Read AMA Morning Rounds®’ most popular stories in medicine and public health from the week of Aug. 31, 2020 – Sept. 4, 2020.

Children may carry coronavirus in noses, throats for weeks, research suggests

CNN (8/28, Howard, Lamotte) reported, “Children can carry coronavirus in their noses and throats for weeks even if they don’t show any symptoms, which might explain how the virus can spread silently, researchers in South Korea reported Friday.” The study was published in JAMA Pediatrics .

Bloomberg (8/28, Gale) reported researchers “tested and tracked 91 children under 19 years of age who tested positive for SARS-CoV-2 infection and were hospitalized or isolated across 22 centers in South Korea in February and March,” and found that nearly “70% of children at risk of infection had symptoms that didn’t get picked up, researchers said.” Furthermore, “93% of pediatric cases would have been missed if doctors had focused on testing symptomatic patients alone, they said.”

Data show coronavirus cases are increasing at a faster rate in children and teenagers than general public

The New York Times (8/31, Leatherby, Jones) reports, “As some schools begin in-person classes, data compiled by the American Academy of Pediatrics from the summer show that cases, hospitalizations and deaths from the coronavirus have increased at a faster rate in children and teenagers than among the general public.” The data collected between May 21 and August 20 “varies from state to state, possibly obscuring differences in how the virus affects infants, young children and adolescents.”

Meanwhile, CNBC (8/31, Feuer) reports, “Coronavirus cases are rising across more than half of the nation even as the outbreak slows across former hotspots in Arizona, Florida, California and Texas.” According to a CNBC analysis of data compiled by Johns Hopkins University, “new cases are up by at least 5%, based on a seven-day average, in 26 states as of Sunday, compared with just 12 states a week ago.” Meanwhile, “in Arizona, Florida, California and Texas, new cases are declining by at least as much, though those states still accounted for nearly 10,000 new cases combined on Sunday – or about a fourth of all new U.S. cases.”

Major changes made to 2021 CPT code for E/M office visits

RevCycle Intelligence (9/1, LaPointe) reports, “The American Medical Association (AMA) implemented major changes to the 2021 Current Procedural Terminology (CPT) code set in an effort to simplify coding and documentation of office visits and other outpatient evaluation and management (E/M) services.” The new code set “modified E/M office visit codes 99201 through 99215 to eliminate history and physical exam as elements for code selection and enable physicians to select the code levels based on medical decision-making or total time.”

FierceHealthcare (9/1, Landi) reports that in a statement, AMA President Susan R. Bailey, MD, said, “To get the full benefit of the burden relief from the E/M office visit changes, health care organizations need to understand and be ready to use the revised CPT codes and guidelines by Jan. 1, 2021.” She added, “The AMA is helping physicians and health care organizations prepare now for the transition and offers authoritative resources to anticipate the operational, infrastructural and administrative workflow adjustments that will result from the pending transition.”

Medscape (9/1, Young, Subscription Publication) says that “the 2021 changes also include new medical testing services sparked by the public health response to the COVID-19 pandemic.”

Editor’s Note: To prepare for the revised codes and guidelines, view the AMA’s preparedness checklist or check out our E/M Office Visits page.

International clinical trials suggest steroids can help people with severe COVID-19

The New York Times (9/2, Rabin) reports, “International clinical trials published on Wednesday confirm the hope that cheap, widely available steroid drugs can help seriously ill patients survive” COVID-19. JAMA published five papers concerning the use of steroids to treat people with severe COVID-19, including a meta-analysis and an editorial that called the studies an “important step forward in the treatment of patients with” COVID-19. Dr. Howard C. Bauchner, the editor-in-chief of JAMA, said, “Clearly, now steroids are the standard of care.” The new studies can be found here, here, and here.

Reuters (9/2, Kelland, Nebehay) reports researchers conducted a pooled analysis of seven international trials and concluded that corticosteroids can reduce the risk of death by 20% in critically ill patients with COVID-19. The trials tested dexamethasone, hydrocortisone, and methylprednisolone. Citing the studies, the WHO issued new guidance recommending the use of steroids to treat severe cases of COVID-19.

Experts say “coronasomnia” could have major impact on public health

The Washington Post (9/3, Brulliard, Wan) reports that “physicians and researchers are seeing signs” that the coronavirus pandemic “is doing deep damage to people’s sleep.” Dubbed “coronasomnia” by some experts, it “could prove to have profound public-health ramifications – creating a massive new population of chronic insomniacs grappling with declines in productivity, shorter fuses and increased risks of hypertension, depression and other health problems.”

AMA Morning Rounds news coverage is developed in affiliation with Bulletin Healthcare LLC. Subscribe to Morning Rounds Daily.

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