A biopsy of the lesion was performed which showed an increased number of eccrine glands and blood vessels within the dermis. Some areas showed an increase in adipocytes and smooth muscle bundles. The changes were consistent with eccrine angiomatous hamartoma (EAH).

The boy was referred to vascular laser therapy for treatment of the lesion.

EAH is a rare benign vascular growth characterized by an increased number of mature eccrine glands and blood vessels in the dermis and subcutis. The lesions are mostly present on the extremities, but cases of diffuse congenital lesions and lesions on the face and trunk have also been described. The lesions can be seen at birth or during the first years of life in about half of the cases, and the others tend to occur later in puberty and rarely in adulthood^.1

Clinically, EAH lesions present as red, yellow to brown papules and plaques. Different dermoscopic patterns have been described which include the popcorn pattern that presents as yellow, confluent nodules with popcornlike shapes over a background of erythema, and linear arborizing vessels. The spitzoid pattern are brown globules on a background of erythema and pseudoreticular pigmentation around the globules. The verrucous hemangiomalike pattern has a bluish-white hue, reddish-blue or bluish lacunae, as seen in our patient.^2-4

Most of the lesions are asymptomatic, but in some patients, they can be associated with pain, hyperhidrosis, and sometimes bleeding. Hyperhidrosis has been reported early in the presentation or during puberty or pregnancy. Our patient had started on amphetamines when hyperhidrosis occurred. Hyperhidrosis is a knowns side effect of this type of medication and may have had a role in the increased sweating noted on the hamartoma.

EAH can clinically look like verrucous hemangiomas, angiokeratomas, and vascular malformations, and histopathology may be needed to differentiate between them. Eccrine nevi and EAH can be similar. Hyperhidrosis is an early and predominant component of eccrine nevi, compared with one-third of EAH.

The exact etiology of this lesion is not known. It is thought to be caused by an abnormal differentiation of the epithelium, adnexal structure, and the mesenchyme during organogenesis.³ No other associated conditions have been described with EAH.

EAH are benign lesions that rarely require treatment. If the lesions are symptomatic or because of cosmetic reasons, they can be removed surgically. There are some reports of successful treatment with pulse dual-wavelength sequential 595- and 1064-nm lasers.⁵ Botulinum toxin has also been used in cases of symptomatic hyperhidrosis.
 

Dr. Matiz is a pediatric dermatologist at Southern California Permanente Medical Group, San Diego. She has no conflicts. Email her at [email protected].

References

1. Smith SD et al. Pediatr Dermatol. 2019 Nov;36(6):909-12.

2. Patterson AT et al. Am J Dermatopathol. 2016;38:413-7.

3. Garcıa-Garcıa SC et al. JAAD Case Rep. 2018;4(2):165-7.

4. Awatef Kelati et al. JAAD Case Rep. 2018;4(8)835-6.

5. Felgueiras J et al. Dermatol Surg. 2015 Mar;41(3):428-30.

A biopsy of the lesion was performed which showed an increased number of eccrine glands and blood vessels within the dermis. Some areas showed an increase in adipocytes and smooth muscle bundles. The changes were consistent with eccrine angiomatous hamartoma (EAH).

The boy was referred to vascular laser therapy for treatment of the lesion.

EAH is a rare benign vascular growth characterized by an increased number of mature eccrine glands and blood vessels in the dermis and subcutis. The lesions are mostly present on the extremities, but cases of diffuse congenital lesions and lesions on the face and trunk have also been described. The lesions can be seen at birth or during the first years of life in about half of the cases, and the others tend to occur later in puberty and rarely in adulthood^.1

Clinically, EAH lesions present as red, yellow to brown papules and plaques. Different dermoscopic patterns have been described which include the popcorn pattern that presents as yellow, confluent nodules with popcornlike shapes over a background of erythema, and linear arborizing vessels. The spitzoid pattern are brown globules on a background of erythema and pseudoreticular pigmentation around the globules. The verrucous hemangiomalike pattern has a bluish-white hue, reddish-blue or bluish lacunae, as seen in our patient.^2-4

Most of the lesions are asymptomatic, but in some patients, they can be associated with pain, hyperhidrosis, and sometimes bleeding. Hyperhidrosis has been reported early in the presentation or during puberty or pregnancy. Our patient had started on amphetamines when hyperhidrosis occurred. Hyperhidrosis is a knowns side effect of this type of medication and may have had a role in the increased sweating noted on the hamartoma.

EAH can clinically look like verrucous hemangiomas, angiokeratomas, and vascular malformations, and histopathology may be needed to differentiate between them. Eccrine nevi and EAH can be similar. Hyperhidrosis is an early and predominant component of eccrine nevi, compared with one-third of EAH.

