January 6, 2021

In today's episode we discuss: —Climate: American physicians from Yale and the University of Maryland argue that the US government should mandate vaccination of migrant detainees against COVID-19. They assert the crowded and inadequate sanitary conditions in these facilities create epicenters for disease proliferation and that without federal mandates, states will fail to vaccinate this vulnerable population. Authors suggest such policy is both sound medical practice and a moral imperative. —Epidemiology: A team of Spanish physicians conducted a retrospective cohort-study using the SEMI-COVID-19 Registry of 12,170 COVID-19 patients from 150 hospitals in Spain to investigate impact of arterial stiffness on mortality. They found arterial stiffness (pulse pressure greater than or equal to 60 mmHg) and systolic blood pressure (SBP) less than 120 mmHg on admission significantly and independently predicted all-cause in-hospital mortality (ORadj: 1.27, p=.0001; ORadj: 1.48, p=.0001, respectively). Authors concluded SBP and pulse pressure values on admission are independent predictors of mortality in COVID-19 patients. —Management: A single-center retrospective cohort study of 157 hospitalized COVID-19 patients in Wuhan, China analyzed 43 demographic, clinical, and laboratory parameters and found an association between higher systolic blood pressure (SBP) on admission and increased mortality. They also utilized regression models to predict mortality and survivability based of available data and they suggest utilizing these models for risk stratification and appropriate triaging of patients to improve outcomes.