Assessment of Filled Buprenorphine Prescriptions for Opioid Use Disorder During the Coronavirus Disease 2019 Pandemic

Nguyễn, Thủy; Gupta, Sumedha; Ziedan, Engy; Simon, Kosali; Alexander, G. Caleb; Saloner, Brendan; Stein, Bradley D.

doi:10.1001/jamainternmed.2020.7497

Cited by 44 publications

(68 citation statements)

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“…The final selection included 26 studies: 4 multicenter prospective cohort studies [ 17 – 20 ], 6 multicenter retrospective cohort studies [ 8 , 21 – 25 ], 1 single center prospective cohort study [ 26 ], 1 multicenter prospective case series [ 27 ], 2 multicenter retrospective case series [ 28 , 29 ], 4 single center prospective case series [ 30 – 33 ] and 8 single center retrospective case series [ 34 – 41 ] (Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review

et al. 2021

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Background The mortality of critically ill patients with COVID-19 is high, particularly among those receiving mechanical ventilation (MV). Despite the high number of patients treated worldwide, data on respiratory mechanics are currently scarce and the optimal setting of MV remains to be defined. This scoping review aims to provide an overview of available data about respiratory mechanics, gas exchange and MV settings in patients admitted to intensive care units (ICUs) for COVID-19-associated acute respiratory failure, and to identify knowledge gaps. Main text PubMed, EMBASE, and MEDLINE databases were searched from inception to October 30, 2020 for studies providing at least one ventilatory parameter collected within 24 h from the ICU admission. The quality of the studies was independently assessed using the Newcastle–Ottawa Quality Assessment Form for Cohort Studies. A total of 26 studies were included for a total of 14,075 patients. At ICU admission, positive end expiratory pressure (PEEP) values ranged from 9 to 16.5 cm of water (cmH2O), suggesting that high levels of PEEP were commonly used for setting MV for these patients. Patients with COVID-19 are severely hypoxemic at ICU admission and show a median ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ranging from 102 to 198 mmHg. Static respiratory system compliance (Crs) values at ICU admission were highly heterogenous, ranging between 24 and 49 ml/cmH2O. Prone positioning and neuromuscular blocking agents were widely used, ranging from 17 to 81 and 22 to 88%, respectively; both rates were higher than previously reported in patients with “classical” acute respiratory distress syndrome (ARDS). Conclusions Available data show that, in mechanically ventilated patients with COVID-19, respiratory mechanics and MV settings within 24 h from ICU admission are heterogeneous but similar to those reported for “classical” ARDS. However, to date, complete data regarding mechanical properties of respiratory system, optimal setting of MV and the role of rescue treatments for refractory hypoxemia are still lacking in the medical literature.

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Section: Resultsmentioning

confidence: 99%

Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review

et al. 2021

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“…We also sought to determine the effect of ECMO on survival. When data from randomized trials are not available, observational analyses may be used to guide practice by adopting a target trial emulation approach [ 31 – 34 ]. Accordingly, we conducted a target trial emulation in which severely hypoxemic patients were categorized according to receipt or no receipt of ECMO in the first 7 days of ICU admission.…”

Section: Discussionmentioning

confidence: 99%

“…We used data from the Study of the Treatment and Outcomes in Critically Ill Patients with COVID-19 (STOP-COVID), a multicenter cohort study that enrolled consecutive adults (≥ 18 years old) with laboratory-confirmed COVID-19 admitted to participating ICUs at 68 geographically diverse hospitals across the United States [ 20 ]. The study was approved with a waiver of informed consent by the Institutional Review Board at each participating site.…”

Section: Methodsmentioning

confidence: 99%

“…We adjusted for confounding using a multivariable Cox model. The following covariates were prespecified based on clinical judgment and prior knowledge [ 20 ], as they were felt to potentially be associated with both ECMO receipt and with survival: age (18–49; 50–59; 60–70); sex; race (White; non-White); body mass index (< 40; ≥ 40; unknown); hypertension; diabetes mellitus; coronary artery disease; congestive heart failure; chronic obstructive pulmonary disease (COPD); PaO 2 /FiO 2 ratio (< 80; 80–99 mmHg); shock (defined as receipt of at least one vasopressor); suspected or confirmed secondary infection; the renal, liver, and coagulation components of the Sequential Organ Failure Assessment score [ 25 , 26 ]; and receipt of rescue therapies for hypoxemia (prone position ventilation, neuromuscular blockade, and inhaled vasodilators, each assessed separately). Acute severity of illness characteristics were assessed on the day of treatment assignment.…”

Section: Methodsmentioning

confidence: 99%

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Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19