The exact etiology of this lesion is not known. It is thought to be caused by an abnormal differentiation of the epithelium, adnexal structure, and the mesenchyme during organogenesis.³ No other associated conditions have been described with EAH.

EAH are benign lesions that rarely require treatment. If the lesions are symptomatic or because of cosmetic reasons, they can be removed surgically. There are some reports of successful treatment with pulse dual-wavelength sequential 595- and 1064-nm lasers.⁵ Botulinum toxin has also been used in cases of symptomatic hyperhidrosis.
 

Dr. Matiz is a pediatric dermatologist at Southern California Permanente Medical Group, San Diego. She has no conflicts. Email her at [email protected].

References

1. Smith SD et al. Pediatr Dermatol. 2019 Nov;36(6):909-12.

2. Patterson AT et al. Am J Dermatopathol. 2016;38:413-7.

3. Garcıa-Garcıa SC et al. JAAD Case Rep. 2018;4(2):165-7.

4. Awatef Kelati et al. JAAD Case Rep. 2018;4(8)835-6.

5. Felgueiras J et al. Dermatol Surg. 2015 Mar;41(3):428-30.

A biopsy of the lesion was performed which showed an increased number of eccrine glands and blood vessels within the dermis. Some areas showed an increase in adipocytes and smooth muscle bundles. The changes were consistent with eccrine angiomatous hamartoma (EAH).

The boy was referred to vascular laser therapy for treatment of the lesion.

EAH is a rare benign vascular growth characterized by an increased number of mature eccrine glands and blood vessels in the dermis and subcutis. The lesions are mostly present on the extremities, but cases of diffuse congenital lesions and lesions on the face and trunk have also been described. The lesions can be seen at birth or during the first years of life in about half of the cases, and the others tend to occur later in puberty and rarely in adulthood^.1

Clinically, EAH lesions present as red, yellow to brown papules and plaques. Different dermoscopic patterns have been described which include the popcorn pattern that presents as yellow, confluent nodules with popcornlike shapes over a background of erythema, and linear arborizing vessels. The spitzoid pattern are brown globules on a background of erythema and pseudoreticular pigmentation around the globules. The verrucous hemangiomalike pattern has a bluish-white hue, reddish-blue or bluish lacunae, as seen in our patient.^2-4

Most of the lesions are asymptomatic, but in some patients, they can be associated with pain, hyperhidrosis, and sometimes bleeding. Hyperhidrosis has been reported early in the presentation or during puberty or pregnancy. Our patient had started on amphetamines when hyperhidrosis occurred. Hyperhidrosis is a knowns side effect of this type of medication and may have had a role in the increased sweating noted on the hamartoma.

EAH can clinically look like verrucous hemangiomas, angiokeratomas, and vascular malformations, and histopathology may be needed to differentiate between them. Eccrine nevi and EAH can be similar. Hyperhidrosis is an early and predominant component of eccrine nevi, compared with one-third of EAH.

The exact etiology of this lesion is not known. It is thought to be caused by an abnormal differentiation of the epithelium, adnexal structure, and the mesenchyme during organogenesis.³ No other associated conditions have been described with EAH.

EAH are benign lesions that rarely require treatment. If the lesions are symptomatic or because of cosmetic reasons, they can be removed surgically. There are some reports of successful treatment with pulse dual-wavelength sequential 595- and 1064-nm lasers.⁵ Botulinum toxin has also been used in cases of symptomatic hyperhidrosis.
 

Dr. Matiz is a pediatric dermatologist at Southern California Permanente Medical Group, San Diego. She has no conflicts. Email her at [email protected].

References

1. Smith SD et al. Pediatr Dermatol. 2019 Nov;36(6):909-12.

2. Patterson AT et al. Am J Dermatopathol. 2016;38:413-7.

3. Garcıa-Garcıa SC et al. JAAD Case Rep. 2018;4(2):165-7.

4. Awatef Kelati et al. JAAD Case Rep. 2018;4(8)835-6.

5. Felgueiras J et al. Dermatol Surg. 2015 Mar;41(3):428-30.

Key clinical point: Persistence of COVID-19-related symptoms for 1 year after the onset of illness is common, even in some individuals with initial mild disease.

Major finding: Overall, 40.7% of participants continued to report 1 or more COVID-19-related symptoms at 12 months after illness onset. 16.4%, 49.5%, and 52.5% of patients with mild, moderate, and severe/critical COVID-19 had 1 or more COVID-19-related symptoms at 12 months after illness onset

Study details: The data come from a Dutch prospective cohort study (RECoVERED) involving 342 patients with COVID-19.

