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August 27 | Daily COVID-19 LST Report

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 pregnant and 26 non-pregnant) with COVID-19 found significantly higher neutrophil%, lymphocyte%, alkaline phosphates, and D-dimer among the pregnant cohort (p<0.001; Table 2), but no significant difference in hospitalization time, time from onset to diagnosis, time of viral shedding, or redirected positive tests. This data suggests no indication that pregnant women are more susceptible to severe adverse outcomes of COVID-19.

Understanding the Pathology

· Researchers in Rome, Italy performed molecular human leukocyte antigen (HLA) typing to compare 99 severe COVID-19 patients to over 1000 previously typed individuals and found a significant association between COVID-19 infection severity and HLA alleles DRB1*15:01, DQB1*06:02, and B*27:07. The investigators suggest HLA alleles may be markers of COVID-19 susceptibility but acknowledge a need for larger scale studies to confirm these findings.

· Analysis of single nucleotide polymorphisms (SNPs) and other mutations of sequenced SARS-CoV-2 genomes from 12 countries within the NCBI database found 47 key point mutations within several SARS-CoV-2 proteins (namely Nsp1, spike glycoprotein, and RdRp) that may play a role in SARS-CoV-2 virulence, suggesting that these point mutations or SNPs could aid the development of antiviral therapies for SARS-CoV-2. Management

· Cardiologists based in Athens, Greece conducted meta-analyses to explore the relationship of smoking with disease severity and mortality of patients hospitalized with COVID-19 in China and the US. The first meta-analysis of 18 studies (n=6210) found that smoking was associated with a slightly increased risk of severe COVID-19—a difference that is more pronounced in younger patients without diabetes. Additional meta-analyses were inconclusive due to the small sample sizes and the findings are limited by poor-quality data and relatively low study heterogeneity.

Adjusting Practice During COVID-19

· UK researchers report the importance of using electronic self-assessments of patient health status or patient reported outcomes in COVID-19 diagnosis, tracking, tracing and symptom monitoring citing multiple benefits of electronic self-assessments. R&D: Diagnosis & Treatments

· A network meta-analysis of 4 randomized clinical studies including 2,049 moderate/severe COVID-19 patients on the effectiveness of remdesivir in COVID-19 treatment found that both 10-day and 5-day regimens of remdesivir corresponded with greater odds of clinical improvement and greater probabilities of clinical recovery as compared to the placebo group. However, the 5-day regimen resulted in greater odds of clinical improvement when compared to the 10-day regimen.

A cohort study of 220 COVID-19 patients in Australia found that on-site SARS-CoV-2 RT-PCR testing had a shorter testing turnaround time and isolation period, fewer pathology test orders, and reduced antibiotic use in COVID-19 negative patients, as compared to send away testing. The investigators advocate for on-site COVID-19 testing as a more efficient method than send away testing, suggesting it may reduce healthcare costs and preserve resources.


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