Outpatient Management of COVID-19 With Monoclonal Antibody Therapy in a Young Renal Transplant Patient.

At baseline, solid organ transplant recipients are at an increased risk for infectious complications due to the complex immunosuppressive regimens. The available data in renal transplant patients who contract coronavirus disease 2019 (COVID-19) demonstrates dangerously high mortality rates (33%) in those who require hospitalization and/or ICU level care. Interestingly, the data for transplant patients who do not require hospitalization shows significantly lower mortality (3%) despite being on an immunosuppressive regimen. We present the case of a young male patient with a history of renal transplant who tested positive for COVID-19; he was mildly symptomatic with cough, sinusitis, and headache, was worked up as an outpatient, and treated as an outpatient with bamlanivimab monotherapy with no adjustment to his immunosuppressive regimen. This case aims to highlight the possibility of safely managing mild cases of COVID-19 in solid organ transplant patients receiving immunosuppression as an outpatient with monoclonal antibody (mAb) therapy.

Pulmonary embolism, transient ischaemic attack and thrombocytopenia after the Johnson & Johnson COVID-19 vaccine.

As with past illnesses, an approach has been taken to vaccinate the population and halt the spread of COVID-19. On 13 April 2021, the US Food and Drug Administration called for a halt in the administration of the Johnson & Johnson (J&J) COVID-19 vaccine due to reports of thrombosis and thrombocytopenia being associated with vaccination. We present the case of a 43-year-old woman with a history of dyslipidaemia, depression, gastro-oesophageal reflux disease and obesity presenting with dyspnoea, headache and light headedness of 3 days' duration. Ten days prior, she had received the J&J COVID-19 vaccine. She was found to have thrombocytopenia, elevated D-dimers, pulmonary emboli and presented 1 day after discharge with an arterial clot despite being on apixaban. Six other US-based cases of venous thrombotic events are being reviewed at present. Patients should be informed of the possibility of such events to provide informed consent.

Patient-Centered Care: Lifestyle Modifications Among Adult Participants With Dyslipidemia.

BACKGROUND: Dyslipidemia, a risk factor for coronary heart disease (CHD), is a burden due to morbidity, mortality, and CHD-related costs. Patient-centered clinical interventions improve adherence to lifestyle modifications among adults with dyslipidemia. OBJECTIVE: The study's objectives were to (a) promote participants' safety through increased knowledge on the risks and prevention of CHD, (b) help participants identify their own barriers to lifestyle modifications, and (c) develop strategies with participants on individualized plans to adhere to healthy living. METHODS: Seventeen participants with dyslipidemia enrolled in a quality improvement over 6 weeks. Participants were from one employee health clinic in Mississippi. Measures are Heart Disease Fact Questionnaire (HDFQ), Framingham Tool, pre- and poststudy lipid panels, and physiologic measurements. Interventions include motivational technique-led interviews as a tool for behavioral change. RESULTS: Pre- and post-HDFQ responses indicated an 18% increase in knowledge attainment because of the patient-centered care interventions. Postinterventions, mean plasma lipid panels were 29% lower, weight loss ranged from 0 to 10.1 pounds, and body mass indexes were 0.4 to 1.2 less. Blood pressures (BPs) preintervention ranged from 120/70 to 159/89. Postinterventions BP ranged from 107/82 to 146/70. CONCLUSIONS: Patient-centered clinical interventions improve management of dyslipidemia through increased knowledge on risks and prevention of CHD and also through finding own barriers to healthy living. IMPLICATIONS: Healthcare providers can make a difference in people's lives through exploring the unhealthy behaviors and discovering ways for better health outcomes.