Shows
The COVID-19 LST ReportWeek of February 15th, 2021In today's episode we discuss:
—Climate: Infectious Disease Society of America (IDSA) made 4 strong recommendations for preventing COVID-19 infection in health care personnel. A pulmonologist and interventional cardiologist from the Cleveland Clinic and Emory University critique recently published IDSA guidelines for preventing COVID-19 infection in healthcare workers. They argue the recommendation to use either respirators or surgical masks conflicts with Centers for Disease Control guidance to use respirators, and believe the guidelines are missing recommendations on proper gloving strategies, which are crucial to avoid self-contamination. The authors suggest the IDSA must clarify these points to alleviate confusion fo...
2021-02-2413 minThe COVID-19 LST ReportCOVID-19 LST TrailerWe are an affiliated group of medical students, PhDs, and physicians keeping up with the latest research on SARS-CoV-2 / COVID-19. We find the newest articles, read them, grade their level of evidence, and bring you the bottom line. Our goal is to empower you to take the best care of yourself and those in your care.
Our Story:
What did University of Washington third-year medical student Jasmine Rah do when her training program was suspended due to COVID-19? She teamed up with her mentor, Dr. Will Smith, an ER Doctor on the front lines...
2021-02-0901 minThe COVID-19 LST ReportWeek of February 1st, 2021In today's episode we discuss:
—Epidemiology
· What does the literature say about face mask usage against COVID-19? A large international, interdisciplinary group summarize the evidence supporting mask wearing to mitigate the spread of COVID-19. They reviewed direct epidemiological evidence, population-level impacts, transmission characteristics, laboratory-based source control experiments, personal protective equipment efficacy research, sociological considerations, and implementation policies. Authors conclude all evidence indicates mask wearing effectively reduces viral droplet transmission and should be encouraged by officials to help minimize the spread of COVID-19.
—Understanding the Pathology: ABO blood group showed minimal differences in SARS-CoV-2 antib...
2021-02-0916 minThe COVID-19 LST ReportJanuary 18, 2021 & January 19, 2021In today's episode we discuss:
—Epidemiology: Seroprevalence of SARS-CoV-2 antibodies in over 6000 healthcare workers show increased occupational risk. Physicians and laboratory scientists from Spain conducted a cross-sectional study of 6,038 healthcare workers (HCW) across 4 regions in Spain to assess the seroprevalence of IgG anti-SARS-CoV-2 antibodies. They found 11% of HCW (n=662) had IgG against SARS-CoV-2, with those with high (OR: 2.06; 95%CI: 1.63-2.62) and moderate (OR: 1.77; 95%CI: 1.32-2.37) risk exposures more likely to have antibodies. Because this rate of seropositivity is slightly higher than in the general Spanish population, authors suggest their data confirm the occupational risk of SARS-CoV-2 infection am...
2021-01-2607 minThe COVID-19 LST ReportJanuary 11, 2021In today's episode we discuss:
—Epidemiology: Do we need routine COVID-19 testing of Emergency Department staff? A study from the University of Washington uses a mathematical model based on the Diamond Princess cruise ship data to predict detection of SARS-CoV-2 in asymptomatic health care workers (HCWs) in the emergency department in regions with high COVID-19 rates. Results revealed that within six months, weekly testing in asymptomatic HCWs would reduce infection rates by 3 to 5.9% when the transmission constant is 1.219e-4 new infections/person^2, while a transmission constant of 3.660e-4 new infections/person^2 would result in reduction of infections by...
2021-01-1506 minThe COVID-19 LST ReportJanuary 8, 2021In today's episode we discuss:
—Epidemiology: The authors present a case report of a 29-year-old SARS-CoV-2 positive woman with minimal, mild symptoms who underwent an uncomplicated and successful vaginal delivery to a healthy baby boy at the University of Missouri Women and Children’s Hospital in April 2020. After birth, the patient’s placenta was subsequently analyzed using hematoxylin-and-eosin (H&E) staining, which revealed evidence of general placental vascular malperfusion possibly due to hypertrophic arteriolopathy along with immunohistochemistry (IHC) staining which revealed the presence of SARS-CoV-2 in chorionic villi endothelial cells. Current literature on COVID-19 in pregnant patien...
2021-01-1502 minThe COVID-19 LST ReportJanuary 7, 2021In today's episode we discuss:
—Adjusting Practice During COVID-19: A team of cardiologists and pharmacists from hospitals in Shanghai and Wuhan, China assessed the association between mortality in hospitalized COVID-19 patients (n=535) and low molecular weight heparin (LMWH) use between January 26-March 26, 2020. They found overall adjusted odds ratio for mortality was lower in the LMWH-users vs non-users (0.20; 95% CI, 0.09-0.46), specifically in severe (0.08; 95% CI, 0.01–0.62) and critically ill cases (0.32; 95% CI ,0.10–0.996). Authors suggest LMWH appears correlated with a survival benefit in hospitalized COVID-19 patients, especially those severely and critically ill.
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2021-01-1501 minThe COVID-19 LST ReportJanuary 6, 2021In today's episode we discuss:
—Climate: American physicians from Yale and the University of Maryland argue that the US government should mandate vaccination of migrant detainees against COVID-19. They assert the crowded and inadequate sanitary conditions in these facilities create epicenters for disease proliferation and that without federal mandates, states will fail to vaccinate this vulnerable population. Authors suggest such policy is both sound medical practice and a moral imperative.
—Epidemiology: A team of Spanish physicians conducted a retrospective cohort-study using the SEMI-COVID-19 Registry of 12,170 COVID-19 patients from 150 hospitals in Spain to investigate impact of arte...
2021-01-1502 minThe COVID-19 LST ReportJanuary 5, 2021In today's episode we discuss:
—Climate: More transparency is needed for emergency use authorizations (EUA), including drugs and vaccines for COVID-19, according to a journalist writing for the Journal of the American Medical Association reporting on a recent US Government Accountability Office (GAO) report. The report calls on the Food and Drug Administration (FDA) to publicly share safety and efficacy data related to EUAs to improve public confidence during this unprecedented time.
—Epidemiology: Persistence of SARS-CoV-2 in a first trimester placenta may have led to transplacental transmission and fetal demise from an asymptomatic mother. An inte...
2021-01-1307 minThe COVID-19 LST ReportJanuary 5, 2021In today's episode we discuss:
—Climate: More transparency is needed for emergency use authorizations (EUA), including drugs and vaccines for COVID-19, according to a journalist writing for the Journal of the American Medical Association reporting on a recent US Government Accountability Office (GAO) report. The report calls on the Food and Drug Administration (FDA) to publicly share safety and efficacy data related to EUAs to improve public confidence during this unprecedented time.
—Epidemiology: Persistence of SARS-CoV-2 in a first trimester placenta may have led to transplacental transmission and fetal demise from an asymptomatic mother. An inte...
2021-01-0904 minThe COVID-19 LST ReportJanuary 4, 2021In today's episode we discuss:
—Climate: A systematic review by an international team of researchers highlights the significant underrepresentation of geriatric patients in published COVID-19 randomized control trials (RCTs). In the 12 RCTs included in the review, patients had mean age of 56.3 years, and were on average 20 years younger than patients from large observational trials. One explanation for this discrepancy is the strict exclusion criteria used for RCTs, which commonly exclude patients with cognitive impairment and multiple comorbidities frequently seen in the elderly population. The authors strongly advocate for future RCTs to include this vulnerable population that has be...
2021-01-0907 minThe COVID-19 LST ReportDecember 30, 2020In today's episode we discuss:
—Climate: The US Centers for Disease Control COVID-19 Response Team used data from three online CARAVAN omnibus surveys (n=858) conducted to assess parental attitudes and concerns about schools reopening during the COVID-19 pandemic and found more white families were in favor of in-person school (62.3%) compared to Hispanic families (50.2%, p=0.014) and Black families (46.0%, p=0.007), while non-white parents were more concerned about schools opening safely (98.8% very or somewhat concerned) than were white families (86.0%, p=0.012). Authors suggest socioeconomic differences and structural inequities may drive these differing attitudes and recommend school districts consider each community's unique ne...
