Becker's Hospital Review

42 CMO / CARE DELIVERY Inflammation, not coronavirus, may be behind loss of smell: Johns Hopkins By Mackenzie Bean L oss of smell from COVID-19 may be a consequence of inflammation caused by the infection, versus a direct outcome from the virus itself, according to a study published April 11 in JAMA Neurology. A team led by researchers at Baltimore-based Johns Hopkins Medicine analyzed brain tissue samples tak- en from the olfactory bulb of 23 people who died of COVID-19 and 14 who died of other causes. Three of the 23 people with COVID-19 lost their sense of smell, four lost some ability to smell and two lost both their sense of smell and taste. People with COVID-19 had more severe vascular inju- ry and fewer axons in the olfactory bulb, the part of the brain responsible for transmitting neural input about odors. This trend was consistent even after researchers controlled for age. While researchers found more nerve and vascular dam- age among people with COVID-19, most of their tissue samples did not contain SARS-CoV-2 virus particles. "Previous investigations that only relied on routine pathological examinations of tissue — and not the in- depth and ultrafine analyses we conducted — surmised that viral infection of the olfactory neurons and olfactory bulb might play a role in loss of smell associated with COVID-19," lead author Cheng-Ying Ho, MD, PhD, asso- ciate professor of pathology at Johns Hopkins University School of Medicine, said in a news release. "But our find- ings suggest that SARS-CoV-2 infection of the olfactory epithelium leads to inflammation, which in turn, damages the neurons, reduces the numbers of axons available to send signals to the brain and results in the olfactory bulb becoming dysfunctional." n 29 physician specialties ranked by annual compensation By Kelly Gooch P hysician income rebounded toward the end of last year as routine patient care returned, with primary care phy- sicians earning an average annual compen- sation of $260,000 and specialists earning an average of $368,000, according to Medscape's "Physician Compensation Report 2022." at compares to $242,000 for primary care physicians and $344,000 for specialists in the 2021 report. "Compensation for most physicians is trend- ing back up as demand for physicians accel- erates," James Taylor, COO of AMN Health- care's leadership solutions division, said in Medscape's 2022 report. "At the height of the pandemic in 2020, Merritt Hawkins saw a 30 percent decrease in client physician recruit- ing engagements year over year. But in the fourth quarter of 2021, physician recruitment engagements hit an all-time high. e market for physicians has done a complete 180 over just seven or eight months." For its report, Medscape collected responses from 13,000 physicians across 29 specialties from Oct. 5, 2021-Jan. 19, 2022. e following is annual physician compen- sation by specialty with the percent changes from the 2021 edition of the Medscape report, which is based on data collected from Oct. 6, 2020-Feb. 11, 2021. is report reflects sal- ary, bonus and profit-sharing contributions for employed physicians, and earnings aer taxes and pre-income tax deductible business expenses for self-employed physicians. Only full-time salaries are used in calculations and percentages are rounded. 1. Plastic surgery: $576,000 (10 percent increase) 2. Orthopedics: $557,000 (9 percent increase) 3. Cardiology: $490,000 (7 percent increase) 4. Otolaryngology: $469,000 (12 percent increase) 5. Urology: $461,000 (8 percent increase) 6. Gastroenterology: $453,000 (12 percent increase) 7. Dermatology: $438,000 (11 percent increase) 8. Radiology: $437,000 (6 percent increase) 9. Ophthalmology: $417,000 (10 percent increase) 10. Oncology: $411,000 (2 percent increase) 11. Anesthesiology: $405,000 (7 percent increase) 12. Surgery, general: $402,000 (8 percent increase) 13. Emergency medicine: $373,000 (5 percent increase) 14. Critical care: $369,000 (1 percent increase) 15. Pulmonary medicine: $353,000 (6 percent increase) 16. OB-GYN: $336,000 (8 percent increase) 17. Pathology: $334,000 (6 percent increase) 18. Nephrology: $329,000 (6 percent increase) 19. Physical medicine and rehabilitation: $322,000 (7 percent increase) 20. Neurology: $301,000 (4 percent increase) 21. Allergy and immunology: $298,000 (9 percent increase) 22. Rheumatology: $289,000 (5 percent increase) 23. Psychiatry: $287,000 (4 percent increase) 24. Internal medicine: $264,000 (6 percent increase) 25. Infectious diseases: $260,000 (6 percent increase) 26. Diabetes and endocrinology: $257,000 (5 percent increase) 27. Family medicine: $255,000 (8 percent increase) 28. Pediatrics: $244,000 (10 percent increase) 29. Public health and preventive medicine: $243,000 (3 percent increase) n

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