Disclosures: This study was supported by the Netherlands Organisation for Health Research and Development (ZonMw) and the Public Health Service of Amsterdam. A Boyd received a grant from ANRS and participated in the Data Safety Monitoring Board or Advisory Board for ZonMw for another study. G de Bree served as a paid member of the scientific advisory board of ExeVir. The remaining authors declared no conflict of interests.

Source: Wynberg E et al. Clin Infect Dis. 2021 Sep 2. doi: 10.1093/cid/ciab759.

Key clinical point: Persistence of COVID-19-related symptoms for 1 year after the onset of illness is common, even in some individuals with initial mild disease.

Major finding: Overall, 40.7% of participants continued to report 1 or more COVID-19-related symptoms at 12 months after illness onset. 16.4%, 49.5%, and 52.5% of patients with mild, moderate, and severe/critical COVID-19 had 1 or more COVID-19-related symptoms at 12 months after illness onset

Study details: The data come from a Dutch prospective cohort study (RECoVERED) involving 342 patients with COVID-19.

Disclosures: This study was supported by the Netherlands Organisation for Health Research and Development (ZonMw) and the Public Health Service of Amsterdam. A Boyd received a grant from ANRS and participated in the Data Safety Monitoring Board or Advisory Board for ZonMw for another study. G de Bree served as a paid member of the scientific advisory board of ExeVir. The remaining authors declared no conflict of interests.

Source: Wynberg E et al. Clin Infect Dis. 2021 Sep 2. doi: 10.1093/cid/ciab759.

Key clinical point: Persistence of COVID-19-related symptoms for 1 year after the onset of illness is common, even in some individuals with initial mild disease.

Major finding: Overall, 40.7% of participants continued to report 1 or more COVID-19-related symptoms at 12 months after illness onset. 16.4%, 49.5%, and 52.5% of patients with mild, moderate, and severe/critical COVID-19 had 1 or more COVID-19-related symptoms at 12 months after illness onset

Study details: The data come from a Dutch prospective cohort study (RECoVERED) involving 342 patients with COVID-19.

Disclosures: This study was supported by the Netherlands Organisation for Health Research and Development (ZonMw) and the Public Health Service of Amsterdam. A Boyd received a grant from ANRS and participated in the Data Safety Monitoring Board or Advisory Board for ZonMw for another study. G de Bree served as a paid member of the scientific advisory board of ExeVir. The remaining authors declared no conflict of interests.

Source: Wynberg E et al. Clin Infect Dis. 2021 Sep 2. doi: 10.1093/cid/ciab759.

Key clinical point: Continuous positive airway pressure (CPAP) therapy in patients with severe COVID-19 who are not likely to benefit from invasive mechanical ventilation (IMV) does not confer a survival advantage over oxygen alone.

Major finding: The overall 30-day mortality rate was 75.6% in the oxygen group vs 77.7% in the CPAP group (Pearson’s Chi-square, P = .8).

Study details: The data come from a retrospective multicentre cohort study involving 479 patients with COVID-19 ineligible for IMV from 7 UK hospitals. Patients given CPAP were compared with those receiving oxygen therapy.

Disclosures: L Pearmain is supported by the Medical Research Council, and TW Felton is supported by the National Institute for Health Research Manchester Biomedical Research Centre. AB reported relationships with Fisher and Paykel and Sanofi Genzyme. The remaining authors declared no conflict of interests.

Source: Bradley P et al. EClinicalMedicine. 2021 Sep 8. doi: 10.1016/j.eclinm.2021.101122.

Key clinical point: Continuous positive airway pressure (CPAP) therapy in patients with severe COVID-19 who are not likely to benefit from invasive mechanical ventilation (IMV) does not confer a survival advantage over oxygen alone.

Major finding: The overall 30-day mortality rate was 75.6% in the oxygen group vs 77.7% in the CPAP group (Pearson’s Chi-square, P = .8).

Study details: The data come from a retrospective multicentre cohort study involving 479 patients with COVID-19 ineligible for IMV from 7 UK hospitals. Patients given CPAP were compared with those receiving oxygen therapy.

Disclosures: L Pearmain is supported by the Medical Research Council, and TW Felton is supported by the National Institute for Health Research Manchester Biomedical Research Centre. AB reported relationships with Fisher and Paykel and Sanofi Genzyme. The remaining authors declared no conflict of interests.

Source: Bradley P et al. EClinicalMedicine. 2021 Sep 8. doi: 10.1016/j.eclinm.2021.101122.

