Coronavirus-19 disease (COVID-19) has quickly spread to cause a global pandemic, and produces a spectrum of disease from mild respiratory illness to severe acute respiratory distress syndrome. Current estimates indicate that 15% of patients with COVID-19 will develop severe disease, and 5 to 10% will require intensive care-level support. In certain scenarios, escalation of life-sustaining therapies (defined as intubation, mechanical ventilation,vasopressor support, and/or hemodialysis) will either not be within the patient’s goals of care, or will unfortunately be unsuccessful. Overall mortality risk from COVID-19is estimated to be between 3 and 5%.
The availability of new and repurposed drugs for the treatment of drug-resistant tuberculosis (DR-TB) provides hope in a field in which treatment options are severely limited and treatment success rates rarely exceed 50%. Despite the ongoing search for shorter, more tolerable, and more efficacious treatment regimens, DR-TB remains a death sentence for a considerable proportion of people affected. Additionally, these patients must bear debilitating side-effects of centuries-old medication, along with social isolation, stigma, loss of income, and psychological distress. Despite reports of reduced mortality among patients receiving bedaquiline, low treatment initiation rates and delayed access to new drugs means that, for the foreseeable future, a large proportion of patients with DR-TB will still be considered to have a terminal illness and will require integration of palliative care into the management of their condition.
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