2021-01-0508 minThe COVID-19 LST ReportDecember 29, 2020In today's episode we discuss:
—Understanding the Pathology: SARS-CoV-2 Infection likely triggers an autoimmune response. A case control study from Northern Italy found elevated inflammatory markers and autoantibodies (ANA, ASCA, IgG and anti-Cardiolipin) in 40 hospitalized COVID-19 patients compared to healthy controls. These results add to the growing body of evidence suggesting the association of COVID-19 with autoimmune disease and inflammatory dysfunction. The authors suggest utilizing these antibodies as prognostic indicators, especially when considering treatment with plasma therapy.
—Management: Is there an effect of artificial liver blood purification treatment on the survival of critically ill COVID-19 pati...
2021-01-0502 minThe COVID-19 LST ReportDecember 22, 2020In today's episode we discuss:
—Climate: Board members of the International Society of Vaccine (ISV) summarize their organization's recent efforts to provide information and resources about COVID-19 vaccines to members worldwide: they provide links to their recent virtual lecture series on COVID-19 vaccines and suggest their organization is a global leader on vaccine development that can provide balanced information to a variety of stakeholders. The authors encourage new researchers and developers to join the ISV at www.isv-online.org.
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2020-12-3101 minThe COVID-19 LST ReportDecember 21, 2020In today's episode we discuss:
—Epidemiology: What was the SARS-CoV-2-specific neutralizing antibody response in Norwegian healthcare workers after the first wave of COVID-19 pandemic? A multicenter prospective survey study of 607 healthcare workers (HCW) by a researcher at the Influenza Centre at the University of Bergen in Norway found 5% of participants (32/607) were seropositive for SARS-CoV-2 (spike-specific IgG, IgM, and IgA antibodies), including 21 who were positive at baseline and 11 who seroconverted during follow-up. 77% of the infected HCWs, in high-risk departments were young nurses aged 23-31. Results also showed that HCW were 11.6 times more likely to contact COVID-19 patients wh...
2020-12-3105 minThe COVID-19 LST ReportDecember 17, 2020In today's episode we discuss:
—Climate: Operations officers from several international biomedical manufacturing companies discuss the ability of manufacturers to reduce distribution of counterfeit vaccines in light of counterfeit SARS-CoV-2 vaccines being found in Russia and Ecuador in 2020. Authors recommend using various tracking methods such as a GS1 2D DataMatrix barcode, QR code and matrix code, or Automatic Identification and Data Capture (AIDC) flow to scan and identify vaccines, trace them from the factory to delivery, and upload that data into an easily accessible system. They suggest such a tracing system is necessary to ensure the delivery of...
2020-12-2304 minThe COVID-19 LST ReportDecember 16, 2020In today's episode we discuss:
—Understanding the Pathology: Researchers from the Department of Health & Exercise Science at Appalachian State University analyze the vascular impact of SARS-CoV-2 on 20 healthy young adults 3-4 weeks post-infection by doppler ultrasound of arterial blood flow in the upper and lower extremities (markers of vascular function) and pulse wave velocity (indicator of arterial stiffness). Results demonstrated that brachial artery flow-mediated dilation (FMD) was 6% lower after COVID-19 infection, which is clinically significant because each 1% decrease in FMD is associated with a 13% higher risk of cardiovascular events, suggesting that systemic vascular dysfunction and arterial st...
2020-12-2302 minThe COVID-19 LST ReportDecember 15, 2020In today's episode we discuss:
—Climate: What are the COVID-19 vaccine trial ethics once we have efficacious vaccines? An expert opinion penned by bioethicists from the National Institutes of Health and Fogarty International Center in Bethesda, MD explore the ethics of continuing blinded, placebo-controlled trials for COVID-19 vaccines in the wake of a safe and efficacious vaccine being approved for widespread use. Authors argue it is ethical to continue trials if participants consent and the risk-benefit profile of the trial remains acceptable, because continuing trials could lead to the discovery of longer lasting vaccines, better immunity, or gr...
2020-12-2304 minThe COVID-19 LST ReportDecember 11, 2020In today's episode we discuss:
—Climate: The editorial team at JAMA explains their decision to publish the Lenze et al study "Fluvoxamine vs placebo and clinical deterioration in outpatients with symptomatic COVID-19: a randomized clinical trial." While it is a preliminary study with limitations, authors argue it warranted publication due to its design as a placebo-controlled, double-blind randomized clinical trial and the authors' methodological adjustments to conduct study activities without physical contact, such as arranging oxygen and medications deliveries for self-quarantining patients and obtaining consent virtually. The team suggests that the Lenze et al pilot study provides an...
2020-12-1503 minThe COVID-19 LST ReportDecember 9, 2020In today's episode we discuss:
—Epidemiology: A systematic review of 39 articles (30 retrospective and 9 prospective) on venous thromboembolic events (VTE) in COVID-19 by a team of cardiologists and molecular biologists from the Central South University in Hunan, China found that D-dimer, fibrinogen, and APTT may be useful in predicting thromboembolic events in patients with severe COVID-19.
—Understanding the Pathology: Physicians at the Icahn School of Medicine used enzyme-linked immunosorbent assay (ELISA) to screen patients (n=72,401) at Mount Sinai Health System for the SARS-CoV-2 spike protein antibody and found that 30,082 patients tested positive (titer 1:80 or higher) with quan...
2020-12-1502 minThe COVID-19 LST ReportDecember 8, 2020In today's episode we discuss:
—Climate: No-fault compensation for vaccine injury. Are we looking at the other side of equitable access to Covid-19 vaccines? An opinion piece on COVID-19 vaccination explains that though there are 79 higher-income countries ready to pay for vaccine distribution in 92 lower-income countries, there is not yet an established method for injury compensation if an adverse vaccine event takes place. This suggests the need for an injury compensation plan in these lower-income countries by incorporating existing systems in wealthier countries, some World Health Organization programs, and the COVAX Facility, an international partnership to help su...
2020-12-1502 minThe COVID-19 LST ReportDecember 7, 2020In today's episode we discuss:
—Understanding the Pathology: Critical illness is associated with cerebral microbleeds for patients with severe COVID-19. A retrospective cohort study conducted at University Hospitals of Strasbourg, France compared 19 severe COVID-19 patients with MRI evidence of microhemorrhage to 18 COVID-19 patients with normal MRI and found more pronounced respiratory failure, higher D-dimer increases, and more frequent need for dialysis in the microhemorrhage group. The researchers hypothesize that blood-brain barrier dysfunction due to hypoxemia and levels of uremic toxins may be a key mechanism of COVID-19-related cerebral microhemorrhage, which clinicians should consider during severe COVID-19 pa...
2020-12-1503 minThe COVID-19 LST ReportDecember 3, 2020In today's episode we discuss:
—Management: A systematic review analyzed a set of 45 studies (n= 4,203 patients) published between November 1, 2019 and March 15, 2020 and found that elevated leukocyte count, alanine aminotransferase (ALT), aspartate transaminase (AST), lactate dehydrogenase (LDH), and procalcitonin levels predicted ICU admission in patients with COVID-19. Acute respiratory distress syndrome (ARDS) was predicted by elevated LDH, while mortality was predicted by increased leukocyte count and elevated LDH. Treatment with lopinavir-ritonavir showed no significant benefit across mortality and ARDS rates, while corticosteroids were associated with a higher rate of ARDS. These findings suggest that elevated levels of LDH, le...
2020-12-1502 minThe COVID-19 LST ReportDecember 4, 2020In today's episode we discuss:
—Understanding the Pathology: Investigators in South Korea analyzed samples from 6 COVID-19-positive patients at 3 tertiary hospitals who had recovered with negative SARS-CoV-2 rRT-PCR results and then presented again with subsequent positive rRT-PCR results. One of the patients, a 21-year-old female with allergic rhinitis, recovered with resolution of symptoms, then presented 2 additional times with mild symptoms and subsequent positive testing. A whole-genome sequencing from samples taken at her first and her third presentations found two distinct genomic clades between the viral RNA in the 2 samples, suggesting evolutions of the SARS-CoV-2 genome. Their findings su...
