December 18 | Daily COVID-19 LST Report

Understanding the Pathology

· Exercise scientists from Appalachian State University compared the vascular function of young adults (mean age 23) three to four weeks after SARS-CoV-2 positive PCR test (n=11) to healthy young adults (n=20) using doppler ultrasound. They found reduced brachial artery flow-mediated dilation (FMD, 2.71±1.21% vs 8.81±2.96%) and femoral artery single passive limb movement (sPLM, 0.04±0.02 AU vs 0.13±0.06 AU) along with increased carotid-femoral pulse wave velocity (PWVcf, 5.83±0.62 m/s vs 5.17±0.66 m/s) in patients recovering from SARS-CoV-2 compared to controls (p<0.01). Authors suggest SARS-CoV-2 infection is associated with reduced vascular function and increased arterial stiffness, possibly heightening cardiovascular risk in young adults in the weeks following infection.

· Laboratory and diagnostic researchers from Africa and infection researchers from Germany retrospectively tested serum samples of 135 healthcare workers collected in 2014 for reactivity against SARS-CoV-2 nucleocapsid (N) antigen and found 23.7% (32/135) were reactive, indicating strong cross-reactivity between SARS-CoV-2 and other more common coronaviruses. Further research is needed to assess if these pre-existing antibodies to the nucleocapsid (N) antigen offer protection against COVID-19, or possibly cause harm by provoking an increased immune/inflammatory reaction.

Transmission & Prevention

· A team including Canadian specialists in Infectious Disease, Critical Care, and Occupational and Environmental Safety and Health compared the efficacy of various mask decontamination techniques: vaporized hydrogen peroxide (VHP), autoclaving, moist heat, peracetic acid dry fogging system (PAF), ethylene oxide (EtO), ultraviolet light C radiation (UV-C), and low temperature hydrogen peroxide gas plasma (LT-HPGP). They treated N95 masks with VSV and SARS-CoV-2, decontaminated them, recovered viral titers, and then repeated fit testing. They found that autoclaving, VHP, PAF, EtO, LT-HPGP, and moist heat successfully sterilized masks. However, the masks which underwent LT-HPGP and EtO could not pass fit testing after only two and three cycles of decontamination, respectively, while the other methods continued to pass testing. Based on these results, they suggest VHP, moist heat, autoclaving, and PAF could be utilized for 5 decontamination cycles to inactivate SARS-CoV-2 on N95 masks without altering N95 masks' filtration ability.

Mental Health & Resilience Needs

· A team from the Researcher Centre for Evidence-Based Practice in Belgium conducted a systematic review of 33 observational studies (29,266 participants) reporting on modifiable risk factors for mental health outcomes in healthcare workers during coronavirus epidemics. They found amount of disease exposure (i.e. direct patient contact or working in high risk units) and risk perception/fear (e.g. fear of infection or infecting others) were associated with worse mental health outcomes (seen in 88% [95%CI: 73-97%, p<0.001] and 92% [95%CI: 64-100%, p=0.003] of included studies, respectively). Clear communication and support from the organization (92%, 95%CI: 62-100%, p=0.006), social support (85%, 95%CI: 55-98%, p =0.022) and personal sense of control (100%, 95%CI: 54-100%, p=0.031) were protective (Table 2). Though authors acknowledge the limited interpretability of their findings due to overall low-quality of included evidence, they suggest that an integrated protective approach is needed to safeguard the mental health of healthcare workers during the COVID-19 pandemic.

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