Key clinical point: Continuous positive airway pressure (CPAP) therapy in patients with severe COVID-19 who are not likely to benefit from invasive mechanical ventilation (IMV) does not confer a survival advantage over oxygen alone.

Major finding: The overall 30-day mortality rate was 75.6% in the oxygen group vs 77.7% in the CPAP group (Pearson’s Chi-square, P = .8).

Study details: The data come from a retrospective multicentre cohort study involving 479 patients with COVID-19 ineligible for IMV from 7 UK hospitals. Patients given CPAP were compared with those receiving oxygen therapy.

Disclosures: L Pearmain is supported by the Medical Research Council, and TW Felton is supported by the National Institute for Health Research Manchester Biomedical Research Centre. AB reported relationships with Fisher and Paykel and Sanofi Genzyme. The remaining authors declared no conflict of interests.

Source: Bradley P et al. EClinicalMedicine. 2021 Sep 8. doi: 10.1016/j.eclinm.2021.101122.

Key clinical point: Smokers have a significantly higher risk for COVID-19 related hospital admission and mortality than nonsmokers.

Major finding: Current smokers had an 80% higher risk for hospitalization than never-smokers (odds ratio, 1.80; 95% confidence interval, 1.26-2.29). Smokers who smoked more than 20 cigarettes a day had a 6.11-fold higher risk of dying from COVID-19 than never-smokers.

Study details: The data come from an observational study of 421,469 individuals from the UK Biobank.

Disclosures: The study was supported by individual grants to several authors. PS Tan, CAC Coupland, MR Munafò, J Hippisley-Cox, and A von Ende reported relationships with pharmaceutical companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Clift AK et al. Thorax. 2021 Sep 27. doi: 10.1136/thoraxjnl-2021-217080.

Key clinical point: Smokers have a significantly higher risk for COVID-19 related hospital admission and mortality than nonsmokers.

Major finding: Current smokers had an 80% higher risk for hospitalization than never-smokers (odds ratio, 1.80; 95% confidence interval, 1.26-2.29). Smokers who smoked more than 20 cigarettes a day had a 6.11-fold higher risk of dying from COVID-19 than never-smokers.

Study details: The data come from an observational study of 421,469 individuals from the UK Biobank.

Disclosures: The study was supported by individual grants to several authors. PS Tan, CAC Coupland, MR Munafò, J Hippisley-Cox, and A von Ende reported relationships with pharmaceutical companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Clift AK et al. Thorax. 2021 Sep 27. doi: 10.1136/thoraxjnl-2021-217080.

Key clinical point: Smokers have a significantly higher risk for COVID-19 related hospital admission and mortality than nonsmokers.

Major finding: Current smokers had an 80% higher risk for hospitalization than never-smokers (odds ratio, 1.80; 95% confidence interval, 1.26-2.29). Smokers who smoked more than 20 cigarettes a day had a 6.11-fold higher risk of dying from COVID-19 than never-smokers.

Study details: The data come from an observational study of 421,469 individuals from the UK Biobank.

Disclosures: The study was supported by individual grants to several authors. PS Tan, CAC Coupland, MR Munafò, J Hippisley-Cox, and A von Ende reported relationships with pharmaceutical companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Clift AK et al. Thorax. 2021 Sep 27. doi: 10.1136/thoraxjnl-2021-217080.

Key clinical point: Patients with multiple sclerosis (MS) receiving anti-CD20 (aCD20) treatment demonstrate a robust T-cell response to an mRNA COVID-19 vaccines.

Major finding: Thirty days following the second dose of an mRNA COVID-19 vaccine, 89% of patients with MS had antispike antibodies, and 50% had mounted anti-receptor-binding domain responses.

Study details: A study assessed antibody and T-cell responses in 20 patients with MS receiving aCD20 treatment and 10 healthy controls.

Disclosures: The study was supported by individual grants to several authors. SE Hensley, EJ Wherry, A Sette, ET Luning Prak, D Jacobs, and A Bar-Or reported relationships with pharmaceutical companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Apostolidis SA et al. Nat Med. 2021 Sep 14. doi: 10.1038/s41591-021-01507-2.

Key clinical point: Patients with multiple sclerosis (MS) receiving anti-CD20 (aCD20) treatment demonstrate a robust T-cell response to an mRNA COVID-19 vaccines.

Major finding: Thirty days following the second dose of an mRNA COVID-19 vaccine, 89% of patients with MS had antispike antibodies, and 50% had mounted anti-receptor-binding domain responses.

Study details: A study assessed antibody and T-cell responses in 20 patients with MS receiving aCD20 treatment and 10 healthy controls.

