· A case report of an ectopic pregnancy presenting late--after 15 days of abdominal pain--highlights the dangers of avoiding care due to fear of contracting COVID-19
· Investigators in South Africa discuss the effects of lockdowns on low- and middle-income countries and recommend that governments ensure health and resource information is both easily accessible and effectively disseminated to their populations by providing resources such as e-banking, water, food, and sanitation, as well as forming community partnerships.
· A retrospective cohort study at the Cleveland Clinic found that the pandemic has significantly decreased the daily number of patients presenting to the hospital and requiring emergent transfer in general (4.5 patients per day to 2.4) and specifically with ST-elevation myocardial infarction and stroke. These results add to the evidence that patients may be reluctant to seek care during the pandemic, leading to an increase in mortality and morbidity outside of the hospital.
· Physicians from New York report six patients hospitalized with COVID-19 who developed hyperpyrexia with peak body temperatures of 107.2 – 109.2°F and onset 6-12 days following admission, and universal mortality within two days of onset. The authors propose hyperpyrexia may result from SARS-CoV-2-related brain injury, immune system dysfunction, and/or hypercoagulability leading to thrombus formation.
Understanding the Pathology
· Researchers reviewed two prospective multicenter cohorts of children hospitalized with bronchiolitis pre-COVID-19 and found that 12% had one of the endemic coronaviruses, 85% of whom had co-infection with another virus. While co-infection was not associated with severity of the disease, higher coronavirus viral load was associated with more severe illness.
· A molecular and genetic analysis of SARS-CoV-1, SARS-CoV-2, and MERS-CoV found that key changes in the nuclear localization sequence and distinct insertions in the spike glycoprotein of the virus may be responsible for the high pathogenicity of SARS-CoV-2 compared to SARS-CoV-1 and MERS-CoV
Transmission & Prevention
· Researchers from Beijing measured the size-dependent filtration efficacy of air purifiers with fine filters (F6 class) and particulate air filters (HEPA, H12 class) and found purifiers with F6 filters removed 54% of aerosols that could carry airborne COVID-19 while those with H12 filters removed 83%.
· A literature review found that povidone-iodine (PVP-I) can be safely administered in the nose at concentrations up to 1.25% and in the mouth at concentrations up to 2.5% for up to 5 months suggesting that PVP-I as a topical solution, may be a safe and effective agent against some coronaviruses.