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February 10 | Daily COVID-19 LST Report

Understanding the Pathology

· Immunologists, microbiologists, and other infectious disease experts from La Jolla Institute for Immunology and University of California, San Diego evaluated immunological memory in 188 patients who provided at least one post-SARS-CoV-2 infection blood sample, with 43 providing longitudinal samples. Spike protein IgG remained stable at 6 months. Compared to one month post-infection, at 6-8 months CD8+T cells declined (70% vs. 50%)(Figure 3) but CD4+T cell memory was maintained (93% vs 92%). Though more corroborating research is needed, authors suggest SARS-CoV-2 infection generates significant immune memory that may be protective against reinfection.


Management

· This study from Columbia University investigates the different phases of COVID-19 infectivity and relates them to targeted therapies in order to determine the most effective time periods in which clinicians ought to intervene. The authors divide infectivity into three periods and five distinct phases and urge scientists to use this framework when studying therapeutics in order to maximize efficacy, using the HIV/AIDS era as an example of how targeted intervention based off infectivity can lead to better outcomes.

Adjusting Practice During COVID-19

· This retrospective study from the Universidade da Coruña, Spain, investigates the impact of the COVID-19 pandemic and subsequent face mask use on the feasibility and results of exercise stress testing. While the patients using face masks during testing did have higher levels of dyspnea, there was no significant difference in baseline characteristics such as functional capacity. Thus the authors conclude that face mask usage does not change the clinical profile of patients undergoing cardiac exercise stress testing.

Mental Health & Resilience Needs

Social epidemiologists and emergency physicians from Ontario, Canada compared the quantity of emergency department (ED) admissions to The Ottawa Hospital for sexual assault and domestic violence from a 2020 COVID-19 time period (March 4 2020 until May 5 2020) with a time matched control group from 2018. They found the number of ED admissions to the Sexual Assault and Domestic Violence Program decreased by 32.93% (56.52% for sexual assault, 48.48% for domestic violence cases). Psychological abuse and outdoor assault increased by 16.9% and 17.6%, respectively. Authors suggest pandemic conditions have decreased victims' access to services, and recommend the development of alternative resources as well as continued monitoring as countries change their lockdown policies.

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