What your doctor is reading on Medscape.com:

APRIL 11, 2020 — Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today: 

It’s Going to Be OK

In the latest Medicine and the Machine podcast, Abraham Verghese, MD, interviews Lloyd B. Minor, MD, the dean of the Stanford University School of Medicine. Minor describes the stress his staff is under but, ultimately, offers a hopeful message.

“No one has backed away; everyone has leaned in. That is what encourages me every day that we’re going to make it through this,” Minor responded when asked what positives he could take away from Stanford’s pandemic response.

A Grim Milestone for the US

The United States has surpassed Italy for the most confirmed COVID-19 deaths in the world, according to a new report in the Washington Post . As of Saturday, there were more than 20,000 American coronavirus fatalities, including a record-high 2100 deaths on Friday. Many experts believe these figures are an underestimation, the Post reported, adding that Dr Deborah Birx, coordinator of the White House coronavirus task force, has speculated that the US has not yet “reached the peak” of the pandemic.

Two MDs, Two Different Coronavirus Infections

A physician couple, both of whom contracted COVID-19, had drastically different experiences. She’s an oncologist; he’s a cardiologist. She remained asymptomatic, he ended up in intensive care. Their experience, shared with Medscape by Noopur Raje, MD, director of the Center for Multiple Myeloma at Massachusetts General Hospital in Boston, illustrates just how much physicians are still learning about the disease.

COVID-19 Pushes Chemotherapy to Homes

Last fall, the University of Pennsylvania in Philadelphia started a pilot program of home-based chemotherapy for two treatment regimens. The program started slowly but steadily grew to 40 patients over a few months.

Then came the coronavirus pandemic. 

Since March, the number of patient referrals to the program jumped to 135 — a 300% increase. The list of chemotherapies offered also grew from two to seven, with several more under consideration. 

Delivering chemotherapy at home is feasible and desirable for a lot of patients, Amy Laughlin, MD, a hematology-oncology fellow involved with the program, points out in a Medscape report. However, the service does not appear to be offered elsewhere in the United States, and the Community Oncology Alliance is opposed to the practice because of patient safety concerns.


Coronavirus Mortality Prediction Tool

Because COVID-19 is a novel coronavirus, the medical community is still getting its arms around important concepts such as the risk of death in an infected patient. QxMD, a website that is part of the Medscape network, provides free calculator and decision-support materials for clinicians. It has adapted information from the Centers for Disease Control and Prevention (CDC) and turned it into a step-by step COVID-19 Prognostic Tool.

The form consists of eight questions about comorbidities for coronavirus, such as history of heart disease, cancer, and stroke. For example, a hypertensive patient, age 55 to 59, has a 1% to 3% age-specific chance of mortality based on US data and a hypertension-specific fatality risk of 6.0% based on Chinese data. 

There is no single mortality risk tool that accounts for multiple variables, a note at the end of the calculator cautions. Mortality rates are similar in the US and China.

Medscape Medical News

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