Impact of early versus late administration of bamlanivimab on readmissions in patients with high-risk COVID-19.

BACKGROUND: Recombinant monoclonal antibody therapies have been utilized under emergency use authorization (EUA) for the prevention of clinical decompensation in high-risk COVID-19 positive patients for up to 10 days from symptom onset. The purpose of this study was to determine the impact of the timing of the monoclonal antibody, bamlanivimab, on clinical outcomes in high-risk COVID-19 positive patients. METHODS: This was an IRB-approved, retrospective evaluation of adult patients who received bamlanivimab per EUA criteria in the emergency department (ED). Patients were dichotomized into two groups- 3 days of symptoms or less (early) versus 4 to 10 days (late). The primary outcome was hospitalization for COVID-related illness at 28 days (or treatment failure). Secondary outcomes were COVID-related ED visits at 28 days, hospital and intensive care unit (ICU) length of stay (LOS), and in-hospital mortality at 28 days. RESULTS: A total of 839 patients were included in the analysis. There was no difference observed in COVID-related hospitalization rates within 28 days between the early and late bamlanivimab administration groups (7.5% vs. 8.2%, p = 0.71). There was no difference in COVID-related ED visits within 28 days with 13% of patients returning to the ED. CONCLUSIONS: In conclusion, there were no differences in the rates of hospitalization at 28 days when bamlanivimab was administered in the first 3 days of illness versus days 4 to 10. Future prospective studies are warranted to expand upon the characteristics of patients that may or may not benefit from monoclonal antibody therapy.

Unvaccinated COVID-19 Pneumonia- a family affair.

The authors present the case of a 15-year-old boy who was infected with COVID-19 by his family and developed pneumonia severe enough to require hospitalization. He was one of several children who required hospitalization, and vaccination was considered by the parent to be "risky" despite this. This case illustrates the complexities of vaccine hesitancy and societal misinformation.

Olecranon Bursitis Secondary to Trauma.

The authors present a case of traumatic olecranon bursitis, initially presumed to be cellulitis. The clinical presentation, diagnosis, and management are discussed.

Symptomatic Pulmonary Hamartoma.

Pulmonary hamartoma is the most common benign tumor of the lungs. It is most often asymptomatic and is discovered incidentally. The condition is two to three times more common in men and is usually seen in the sixth to seventh decade of life. The authors present the case of a 44-year-old female in whom the condition was symptomatic, causing cough, shortness of breath, and fatigue. This case is unusual in that it occurred in a woman in her 40s and was symptomatic. The authors discuss the presentation, clinical features, and management of pulmonary hamartoma.

Biosurveillance of ED visits for gastroenteritis.

OBJECTIVE: Our objective was to characterize emergency department (ED) visits for gastroenteritis by season and age and develop a predictive model. METHODS: We performed a retrospective cohort study of patients seen in 19 EDs from 1988 to 2002. We examined differences in the annual peaks of younger (<60 months) and older (>60 months) age groups and developed a time series regression model. RESULTS: Of the 5,182,019 total visits, 88,504 were for gastroenteritis. On average, the percentage of gastroenteritis on the peak days was higher in the younger (26%) than older group (4%), and the peaks for the younger group occurred 36 days after those for the older group. CONCLUSION: Emergency department visits for gastroenteritis vary greatly by season and age. Our time series predictive model was a good fit to actual incidence patterns. These variations should be accounted for in designing a system to detect bioterrorism and for surveillance of naturally occurring epidemics.