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June 4 | Daily COVID-19 LST Report

Climate:

· Delayed presentation for stroke may prohibit time-sensitive treatment with tissue plasminogen activator (tPA).

· Theories attempting to explain the relatively low case fatality rate (CFR) in Africa (3%) compared to the Americas (6%) and Europe (9%) include:

o Minimal early transmission from Asia and Europe

o Younger population and warm, dry climate

o Underestimation of the CFR due to limited resources and testing


Epidemiology:

· Data from the Korean Centers for Disease Control and Prevention estimates the burden of disease from the pandemic to be 4.930 Disability-Adjusted Life Years (DALYs) per 100,000 population.

· Belgian authors studying anosmia in COVID-19 found:

o 87% of those reporting anosmia for less than 12 days were RT-PCR positive for COVID-19 (vs 23% >12d).

o However, olfactory performance testing found 25% patients were actually normosmic.

Understanding the Pathology:

· Data from the University of Washington hospital system found <1% of asymptomatic patients without known exposure tested positive for COVID-19, compared to 10.3% in symptomatic patients.

· A retrospective study of the first 1000 COVID-19 patients at New York-Presbyterian Hospital found a bimodal distribution in time-to-intubation after symptom onset (3-4 days & 9 days), suggesting careful monitoring for patients who are 5-8 days post-symptom onset to anticipate disease progression.

Transmission:

· Scant evidence of detectable SARS-CoV-2 in semen and breastmilk has researchers calling for more robust research to understand implications of potential sexual and vertical transmission.

· Serologic and RT-PCR testing of an entire otolaryngology unit staff (n=58) in a high-prevalence region of Italy found 9% positivity; however, survey results showed out-of-hospital COVID-19 exposure was associated with a higher risk of infection (p=0.008).