2020-12-1201 minThe COVID-19 LST ReportDecember 2, 2020In today's episode we discuss:
—Climate: A review by pediatric specialists with The Ruth & Bruce Rappaport Faculty of Medicine in Haifa, Israel discusses the phenomenon known as “vaccine hesitancy” (continued deferment of vaccines despite proven effectiveness and extremely rare adverse effects), and the barrier it could create for eventual adoption of a COVID-19 vaccine, and suggest patient education on vaccine contraindications and lack of evidence supporting adverse reactions or autoimmune disease associations may reduce vaccine hesitancy. Additionally, they suggest thorough vaccine research and multimedia educational campaigning will be needed for the coming COVID-19 vaccines.
—Epidemio...
2020-12-1204 minThe COVID-19 LST ReportDecember 1, 2020In today's episode we discuss:
—Epidemiology: Is there SARS-CoV-2 persistence and non-protective immunity in infected haematological patients? Greek infectious disease physicians present a case of 35-year-old with a history of acute lymphoblastic leukemia 14 days status-post chemotherapy with R-hyper-CVAD who presented on April 8, 2020 with pneumonia after positive RT-PCR for SARS-CoV-2 on March 26. The patient eventually recovered after a seven-week hospitalization and developed antibodies suggestive of immunologic memory but was later readmitted on July 22 with severe COVID-19 pneumonia despite serologic testing with continued adequate IgG. Authors suggest defective innate and adaptive immunity in immunocompromised patients may facilitate SARS-CoV-2 infection (i...
2020-12-1204 minThe COVID-19 LST ReportNovember 30, 2020In today's episode we discuss:
—Epidemiology: There is higher prevalence of pulmonary macrothrombi in SARS-CoV-2 than in influenza A. A comparative analysis by pathologists at University Hospital Zurich in Switzerland assessed pulmonary macrothrombi autopsy findings in 411 patients who died from the Influenza A pandemic in 1918/1919, 12 from Influenza A in 2009-2020, and 75 for COVID-19. They found COVID-19 patients had significantly higher occurrences of grossly visible pulmonary thrombosis despite empiric thrombophylaxis due to in situ clot formation associated with SARS-CoV-2. Authors suggest a specific COVID-19 coagulopathy may be linked to higher mortality rate seen in COVID-19 compared to the se...
2020-12-1204 minThe COVID-19 LST ReportNovember 25, 2020In today's episode we discuss:
—Transmission & Prevention: A review by biomedical engineers in Canada discusses the possibility of using animal models including rhesus macaques, hamsters, and ferrets to help guide research on COVID-19 vaccine development. They also describe 8 current vaccine platforms, including 139 vaccine candidates in pre-clinical evaluation and 26 in clinical evaluation, and highlight the importance of introducing an effective COVID-19 vaccine to return to pre-pandemic life.
—Management: Emergency Medicine and Cardiovascular physicians from Mayo Clinic conduct a review reporting an increased risk of cardiac involvement in athletes with COVID-19: they discuss how 10-27.8% of a...
2020-12-0802 minThe COVID-19 LST ReportNovember 24, 2020In today's episode we discuss:
—Epidemiology: Body Mass Index is correlated with Risk for Intubation or Death in SARS-CoV-2 Infection according to a retrospective cohort study. The study, conducted at Columbia University Irving Medical Center, investigated the association between body mass index (BMI) and risk for intubation or death, inflammation, cardiac injury, or fibrinolysis from SARS-CoV-2 infection in 2,466 hospitalized COVID-19-positive adults. Compared to overweight patients, patients with class 3 obesity had the highest risk of intubation or death (hazard ratio, 1.6 [95% CI, 1.1 to 2.1]), though these effects were most clear in patients less than 65 years old. BMI was no...
2020-12-0803 minThe COVID-19 LST ReportNovember 23, 2020In today's episode we discuss:
—Understanding the Pathology: Truncation of orf3b in the circulating SARS-CoV-2 strains has been shown in one study. Microbiologists and Infectious Disease researchers from the University of Hong Kong analyze the genome of SAR-CoV-2 with a particular focus on the orf3b gene, which was found to antagonize type-I interferon activation. Using the sequence data from the GISAID depository, they report a steady increase and persistence of the truncated form of the orf3b gene in SARS-CoV-2 strains worldwide, particularly in countries with the highest confirmed number of COVID-19 cases. The au...
2020-12-0803 minThe COVID-19 LST ReportNovember 20, 2020In today's episode we discuss:
—Epidemiology: A retrospective case series conducted by radiologists from Zucker School of Medicine at Hofstra/Northwell in Manhasset, NY evaluated imaging features of six patients (all >65 years old) who presented to the emergency department with PCR-confirmed moderate-to-severe SARS-CoV-2 infection that was complicated by thromboembolic events. These authors suggest a hyper-inflammatory state secondary to SARS-CoV-2 infection may increase susceptibility to systemic thrombosis and recommend venous thromboembolism (VTE) prophylaxis in severe COVID-19 cases.
—Understanding the Pathology: Australian pulmonologists respond to recently published data by Mo et al, 2020 that showed diffusion capacity of c...
2020-12-0801 minThe COVID-19 LST ReportNovember 18, 2020In today's episode we discuss:
—Epidemiology: Pediatric cardiologists from the Association for European Pediatric and Congenital Cardiology's COVID-19 Rapid Response Team evaluated 286 children with symptoms of multisystem inflammatory syndrome in children (MIS-C) and found 65% had laboratory evidence of current or past COVID-19 infection, 93% had cardiac involvement, and all had elevated inflammatory markers, suggesting pediatric patients with MIS-C should be monitored for cardiovascular complications and rising biomarkers.
· A literature review conducted by an international panel of pediatric dermatologists describes documented skin manifestations of COVID-19 in children including chilblain-like lesions, erythema multiforme, urticaria (10-20% of cutaneous manifestation rep...
2020-11-2100 minThe COVID-19 LST ReportNovember 17, 2020In today's episode we discuss:
—Epidemiology: Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection according to one study. Immunologists and infectious disease specialists at St. James’s Hospital in Dublin, Ireland examined prevalence of post-COVID-19 fatigue in 128 patients who had recovered from COVID-19 using the Chalder Fatigue Score (CFQ-11). They found 52.3% (67/128) of participants met the criteria for fatigue at a median of 10 weeks following initial symptoms and fatigue was associated with female gender and preexisting depression/anxiety, but data showed no association between total CFQ-11 score and age, disease course, or labo...
2020-11-2100 minThe COVID-19 LST ReportNovember 16, 2020In today's episode we discuss:
—Climate: The International COVID-19 Parental Attitude Study (COVIPAS) group conducted a cross-sectional survey of 1541 caregivers from six countries and found that 65% of caregivers were willing to vaccinate their child against COVID-19 whenever a vaccine became available, and that 52% of those refusing vaccination reported that the newness of the vaccine was a deciding factor. Authors suggest these findings demonstrate the need for effective public health education efforts regarding the safety, efficacy, and utility of any available COVID-19 vaccine
—Epidemiology: Massive dissemination of a SARS-CoV-2 Spike Y839 variant in Portugal was found. Bioi...
2020-11-2000 minThe COVID-19 LST ReportNovember 13, 2020In today's episode we discuss:
—Adjusting Practice During COVID-19: A prospective survey study of 66 patients who had undergone image-guided corticosteroid injections for pain management by musculoskeletal imaging specialists at Massachusetts General Hospital in Boston found no significant difference in rates of new COVID-19 cases between patients who received corticosteroid injections (n=1/66, 25 year-old male, 19 days following injection) and the general population (p=0.44), suggesting that corticosteroid injections are safe to perform during the COVID-19 pandemic.
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2020-11-2000 minThe COVID-19 LST ReportNovember 12, 2020In today's episode we discuss:
—Epidemiology: A retrospective cohort study by physicians in Wuhan, China found no significant difference in levels of testosterone, follicle-stimulating hormone, or luteinizing hormone between 39 male patients with SARS-CoV-2 and 22 control patients without SARS-CoV-2 (p<0.05) nor between cases with severe versus moderate disease severity; however, 20 patients with >50 days of viral shedding had elevated estradiol levels compared to those with shorter shedding duration (p<0.05), suggesting that SARS-CoV-2 is unlikely to cause sterility or hypogonadism.
