Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection
Key Points Question What symptoms are differentially present in SARS-CoV-2–infected individuals 6 months or more after infection compared with uninfected individuals, and what symptom-based criteria can be used to identify postacute sequelae of SARS-CoV-2 infection (PASC) cases? Findings In this analysis of data from 9764 participants in the RECOVER adult cohort, a prospective longitudinal cohort study, 37 symptoms across multiple pathophysiological domains were identified as present more often in SARS-CoV-2–infected participants at 6 months or more after infection compared with uninfected participants. A preliminary rule for identifying PASC was derived based on a composite symptom score. Meaning A framework for identifying PASC cases based on symptoms is a first step to defining PASC as a new condition. These findings require iterative refinement that further incorporates clinical features to arrive at actionable definitions of PASC.
11 clinical trials that will shape medicine in 2023
2022 has been a rollercoaster year for biopharma, as it has faced an industry-wide slowdown and late-stage clinical trial failures, as well as breakthroughs and regulatory approvals. COVID-19 has continued to disrupt nearly all aspects of clinical trial infrastructure, from patient recruitment to supply chains, but despite this, 2023 promises to bring many new readouts from different branches of medicine (Table 1). Nature Medicine asked 11 leading experts for their top clinical trials to watch in the coming year
Association of Baseline Adherence to Antihypertensive Medications With Adherence After Shelter-in-Place Guidance for COVID-19 Among US Adults
Question: Does baseline antihypertensive medication adherence identify individuals at risk for poor adherence during sheltering for COVID-19? Findings This cohort study assessed antihypertensive medication adherence as the proportion of days covered (PDC) from filled prescriptions claims for 6 months before and after COVID-19 sheltering guidance in a random sample of 27 318 US adults. Poor adherence (PDC < 50) during sheltering occurred in 73% with poor baseline adherence, 32% with fair baseline adherence (PDC 50-79), and 10% with good baseline adherence (PDC ≥ 80). These findings suggest that adherence-promoting interventions may be helpful irrespective of sheltering for poor baseline adherence and during sheltering for fair baseline adherence.
Changes in the Relationship Between Income and Life Expectancy Before and During the COVID-19 Pandemic, California, 2015-2021
Key Points Question How did the first 2 years of the COVID-19 pandemic affect life expectancy in California and the relationship between census tract income and life expectancy relative to prepandemic years? Findings In this retrospective analysis of 1 988 606 deaths in California during 2015 to 2021, life expectancy declined from 81.40 years in 2019 to 79.20 years in 2020 and 78.37 years in 2021. Life expectancy differences between the census tracts in the highest and lowest income percentiles increased from 11.52 years in 2019 to 14.67 years in 2020 and 15.51 years in 2021. Meaning This ecological study of deaths in the state of California demonstrated that life expectancy declines in 2020 increased in 2021 and that the life expectancy gap by income level increased during the first 2 years of the COVID-19 pandemic relative to the pre-pandemic period.
Four Vaccine Doses Prevented Severe Omicron COVID-19 Better Than 3
Older patients in Israel who received a fourth dose of the BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine were more than 3 times less likely to develop severe COVID-19 than those who received only 3 doses. But while protection against severe disease did not wane during the testing period, protection against confirmed infection appeared short-lived.