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November 12 | Daily COVID-19 LST Report

Epidemiology

· A retrospective cohort study by physicians in Wuhan, China found no significant difference in levels of testosterone, follicle-stimulating hormone, or luteinizing hormone between 39 male patients with SARS-CoV-2 and 22 control patients without SARS-CoV-2 (p<0.05) nor between cases with severe versus moderate disease severity; however, 20 patients with >50 days of viral shedding had elevated estradiol levels compared to those with shorter shedding duration (p<0.05), suggesting that SARS-CoV-2 is unlikely to cause sterility or hypogonadism.

Transmission & Prevention

· An international group of vaccine development experts from the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Working Group conducted a review of available literature regarding vaccine-associated enhanced disease (VAED) and determined that the risk of COVID-19 VAED is similar to the risk associated with any other viral vaccine and acknowledge that the human experience of COVID-19 may differ from animal or in-vitro studies, recommending rigorous surveillance and phase 3 trials to evaluate safety and efficacy of any COVID-19 vaccine.


Management

· A retrospective cohort study by pediatricians in Florence, Italy of central precocious puberty (CPP) in girls presenting to their clinic during and after the Italian COVID-19 lockdown (March-July 2020) compared to the same period in 2015-2019 found more new cases of CPP in 2020 compared to previous years (37 vs. 16-19, p<0.0005) with accelerated progression in girls with previously diagnosed CPP (p<0.0005), more advanced Tanner stage in newly diagnosed CPP (p<0.005), and higher levels of luteinizing hormone (LH) and estradiol (E2) (p<0.005). These changes are attributed to the psychological stresses, increased BMI, and increased electronic device use during lockdown and suggest environmental factors strongly influence pubertal development.

Adjusting Practice During COVID-19

· A letter to the editor by The Netherlands Comprehensive Cancer Organization discusses derailed oncological care due to COVID-19 and subsequent reprioritization of health care services and determined that healthcare changes resulting from COVID-19 contributed to fewer breast and colorectal cancer diagnoses among age groups eligible for cancer screening, with slow return to expected rates following gradual restarts of cancer screenings. More information is needed to determine the long term clinical outcomes of decreased cancer screening and diagnoses, particularly whether these findings may represent decreased "overdiagnosis of particular early-stage cancers," but believe the trend warrants further investigation.

R&D: Diagnosis & Treatments

· Spanish immunologists investigated immunogenicity of cysteine-like protease (Mpro, a non-structural SARS-CoV-2 protein) by comparing samples from 36 COVID-19 patients diagnosed via RT-PCR versus 33 negative controls and, using ELISA (Mpro sensitivity 97% and specificity 100%), found high titers of IgG, IgM, and IgA against Mpro in serum and detected Mpro antibodies in all saliva samples collected from patients with the highest serum antibody titers (n=12), suggesting that detection of Mpro antibodies could be used to distinguish infected from non-infected individuals and that saliva tests could be used as a reliable, non-invasive test for seropositivity. · An in vitro study by researchers in Ecuador proposed development of amino-ester magnetic nanoparticles (Poly-NH2-MNP) as a cost-efficient and rapid method for COVID-19 diagnostics, in an effort to improve and expand testing across Latin America, and predict that utilizing magnetic nanoparticles (MNPs) will allow for production of ~50,000 COVID-19 tests in two days. Their efficacy was confirmed via RT-PCR analysis detecting presence of SARS-CoV-2 and correct RNA extraction by Poly-NH2-MNP in 38 minutes.

Mental Health & Resilience Needs

· Public health experts at the University of Nevada, Las Vegas conducted a cross-sectional survey of 194 undergraduate and graduate students assessing demographic factors, exercise minutes, and PHQ-9 scores before and after the issuance of a stay-at-home order (May 7-28, 2020) and found mean PHQ-9 score increased from 5.58 pre-order to 9.61 after (p<0.01) and mean physical activity minutes decreased from 409 to 330 minutes (p=0.01), suggesting that because the stay-at-home order correlated with increased levels of depression and decreased levels of physical activity among college students, colleges should consider targeted interventions teaching coping skills and resiliency for students.

Resources

· A study by anesthesiologists at University Medical Centre Maribor, Slovenia and Bern University Hospital, Switzerland compared quality of 155 COVID-19 related publications versus 130 non-COVID-19 publications in the New England Journal of Medicine, Journal of the American Medical Association, and The Lancet from and found non-COVID-19 publications were more likely to have higher levels of evidence (95% CI for OR, 7.0-47; p<0.001) and had favorable quantitative quality scores (mean difference, 11.1; 95% CI, 8.5-13.7; p<0.001) compared to COVID-19 publications, indicating that initial COVID-19 research published in these major scientific journals was not up to their typical standards, but further analysis on progression of COVID-19 research is warranted.

· Swedish emergency physicians and a data scientist assessed trends in published scientific literature on COVID-19 by analyzing 16,670 articles published between February 14 and June 1, 2020 with a PubMed title or abstract including the phrase "covid" or "covid-19” and, using Latent Dirichlet Allocation, identified 14 main topics and assessed their frequency as the pandemic progressed, finding that the proportion of papers on epidemiology, modeling, healthcare response, and radiology decreased throughout their study period while those on clinical manifestations and protective measures increased.


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