Disclosures: The study was supported by individual grants to several authors. SE Hensley, EJ Wherry, A Sette, ET Luning Prak, D Jacobs, and A Bar-Or reported relationships with pharmaceutical companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Apostolidis SA et al. Nat Med. 2021 Sep 14. doi: 10.1038/s41591-021-01507-2.

Key clinical point: Patients with multiple sclerosis (MS) receiving anti-CD20 (aCD20) treatment demonstrate a robust T-cell response to an mRNA COVID-19 vaccines.

Major finding: Thirty days following the second dose of an mRNA COVID-19 vaccine, 89% of patients with MS had antispike antibodies, and 50% had mounted anti-receptor-binding domain responses.

Study details: A study assessed antibody and T-cell responses in 20 patients with MS receiving aCD20 treatment and 10 healthy controls.

Disclosures: The study was supported by individual grants to several authors. SE Hensley, EJ Wherry, A Sette, ET Luning Prak, D Jacobs, and A Bar-Or reported relationships with pharmaceutical companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Apostolidis SA et al. Nat Med. 2021 Sep 14. doi: 10.1038/s41591-021-01507-2.

Key clinical point: A study has identified at least 3 modifiable behaviors that may increase the personal risk for COVID-19.

Major finding: Higher number of nonhousehold contacts (odds ratio [OR], 1.10 per 10 contacts; P = .024), attending events having at least 10 people (OR, 1.26 per 10 events; P = .007), and visiting restaurants (OR, 1.95 per 10 visits; P less than .001) were associated with a significantly increased risk for incident COVID-19.

Study details: The data come from a prospective cohort study of 28,575 individuals across 99 countries.

Disclosures: The study was supported by grants from the National Institutes of Health/National Institute of Biomedical Imaging and Bioengineering to GM Marcus, J Olgin, and M Pletcher. The authors declared no competing interests.

Source: Lin A et al. BMJ Open. 2021 Sep 21. doi: 10.1136/bmjopen-2021-052025.

Key clinical point: A study has identified at least 3 modifiable behaviors that may increase the personal risk for COVID-19.

Major finding: Higher number of nonhousehold contacts (odds ratio [OR], 1.10 per 10 contacts; P = .024), attending events having at least 10 people (OR, 1.26 per 10 events; P = .007), and visiting restaurants (OR, 1.95 per 10 visits; P less than .001) were associated with a significantly increased risk for incident COVID-19.

Study details: The data come from a prospective cohort study of 28,575 individuals across 99 countries.

Disclosures: The study was supported by grants from the National Institutes of Health/National Institute of Biomedical Imaging and Bioengineering to GM Marcus, J Olgin, and M Pletcher. The authors declared no competing interests.

Source: Lin A et al. BMJ Open. 2021 Sep 21. doi: 10.1136/bmjopen-2021-052025.

Key clinical point: A study has identified at least 3 modifiable behaviors that may increase the personal risk for COVID-19.

Major finding: Higher number of nonhousehold contacts (odds ratio [OR], 1.10 per 10 contacts; P = .024), attending events having at least 10 people (OR, 1.26 per 10 events; P = .007), and visiting restaurants (OR, 1.95 per 10 visits; P less than .001) were associated with a significantly increased risk for incident COVID-19.

Study details: The data come from a prospective cohort study of 28,575 individuals across 99 countries.

Disclosures: The study was supported by grants from the National Institutes of Health/National Institute of Biomedical Imaging and Bioengineering to GM Marcus, J Olgin, and M Pletcher. The authors declared no competing interests.

Source: Lin A et al. BMJ Open. 2021 Sep 21. doi: 10.1136/bmjopen-2021-052025.

Key clinical point: The risk of contracting COVID-19 among nonimmune family members decreases as the number of immune family members increases.

Major finding: An inverse dose-response association was seen between the number of immune members in each family and the risk for incident COVID-19 in nonimmune family members. Families with 1 immune member had a 45%-61% lower risk for COVID-19, whereas families with 4 immune members had a 97% lower risk.

Study details: The data come from an analysis of 1,789,728 individuals from 814,806 families, consisting of 2-5 members each.

Disclosures: Information on funding was not available. The authors declared no competing interests.

Source: Nordström P et al. JAMA Intern Med. 2021 Oct 11. doi: 10.1001/jamainternmed.2021.5814.

Key clinical point: The risk of contracting COVID-19 among nonimmune family members decreases as the number of immune family members increases.

Major finding: An inverse dose-response association was seen between the number of immune members in each family and the risk for incident COVID-19 in nonimmune family members. Families with 1 immune member had a 45%-61% lower risk for COVID-19, whereas families with 4 immune members had a 97% lower risk.