—Transmission & Prevention: An international group of vaccine development experts from the Accelerating COVID-19 Ther...
2020-11-1400 minThe COVID-19 LST ReportNovember 11, 2020In today's episode we discuss:
—Epidemiology: An observation-based modeling study conducted at Columbia University analyzed reproductive numbers of COVID-19 in the United States and found a significant and rapid drop following social distancing and other control measures. Based on changes expected from such control measures in counterfactual models, a substantial number of cases and deaths could have been avoided if control measures were implemented 1 to 2 weeks earlier.
· An optimization model by mathematicians and data scientists using daily travel surveys, census data, and USPS building locations across various states estimated that >94% of Americans would travel to...
2020-11-1400 minThe COVID-19 LST ReportNovember 10, 2020In today's episode we discuss:
—Transmission & Prevention: Pediatricians published best practices for breastfeeding mothers who were positive for or exposed to COVID-19 in JAMA Pediatrics. The authors express that while the literature is uncertain on risk of COVID-19 transmission through breastmilk, this route of transmission seems unlikely, and protective antibodies are likely to be the only SARS-CoV-2 related material to be transmitted. They believe their proposed practices for breastfeeding while infected with COVID-19 will promote safe breastfeeding, although they note these suggestions may change overtime.
· Is there an association Between Early Treatment With Tocilizumab and...
2020-11-1400 minThe COVID-19 LST ReportNovember 6, 2020In today's episode we discuss:
—Epidemiology: How effective are public health measures, such as quarantine, in decreasing viral spread? An extended Susceptible–Infected–Recovered (SIR) model to estimate the case rate mortality (CFR) of COVID-19 in Wuhan and the rates of infection, recovery, and death globally revealed an estimated CFR of 4.4% and an estimated quarantine effect against transmission of 99.3%, highlighting the importance of adherence to public health quarantine policies in decreasing viral spread during the pandemic.
—Understanding the Pathology: What is the duration of SARS-CoV-2 antibodies in plasma after symptom onset? Infectious Disease researchers from China st...
2020-11-1200 minThe COVID-19 LST ReportNovember 5, 2020In today's episode we discuss:
—Understanding the Pathology: Do childhood vaccines help protect against SARS-CoV-2? A team of Egyptian virologists inoculated mice with common childhood vaccines (BCG, Pneumococcal, Rotavirus, Diphtheria, Tetanus, Pertussis, Hepatitis B, Haemophilus influenzae, Meningococcal, Measles, Mumps, and Rubella) and found no evidence of cross-reacting antibodies against SARS-CoV-2 in serum up to seven weeks post-vaccination, suggesting that if childhood vaccines provide protection against SARS-CoV-2, it may not be antibody mediated.
—Transmission & Prevention: How often are discharged patients re-testing positive for SARS-CoV-2? A review of 62 studies evaluating recurrence of SARS-CoV-2 viral RNA in disc...
2020-11-1200 minThe COVID-19 LST ReportNovember 4, 2020In today's episode we discuss:
—Understanding the Pathology: Should we be testing for more than SARS-CoV-2 antibodies? Microbiologists, pathologists, and public health experts associated with Mount Sinai Hospital analyzed 3277 blood specimens from recovered COVID-19 patients and found that neutralizing antibody level is the highest 31-35 days post symptom onset, even though general SARS-CoV-2 antibody levels had been high (well above the 160 titer range cutoff) long before this, suggesting the importance of also testing for neutralizing antibodies.
—Transmission & Prevention: How do close contact and aerosol transmission risks compare? Swiss environmental engineers applied a Quantitative Microbial Risk...
2020-11-0900 minThe COVID-19 LST ReportNovember 3, 2020In today's episode we discuss:
—Climate: Hospital Volumes during the COVID-19 Pandemic in 2 US Medical Centers, Stanford University Medical Center and New York-Presbyterian/Weill Cornell Medical Center, were explored with the incidence of 5 medical emergencies: acute MI, ischemic stroke, nontraumatic subarachnoid hemorrhage, ectopic pregnancy, and appendicitis. Authors found decreased incidence of acute myocardial infarction, non-traumatic subarachnoid hemorrhage, and ischemic stroke cases in both centers, a decrease in appendicitis cases in New York, and no changes in ectopic pregnancy cases at either center. They implicate that deferring seeking care for acute conditions due to the fear of co...
2020-11-0900 minThe COVID-19 LST ReportSeptember 15, 2020On today's episode we discuss:
—Epidemiology: Random COVID-19 testing of 200 people in Chelsea, MA using the BioMedomics SARS-CoV-2 combined IgM/IgG LFA to determine seropositivity in a group of asymptomatic patients showed that 24.7% of seropositive participants were asymptomatic, suggesting that better safety precautions such as improved testing, isolation, contact-tracing, and distancing are needed as a high number of individuals can be carrying the virus asymptomatically.
· A systematic review of 97 studies exploring COVID-19 in 230,398 health care workers (HCW) showed COVID-19 prevalence of 11% by RT-PCR (95% CI: 7-15%) and 7% by antibody detection (95% CI: 4-11%) with serious complications seen in...
2020-09-1702 minThe COVID-19 LST ReportSeptember 14, 2020On today's episode we discuss:
—Climate: Analysis of a cross-sectional, self-reported survey of 10,624 Internet users revealed that 17% of survey participants used telehealth due to the pandemic with Blacks, Latinos, and those identified with other races having statistically significant higher odds than White participants. The authors urge the need for social change to combat systemic racism, especially in the setting of the COVID-19 pandemic, and call for better access and adaptation to telehealth for all races, ethnicities, and socioeconomic groups.
· Anthropologists from Austria and Pakistan offer multiple reasons why COVID-19 may overwhelm low-income countries, using Pakistan as...
2020-09-1702 minThe COVID-19 LST ReportSeptember 10, 2020On today's episode we discuss:
—Understanding the Pathology: An observational study of 67 COVID-19 non-ICU patients (45 male, 22 female) admitted to COVID Hospital of Policlinico of Bari, Italy investigating the role of IL-6 levels in loss of taste/smell found a statistically significant correlation between decreased IL-6 and improvement in smell (p<0.05) and taste (p=0.047) (Table 3). The authors believe these results highlight the local inflammatory actions of IL-6 on chemosensory receptors, resulting in taste and smell disorders in COVID-19.
· A neuropathology research group affiliated with Harvard Medical School in Boston report on autopsy and clinical neurologic fin...
2020-09-1303 minThe COVID-19 LST ReportSeptember 9, 2020On today's episode we discuss:
—Epidemiology: Public health experts affiliated with Indiana University estimated the infection fatality ratios (IFR) of SARS-CoV2 based on antibody tests in a random sample of residents aged 12+ in Indiana. The average age of decedents was 76.9 (SD 13.1). 1099 COVID-19 deaths were recorded and the average IFR was 0.26%, but stratified IFR varied by age: >60yo IFR 1.71%, <40yo IFR 0.01%; and by race: whites IFR 0.18% and non-whites IFR 0.59%. These results from the SARS-CoV-2 population prevalence data suggest that risk of death increases with age and varies by race.
· A retrospective single center stu...
2020-09-1304 minThe COVID-19 LST ReportSeptember 8, 2020On today's episode we discuss:
—Epidemiology: Experienced scientists from the Center for Tobacco Control Research and Education at the University of California San Francisco conducted a meta-analysis of 19 peer-reviewed papers involving 11,590 COVID-19 patients. They found a positive association between smoking and severe progression of COVD-19. Authors suggest that while this data clearly shows smoking puts COVID-19 patients at increased risk for disease progression, the actual risk may be even higher due to limitations in the reviewed papers.
—Transmission & Prevention: Infection control experts from West China Hospital of Sichuan University in Chengdu discuss prev...
2020-09-1005 minThe COVID-19 LST ReportSeptember 4, 2020On today's episode we discuss:
—Climate: An online survey of gay, bisexual and other men who have sex with men assessed changes in sexual behavior, prophylaxis use, and disease testing during the COVID-19 lockdown. Findings included a mean increase of 2.3 sexual partners during lockdown, HIV and other STI screenings were decreased in about a third of respondents, and lockdown prevented 8.9% of respondents from accessing HIV PrEP. This study suggests the need to help ensure that populations needing these services will have access to them, especially during the pandemic.
