Understanding the Pathology
· 80% of SARS-CoV-2 positive patients will have IgM antibodies by 7 days (decline at 27 days), and 95% will have IgM antibodies by 12 days (decline at 120 days). A team of internists from the Portland VA Research Foundation in Oregon conducted a sequential systematic review of 66 observational studies (n=16525) regarding antibody responses after SARS-CoV-2 infections and found 80% of SARS-CoV-2 positive patients developed detectable IgM antibody at a mean of 7 days with a decline after day 27. Measurable IgG was detectable in 95% of patients by day 12, plateaued at day 25, and declined after 120 days. Although limited by the quality of included studies, authors suggest their review provides a basis for understanding humoral immune responses to SARS-CoV-2 and recommend further studies evaluating both humoral and cell-mediated responses.
Transmission & Prevention
· Moist heat, microwave-generated steam processing, and ultraviolet germicidal irradiation are favorable to vaporized hydrogen peroxide and ethylene oxide decontamination processes. A systematic review conducted by researchers from the School of Medicine at UCLA in Los Angeles, California involved 42 articles from PubMed and EMBASE published through January 31, 2021 regarding 5 types of respirator-decontaminating processes. Moist heat, microwave-generated steam processing, and ultraviolet germicidal irradiation provide the most effective pathogen removal with preserved filtration and are easily implementable due to readily available equipment and lesser treatment times. These options are more favorable than vaporized hydrogen peroxide which has longer treatment times and higher cost and ethylene oxide which has toxic residues. Decision making strategies for choosing the most effective means of decontamination are suggested. Many of these studies didn't specifically involve SARS-CoV-2 decontamination, so additional research is needed for further investigation of these methods.
Adjusting Practice During COVID-19
· Children and teenagers in China were found to have accelerated reversible myopic progression during different rounds of the lockdown. Researchers from the Eye Hospital and School of Ophthalmology and Optometry at Wenzhou Medical University and the National Clinical Research Center for Ocular Diseases in Wenzhou, Zhejiang, China conducted an analysis of 29,719 junior high students in Hangzhou, China participating in the cohort study, Myopia Screening Survey Of Children and Teenagers In Schools (MYOSOTIS), examining their corrected and non-corrected visual acuity (VA) and change in spherical equivalent refraction (SER) during the COVID-19 lockdown. They found an accelerated reversible myopic progression during different rounds of the lockdown, which they speculate is from accumulative spasms, and suggest further consideration and management for this condition in children and teenagers in the setting of future lockdowns.
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