Becker's Clinical Quality & Infection Control

25 PATIENT SAFETY & OUTCOMES Why some COVID-19 patients suffer from low oxygen levels: 4 study findings By Gabrielle Masson S ARS-CoV-2, the virus that causes COVID-19, infects immature red blood cells, reducing oxygen in the blood and hindering immune response, according to a study published May 11 in Stem Cell Reports. Researchers at Canada-based Universi- ty of Alberta examined the blood of 128 COVID-19 patients, including critically ill individuals admitted to intensive care, those who were hospitalized with moderate symp- toms, and those who had milder symptoms who only spent a few hours in the hospital. Four key findings: 1. The researchers found that, as the disease became more severe, more immature red blood cells flooded blood circulation, sometimes accounting for up to 60 percent of total cells in the blood. By comparison, immature red blood cells account for less than 1 percent, or none at all, in a healthy individual's blood. The problem is that immature red blood cells do not transport oxygen. 2. "Immature red blood cells reside in the bone marrow and we do not normally see them in blood circulation," Shokrollah Elahi, MD, PhD, study lead and associate professor at the university, told Troy Media. "is in- dicates that the virus is impacting the source of these cells. As a result, and to compensate for the depletion of healthy immature red blood cells, the body is producing signifi- cantly more of them in order to provide enough oxygen for the body." 3. Immature red blood cells are highly susceptible to COVID-19 infection. As im- mature red blood cells are destroyed by the virus, the body is unable to replace mature red blood cells, and the ability to transport oxygen in the bloodstream is impaired. "We have demonstrated that more immature red blood cells mean a weaker immune response against the virus," Dr. Elahi said. 4. Dr. Elahi's team also tested various drugs to see whether they could reduce immature red blood cells' susceptibility to the virus. "We tried the anti-inflammatory drug dexameth- asone, which we knew helped to reduce mortality and the duration of the disease in COVID-19 patients, and we found a signifi- cant reduction in the infection of immature red blood cells," Dr. Elahi said. "So we are not repurposing or introducing a new medication; we are providing a mechanism that explains why patients benefit from the drug." n COVID-19 in kids tied to more complications than flu By Erica Carbajal C ompared to the flu, kids with a COVID-19 infection face a higher risk for hospitalization and pneumonia, among other complications, according to a study published May 28 in Pediatrics. Researchers compared 30-day outcomes of 242,158 children aged 18 and younger diagnosed with COVID-19 to those of 2,084,180 children who had the flu between 2017-18. The in- ternational study included data from the U.S., France, Germa- ny, Spain and South Korea. Four percent of the COVID-19 cohort were hospitalized. Overall, asthma was the most common comorbidity among the group, with about 28 percent of U.S. patients with the condition. In most databases, hospitalizations were higher among COVID-19 patients. For example, in one of the U.S. databases, the hospitalization rate for COVID-19 patients was 33.2 per- cent compared to 7.4 percent among those with the flu. Researchers also compared the 30-day outcomes for death, pneu- monia and multisystem inflammatory syndrome in children. "Overall, all outcomes were more frequent in children/ad- olescents with COVID-19 diagnosis than those with a diag- nosis of seasonal influenza in 2018, suggesting more severe disease prognosis in children with COVID-19 than influenza," the study said. n Healthgrades recognizes 870 hospitals for patient safety, experience excellence By Mackenzie Bean H ealthgrades has identified 870 hospitals as the recipients of its 2021 Patient Safety Excellence Award and Outstanding Patient Experience Award, the organization said May 11. Healthgrades awarded 453 hospitals with its patient safety award for their excellent clinical outcomes among its Medicare population. To determine the recipients, Healthgrades assessed hospitals' 2017-19 outcomes for 14 patient safety indi- cators defined by the Agency for Healthcare Research and Quality. If all U.S. hospitals performed similarly to award winners, an average of 53,624 safety events could have been avoided, Healthgrades found. The organization also recognized 417 hospitals with its 2021 Outstanding Patient Experience Award. The winners were selected from a pool of 3,297 hospitals that submitted at least 100 patient experience surveys to CMS for admissions between January 2019 and December 2019. n

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