This is an update of the American College of Physicians' living, rapid practice points on the use of remdesivir for treatment of COVID-19. This update is based on an updated living, rapid systematic review that included studies published through 19 October 2021 and identified 2 new studies meeting inclusion criteria.

DESCRIPTION: The Scientific Medical Policy Committee (SMPC) of the American College of Physicians (ACP) developed these living, rapid practice points to summarize the current best available evidence on the antibody response to SARS-CoV-2 infection and protection against reinfection with SARS-CoV-2. This is version 2 of the ACP practice points, which serves to update version 1, published on 16 March 2021. These practice points do not evaluate vaccine-acquired immunity or cellular immunity. METHODS: The SMPC developed this version of the living, rapid practice points based on an updated living, rapid, systematic review conducted by the Portland VA Research Foundation and funded by the Agency for Healthcare Research and Quality. PRACTICE POINT 1: Do not use SARS-CoV-2 antibody tests for the diagnosis of SARS-CoV-2 infection. PRACTICE POINT 2: Do not use SARS-CoV-2 antibody tests to predict the degree or duration of natural immunity conferred by antibodies against reinfection, including natural immunity against different variants. RETIREMENT FROM LIVING STATUS: Although natural immunity remains a topic of scientific interest, this topic is being retired from living status given the availability of effective vaccines for SARS-CoV-2 and widespread recommendations for and prevalence of their use. Currently, vaccination is the best clinical recommendation for preventing infection, reinfection, and serious illness from SARS-CoV-2 and its variants.

Chronic hepatitis C (CHC) is associated with a higher risk of developing type 2 diabetes mellitus (DM). In patients with preexisting type 2 DM, CHC often worsens glycemic control. With direct-acting antivirals (DAAs)-based treatment regimens for CHC, nearly all patients achieve sustained virologic response (SVR). There is limited literature demonstrating improvement in the glycemic index of patients with DM following the eradication of hepatitis C virus (HCV) with DAA. Thus, it is reasonable to hypothesize that early treatment of CHC and optimal glycemic control in these patients could prevent chronic complications of diabetes and worsening of liver disease. We performed a retrospective cohort study examining whether HCV eradication with DAAs leads to improved glycemic index in patients with DM and the feasibility of safely and successfully offering such care at a primary care physician/providers (PCP) office.

Staphylococcus simulans is a coagulase-negative organism, mainly an animal pathogen. Reports of human infection have been infrequent, mainly in patients with repeated animal contact. We report the first case of pleural empyema in an elderly woman. S. simulans tends to cause more severe infection because of a biofilm layer which helps in adherence and colonization of smooth surfaces, especially prosthetic devices, shunts, and catheters. The challenging problem even after CoNS isolation and identification is the assessment of their clinical relevance. Major factors that inhibit the penetration of antibiotics is the large-sized effusions/empyema, thickness of pleura, and the nature of antibiotic itself. Source control for septic patients remains the cornerstone of treatment along with optimal antimicrobial coverage. Staphylococcus simulans, a coagulase-negative staphylococcus, is emerging as an important cause of virulent infections with high mortality in humans. Given its propensity for multidrug resistance, including vancomycin, there is an imperative for early and accurate identification of the isolate. Despite aggressive treatment, the patient succumbed to her illness.