Research Roundup: COVID; Diabetes; Fasting; Hyperinflammatory Syndrome; Low-Dose Zinc
Each week, KHN compiles a selection of recently released health policy studies and briefs.
CIDRAP:
Study Finds 100% Death Rate In COVID-19 Patients After CPR
All 54 COVID-19 patients who underwent cardiopulmonary resuscitation (CPR) in a Michigan hospital died, leading to questions about the risks and benefits of performing a procedure that exposes healthcare personnel to the coronavirus amid limited supplies of personal protective equipment (PPE). The findings, published yesterday in a research letter in JAMA Internal Medicine, found that 52 of 54 patients who experienced cardiac arrest from Mar 15 to Apr 3 (96.3%) had nonshockable rhythms, 44 (81.5%) with pulseless cardiac electrical activity, and 8 (14.8%) with asystole (flatlining). Nonshockable rhythms are those in which the use of defibrillation is highly unlikely to restore a normal heartbeat. (Van Beusekom, 9/29)
New England Journal of Medicine:
Cardiovascular Outcomes With Ertugliflozin In Type 2 Diabetes
In a multicenter, double-blind trial, we randomly assigned patients with type 2 diabetes and atherosclerotic cardiovascular disease to receive 5 mg or 15 mg of ertugliflozin or placebo once daily. With the data from the two ertugliflozin dose groups pooled for analysis, the primary objective was to show the noninferiority of ertugliflozin to placebo with respect to the primary outcome, major adverse cardiovascular events (a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke). The noninferiority margin was 1.3 (upper boundary of a 95.6% confidence interval for the hazard ratio [ertugliflozin vs. placebo] for major adverse cardiovascular events). The first key secondary outcome was a composite of death from cardiovascular causes or hospitalization for heart failure. (Cannon et al, 9/23)
JAMA Network:
Effects Of Time-Restricted Eating On Weight Loss And Other Metabolic Parameters In Women And Men With Overweight And Obesity
What is the effect of time-restricted eating on weight loss and metabolic health in patients with overweight and obesity? In this prospective randomized clinical trial that included 116 adults with overweight or obesity, time-restricted eating was associated with a modest decrease (1.17%) in weight that was not significantly different from the decrease in the control group (0.75%). (Lowe et al, 9/28)
The Lancet Rheumatology:
Clinical Criteria For COVID-19-Associated Hyperinflammatory Syndrome: A Cohort Study
A subset of patients with COVID-19 develops a hyperinflammatory syndrome that has similarities with other hyperinflammatory disorders. However, clinical criteria specifically to define COVID-19-associated hyperinflammatory syndrome (cHIS) have not been established. We aimed to develop and validate diagnostic criteria for cHIS in a cohort of inpatients with COVID-19. (Webb et al, 9/29)
New England Journal of Medicine:
Lower-Dose Zinc For Childhood Diarrhea — A Randomized, Multicenter Trial
The World Health Organization recommends 20 mg of zinc per day for 10 to 14 days for children with acute diarrhea; in previous trials, this dosage decreased diarrhea but increased vomiting. We randomly assigned 4500 children in India and Tanzania who were 6 to 59 months of age and had acute diarrhea to receive 5 mg, 10 mg, or 20 mg of zinc sulfate for 14 days. The three primary outcomes were a diarrhea duration of more than 5 days and the number of stools (assessed in a noninferiority analysis) and the occurrence of vomiting (assessed in a superiority analysis) within 30 minutes after zinc administration. (Dhingra et al, 9/24)
