Description

— Climate: Theories attempting to explain the relatively low case fatality rate (CFR) in Africa (3%) compared to the Americas (6%) and Europe (9%) include:

• Minimal early transmission from Asia and Europe
• Younger population and warm, dry climate
• Underestimation of the CFR due to limited resources and testing

- Authors from the University of Arkansas describe howdelayed presentation for stroke may be prohibiting time-sensitive treatment with tissue plasminogen activator (tPA).

— Epidemiology:  

-Data from the Korean Centers for Disease Control and Prevention estimates the burden of disease from the pandemic to be 4.93 Disability-Adjusted Life Years per 100,000 population.

- Belgian authors studying anosmia in COVID-19 found that

• 87% of those reporting anosmia for less than 12 days were RT-PCR positive for COVID-19 (vs only 23% testing positive in patients reporting symptoms longer than 12 days).
• However, olfactory performance testing found 25% patients were actually having normal smell despite their self reported symptoms.

— Understanding the Pathology: 

-Data from the University of Washington hospital system found <1% of asymptomatic patients without known exposure tested positive for COVID-19, compared to 10% in symptomatic patients.

- A retrospective study of the first 1000 COVID-19 patients at New York-Presbyterian Hospital found a bimodal distribution in time-to-intubation after symptom onset (3-4 days & 9 days), suggesting careful monitoring of patients 5-8 days post-symptom onset to anticipate disease progression.

— Transmission and Prevention: 

- Scant evidence of detectable SARS-CoV-2 in semen and breastmilk has researchers calling for more robust research to understand implications of potential sexual and vertical transmission of the disease.

- Serologic and RT-PCR testing of an entire otolaryngology unit staff (with an n=58), in a high-prevalence region of Italy, found a 9% positivity; however, survey results showed that their out-of-hospital COVID-19 exposure was actually associated with a higher risk of contracting the infection.

— Management:

- Authors argue against using two consecutive negative PCR tests as a guide for discontinuation of isolation precautions, highlighting how nearly 1/5 patients test positive after two negatives and the substantial amount of PPE and resources required for these tests.

— R&D Diagnosis and Treatment: 

- Brazilian pathologists coorelate lung US findings to histopathology in COVID-19 autopsies.

— Mental Health:  

- How COVID-19 trauma can countertransfer to psychotherapists, especially less experienced clinicians earlier in their careers.