for severe complications and should take extra precautions. The FDA continues to investigate the situation, and no current public health risk has been identified.
