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June 22 | Daily COVID-19 LST Report

Climate

· Researchers from the University of Wisconsin-Madison propose a framework for early communication of risks for healthcare workers that can inform future communication in public health emergencies.

· An analysis of the economic impact of COVID-19 on older adults highlights that more than 1/3 of adults 65 years or older live in counties with a high cost of living and increased COVID-19 prevalence demonstrating an overlap between "infection rates and economic insecurities" during COVID-19 with nearly 25% of these adults relying on Social Security benefits that may be insufficient to meet financial needs during a pandemic. The authors encourage employment and economic recovery strategies to take into consideration the older population.





Epidemiology

· A survey was conducted in Israel of 140 ambulatory, non-hospitalized COVID-19 patients that found that while both sexes report common symptoms (ie., cough, weakness, and myalgia), symptoms overall were more frequent among women and olfactory dysfunction, and oral symptoms (dry mouth, taste dysfunction, facial pain, masticatory pain) were common, even in the absence of other symptoms (25.8%), placing increased emphasis in exploring olfactory dysfunction and oral manifestations to diagnose COVID-19.

· A two-center retrospective study at Wuhan Pulmonary Hospital and Tongji Hospital examining 1,018 COVID-19 patients found that increased interleukin-6 (IL-6) levels (>20 pg/mL; P<0.001) and decreased CD8+ T cell levels (<165 cells/mul; P<0.001) are both independently associated with increased mortality in patients with COVID-19, suggesting that both of these indicators may help clinicians in prognostication and clinical decision making.

· Researchers at an urban teaching hospital in Lombardy, Italy examined 69 cases of hospitalized COVID-19 patients ≥80 years of age with 23 patients who died found a significant association between severe dementia and increased mortality and independent risk factors for death in this population included a lactate dehydrogenase level >464 U/L and an oxygen saturation level ≤90% at admission.


Understanding the Pathology

· A SARS-CoV-2 genomic and phylogenic analysis in India discovered four unique sequence regions that interact with the angiotensin converting enzyme (ACE)-2 receptor and may be potential targets for antibody vaccine design and revealed that bat SARS-CoV genome is the closest homolog of human SARS-CoV-2, supporting evidence that the COVID-19 outbreak originated from bat-to-human zoonotic transmission.


Management

· A case series of 63 positive end-expiratory pressure (PEEP) titrations performed in 15 patients with COVID-19-related ARDS using electrical impedance tomography (EIT) found that high PEEP were from personalized PEEP at the level of lowest relative alveolar overdistention and collapse, PEEP set was positively correlated to BMI (p< 0.001), and individualized PEEP titration could result in improved clinical outcomes but further research is needed to confirm whether this personalized PEEP titration a