Brenner²,

et al. 2021

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Purpose Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19). Methods We examined the clinical features and outcomes of 190 patients treated with ECMO within 14 days of ICU admission, using data from a multicenter cohort study of 5122 critically ill adults with COVID-19 admitted to 68 hospitals across the United States. To estimate the effect of ECMO on mortality, we emulated a target trial of ECMO receipt versus no ECMO receipt within 7 days of ICU admission among mechanically ventilated patients with severe hypoxemia (PaO 2 /FiO 2 < 100). Patients were followed until hospital discharge, death, or a minimum of 60 days. We adjusted for confounding using a multivariable Cox model. Results Among the 190 patients treated with ECMO, the median age was 49 years (IQR 41–58), 137 (72.1%) were men, and the median PaO 2 /FiO 2 prior to ECMO initiation was 72 (IQR 61–90). At 60 days, 63 patients (33.2%) had died, 94 (49.5%) were discharged, and 33 (17.4%) remained hospitalized. Among the 1297 patients eligible for the target trial emulation, 45 of the 130 (34.6%) who received ECMO died, and 553 of the 1167 (47.4%) who did not receive ECMO died. In the primary analysis, patients who received ECMO had lower mortality than those who did not (HR 0.55; 95% CI 0.41–0.74). Results were similar in a secondary analysis limited to patients with PaO 2 /FiO 2 < 80 (HR 0.55; 95% CI 0.40–0.77). Conclusion In select patients with severe respiratory failure from COVID-19, ECMO may reduce mortality. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-020-06331-9.

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“…33–50 % der COVID-19-Patient*innen mit AKI gegenüber 7–8 % der Patient*innen ohne AKI sterben während des Krankenhausaufenthalts [ 10 , 13 ]. Die Mortalität steigt stadienabhängig und ist erwartungsgemäß mit 57–73 % am höchsten bei Patient*innen, die Nierenersatztherapie erhalten [ 17 , 18 , 20 , 34 ]. Zum Vergleich: Die Krankenhausmortalität unter den AOK-Patient*innen, welche invasiv beatmet wurden, jedoch kein Nierenersatzverfahren benötigten, betrug 44,8 % [ 20 ].…”

Section: Verlauf Von Covid-19-assoziiertem Nierenversagen Bei Intensiunclassified

COVID-19 und akute Nierenschädigung im Intensivbereich

et al. 2020

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Die akute Nierenschädigung („acute kidney injury“, AKI) ist eine häufige und schwere Komplikation bei COVID-19(„coronavirus disease 2019“)-Patient*innen auf der Intensivstation. Dabei zeigt sich eine enge Assoziation zwischen der Schwere des Krankheitsverlaufs von COVID-19 und dem Auftreten von Nierenversagen. Den Hauptrisikofaktor für ein nierenersatztherapiepflichtiges Nierenversagen stellt die Notwendigkeit einer invasiven Beatmung dar, wobei der Beginn des Nierenversagens häufig eng mit dem Intubationszeitpunkt assoziiert ist. Zusätzlich stellen Risikofaktoren für schwere COVID-19-Verläufe gleichzeitig Risikofaktoren für ein schweres Nierenversagen dar. AKI bei COVID-19 weist eine hohe Mortalität auf und führt bei einem Teil der Patient*innen zu anhaltender Niereninsuffizienz. Allerdings kommt es bei einem recht großen Teil der dialysepflichtigen Überlebenden zu einer Erholung der Nierenfunktion. Im Hinblick auf Vermeidung und Therapie des COVID-19-assoziierten Nierenversagens gelten bislang dieselben Empfehlungen wie für AKI anderer Ursachen (Kidney Disease: Improving Global Outcomes, KDIGO-Bundles). Bei hohem Patient*innenaufkommen und entsprechend ausgelasteten Ressourcen kann die Durchführung von extrakorporalen Nierenersatzverfahren im Kontext einer krankheitsassoziierten Hyperkoagulabilität kritisch werden. Zur Vermeidung von Triage-Situationen wurde in einzelnen Zentren die akute Peritonealdialyse als Alternative zu den extrakorporalen Verfahren eingesetzt.

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Assessment of Filled Buprenorphine Prescriptions for Opioid Use Disorder During the Coronavirus Disease 2019 Pandemic

Abstract: the categorization of certain passive activities as nonmeaningful and that activities were assessed by self-report. Nonetheless, we believe engagement in meaningful activities is central to one's identity and well-being.

Cited by 44 publications

References 2 publications

Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review

Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review

Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19

COVID-19 und akute Nierenschädigung im Intensivbereich

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