Trending Clinical Topic: Pandemic

Ryan Syrek


March 20, 2020

Each week, we identify one top search term, speculate about what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, feel free to share them with us on Twitter or Facebook.

Once again, concerns and developments regarding the ongoing global spread of COVID-19 resulted in a top trending clinical topic. On March 11, the World Health Organization formally declared the COVID-19 outbreak a pandemic, the first such announcement for a coronavirus. WHO Director-General Tedros Adhanom Ghebreyesus reiterated the need for a comprehensive approach to the crisis, including isolation, testing, and treating of every case and tracing every contact, as well as preparing hospitals and healthcare professionals for the challenges to come.

One of the major concerns is the high mortality rate seen in certain individuals. A study published in The Lancet examined adult inpatients with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital who had been discharged or died by January 31. The review found that patients who did not survive hospitalization were more likely to be older and to have comorbidities and elevated D-dimer levels. Showing signs of sepsis on admission, comorbidities such as hypertension and diabetes, abnormal blood clotting, and the prolonged use of noninvasive ventilation were also important factors that contributed to increased mortality.

An editorial published in the New England Journal of Medicine suggested that the mortality rate associated with COVID-19 may actually be "considerably less than 1%," as opposed to the 2% number reported by some groups. The editorial was published alongside a report of laboratory-confirmed COVID-19 cases, which found a mortality rate of 1.4% among 1099 patients. However, authors of the editorial suggested that the number of asymptomatic or minimally symptomatic cases is likely several times higher than the number of reported cases, which would lower the fatality rate significantly below 1%.

In potentially encouraging news, a team of researchers has discovered commonalities between SARS-CoV-2, the disease that causes COVID-19, and SARS-CoV, which may lead to a target for antiviral intervention. The findings were published in Cell and also show that antibody responses raised against SARS-S during infection or vaccination may offer some protection against SARS-CoV-2 infection. The hope is that further research will soon lead to effective treatment for patients with COVID-19.

COVID-19 and related subjects are likely to stay among the top trending clinical topics for the foreseeable future. A reminder that you can find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Read more about practice essentials for COVID-19.


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