—Epidemiology: Post-discharge surveillance of 285 adult patients with COVI...
2020-09-0804 minThe COVID-19 LST ReportSeptember 3, 2020On today's episode we discuss:
—Epidemiology: Systematic review and meta-analysis of 42 studies including 23,353 COVID-19 positive patients estimated random prevalence of olfactory dysfunction to be 38.5%, taste dysfunction 30.4%, and overall chemosensory dysfunction 50.2% among these patients with Caucasians having a 3-6 times higher prevalence of chemosensory deficits (43.2%) than East Asians (15.1%). These results suggest that chemosensory dysfunction is a relatively common effect of COVID, though inter-study variability was high for this analysis.
· A retrospective observational study conducted in Wuhan, China found that among 126 patients with confirmed COVID-19 infection, 3 patients had a re-detected COVID-19 positive result via RT-PCR when tested 11-20...
2020-09-0804 minThe COVID-19 LST ReportSeptember 2, 2020On today's episode we discuss:
—Epidemiology: A study of 47 COVID-19 patients in JiangXi Province, China found that patients whose SARS-CoV-2 oropharyngeal nucleic acid tests turned negative slowly (over more than one week) were significantly more fatigued than patients whose tests turned negative rapidly (within one week), suggesting fatigue may be a clinical sign of persistent active SARS-CoV-2 infection.
· A case series found that out of 3,375 patients with Systemic Lupus Erythematosus (SLE), 3 were infected with COVID-19. All 3 were treated with various immunosuppressive therapies (including hydroxychloroquine) and needed escalating treatment regimens in conjunction with COVID-19 infection treatment. How...
2020-09-0803 minThe COVID-19 LST ReportSeptember 1, 2020On today's episode we discuss:
—Epidemiology: Investigators affiliated with the Laboratorio de Investigacao Medica em Envelhecimento at Universidade de Sao Paulo performed a longitudinal, observational study on 707 COVID-19 patients admitted to a tertiary university hospital in Sao Paulo, Brazil and found that 33% (n=234) of patients had descriptors of delirium (confusional state, disorientation, hallucinations, etc;). Additionally, delirium was independently associated with length of hospital stay, ICU admission, and in-hospital deaths in adults older than the age of 50. Based on these findings, the authors suggest that healthcare workers should assess for delirium among COVID-19 patients, which may help monitor th...
2020-09-0301 minThe COVID-19 LST ReportAugust 31, 2020On today's episode we discuss:
· Smoking Is Associated With COVID-19 Progression: A Meta-analysis: Authors affiliated with University of California, San Francisco and Mahidol University conducted a meta-analysis (n= 19 studies between January 1 and April 28, 2020 from China, U.S., and Korea) of 11,590 total patients with COVID-19 and found that 731 of these patients reported a history of smoking.
· Household Composition May Explain COVID-19 Racial/Ethnic Disparities: A summary of a study by the Agency for Healthcare Research and Quality (U.S.), written by JAMA scientific news writer Rita Rubin, MA, explains that the higher observed death rates from CO...
2020-09-0302 minThe COVID-19 LST ReportAugust 28, 2020On today's episode we discuss:
—Climate: Primary care residents at Brigham and Women's Hospital in Boston discuss the importance of community health centers (CHCs) in serving low socioeconomic status, immigrant, rural, and racial/ethnic minority patients during the COVID-19 pandemic. The authors call for Congressional action to ensure adequate funding to CHCs and universal coverage to individuals without employer-sponsored insurance, suggesting that the pandemic may provide an impetus for improving the United States healthcare system so that CHC's could serve patients more effectively.
—Epidemiology: A multicenter cross-sectional study found that among 614 patients with confirmed COVID-19, 278 had...
2020-09-0302 minThe COVID-19 LST ReportAugust 27, 2020On today's episode we discuss:
—Climate: A group at USC's Keck School of Medicine identified public health concerns of COVID-19 risk in individuals who vape through systematic surveillance on Twitter. They discuss whether this population should be prioritized in COVID-19 screening and whether individuals should stop vaping as a preventive measure. They additionally identified posts sharing unsubstantiated health claims of vaping methods/products used to protect against COVID-19 and discuss the need for additional research in vaping and COVID-19 to combat misinformation.
—Epidemiology: A retrospective single-center study in Wuhan, China including 43 women of child-bearing age (17 preg...
2020-09-0301 minThe COVID-19 LST ReportAugust 26, 2020On today's episode we discuss:
—Epidemiology: A retrospective study of 242 COVID-19 positive inpatients found that 19% had bacterial co-infection and those with bacterial co-infection had an increased risk of mechanical ventilation (44% vs. 17%) and death (50% vs. 15%) independent of demographics and co-morbidities. The authors suggest the concomitant bacterial infection is relatively common in COVID-19 inpatients and may be associated with increased patient mortality.
—Transmission & Prevention: Investigators at Guangzhou Blood Center, China assessed the presence of anti-SARS-CoV-2 antibodies in the blood of 2,199 volunteer blood donors. They found that of 7 total blood donors with positive serum-SARS-CoV-2 antigen reactivity, only 2 poss...
2020-09-0302 minThe COVID-19 LST ReportAugust 25, 2020On today's episode we discuss:
—Epidemiology: Australian systematic review and meta-analysis further confirm that patients with chronic disease are at higher risk for worse outcomes with COVID-19. The most common comorbidities were hypertension (22%), diabetes (14%), and cardiovascular diseases (13%). Crude case fatality rate (CFR) was 7% overall but increased significantly with an increasing number of comorbidities.
—Understanding the Pathology: A retrospective cross-sectional study by Chest Diseases specialists in Turkey enrolled 123 adult COVID-19 pneumonia patients with pulmonary infiltrates on CT chest (34 mild, 89 severe), comparing 91 BCG-vaccinated and 32 unvaccinated patients and found increased age (p<0.001) and low income (p<0.001) to b...
2020-08-2704 minThe COVID-19 LST ReportAugust 24, 2020On today's episode we discuss:
—Climate: Physicians affiliated with the Icahn School of Medicine at Mount Sinai, Harvard School of Medicine, and Duke University Medical Center consider the downside of "pressurized research" in the context of previous healthcare crises and reflect on the shortcomings of poor research that have occurred during previous calamities, including the secondary pneumonias that followed trials of immunotherapies during the 1918 influenza epidemic and cases of Guillain–Barre syndrome following swine flu vaccination in 1976. The authors recognize the challenges to meet demands for effective therapies and vaccine development, however, they urge for caution and humi...
2020-08-2707 minThe COVID-19 LST ReportAugust 14, 2020On today's episode we discuss:
—Climate: In this study, investigators from Canada compared mean change in driving from baseline (using Apple Mobility Trends) and COVID-19 mortality rate as of April 30th, 2020 in 36 countries with the highest number of COVID-19 cases globally, excluding those for which driving distance data was not available. They found decreased driving to be associated with lower COVID-19 mortality ( p<0.001), highlighting the importance of social distancing measures to curb the spread and mortality associated with COVID-19.
—Epidemiology: Newborns of COVID-19 mothers: short-term outcomes of colocating and breastfeeding from the pandemic's epicenter: A re...
2020-08-2406 minThe COVID-19 LST ReportAugust 13, 2020On today's episode we discuss:
—Climate: An author affiliated with the Department of Health & Human Performance at the University of Tennessee presents the 2018 Social Vulnerabilities for the American Indian and Alaska Native people (AIAN) by tribal geographic areas and calls attention to the high risk of contracting COVID-19 and its associated complications among the AIAN people. The author highlights the potential value of utilizing these resources in order to understand the COVID-19 impact on AIAN communities and their ability to recover from the pandemic.
—Understanding the Pathology: A group of pharmacists and toxicologists in Spai...
2020-08-2402 minThe COVID-19 LST ReportAugust 12, 2020On today's episode we discuss:
— Epidemiology: A comparison of outcomes among COVID-19 patients with (n=21) and without (n=236) chronic hepatitis B virus (HBV) infection found that a similar proportion of patients in both groups progressed to severe disease and exhibited at least one transaminase elevation, suggesting that chronic HBV infection does not appear to affect COVID-19 outcomes.