Study details: The data come from an analysis of 1,789,728 individuals from 814,806 families, consisting of 2-5 members each.

Disclosures: Information on funding was not available. The authors declared no competing interests.

Source: Nordström P et al. JAMA Intern Med. 2021 Oct 11. doi: 10.1001/jamainternmed.2021.5814.

Key clinical point: The risk of contracting COVID-19 among nonimmune family members decreases as the number of immune family members increases.

Major finding: An inverse dose-response association was seen between the number of immune members in each family and the risk for incident COVID-19 in nonimmune family members. Families with 1 immune member had a 45%-61% lower risk for COVID-19, whereas families with 4 immune members had a 97% lower risk.

Study details: The data come from an analysis of 1,789,728 individuals from 814,806 families, consisting of 2-5 members each.

Disclosures: Information on funding was not available. The authors declared no competing interests.

Source: Nordström P et al. JAMA Intern Med. 2021 Oct 11. doi: 10.1001/jamainternmed.2021.5814.

Key clinical point: In patients receiving high-flow nasal cannula (HFNC) for acute hypoxemic respiratory failure associated with COVID-19, initiating awake prone positioning (proning) soon after HFNC may improve survival.

Major finding: Initiating awake proning within 24 hours of HFNC was associated with lower mortality rates than late proning (26% vs 45%; P = .039).

Study details: The data come from a post hoc analysis of a trial evaluating awake proning in HFNC-treated patients with COVID-19 with respiratory failure (n=125).

Disclosures: The study was supported by the Rice Foundation. R Kaur, DL Vines, JD Scott, MW Trump, and J Li reported relationships with pharmaceutical/medical device companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Kaur R et al. Crit Care. 2021 Sep 17. doi: 10.1186/s13054-021-03761-9.

Key clinical point: In patients receiving high-flow nasal cannula (HFNC) for acute hypoxemic respiratory failure associated with COVID-19, initiating awake prone positioning (proning) soon after HFNC may improve survival.

Major finding: Initiating awake proning within 24 hours of HFNC was associated with lower mortality rates than late proning (26% vs 45%; P = .039).

Study details: The data come from a post hoc analysis of a trial evaluating awake proning in HFNC-treated patients with COVID-19 with respiratory failure (n=125).

Disclosures: The study was supported by the Rice Foundation. R Kaur, DL Vines, JD Scott, MW Trump, and J Li reported relationships with pharmaceutical/medical device companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Kaur R et al. Crit Care. 2021 Sep 17. doi: 10.1186/s13054-021-03761-9.

Key clinical point: In patients receiving high-flow nasal cannula (HFNC) for acute hypoxemic respiratory failure associated with COVID-19, initiating awake prone positioning (proning) soon after HFNC may improve survival.

Major finding: Initiating awake proning within 24 hours of HFNC was associated with lower mortality rates than late proning (26% vs 45%; P = .039).

Study details: The data come from a post hoc analysis of a trial evaluating awake proning in HFNC-treated patients with COVID-19 with respiratory failure (n=125).

Disclosures: The study was supported by the Rice Foundation. R Kaur, DL Vines, JD Scott, MW Trump, and J Li reported relationships with pharmaceutical/medical device companies and/or research organizations. The remaining authors declared no conflict of interests.

Source: Kaur R et al. Crit Care. 2021 Sep 17. doi: 10.1186/s13054-021-03761-9.

Key clinical point: Serum albumin levels at presentation may be a potential marker for COVID-19 severity and prognosis.

Major finding: Serum albumin of <3.5 g/dL was an independent risk factor for severe infection (adjusted odds ratio [aOR], 2.924; 95% confidence interval [CI], 1.509-5.664) and 30-day mortality (aOR, 2.615; 95% CI, 1.131-6.051).

Study details: A retrospective observational study included 296 patients with COVID-19 from emergency departments of 3 hospitals in Italy.

Disclosures: The study did not receive any funding. The authors declared no competing interests.

Source: Turcato G et al. Emerg Med J. 2021 Sep 21. doi: 10.1136/emermed-2020-210081.

Key clinical point: Serum albumin levels at presentation may be a potential marker for COVID-19 severity and prognosis.

Major finding: Serum albumin of <3.5 g/dL was an independent risk factor for severe infection (adjusted odds ratio [aOR], 2.924; 95% confidence interval [CI], 1.509-5.664) and 30-day mortality (aOR, 2.615; 95% CI, 1.131-6.051).

