The group of Italian psychologists propose guidelines to mitigate sleep deprivation in frontline healthcare providers during the COVID-19 pandemic. These authors call attention to the negative effects of emergency-induced sleep deprivation and advocate for taking care of those who are providing care during the pandemic.
Analysis of 1,855 people booked and 2,129 released from Cook County Jail in March found that cycling people in and out of jails for trials and hearings is associated with 15.7% of all COVID-19 cases in Illinois, 15.9% of cases in Chicago, and accounts for 55% of variance in case rates across zip codes in Chicago. The authors highlight these findings as support for broader criminal justice reform by reducing reliance on arrest and incarceration.
The Boston Health Care for the Homeless Program tested 1,297 individuals experiencing homelessness over 6 weeks and found 33% to be positive for COVID-19, suggesting the homeless population is especially susceptible to large outbreaks of COVID-19 and a reduction in morbidity and mortality in this population should remain a cornerstone of public health efforts.
Public policy experts at Harvard advocate for a hospital funding budget model in which patient volume does not determine revenue to help alleviate the disproportionate financial stress encumbered by rural hospitals across the United States in light of the COVID-19 pandemic.
An international group of researchers utilized case data in combination with linear regression models and best-subset model selection to determine that a 1 day delay in implementing social distancing protocols resulted in a SARS-CoV-2 containment delay of 2.41 days.
A retrospective chart review utilizing data from 15 hospitals in China shows that 55 of 252 COVID-19 positive patients were afebrile with similar rates of severe illness in febrile versus nonfebrile patients emphasizing that fever alone may not be an adequate measure of COVID-19 presence or progression.
Among 87 pregnant persons who tested positive for COVID-19 and delivered (41 vaginal and 37 cesarean) within the next 14 days, nine women who had cesarean delivery developed severe adverse outcomes and eight showed clinical deterioration compared to vaginal delivery which had no severe adverse outcomes and only two cases of clinical deterioration.
A retrospective case series of 44 children hospitalized with COVID-19 found that fever (100%) and gastrointestinal symptoms (84.1%) were the predominant presenting symptoms associated with multisystem inflammatory syndrome in children.
Understanding the Pathology
Presence of lipid droplets characteristic of a fat embolism found on autopsy of a COVID-19 patient led a group of Italian researchers to posit that destruction of adipocytes by SARS-CoV-2 and subsequent fat embolism could play a role in poor clinical outcomes for obese patients.
Transmission and Prevention