Becker's Clinical Quality & Infection Control

37 QUALITY IMPROVEMENT & MEASUREMENT Johns Hopkins creates COVID-19 death risk calculator By Jackie Drees B altimore-based Johns Hopkins Univer- sity researchers developed an online calculator that estimates the individ- ual and community-level risk of dying of COVID-19, which could help officials priori- tize groups for vaccination. Public health researchers used information from existing large studies to estimate the risk of COVID-19 mortality for individuals based on age, gender, sociodemographic factors and medical history. An algorithm then esti- mates the risk for individuals in the general population who are currently uninfected as well as factors associated with risk of future infection and complications after infection. The calculator, published Dec. 11, is avail- able online and updated weekly. Users can see how factors such as age, sex and race/ ethnicity can be used to identify the risk of COVID-19 mortality for a specific community, corporation or group. By combining data on individual-level factors with community-level pandemic dynamics, the tool can be useful in setting priorities for distributing early COVID-19 vaccines and other scarce preventive resources such as certain personal protective equipment, the researchers said. n Arthritis drugs may reduce deaths for severely ill COVID-19 patients, study finds By Mackenzie Bean T he use of two arthritis drugs may lower the death rate for severely ill COVID-19 patients, according to research published Jan. 7 in the medical preprint server medRXiv. For the study, which has not been peer-reviewed, researchers from Imperial College London examined the outcomes of 803 COVID-19 patients who required intensive care. About half of the patients received either the arthritis drug tocilizumab or sarilumab, while the other half received standard care. e death rate for patients who received tocilizumab or sarilumab was 27 percent, compared to 36 percent for patients in the control group. Patients who took the arthritis drugs were able to discontinue use of certain machines and medications needed to support lung or heart health sooner and were discharged a few days earlier than patients who did not receive the medications, reported e New York Times. e study's findings contradict numerous clinical trials, which found arthritis drugs did not benefit COVID-19 patients, including those from Sanofi and Novartis.e new findings spurred Britain on Jan. 8 to issue new guidance for healthcare providers to use the two arthritis drugs for severely ill patients, reported the Times. While some scientists not involved with the study have called the find- ings promising, others have taken a more cautious approach. "I guess I would interpret with caution until this was published in a peer-reviewed journal," Lauren Henderson, MD, a rheumatologist at Boston Children's Hospital, told the Times. n When Black physicians care for Black babies, death rate drops sharply By Iain Carlos A n analysis of 1.8 million hospital births in Florida between 1992 and 2015 found the Black infant mortality rate was cut in half when Black infants were cared for by Black physicians, The Washington Post reported Jan. 13. "It is the first empirical evidence to describe the impact of the physi- cian's race on an outcome such as infant mortality," Rachel Hardeman, PhD, one of the researchers and an associate professor at the Universi- ty of Minnesota School of Public Health in Minneapolis, told the Post. The researchers said open questions remain about their findings, reported the Post, including: • If physician race proxies for differences in physician practice behavior • Which differences in practice are being influenced by the race of the physician • What policymakers and those in the healthcare industry should do to ensure optimal care for all newborns By race, Black infants have the highest infant mortality rate, at around 10.8 deaths per 1,000 live births, compared to a white infant mortality rate of 4.6 per 1,000, according to the CDC. Only 5 percent of physicians identify as Black and 4.9 percent of pedi- atricians do, reported the Post. "We hope this study provides a basis for additional work that advanc- es our understanding of inequality, its origins and how practitioners can work toward creating better and more-equitable birth outcomes," wrote the researchers. n

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