Study details: A retrospective observational study included 296 patients with COVID-19 from emergency departments of 3 hospitals in Italy.

Disclosures: The study did not receive any funding. The authors declared no competing interests.

Source: Turcato G et al. Emerg Med J. 2021 Sep 21. doi: 10.1136/emermed-2020-210081.

Key clinical point: Serum albumin levels at presentation may be a potential marker for COVID-19 severity and prognosis.

Major finding: Serum albumin of <3.5 g/dL was an independent risk factor for severe infection (adjusted odds ratio [aOR], 2.924; 95% confidence interval [CI], 1.509-5.664) and 30-day mortality (aOR, 2.615; 95% CI, 1.131-6.051).

Study details: A retrospective observational study included 296 patients with COVID-19 from emergency departments of 3 hospitals in Italy.

Disclosures: The study did not receive any funding. The authors declared no competing interests.

Source: Turcato G et al. Emerg Med J. 2021 Sep 21. doi: 10.1136/emermed-2020-210081.

Black and Latina women are more likely to have an open surgery compared with a minimally invasive procedure to treat ectopic pregnancy, according to research presented at the American Society for Reproductive Medicine’s 2021 meeting.

The researchers found that Black and Latina women had 50% lesser odds of undergoing laparoscopic surgery, a minimally invasive procedure, compared to their White peers.

“We see these disparities in minority populations, [especially in] women with regard to so many other aspects of [gynecologic] surgery,” study author Alexandra Huttler, MD, said in an interview. “The fact that these disparities exist [in the treatment of tubal pregnancies] was unfortunately not surprising to us.”

Dr. Huttler and her team analyzed data from the American College of Surgeons’ National Surgical Quality Improvement Program, which followed more than 9,000 patients who had undergone surgical management of a tubal ectopic pregnancy between 2010 and 2019. Of the group, 85% underwent laparoscopic surgery while 14% had open surgery, which requires a longer recovery time.

The proportion of cases performed laparoscopically increased from 81% in 2010 to 91% in 2019. However, a disproportionate number of Black and Latina women underwent open surgery to treat ectopic pregnancies during this time. Because they are more invasive, open surgeries are associated with longer operative times, hospital stays, and increased complications, Dr. Huttler said. They are typically associated with more pain and patients are more likely to be admitted to the hospital for postoperative care.

On the other hand, minimally invasive surgeries are associated with decreased operative time, “less recovery and less pain,” Dr. Huttler explained.

The researchers also looked at trends of the related surgical procedure salpingectomy, which is surgical removal of one or both fallopian tubes versus salpingostomy, a surgical unblocking of the tube. Of the group, 91% underwent salpingectomy and 9% underwent salpingostomy.

Researchers found that Black and Latina women had 78% and 54% greater odds, respectively, of receiving a salpingectomy. However, the clinical significance of these findings are unclear because there are “many factors” that are patient and case specific, Dr. Huttler said.

The study is important and adds to a litany of studies that have shown that women of color do not receive optimal care, said Ruben Alvero, MD, who was not involved in the study.

“Women of color in general have seen compromises in their care at many levels in the system,” Dr. Alvero, professor of obstetrics and gynecology at Stanford (Calif.) University, said in an interview. “We really have to do a massive overhaul of how we treat women of color so they get the same level of treatment that all other populations receive.”

While the factors contributing to these health disparities can be complicated, Dr. Alvero said that one reason for this multivariate discrepancy could be that Black and Latina women tend to seek care at, or only have access to, underresourced hospitals.

Dr. Huttler said she hopes her findings prompt further discussion of these disparities.

“There really are disparities at all levels of care here and figuring out what the root of this is certainly requires further research,” Dr. Huttler said.

The experts interviewed disclosed no conflicts on interests.

Black and Latina women are more likely to have an open surgery compared with a minimally invasive procedure to treat ectopic pregnancy, according to research presented at the American Society for Reproductive Medicine’s 2021 meeting.

The researchers found that Black and Latina women had 50% lesser odds of undergoing laparoscopic surgery, a minimally invasive procedure, compared to their White peers.

“We see these disparities in minority populations, [especially in] women with regard to so many other aspects of [gynecologic] surgery,” study author Alexandra Huttler, MD, said in an interview. “The fact that these disparities exist [in the treatment of tubal pregnancies] was unfortunately not surprising to us.”

Dr. Huttler and her team analyzed data from the American College of Surgeons’ National Surgical Quality Improvement Program, which followed more than 9,000 patients who had undergone surgical management of a tubal ectopic pregnancy between 2010 and 2019. Of the group, 85% underwent laparoscopic surgery while 14% had open surgery, which requires a longer recovery time.

