Epidemiology
· This case series conducted by Italian nephrologists studied the ability of 210 adult patients on chronic hemodialysis (HD) to mount a detectable and persistent antibody response to SARS-CoV-2. They found that all symptomatic survivors of COVID-19 developed an initial immune response, but there was a subsequent decline in persistent seropositivity at 6 months. They also found that in individuals with asymptomatic or mild COVID-19, the virus induced a stronger memory T cell response than humoral immune response, and therefore, seroprevalence may be a poor indicator of protection against the virus. This study is the first of its kind and provides valuable information as to the ability of anti-SARS-CoV-2 spikes IgG to protect against a virus re-infection.
Understanding the Pathology
· Obstetricians and pathologists from Maimonides Medical Center collaborate on this case control study, which compared histopathological findings in placental tissue from 150 patients (85 SARS-CoV-2 positive via RT-PCR) using the Amsterdam consensus group criteria. After analyzing various variables such as vascular perfusion, fibrin concentrations, and chorangiosis, the authors found no statistically significant histopathological difference between the two groups nor did they identify any immunohistochemical presence of SARS-CoV-2 within the placentas of COVID-19 patients. These findings, which are congruent with current literature, suggest that direct viral invasion of placental tissue is not a pathophysiological mechanism of COVID-19 in pregnancy, although larger studies are needed to determine variations in chronic inflammatory lesions such as basal chronic villitis and chronic deciduitis.
Adjusting Practice During COVID-19
This research letter from the University of Texas, Austin, discusses how the executive order to postpone non-essential surgeries until April 21, 2020 due to the COVID-19 pandemic has affected abortions in Texas. Results revealed a 38% decrease overall in abortions at Texas clinics as well as greater numbers of residents receiving out-of-state abortion care. Additionally, they found increases in medically managed abortions from 39% the year prior to 80% in this period and an 82.6% increase in abortions at or after 12 weeks gestational age after the ban was lifted. The authors conclude that overall trends in delays seeking care during this pandemic were likely exacerbated by the effects of the ban in this population.
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