· A systematic review and meta-analysis including 5829 COVID-19 pediatric patients found that in general, nonspecific symptoms such as fever and cough were very common in these patients as were normal white blood cell counts. Additionally, among children younger than 1 yea...
2020-08-1403 minThe COVID-19 LST ReportAugust 10, 2020Epidemiology
· A case report of a 29-year-old SARS-CoV-2 positive woman with minimal, mild symptoms who underwent an uncomplicated and successful vaginal delivery revealed the following in the placenta: 1. Evidence of general placental vascular malperfusion possibly due to hypertrophic arteriolopathy; notably, there were no signs of fetal malperfusion or micro-thrombi and 2. Presence of SARS-CoV-2 in chorionic villi endothelial cells. The authors posit that this case is the first report of placental SARS-CoV-2 in the setting of mild COVID-19 disease, where the patient had only symptoms of mild myalgias.
· In comparing hematological fe...
2020-08-1203 minThe COVID-19 LST ReportAugust 7, 2020Climate
· Dr. Melina R. Kibbe from UNC Chapel Hill in the Department of Surgery argues that the COVID-19 pandemic has disproportionately affected female parents working in academic and/or clinical environments with reduction in female manuscript authorship, citing drops in female-first authors (4%), female-last authors (6%), and female-corresponding authors (7%) from 2019 to 2020 in terms of published JAMA Surgery articles. She suggests that protocols should be put in place to alleviate this disparity, such as extending grant end-dates, incorporating offsetting work shifts, and increasing allowances for part-time work.
Transmission & Prevention
· Canadian researchers investigated the effectiveness of pe...
2020-08-1105 minThe COVID-19 LST ReportAugust 6, 2020Epidemiology
· A recent case report describes an 18-year old male patient diagnosed with COVID-19 after presenting with fever, anorexia, and headache at a clinic on Reunion Island in the Indian Ocean. He later returned with fever, rash, dyspnea, and arthromyalgias and was discovered to be positive for dengue as well highlighting the importance to test for both conditions when clinically indicated.
Understanding the Pathology
· Single cell RNA sequencing of human kidney cells revealed that the expression of angiotensin converting enzyme 2 was highest in the proximal convoluted tubule cells and glomerular parietal cells providing ce...
2020-08-1105 minThe COVID-19 LST ReportAugust 5, 2020Epidemiology
· Investigators at the CDC performed an analysis of COVID-19 cases from early in the pandemic and found that among the first case reported in each of 99 countries, 60% were in individuals with a history of travel to China, Italy, or Iran.
Understanding the Pathology
· A retrospective study conducted in Spain found that a cohort of 134 COVID-19 patients had significantly elevated levels of uroporphyrin I, coproporphyrin I, and coproporphyrin III when compared to patients with COVID-19 negative pneumonia. These findings provide evidence to suggest that the accumulation of these markers may exacerbate heme shortages wh...
2020-08-1103 minThe COVID-19 LST ReportAugust 4, 2020CLIMATE:
· An article by Talha Burki in The Lancet argues that the COVID-19 pandemic has had a more negative impact on women compared to men across the globe. She suggests this is in large part due to the indirect effects of the pandemic on women's health, such as an increase in economic, social, and political disparities between men and women, increased domestic violence against women, and decreased access to care for pregnant women. In short, despite COVID-19 causing a disproportionately higher number of deaths in men, there is mounting evidence that the indirect effects the pandemic has o...
2020-08-1004 minThe COVID-19 LST ReportAugust 3, 2020CLIMATE:
· This review, composed of a literature review and anecdotes from the authors' students, highlights that the fact that a greater percentage of African Americans have succumbed to COVID-19 than other racial and ethnic groups, and discusses economic and social challenges faced by the Black community during the pandemic. The authors advocate for further analysis now and post-pandemic to determine the impact of structural racism and identify strategies to mitigate these disparities (including access to care, improving the education system, and voting rights).
EPIDEMIOLOGY:
· A case report and case series of COVID-19 patients wh...
2020-08-0803 minThe COVID-19 LST ReportJuly 31, 2020CLIMATE:
· Recent United States healthcare policy updates related to COVID-19 include: - The Supreme Court will be hearing California versus Texas to determine if the Affordable Care Act (ACA) is invalid due to the potential unconstitutionality of its “individual mandate” that implements a fine for citizens that do not have health insurance and opt out of coverage; this is a move that Democrats say poses extra risk during COVID-19 due to the potential for individuals to lose healthcare coverage - The House passed the Health and Economic Recovery Omnibus Emergency Solutions Act, which includes a speci...
2020-08-0804 minThe COVID-19 LST ReportJuly 30, 2020On today's episode we discuss:
— Epidemiology:
Researchers from Thailand reviewed epidemiological data on universal Bacillus Calmette-Guérin (BCG) vaccination and found that countries without universal BCG vaccination have the highest number of COVID-19 deaths. They attribute this to the theory that the BCG vaccine enhances both adaptive and innate immune response for viral clearance though acknowledge that the supporting evidence is limited.
· A retrospective study including 442 patients with COVID-19 found that male sex was the factor most associated with greater illness severity. Additionally, older age, African American race, obesity, and pre-existing cond...
2020-08-0804 minThe COVID-19 LST ReportJuly 29, 2020On today's episode we discuss:
— Climate: The Immunization Action Coalition and the Vanderbilt School of Medicine discuss the progress of developing a COVID-19 vaccine, detailing the 11 vaccines in phase 1/2 clinical trials and the inclusion of multiple countries in the development of a Target Product Profile, a tool for quantifying critical vaccine characteristics. The authors emphasize the need for well-established infrastructure and logistical planning in order to distribute a potential COVID-19 vaccine safely and effectively to the world in a timely manner.
— Epidemiology: Researchers in the United States and United Kingdom used Twitter data to p...
2020-08-0305 minThe COVID-19 LST ReportJuly 28, 2020On today's episode we discuss:
— Climate: A cross-sectional study surveying 128 researchers, clinicians, and academic personnel showed that 63.3% found social media to be the most important source of information while 67.2% found it to be misinformation. A majority of the respondents supported mandatory peer review and organization of a trustworthy COVID-19 database to combat potentially deadly misinformation.
A systematic review and meta-analysis evaluating 14 qualifying studies claims to have found that COVID-19 patients with a BMI exceeding 25 kg/m^2 had worse prognosis in all age groups, especially the elderly population, suggesting that this population should be "given special at...
2020-07-3004 minThe COVID-19 LST ReportMay 26, 2020Your daily COVID-19 LST Report:
— Climate: Investigators from the Harvard Business School, Indiana University School of Public Health, and the University of San Francisco’s Department of Medicine found that 41.2% of 3,512 hospitals and 302 hybrid health records were unable to receive electronic COVID-19 surveillance data, demonstrating a crucial need for IT infrastructure in public health management of COVID-19.
— Epidemiology: In a retrospective study of 72 COVID-19 patients admitted to the Beijing YouAn Hospital between January 21 and February 17, 2020 patients with severe and critical disease showed...
2020-05-2807 minThe COVID-19 LST ReportMay 25, 2020Your daily COVID-19 LST Report:
— Climate: COVID-19 brings to light the need for universal health care services and Italian authors demand further government investments in the development of such structures. The COVID-19 pandemic has created dissonance between practicality and the traditional four pillars of medical ethics: autonomy, beneficence, non-maleficence, and justice.
— Epidemiology: Authors speculate that anosmia is a specific symptom that can be used as a cheap and effective screening tool for COVID-19. Coupled with the fact that olfactory mucosa has a high expression of ACE2 transcript, they speculate that anosmia is d...
2020-05-2708 minThe COVID-19 LST ReportMay 22, 2020Your daily COVID-19 LST Report:
— Climate: A letter to the editor exploring the ethics of the fast-tracked review process of COVID-19 papers currently being utilized by many scientific journals during the pandemic. The authors argue that faster publication of COVID-19-related data does not outweigh the risks of publishing possibly erroneous and lower quality papers. The authors call for a return to the normal review process to uphold publication ethics.
— Epidemiology:
- The authors report the results of a two-center cross sectional study in Wuhan, China, that revealed high rates of lowe...
