Many COVID-19 patients present with atypical symptoms, such as delirium, smell and taste dysfunction, or cardiovascular features. Based on inpatient electronic health record data between March 1 and April 20 of 2020, this cohort study examined the frequency of atypical presentation of COVID-19 among older adults. Analyses suggest that atypical presentation was often characterized by functional decline or altered mental status.

Antimicrobial stewardship is one strategy to improve antibiotic use to reduce hospital-acquired infections. In this editorial, the authors discuss negative effects of COVID-19 on antimicrobial resistance and antibiotic stewardship in the emergency department (ED) and approaches for optimizing ED stewardship during the pandemic.  

The opioid epidemic is an ongoing patient safety issue. This study examined the impact of the COVID-19 state emergency declaration on nonfatal, unintentional opioid-related overdoses. The authors identified a greater number of opioid overdoses occurring between March 1 to June 30, 2020 compared to March 1 to June 30, 2019, and that Black patients made up a larger proportion of the overdose visits compared with the previous year. These results highlight the potential impact of COVID-19 on racial/ethnic disparities.

This cohort explored the mental health impacts of a universal COVID-19 testing program on asymptomatic pregnant women and labor and delivery health care workers. Among multiparous women who tested negative, nearly 35% reported that COVID-19 led to additional fear or anxiety postpartum compared with previous deliveries. Labor and delivery health care workers reported that COVID-19 decreased job satisfaction and increased job-related anxiety.