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December 17 | Daily COVID-19 LST Report

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 safe and authentic vaccines from factories to the public.


Epidemiology

· A team from Johns Hopkins University and Brown University conducted a systematic review and meta-analysis of 77 studies (38906 hospitalized patients) and found the overall prevalence of death from COVID-19 among hospitalized patients was 23% (19–27%) in the US and Europe versus 11% (7–16%) in China. Risk factors for death included age 60 or older (sRR = 3.6; 95% CI: 3.0–4.4; I^2 77%), male gender (sRR=1.3; 1.2–1.4; I^2 18%), smoking history (sRR=1.3; 1.1–1.6; I^2 68%), COPD (sRR=1.7; 1.4–2.0; I^2 66%), diabetes (sRR=1.5; 1.4–1.7; I^2 58%), heart disease (sRR=2.1; 1.8– 2.4; I^2 69%), CKD (sRR =2.5; 2.1–3.0; I^2 72%). They observed similar risk factors for severe disease (respiratory rate>30, oxygen saturation<93%, and PaO2/FiO2<300 and/or lung infiltrates>50% within 24–48 hours).

· Pediatricians from Arnold Palmer Hospital for Children in Orlando, Florida discuss the case of a female infant born at 40 weeks gestation to a 15-year-old primigravida woman with asymptomatic COVID-19 who tested positive at 24 hours of life via rt-PCR. She developed a fever at 25 hours of life and later required supplemental oxygen, CPAP, and remdesivir to achieve an SpO2 of 88% on day of life 4. On day of life 5, she developed acute respiratory failure requiring intubation and dexamethasone. The infant eventually developed superimposed bacterial pneumonia with Staphylococcus lugdunensis on sputum cultures, and after aggressive treatment was eventually weaned back to room air. The authors claim this case illustrates vertical transmission of COVID-19 is possible due to the rapid onset of symptoms after birth; however, neither the placenta nor the amniotic fluid were sampled. This case illustrates severe disease in a neonate with likely superimposed bacterial pneumonia and possible vertical transmission.

Transmission & Prevention

· Researchers from England studying COVID-19 transmission in the education system found that the overall risk of SARS-CoV2 infection among children and school staff was low: there was minimal evidence of transmission from student to student or student to faculty member, and infected children most commonly acquired SARS-CoV-2 from family members at home. Data suggests that the rate of transmission in schools was directly correlated with regional COVID-19 prevalence, suggesting that re-opening schools may not significantly increase infection rates among children or school staff unless this is during a surge or in high prevalence areas.

· Members of the US Centers for Disease Control COVID-19 Response Team summarize their recommended public health strategies for mitigation of community SARS-CoV-2 transmission: they recommend the use of face masks, maintaining physical distancing, prompt case investigation, avoiding crowded situations, increasing protection for persons at highest risk for severe COVID-19, adequately protecting healthcare workers, improved hygiene practices, avoiding unnecessary travel, and widespread use of safe vaccines. Authors suggest following such evidence-based measures will substantially contribute to combating transmission of COVID-19.

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