Becker's Clinical Quality & Infection Control

32 QUALITY IMPROVEMENT & MEASUREMENT Physician viewpoint: What sepsis can teach us about COVID-19 recovery By Mackenzie Bean B est practices for sepsis care and recovery offer physicians numerous lessons to promote quicker recoveries for patients with severe COVID-19 cases, two physicians wrote in an op-ed published in JAMA. e op-ed's authors are: • Hallie Prescott, MD, associate professor of pulmo- nary and critical care medicine at the University of Michigan in Ann Arbor • Timothy Girard, MD, associate professor of critical care medicine at the University of Pittsburgh School of Medicine Up to one-fih of patients hospitalized with COVID-19 develop severe cases, which may entail viral sepsis or acute respiratory distress syndrome, Drs. Prescott and Girard said. "Given that the acute manifestations of severe COVID-19 are similar in many ways to those of sepsis in general, sur- vivors of severe COVID-19 are anticipated to experience similar challenges as other sepsis survivors," they said. Research shows sepsis survivors face several long-term issues related to the condition, including post traumatic stress disorder, pulmonary dysfunction and decreased quality of life from health issues. Researchers said patients who have survived COVID-19 may experience issues even more severe than those of sepsis patients since the pan- demic has interrupted normal healthcare practices. Intensive care unit physicians can prevent some of these adverse outcomes by "prioritizing sedation minimization, daily breathing trials, early mobility and other evi- dence-based practices," the authors wrote. ey acknowl- edged that some of these practices, which require a lot of time and clinical coordination, may not always be feasible for overwhelmed ICUs. e authors also said patients who develop viral sepsis from COVID-19 may benefit from the following care recommendations: • Anticipatory guidance about potential new problems • Screening for new impairments at hospital discharge and early outpatient follow-up • Anticipation and mitigation of risk for common and preventable health deterioration • Medication optimization and referral or instructions for a structured exercise program n Down syndrome linked to 10 times higher COVID-19 death risk, UK study finds By Erica Carbajal A dults with Down syndrome are 10 times more likely to die from COVID-19 and about five times more likely to be hospitalized from the virus, according to a study pub- lished in Annals of Internal Medicine. Researchers analyzed data on more than 8 million adults, of which 4,053 had Down syndrome. Researchers evaluated whether health issues associated with Down syndrome — includ- ing immune dysfunction, congenital heart disease and pulmo- nary pathology — may make the condition a risk factor for severe COVID-19 cases. Out of the 4,053 adults with Down syndrome, 68 died between Jan. 24 and June 30. About 40 percent of deaths were tied to COVID-19, 25 percent were due to pneumonia or pneumonitis and 35 percent were from other causes. A total of 41,685 adults without Down syndrome died during the study period, with 20.3 percent of deaths related to COVID-19. The findings may inform policy and motivate further investiga- tion, as the CDC does not currently list Down syndrome as a risk factor for COVID-19, the study authors said. "Novel evidence that specific conditions may confer elevated risk should be used by public health organizations, policymak- ers and healthcare workers to strategically protect vulnerable individuals," they concluded. n Boston Children's Hospital ends 2 intersex surgeries By Gabrielle Masson B oston Children's Hospital will no longer perform two types of genital surgeries on intersex children if they are too young to meaningfully consent, reported The 19th News. The hospital "will not perform clitoroplasty or vaginoplasty in patients who are too young to participate in a meaningful dis- cussion of the implications of these surgeries, unless anatomical differences threaten the physical health of the child," a hospital spokesperson told The 19th. Boston Children's decision could reflect a turning point, activists said. It comes on the heels of a similar move by Chicago-based Ann and Robert H. Lurie Children's Hospital, which said in July it would be ending cosmetic surgies on intersex infants. "Now that there are two hospitals, people in the community are going to feel more ability to pressure their hospitals to do the same," said Pidgeon Pagonis, cofounder of the Intersex Justice Project. n

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