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Cardiovascular Medicine - Other Cardiology

Higher risk of cardiovascular disease in survivors of COVID-19 (March 2022)


The acute cardiovascular (CV) complications of COVID-19 have been well described, but few studies have examined the association between COVID-19 and long-term CV outcomes. In a study that recorded the one-year incidence of CV disease among nearly 5.8 million United States veterans, patients who had COVID-19 had an increased risk of major adverse CV events (all-cause mortality, stroke, or myocardial infarction) at one year when compared with those who did not have COVID-19 (adjusted hazard ratio 1.55).2 In addition, patients with more severe COVID-19 were more likely to develop CV disease than those who had less severe COVID-19. While no direct causal mechanism has been established between COVID-19 and CV disease, patients with COVID-19 may have a higher risk of long-term CV outcomes.


Family Medicine - Immunizations

2022 ACIP immunization recommendations for adults (February 2022)


The 2022 Advisory Committee on Immunization Practices (ACIP) recommendations for immunizations in adults aged 19 and older have been approved by the United States Centers for Disease Control and Prevention (CDC).3 Significant updates include previously released recommendations for use of hepatitis B vaccination (HepB) in healthy adults, recombinant zoster vaccine (RZV) in immunocompromised adults, and pneumococcal conjugate vaccines (PCV15 and PCV20) in different age groups. Recommendations for COVID-19 vaccination are not included in the ACIP immunization tables and are found elsewhere.


Family Medicine - Adult General Internal Medicine

Prolonged duration of symptoms in COVID-19 ICU survivors (February 2022)


The duration of symptoms following COVID-19 is unclear. A recent study reported that three-quarters of intensive care unit COVID-19 survivors had physical symptoms at one year. These included physical weakness (39 percent), joint symptoms (26 percent), and myalgia (21 percent).4 Mental symptoms were reported by 26 percent and cognitive symptoms by 16 percent of survivors. These symptoms are consistent with post-intensive care syndrome (PICS) and need to be addressed during recovery from COVID-19.


Dermatology - Atopic Dermatitis and other Dermatitis

Tralokinumab for atopic dermatitis (February 2022)


Adults with persistent, moderate-to-severe atopic dermatitis (AD) despite optimal topical therapy may require systemic immunomodulatory therapy to achieve adequate disease control. In a recent randomized trial of 380 adults with moderate-to-severe AD, more patients assigned to subcutaneous tralokinumab, a fully human monoclonal anti-interleukin-13 antibody, achieved a 75 percent improvement in the Eczema Area and Severity Index at 16 weeks compared with placebo (56 versus 36 percent, respectively).1 All patients were allowed to use a midpotency topical corticosteroid as needed. Treatment was generally well tolerated. Conjunctivitis was more common in patients receiving tralokinumab than in those receiving placebo. These findings support the efficacy of tralokinumab for adults with AD; this and other studies were the basis for US Food and Drug Administration approval of tralokinumab for this indication. However, long-term studies are needed before its use becomes routine.


1. Silverberg JI, Toth D, Bieber T, et al Tralokinumab plus topical corticosteroids for the treatment of moderate-to-severe atopic dermatitis: results from the double-blind, randomized, multicentre, placebo-controlled phase III ECZTRA 3 trial. Br J Dermatol 2021; 184:450. [Context Link]


2. Xie Y, Xu E, Bowe B, Al-Aly Z. Long-term cardiovascular outcomes of COVID-19. Nat Med 2022. [Context Link]


3. Murthy N, Wodi AP, Bernstein H, et al Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older - United States, 2022. MMWR Morb Mortal Wkly Rep 2022; 71:229. [Context Link]


4. Heesakkers H, van der Hoeven JG, Corsten S, et al Clinical Outcomes Among Patients With 1-Year Survival Following Intensive Care Unit Treatment for COVID-19. JAMA 2022; 327:559. [Context Link]


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