Climate
· A review illustrates how African Americans are disproportionately infected and hospitalized due to COVID-19 infection and constitute over 1/3 of the reported COVID-19 related deaths in the United States – far exceeding those of other races. The authors discuss how disparities faced by African Americans are a result of structural racism and provide several recommendations to reduce disadvantageous health inequality moving forward.
· Public health experts in the United States indicate that communication regarding the COVID-19 pandemic must be improved by having a clear, singular communicator from the government, actively fighting the spread of misinformation, continuing to maintain peer-reviewed processes for research, and utilizing social media to address a wider demographic.
Understanding the Pathology
· Investigators found that the conjunctiva and cornea both express ACE2 at a low level and transmembrane serine protease 2 (TMPRSS2) at moderate levels. Since these proteins are known to interact with the spike proteins of SARS-CoV-2, these findings support the possibility that SARS-CoV-2 can transmit through the eyes, warranting further study on this mode of transmission.
· Single cell RNA sequencing of nasopharyngeal and bronchial samples from 24 patients found a 3-fold increase of ACE2 receptor expression in patients with COVID-19. Further, their findings suggest that the inhibition of chemokine receptors CCR1 and CCR5, which were found to be highly expressed in critical COVID-19 cases, may decrease immune hyperactivation and thus may serve as potential therapeutic targets.
Management:
· A retrospective cohort study in Italy found that the percent of compromised lung volume, as determined by a quantitative computer tomography (QCT) analysis, was an effective predictor of intubation and mortality risk among 222 hospitalized patients with COVID-19 adding to the existing literature that compromised lung volume and QCT can be used to triage COVID-19 patients upon arrival at a hospital.
Adjusting Practice During COVID-19:
· Physicians from Quebec, who have organized aeromedical transfers for 50 COVID-19 patients since March, discuss strategies to maximize patient and crew safety, enhance intubation protocols between facilities, establish protocols for early transfers, improve in-flight communications, and managing cross-contamination within aircraft.
R&D Diagnosis and Treatment:
· A study of 106 COVID-19 positive patients with pneumonia symptoms determined that C-reactive protein levels and lymphocyte percentage correlated with volume of disease measured by CT scan providing data to support the use of these values.
· A docking and molecular dynamics simulation found an 18 amino-acid inhibitory peptide that exhibits the theoretical capacity to interfere with the interaction between the SARS-CoV-2 S-glycoprotein and the ACE2 receptor, preventing viral entry into the cell. The authors suggest that inhibitory peptides may be developed as SARS-CoV-2 treatment and are continuing their investigation in this area with cell-based assays.
Mental Health and Resilience:
· A cross-sectional study (n=257) from Bahrain found that front line healthcare workers had poorer sleep quality and higher perceived stress than non-front-line healthcare workers (p=?), further highlighting the need for increased mental health resources to maintain a healthy workforce during the pandemic, especially amount female workers.
Click here to download full report