2020-05-2408 minThe COVID-19 LST ReportMay 19, 2020Your daily COVID-19 LST Report:
— Climate: Based on a 2018 systematic review of the SARS and MERS literature, authors identified key areas of research for these coronaviruses. They noticed that research was lacking in viral pathogenesis, clinical characterization, infection prevention and candidate therapeutics, and therefore recommend prioritizing research in these fields for the study of SARS-CoV-2.
— Epidemiology: Contact tracing in Korea linked initial COVID-19 cases to several fitness class instructors. 26% of participants in their classes developed infection. Investigators speculate that the environment of a fitness class: a moist, warm atmosphere in a confined area...
2020-05-2107 minThe COVID-19 LST ReportMay 18, 2020Your daily COVID-19 LST Report:
— climate: After lockdown was initiated, air pollution over northern India reached a 20-year low with New Delhi seeing 50% reduction in air pollution leading investigators to suggest that the COVID-19 pandemic is a good opportunity to learn and understand how lockdown activities can help minimize air pollution in the long term.
— Epidemiology: A critically ill 69 year old male COVID-19 patient was found to have both classic COVID-19 CT findings as well as atypical reversed halo sign, suggestive of fungal infection. Endotracheal aspiration culture grew aspergillosis and...
2020-05-1909 minThe COVID-19 LST ReportMay 16, 2020Your daily COVID-19 LST Report:
— Researchers found nine SARS-CoV-2 neutralizing humanized llama antibodies that successfully blocked viral S protein and angiotensin-converting-enzyme-2 (ACE2) interaction in vitro. They postulate that combinations of these antibodies in creating a single multi-specific antibody could increase this effect, which should be further studied in hopes of contributing to treatment and diagnosis of infection.
— There is growing concern for the safety of female frontline humanitarian workers, with accounts from the Democratic Republic of Congo and the Phillipines of workers being expelled from their apartments for fear that they are carrying COVID-19, reports of h...
2020-05-1708 minThe COVID-19 LST ReportMay 15, 2020Your daily COVID-19 LST Report:
— More evidence suggesting the lack of negative predictive value of the nasopharyngeal swab RT-PCR continues to build:
— A case report of an obese 14 year old boy who presented initially with fever, gastrointestinal symptoms, and a negative COVID-19 nasopharyngeal swab subsequently developed severe respiratory and cardiac symptoms and positive SARS-CoV-2 on retest. This case emphasizes obesity as a potential independent risk factor for COVID-19 as well as the poor negative predictive value of nasopharyngeal swabs.
— A case report of a cystic fibrosis patient with ultimately diagnosed with COVID-19 via positi...
2020-05-1707 minThe COVID-19 LST ReportMay 14, 2020Your daily COVID-19 LST Report:
— Careful assessment of N95 respiratory decontamination through ultraviolet germicidal irradiation is urged to ensure adequate fit and continued protection because different models of N95 respirators were highly variable in passing a fit test after this treatment. Some models did not pass the baseline fit test, while others were able to withstand multiple or even twenty repeat treatments.
— Clinicians are reminded to actively work against anchoring bias during the pandemic. A septic 94 year-old male admitted with fever, leukocytosis, tachypnea, tachycardia, hypoxia, and infiltrates on chest X-ray was found to have...
2020-05-1611 minThe COVID-19 LST ReportMay 12, 2020Your daily COVID-19 LST Report:
— A case report of a COVID-19 positive presymptomatic individual who attended a full-day meeting in Germany, found that he transmitted the virus to 11 of the 13 other participants indicating the high transmission risk of in-person meetings.
— But clearly, removing physical human contact has been having dramatically negative impact on mental health, the economy and life as we know it. How do we move forward?
— Public health experts describe how in Syria, lack of transparency, the high number displaced persons, and a health care system decimated by a decade of con...
2020-05-1506 minThe COVID-19 LST ReportMay 11, 2020Your daily COVID-19 LST Report:
— A retrospective imaging study of 749 COVID-19 patients found that among the 21% who developed neurological symptoms, 44% exhibited abnormalities on brain MRI such as cortical signal abnormalities, cortical diffusion restriction, and leptomeningeal enhancement.
— A study of nasopharyngeal swabs, sputum, and stool samples in 49 patients with COVID-19 found viral persistence, measured from symptom onset, to range between 15.6 days in mild cases to 49.4 days in severe cases.
— A study of over 1,000 COVID-19 patients found that those who received hydroxychloroquine were more ill at baseline and there was no significant association between hydroxychloroquine admini...
2020-05-1307 minThe COVID-19 LST ReportMay 9, 2020Your daily COVID-19 LST Report:
— A study of viral load in 13 asymptomatic patients that tested positive for COVID-19, demonstrated that in the 3 patients who developed symptoms, the highest viral load generally occurred 2 days prior to symptom onset indicating a high risk of transmission prior to symptoms.
— A case report of a patient who presented with vomiting and abdominal pain after ingesting 10 ml of ethanol-containing hand disinfectant daily for over three weeks. They thought it would prevent COVID-19 infection emphasizes the major health risks of misinformation and increased access to disinfectants during the COVID-19 pandemic.
2020-05-1006 minThe COVID-19 LST ReportMay 8, 2020Your daily COVID-19 LST Report:
— Based on literature that suggests SARS-CoV-2 spreads more readily in cold, dry climates, researchers propose that air should be humidified to support the efficacy of the mucosal barrier.
— A scoping review of 67 studies found that medical grade masks are superior to improvised masks and N95 respirators may be superior to surgical masks in the inpatient setting but have equal performance in outpatient settings.
— Public health experts propose a “one house one-person” plan where only one person from a household is tested and their infection status is extrapolated to the whole...
2020-05-0906 minThe COVID-19 LST ReportMay 7, 2020Your daily COVID-19 LST Report:
— A systematic review and meta-analysis of 10 studies including over 1300 COVID-19 patients found that olfactory and gustatory dysfunction were present in 53% and 44% of patients, respectively.
— Analysis of the effect of N95 reuse decontamination processes on filtration efficiency found that steam, 75C heat, and ultraviolet germicidal treatments had little effect on filtration efficacy; whereas, ethanol submersion and chlorine spray caused significant reductions in filtration.
— One study of 198 COVID-19 patients found a high risk of venous thromboembolisms with occurrence in 59% of the 75 ICU patients within the first 21 days.
— Visit COVID19L...
2020-05-0807 minThe COVID-19 LST ReportMay 6, 2020Your daily COVID-19 LST Report:
— An analysis of ultraviolet-C (UVC) decontamination of N95 respirators coated in MRSA or a bacteriophage found high variability of viral or bacterial persistence by different locations on the respirators and reduction levels that did not meet the criteria for decontamination.
— The cellular protease Furin, was found to cleave the SARS-CoV-2 S protein S1/S2 multibasic site, which mediates cell to cell fusion and entry into human lung cells. Thus, Furin is suggested for therapeutic potential.
— In a recent case report, a 47 year old man died from small bowel perfor...
2020-05-0807 minThe COVID-19 LST ReportMay 5, 2020Your daily COVID-19 LST Report:
— The Seattle Flu Study is a multi-institutional, community-wide surveillance project initially intended to track data from influenza that began testing nasal swabs for COVID-19 in any patient with respiratory symptoms. From January 1-March 9, they found that 1.1% of participants tested positive for COVID-19 in 30% of patients seeking clinical care.
— In a retrospective analysis of over 3,000 COVID-19 patients, researchers found that RNA-based diagnostic testing methods lacked negative predictive value, though they were useful indicators for clinical course, pattern, and prognosis.
— Convalescent plasma transfusion was found to be safe, clinically effective, and be...
2020-05-0707 minThe COVID-19 LST ReportMay 4, 2020Your daily COVID-19 LST Report:
— A study of COVID-19 cases by borough in New York found that the Bronx, which has the highest proportion of ethnic minorities, the most people living in poverty, and the lowest level of education had higher rates of COVID-19 hospitalization than higher income boroughs such as Manhattan.
— Rapid implementation of and training for powered air-purifying respirators at a hospital in Singapore has helped the intensive care and anesthesiology departments achieve 0 patient to doctor transmissions of SARS-CoV-2.
