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Emergency Medicine Journal COVID-19 monthly top five
  1. Mohammed H Elwan1,2,
  2. Sarah L Edwards3,
  3. Mostafa Hassanein3,
  4. Alasdair Moffat3,
  5. James David van Oppen4,
  6. Damian Roland5,
  7. Timothy J Coats1,
  8. Anisa Jabeen Nasir Jafar6,7
  9. RCEM COVID-19 CPD Team
    1. 1 Department of Cardiovascular Sciences, University of Leicester, Leicester, Leicestershire, UK
    2. 2 Emergency Medicine, Alexandria University, Alexandria, Egypt
    3. 3 Emergency Department, University Hospitals of Leicester NHS Trust, Leicester, UK
    4. 4 Department of Health Sciences, University Hospitals of Leicester NHS Trust, Leicester, UK
    5. 5 Children's Emergency Department, University Hospitals of Leicester NHS Trust, Leicester, UK
    6. 6 Emergency Department, Manchester Royal Infirmary, Manchester, UK
    7. 7 Humanitarian and Conflict Response Institute, University of Manchester, Manchester, Manchester, UK
    1. Correspondence to Dr Mohammed H Elwan, Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 5WW, UK; m.elwan{at}

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    Edited by Dr Anisa Jafar on behalf of the RCEM COVID-19 CPD team

    Following from the successful ‘RCEM weekly top five’ series starting in April 2020, this is the fourth of a monthly format for Emergency Medicine Journal (EMJ) readers. We have undertaken a focused search of the PubMed literature using a standardised COVID-19 search string. Our search between 1 January and 31 January 2020 returned 4138 papers limited to human subjects and English language. We also searched high impact journals for papers of interest.

    Our team have narrowed down the most interesting, relevant and important of the papers and provided a critical snapshot of five of those we felt most deserved EMJ reader attention. Importantly, we have highlighted not only the main findings from the papers but key limitations and considerations for EM clinicians when interpreting the work. In doing so, have created an accessible window into pertinent research findings for our busy colleagues during this fast-paced and ever-changing COVID-19 landscape.

    The papers are ranked in one of three categories, allowing you to focus on the papers that are most vital to your practice:

    • Worth a peek—interesting, but not yet ready for prime time.

    • Head turner—new concepts.

    • Game changer—this paper could/should change practice.

    This month’s searches were undertaken by the Emergency Medicine Academic Group in Leicester. We look forward to next month’s instalment from our friends and colleagues down the M69 in Coventry.

    Development and validation of the ISARIC 4C deterioration model for adults hospitalised with COVID-19: a prospective cohort study

    Topic: prognosis

    Rating: head turner

    Prognostic models for risk of deterioration in acute COVID-19 could inform clinical management decisions, plan appropriate treatment escalation for patients and forecast resource needs for hospitals. This paper from the International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) group developed and validated a predictive model for in-hospital deterioration defined as any requirement for ventilatory support, critical care or death.1

    Adults …

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    • Twitter @drmhuss, @drsarahedwards, @J_vanOppen, @damian_roland, @TJCoats, @EMergeMedGlobal

    • Collaborators RCEM COVID-19 CPD Team: Dr Charles Reynard, Dr Anisa Jafar, Dr Daniel Darbyshire, Dr Govind Oliver, Dr Gabrielle Prager and Professor Simon Carley.

    • Contributors AJ performed the literature search. TC and ME assembled the team of authors. TC, SE, MH, AM, JvO and DR screened titles in provided literature search and long-listed articles. ME, SE and TC handsearched selected journals. ME sifted the long list and selected articles for inclusion. All authors contributed to writing and editing the final piece.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JvO declares funding from the National Institute for Health Research (Doctoral Research Fellowship NIHR300901). JvO is an author of the third study reviewed here. Citation screening was collaborative among the whole team. JvO was not involved in the review, appraisal, or final selection of this study.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.