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May 29 | Daily COVID-19 LST Report

Climate

· Irish psychiatrists urge the international community to take action to reduce transmission among prisoner populations. They make recommendations for public health and screening, psychiatric and medical care. Finally, they call for reforms in the accommodations provided for prisoners in addition to those the criminal justice system itself.


May 29 | Daily COVID-19 LST Report

Understanding Pathology

· Physicians from Duke University School of Medicine hypothesize that the mortality in COVID-19 patients may arise from autonomic dysfunction. They suggest that targeting the cholinergic pathway would have an anti-inflammatory effect due to the suppression of the cytokine storm, and promote further study surrounding the role of the parasympathetic nervous system in SARS-CoV2’s hyperinflammatory effects.

Transmission & Prevention

· A study conducted at the Virginia Tech Carilion School of Medicine by the authors found no statistically significant difference in filtration efficiency between expired P100 filter cartridges and N95 respirators, suggesting that expired P100 respirators could potentially be effective during PPE shortages.

Management

· Guidelines and recommendations for managing COVID-19 patients include:

o The International Society on Thrombosis and Hemostasis’ report on venous thromboembolisms

o Extracorporeal blood purification


· Elevated soluble E-selectin and angiopoietin-2 levels (markers of endothelial activation/microvascular dysfunction) were strongly correlated with admission to the ICU, suggesting potential prognostic value of these biomarkers – based on a prospective study of 40 consecutive patients with COVID-19 admitted to Georges Pompidou European hospital in Paris, France.

· The Neutrophil to Lymphocyte Ratio (NLR) on admission for non-survivors was significantly higher than for survivors in a retrospective cohort study of 1,004 COVID-19 patients.

o Multivariate logistic regression modelling showed an NLR greater than 11.75 was significantly associated with all-cause mortality in the hospital.