— New guidelines and recommendations from this weekend include:
Italian provisional guidelines for au...
2020-05-0608 minThe COVID-19 LST ReportMay 2, 2020Your daily COVID-19 LST Report:
— A woman from Wuhan exhibited persistent viral shedding for 36 days after symptom resolution, demonstrating the prolonged potential infectivity of recovered patients.
— A new report of SARS-CoV-2 RT-PCR positivity in urine of an infected patient grows concerns of it’s spread.
— Preliminary data from Portugal found that excess all cause mortality during the pandemic has been 3-5 fold higher than what can be explained by the official COVID-19 death count, highlighting the significant role of undiagnosed COVID-19 and overall reduced access to healthcare during the pandemic.
— Visit COVID19LST...
2020-05-0407 minThe COVID-19 LST ReportMay 1, 2020Your daily COVID-19 LST Report:
— There are a number of case reports highlighting atypical presentations of patients subsequently found to be COVID-19 positive.
— A patient presented complaining of otalgia and tinnitus only was found to have positive COVID-19 RT-PCR as well as lung involvement in CT.
— Adding to the conversation of androgen associations to COVID-19, researchers hypothesize that benign prostatic hyperplasia treatments, specifically 5α-reductase inhibitors, may contribute to the higher mortality observed in men by causing increased lung concentrations of androgens, which can have anti-regenerative effects in damaged lung tissue.
— Visit COV...
2020-05-0407 minThe COVID-19 LST ReportApril 30, 2020Your daily COVID-19 LST Report:
— A possible theory on why some previously recovered patients are re-testing positive.
— Utility of artificial intelligence and POCUS in diagnosis of COVID-19 pneumonia.
— Hematologic and inflammatory markers that may be useful in predicting severity of disease…
— Growing evidence of the dermatologic manifestations of COVID-19
— Visit COVID19LST.org for our full report with links to the articles.
— Reach out to us at: contact@covid19lst.org
2020-05-0208 minThe COVID-19 LST ReportApril 29, 2020Your daily COVID-19 LST Report:
— Measurements of aerosolized viral RNA in various locations in two Wuhan hospitals found the highest concentrations to be in patient toileting areas and other poorly ventilated areas.
— Results from a case series led to recommendation that patients should have serial CT scans to document lung lesion resolution before discharge and a follow-up RT-PCR and CT scan after discharge to decrease risk of continued infection.
— Visit COVID19LST.org for our full report with links to the articles.
— Reach out to us at: contact@covid19lst.org
2020-04-3007 minThe COVID-19 LST ReportApril 28, 2020Your daily COVID-19 LST Report:
— A case series of almost 200 COVID-19 patients found that the frequency of pulmonary embolism in infected patients is 2 times higher than that found during the control period.
— Utmost caution is recommended for cryopreserving sperm, which has been found to have low risk of significant virus shedding but there is suggestion that may not be an acceptable risk.
— A pilot cohort study with Baricitinib therapy for COVID-19 patients found significant improvement of clinical and respiratory parameters within two weeks.
— Visit COVID19LST.org for our full report with lin...
2020-04-3006 minThe COVID-19 LST ReportApril 27, 2020Your daily COVID-19 LST Report:
— Preliminary data suggest COVID-19 disease burden may be lower in countries that routinely vaccinate with the BCG tuberculosis vaccine.
— Analysis of lower respiratory tract sputum samples from 92 patients found that viral load exhibits a direct correlation with disease severity.
— Epidemiologists propose an “inverse quarantine,” where only high risk uninfected individuals are isolated, as an economically viable method of reducing mortality.
— Using COVID-19 immunity serosurveillance has become a trendy way to discuss how to make the decision to initiate return-to-work, yet, several challenges remain.
— Visit COVID19LST.org...
2020-04-2908 minThe COVID-19 LST ReportApril 25, 2020Your daily COVID-19 LST Report:
— Hoarding household cleaners has it's downsides: an upsurge in accidental poisonings
— A recent Lancet article proposes universal weekly COVID-19 testing to ascertain a more accurate measure of prevalence and incidence so that policy is not based solely on models.
— Increasing evidence support warmer climates inhibiting COVID-19 transmission; Many expect the northern hemisphere to experience reduced incidence while the southern hemisphere sees an increase in disease.
— Based on data from a Chinese study on complications in COVID-19 patients, 45% of the US population meets the criteria...
2020-04-2608 minThe COVID-19 LST ReportApril 24, 2020Your daily COVID-19 LST Report:
— A literature review of 249 COVID-19 articles published between Dec 1st-Feb 6 for research gaps found that there was a lack of randomized controlled trials, cohort studies, and studies on clinical practice.
— Additionally, they found that most of the guidance/guidelines developed by the WHO, US, CDC, ECDC and several Chinese Institutions did not fulfill the principles of evidence-based practice.
— Using an avian coronavirus as a surrogate, researchers found that steaming N95 masks over boiling water for 5 minutes inactivated the virus and caused no significant loss of fil...
2020-04-2506 minThe COVID-19 LST ReportApril 23, 2020Your daily COVID-19 LST Report:
— Climate: Growing evidence suggests COVID-19-like viruses may be circulating among wild animals. Call to action for improving care and awareness of vulnerable populations disproportionately affected during this pandemic, such as those with opioid use disorder and victims of domestic violence,
— Epidemiology: Larger scale studies continue to emerge from Italy with more data on symptomatology, clinical course, and fatality rate.
—Pathophysiology: Ongoing discussion on association between obesity and COVID-19 severity, with theories regarding role of ACE2 receptor and proinflammatory cytokines. Cutaneous manifestations of COVID...
2020-04-2506 minThe COVID-19 LST ReportApril 22, 2020Your daily COVID-19 LST Report:
—A meta-analysis of 28 studies found that elevated cardiac injury biomarkers and acute cardiac injury are more common in severe to fatal cases.
—Emerging findings reveal that mutated, distinct clades of SARS-CoV-2 with varying virulence may be an additional factor at play
—An analysis of 30 provincial capital cities in China found that increases in ambient temperature and diurnal temperature range were correlated with a decline in daily case counts, similar to what has been observed with influenza
—American Academy of Otolaryngology recommend that smell dysfunction with or without taste dysfunction be a pri...
2020-04-2306 minThe COVID-19 LST ReportApril 19, 2020Your daily COVID-19LST Report:
— More than 9000 health care workers tested positive for COVID-19, 27 have died; 55% reported having no other contact with COVID-19 patients except at work
— Projection modeling predicts high incidence of COVID-19 in South Korea expected to continue through June
— More evidence for smell dysfunction in COVID-19 patients and the potential role of androgens in the pathology
— Visit COVID19LST.org for our full report.
2020-04-2206 minThe COVID-19 LST ReportApril 18, 2020Your daily COVID-19 LST Report:
Our most reliably data heavy report yet!
Multiple systematic meta-analyses describing:
— The early symptoms of COVID-19
— Risks associated with pregnancy
Guidelines:
— Management of acute covid-19 cardiovascular syndrome from Circulation
— Management of difficult airways, tracheostomy and laryngectomy
— Visit COVID19LST.org for our full report.
2020-04-2206 minThe COVID-19 LST ReportApril 17, 2020Your daily COVID-19 LST Report:
Testing continues to be unreliable: more evidence shows the need for repeated negative tests before release from quarantine. — Mechanistically and theoretically an argument could be made for Remdesivir’s efficacy but much remains uncertain. — Continued concerns for health care workers with their increased risk for mental illness based on studies on health care staff in China and guidelines for promoting "Deliberate Resilience". —Visit COVID19LST.org for our full report.
2020-04-2204 minThe COVID-19 LST ReportWelcome to the COVID-19 LST ReportIntroduction to the COVID-19 Literature Surveillance Team (LST). We are an affiliated group of physicians, medical students, and PhDs keeping up with the latest research on SARS-CoV-2 / COVID-19. We find the newest articles, read them, grade their level of evidence, and bring you the bottom line. Our goal is to empower you to take the best care of yourself and those in your care. Our mission to keep you informed and up to date with the latest developments.
Visit COVID19LST.org for our full daily report with links to the articles.
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2020-04-2101 min