Risk of Post-acute Symptoms and Conditions After SARS-CoV-2 Compared to Other Respiratory Viral Infections: A Systematic Review and Meta-Analysis
Researchers pooled 14 cohort studies comparing lingering symptoms in adults after SARS-CoV-2 with those after other respiratory viruses, mostly influenza-like illness, influenza and RSV. Only a few outcomes were clearly more common after COVID: pulmonary embolism, abnormal breathing, fatigue, hemorrhagic stroke, brain fog and palpitations. Heart rate abnormalities were borderline, and most other outcomes were no more frequent than after other viral infections. The authors conclude that post-COVID condition is one example of a broader group of post-acute infection syndromes, not something entirely unique to SARS-CoV-2. Urgent Care Clinical implications: Clinicians should take persistent fatigue, dyspnea, palpitations, and cognitive complaints seriously after any respiratory virus, not just COVID. Keep PE and cardiopulmonary causes on the differential for patients with post-COVID breathing or heart symptoms. Full Access: International Journal of Infectious Diseases
Nationwide Increase in Reported Human Rabies Exposures: Rabies Post-exposure Prophylaxis Administration
CDC issued a Health Advisory on September 10 about a nationwide rise in rabies exposures and errors in post-exposure prophylaxis (PEP). Rabies inquiries to CDC were up 17% in July and August compared with last year, and use of rabies vaccine and HRIG rose about 33% and 76%. Supplies are fine, but mistakes lead to unnecessary treatment, adverse effects, and cost. The most common errors are gluteal vaccine injections, poor HRIG infiltration of wounds, mixing HRIG and vaccine in one syringe or site and giving HRIG to previously vaccinated patients. Urgent Care Clinical implications: Do a careful risk assessment before starting PEP, check prior vaccination and immune status and call your health department. Full Access: CDC
Deaths: Leading Causes for 2024
National Center for Health Statistics reports that the 10 leading causes accounted for 70.9% of all U.S. deaths in 2024, with the ranked order largely unchanged from 2023. Heart disease (22.2%) and malignant neoplasms (20.2%) remained first and second, followed by accidents/unintentional injuries (6.4%), cerebrovascular disease (5.4%), and chronic lower respiratory disease (4.7%). The most notable movement was suicide rising from 11th to 10th, while COVID-19 fell from 10th to 15th on a 37% year-over-year decline in deaths. Unintentional injury was the leading cause of death for every age group from 1 through 44 years. Urgent Care Clinical Implications: The dominance of unintentional injury across all working-age groups reinforces that trauma, overdose, and injury-related presentations are the highest-yield targets for risk assessment and intervention in the ambulatory and Urgent Care setting. Full Access: NVSS
Antibiotic Treatment and Antimicrobial Resistance in Urinary Tract Infections Among the Older Population in Denmark, 1999–2023
This national register-based surveillance study tracked prescribing of four UTI antibiotics (pivmecillinam, sulfamethizole, trimethoprim, nitrofurantoin) in Danes ≥70 years and resistance in E. coli and K. pneumoniae urine isolates. UTI antibiotic consumption peaked in 2014 and fell 28.4% by 2023, while resistance to all four agents declined significantly from 2018 to 2023 — trends the authors attribute to national stewardship initiatives begun after 2013. Notably, pivmecillinam use rose 3.5-fold yet its resistance fell, and the number of urine isolates rose over the period, hinting at more infections or more testing. The design is descriptive and ecological, so the stewardship-to-resistance link is correlational, not causal; the agents and the ≥70 primary-care/long-term-care population also limit US applicability. Urgent Care Clinical implications: The one portable, guideline-consistent takeaway is that pivmecillinam maintains low resistance despite heavy use and is a rational first-line agent for uncomplicated UTI. Full Access: Europe’s Journal on Infectious Disease