Association of Treatment with Remdesivir and 30-day Hospital Readmissions in Patients Hospitalized with COVID-19.

BACKGROUND: Since the beginning of COVID-19 pandemic, there has been a widespread use of remdesivir in adults and children. There is little known information about remdesivir's role in reducing 30-day readmissions after hospitalization with COVID-19. This study aimed to determine whether treatment with remdesivir was associated with reduced risk of 30-day readmission after index hospitalization with COVID-19. METHODS: The study was a multi-center cohort study in Rhode Island, USA. Patients included all adults that were discharged after hospital treatment for COVID-19 between April 1st and December 31st, 2020. The main study outcomes were length of hospital stay, 30-day readmission, and post-discharge 30 days mortality. RESULTS: A total of 2,062 patients (2,279 hospitalizations) were included in the analytic sample. Patients were less likely to be readmitted within 30 days if they received remdesivir relative to not receiving remdesivir; associations were strongest for those with mild disease (RR: 0.31; 95% CI: 0.13,0.75). Remdesivir treatment was associated with reduction in all-cause mortality (HR: 0.65; 95% CI: 0.49,0.85) and an increase in length of stay (estimated average increase of 3.27 days; 95% CI: 2.11,4.44). LIMITATION: Unmeasured factors such as time-to-treatment and severity of disease prior to initiation of remdesivir. CONCLUSIONS: Remdesivir may be an effective strategy for reducing progression to severe COVID-19 disease and limiting morbidity associated with readmission to hospital. Larger prospective studies are justified to study the role of remdesivir in mild or early COVID-19 with high risk of disease progression and readmission to hospital within 30 days.

Cryptic Presentation of Disseminated Cryptococcosis.

Cryptococcosis is a global invasive mycosis, commonly encountered in patients with HIV/AIDS with low CD4 counts, diabetics, organ and stem-cell transplant recipients, malignancies, and other patients with immunosuppression. The presentation depends on which organ is usually involved although multi-organ involvement may be present. Here, we describe a young female with an enlarging flank mass, found to have disseminated cryptococcosis in the setting of immunosuppression.

An Unusual Presentation of Kikuchi-Fujimoto Disease with Recurrent Fever and Syncope.

Kikuchi-Fujimoto (KF) disease, also known as necrotizing histiocytic lymphadenopathy, is a rare, benign disorder of the lymph nodes of young adults, predominantly young females. The exact cause of KF disease is unknown. Here, we report a young female with recurrent fever and syncopal episodes diagnosed with KF disease on lymph node biopsy.

Complete heart block associated with Remdesivir in COVID-19: a case report.

BACKGROUND: Since the pandemic began in 2020, Remdesivir has been widely used for the treatment of coronavirus disease-2019 (COVID-19). Here, we describe a case of a patient with COVID-19 who developed transient complete atrioventricular (AV) block and bradycardia after initiating treatment with Remdesivir. CASE SUMMARY: A 72-year-old male with a history of atrial fibrillation and lung cancer was hospitalized for COVID-19. Electrocardiogram (ECG) on admission demonstrated atrial fibrillation and right bundle branch block. He was started on a course of Dexamethasone and Remdesivir. Within 24 h of starting Remdesivir, he was noted to be in atrial fibrillation with ventricular rates between 30 and 40 b.p.m. On Day 5 of Remdesivir therapy, ECG demonstrated complete AV block. Having completed the Remdesivir regimen, during the next 48 h, he was closely monitored, and the AV block resolved spontaneously. As he remained asymptomatic and had an adequate chronotropic response with activity, pacemaker implantation was not recommended. DISCUSSION: Despite the widespread use of Remdesivir, there is little known information about its cardiac toxicity. Daily ECGs and close cardiac surveillance of patients who develop severe bradycardia or AV block are essential. Discontinuation of the medication usually results in the resolution of these cardiac disturbances.

Endocrinological abnormalities and Takotsubo cardiomyopathy.

Dear Editor, We read with much excitement in the article "Takotsubo syndrome and pheochromocytoma: an insidious combination" published by Maffé et al. in your esteemed journal...

COVID-19-induced granulomatosis with polyangiitis.

COVID-19 and granulomatosis with polyangiitis share many clinical and radiological features, making it challenging for clinicians to distinguish between the two. In this case report, we describe a patient who was diagnosed with COVID-19 in October 2020. One month later, she presented with persistent fatigue, shortness of breath and anaemia with worsening renal functions, found to have elevated antineutrophil cytoplasmic antibodies and antiproteinase 3 antibodies, and diagnosed with granulomatosis with polyangiitis.

A Tale of Two Ps: Panniculitis Secondary to Acute Pancreatitis.

Pancreatic panniculitis (PP) is a rare variant of panniculitis that affects patients with pancreatic disorders, most commonly pancreatic malignancy or acute/chronic pancreatitis. Patients often present with painful, erythematous nodules on their lower extremities that may undergo spontaneous ulceration and necrosis. Treatment is largely supportive and should address the underlying pancreatic disease.

90Y-ibritumomab tiuxetan radiotherapy as first-line therapy for early stage low-grade B-cell lymphomas, including bulky disease.

(90) Y-ibritumomab-tiuxetan ((90) YIT) was used as a first-line therapy for patients with early-stage follicular lymphoma (FL) or marginal zone B-cell lymphoma (MZL). Thirty-one patients were treated, with an overall 3-month response rate of 100% (68% complete response, 29% unconfirmed complete response and 3% partial response). At a median follow-up of 56 months, ten patients (32%) had disease relapse or progression. The progression-free rates at 3 and 5 years were lower in males, patients with FL, stage II disease and non-bulky disease, although they did not reach statistical significance. Grade 3-4 neutropenia, thrombocytopenia and anaemia were 61%, 35%, and 3%, respectively. (90) YIT was well tolerated, including in those patients over 60 years old, and achieved high response rates in patients with early-stage low-grade B-cell lymphomas. Bulky disease did not adversely affect tumour response.