Editor's note: Because information on COVID-19 continues to evolve, this content may have changed since we went to press in mid-April.
* Two years into the pandemic, the U.S. COVID-19 death rate is higher than that of any other large, comparably developed country, according to a New York Times analysis of several large databases. Reasons for this include vaccine hesitancy and a large portion of the population not having received their booster shot.
* A randomized clinical trial of 360 U.S. adults found that a substantial proportion misinterpreted the negative results of at-home COVID-19 tests, and as a result may have failed to self-quarantine or may have quarantined unnecessarily. The authors, writing in the March JAMA Internal Medicine, suggest that redesigned instructions may increase the benefits and reduce the harms of these self-test kits.
* An exploratory study in the February 8 JAMA evaluated patients in 11 Dutch hospitals who survived ICU treatment for COVID-19 and found that patients reported physical, mental, and cognitive symptoms one year later. The most frequently reported new physical problems were weakened condition, joint stiffness and pain, muscle weakness, and myalgia. And an analysis in the March 14 European Heart Journal suggested that even mild to moderate COVID-19 infections can cause lingering changes to a patient's heart and cardiovascular system.
* A performance improvement initiative conducted at a New York nursing home-the Coler Rehabilitation and Nursing Care Center-aimed to reduce the COVID-19 fatality rate by 33% among residents by focusing on early identification of infection and close monitoring of symptoms. The initiative implemented a bundle whose components included taking vital signs (including oxygen saturation via pulse oximetry) of all residents at least once per shift, frequent follow-up visits by clinical staff, timely diagnostic testing of symptomatic residents, and identification of residents suitable for palliative care. The authors, writing in the January/February American Journal of Medical Quality, suggest that the bundle can be applied elsewhere after appropriate assessment.
* Two recent studies have shown the effects of COVID-19 in pregnant women. A study in the February 22 JAMA found that SARS-CoV-2 infection was associated with an increased risk of maternal mortality or serious morbidity from obstetric complications. Another, published on February 10 online in the Archives of Pathology and Laboratory Medicine, suggests that the coronavirus can invade and destroy the placenta and lead to stillbirths. In the cases highlighted in the study, intrauterine and perinatal death likely resulted directly from placental insufficiency, and not from SARS-CoV-2 involvement of the fetus.