The proportion of cases performed laparoscopically increased from 81% in 2010 to 91% in 2019. However, a disproportionate number of Black and Latina women underwent open surgery to treat ectopic pregnancies during this time. Because they are more invasive, open surgeries are associated with longer operative times, hospital stays, and increased complications, Dr. Huttler said. They are typically associated with more pain and patients are more likely to be admitted to the hospital for postoperative care.

On the other hand, minimally invasive surgeries are associated with decreased operative time, “less recovery and less pain,” Dr. Huttler explained.

The researchers also looked at trends of the related surgical procedure salpingectomy, which is surgical removal of one or both fallopian tubes versus salpingostomy, a surgical unblocking of the tube. Of the group, 91% underwent salpingectomy and 9% underwent salpingostomy.

Researchers found that Black and Latina women had 78% and 54% greater odds, respectively, of receiving a salpingectomy. However, the clinical significance of these findings are unclear because there are “many factors” that are patient and case specific, Dr. Huttler said.

The study is important and adds to a litany of studies that have shown that women of color do not receive optimal care, said Ruben Alvero, MD, who was not involved in the study.

“Women of color in general have seen compromises in their care at many levels in the system,” Dr. Alvero, professor of obstetrics and gynecology at Stanford (Calif.) University, said in an interview. “We really have to do a massive overhaul of how we treat women of color so they get the same level of treatment that all other populations receive.”

While the factors contributing to these health disparities can be complicated, Dr. Alvero said that one reason for this multivariate discrepancy could be that Black and Latina women tend to seek care at, or only have access to, underresourced hospitals.

Dr. Huttler said she hopes her findings prompt further discussion of these disparities.

“There really are disparities at all levels of care here and figuring out what the root of this is certainly requires further research,” Dr. Huttler said.

The experts interviewed disclosed no conflicts on interests.

Black and Latina women are more likely to have an open surgery compared with a minimally invasive procedure to treat ectopic pregnancy, according to research presented at the American Society for Reproductive Medicine’s 2021 meeting.

The researchers found that Black and Latina women had 50% lesser odds of undergoing laparoscopic surgery, a minimally invasive procedure, compared to their White peers.

“We see these disparities in minority populations, [especially in] women with regard to so many other aspects of [gynecologic] surgery,” study author Alexandra Huttler, MD, said in an interview. “The fact that these disparities exist [in the treatment of tubal pregnancies] was unfortunately not surprising to us.”

Dr. Huttler and her team analyzed data from the American College of Surgeons’ National Surgical Quality Improvement Program, which followed more than 9,000 patients who had undergone surgical management of a tubal ectopic pregnancy between 2010 and 2019. Of the group, 85% underwent laparoscopic surgery while 14% had open surgery, which requires a longer recovery time.

The proportion of cases performed laparoscopically increased from 81% in 2010 to 91% in 2019. However, a disproportionate number of Black and Latina women underwent open surgery to treat ectopic pregnancies during this time. Because they are more invasive, open surgeries are associated with longer operative times, hospital stays, and increased complications, Dr. Huttler said. They are typically associated with more pain and patients are more likely to be admitted to the hospital for postoperative care.

On the other hand, minimally invasive surgeries are associated with decreased operative time, “less recovery and less pain,” Dr. Huttler explained.

The researchers also looked at trends of the related surgical procedure salpingectomy, which is surgical removal of one or both fallopian tubes versus salpingostomy, a surgical unblocking of the tube. Of the group, 91% underwent salpingectomy and 9% underwent salpingostomy.

Researchers found that Black and Latina women had 78% and 54% greater odds, respectively, of receiving a salpingectomy. However, the clinical significance of these findings are unclear because there are “many factors” that are patient and case specific, Dr. Huttler said.

The study is important and adds to a litany of studies that have shown that women of color do not receive optimal care, said Ruben Alvero, MD, who was not involved in the study.

“Women of color in general have seen compromises in their care at many levels in the system,” Dr. Alvero, professor of obstetrics and gynecology at Stanford (Calif.) University, said in an interview. “We really have to do a massive overhaul of how we treat women of color so they get the same level of treatment that all other populations receive.”

While the factors contributing to these health disparities can be complicated, Dr. Alvero said that one reason for this multivariate discrepancy could be that Black and Latina women tend to seek care at, or only have access to, underresourced hospitals.

Dr. Huttler said she hopes her findings prompt further discussion of these disparities.

“There really are disparities at all levels of care here and figuring out what the root of this is certainly requires further research,” Dr. Huttler said.

The experts interviewed disclosed no conflicts on interests.