The emergence of SARS-CoV-2/2019 novel coronavirus (COVID-19) has created a global pan-demic with no approved treatments or vaccines. Many treatments have already been administered to COVID-19 patients but have not been systematically evaluated. We performed a systematic literature review to identify all treatments reported to be administered to COVID-19 patients and to assess time to clinically meaningful response for treatments with sufficient data. We searched PubMed, BioRxiv, MedRxiv, and ChinaXiv for articles reporting treatments for COVID-19 patients published between 1 December 2019 and 27 March 2020. Data were analyzed descriptively. Of the 2706 articles identified, 155 studies met the inclusion criteria, comprising 9152 patients. The cohort was 45.4% female and 98.3% hospitalized, David C. Fajgenbaum and Johnson S. Khor contributed equally to this study.

Summary Geographically dispersed patients, inconsistent treatment tracking, and limited infrastructure slow research for many orphan diseases. We assess the feasibility of a patient-powered study design to overcome these challenges for Castleman disease, a rare hematologic disorder. Here, we report initial results from the ACCELERATE natural history registry. ACCELERATE includes a traditional physician-reported arm and a patient-powered arm, which enables patients to directly contribute medical data and biospecimens. This study design enables successful enrollment, with the 5-year minimum enrollment goal being met in 2 years. A median of 683 clinical, laboratory, and imaging data elements are captured per patient in the patient-powered arm compared with 37 in the physician-reported arm. These data reveal subgrouping characteristics, identify off-label treatments, support treatment guidelines, and are used in 17 clinical and translational studies. This feasibility study demonstrates that the direct-to-patient design is effective for collecting natural history data and biospecimens, tracking therapies, and providing critical research infrastructure.

Neurotrophic keratopathy (NK), or neurotrophic keratitis, is a degenerative condition that results from decreased innervation to the cornea. The cornea is innervated by the ophthalmic branch of the trigeminal nerve. Neurotrophic keratopathy is most commonly caused by herpes keratitis however, any condition that disrupts the normal corneal innervation can cause NK. Neurotrophic keratopathy is a clinical diagnosis and is classified into three stages based on the disease severity. Stage 1 has mild epithelial defects, such as punctate keratopathy, stage 2 disease has persistent epithelial defects, and stage 3 is defined by the presence of ulcers. Current treatment modalities consist of medical and surgical options. Stage 1 is treated with lubrication through artificial tears, eyelid taping, and punctal plug/cautery. Stage 2 treatment can involve therapeutic contact lenses, topical autologous or allogenic serum, tarsorrhaphy, botulinum toxin injections, and possibly anti-inflammatory medications. Stage 3 disease may require human nerve growth factor, amniotic membrane transplantation, conjunctival flap, or corneal neurotization. New therapies, such as matrix regenerating therapy, plasma rich in growth factors, Thymosin β4, Substance P/Insulin like growth factor-1, and nicergoline represent exciting future options. KEY MESSAGES Neurotrophic keratopathy is a rare degenerative disease defined by decreased innervation to the cornea that is associated with significant morbidity. Treatment options range from lubrication alone to various medical and surgical treatments. Matrix regenerating therapy, plasma rich in growth factors, Thymosin β4, Substance P/Insulin like growth factor-1, and nicergoline are exciting novel therapies that will influence how neurotrophic keratopathy is treated in the future.

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Background: Rupture of the distal biceps tendon remains an uncommon injury that is ideally treated by operative repair. Single-incision anterior approach with suture anchor repair is one such method. The purpose of this study was to describe the outcomes in patients who underwent repair of the distal biceps tendon with single anterior incision and suture anchor repair. Methods: One hundred and nineteen patients (120 repairs) with distal biceps tendon repairs between January 1, 2002 and December 31, 2012 were identified and their charts retrospectively reviewed. Twenty-five of these patients participated in additional collection of outcome data including range of motion, strength, pain, satisfaction, and clinical outcome. Results: In the retrospective analysis, the population was 93% male. Average age was 47.3 yr; however, females had a significantly higher mean age (62.5). Most of the patients (69.8%) returned to full or partial work. The additional data collection cohort reported high satisfaction, little-to-no pain on visual analog scale (VAS) and average Disability of the Arm Shoulder and Hand (DASH) scores. Patients with workers’ compensation claims reported significantly higher pain and worse DASH scores. There was small but significant loss of pronation, and a small loss of grip strength that approached significance. Conclusions: Single anterior incision with suture anchor repair may be utilized for repair of ruptures of the distal biceps tendon with good clinical and functional outcomes and minimal loss of range of motion and strength. Females tend to be older at presentation than males with this condition. As in other studies, workers’ compensation claims were associated with poorer clinical outcomes. Level of Evidence: Therapeutic, level IV, case series study.